SCHEDNO|CPTNO|CPT|POS 11|LOOKUP|POS 21-24|PROFAMT
125|V5364|V5364 - DYSPHAGIA SCREENING|42.6|42.6||
125|V5363|V5363 - LANGUAGE SCREENING|14.06|14.06||
125|V5362|V5362 - SPEECH SCREENING|32.32|32.32||
125|V5336|V5336 - REPAIR COMMUNICATION DEVICE|138.62|138.62||
125|V5289|V5289 - ALD FM/DM ADAPT/BOOT COUPLIN|28.8|28.8||
125|V5288|V5288 - ALD FM/DM TRANSMITTER ALD|305.6|305.6||
125|V5287|V5287 - ALD FM/DM RECEIVER -  NOS|11.2|11.2||
125|V5286|V5286 - ALD BLU TOOTH FM/DM RECEIVER|275.74|275.74||
125|V5284|V5284 - ALD FM/DM EAR LEVEL RECEIVER|1088.16|1088.16||
125|V5282|V5282 - ALD FM/DM SYSTEM BINAURAL|837.52|837.52||
125|V5281|V5281 - ALD FM/DM SYSTEM -  MONAURAL|2048.65|2048.65||
125|V5275|V5275 - EAR IMPRESSION|30.11|30.11||
125|V5273|V5273 - ALD FOR COCHLEAR IMPLANT|830.1|830.1||
125|V5272|V5272 - TDD|147.29|147.29||
125|V5271|V5271 - ALD -  TV CAPTION DECODER|1680|1680||
125|V5270|V5270 - ALD -  TV AMPLIFIER -  ANY TYPE|137.16|137.16||
125|V5269|V5269 - ALERTING DEVICE -  ANY TYPE|285.4|285.4||
125|V5268|V5268 - ALD TELEPHONE AMPLIFIER|222.32|222.32||
125|V5267|V5267 - HEARING AID SUP/ACCESS/DEV|162.59|162.59||
125|V5266|V5266 - BATTERY FOR HEARING DEVICE|1.16|1.16||
125|V5265|V5265 - EAR MOLD/INSERT -  DISP|19.01|19.01||
125|V5264|V5264 - EAR MOLD/INSERT|56.18|56.18||
125|V5241|V5241 - DISPENSING FEE -  MONAURAL|0.01|0.01||
125|V5240|V5240 - DISP FEE CONTRALATERAL BINAU|290.28|290.28||
125|V5230|V5230 - HEARING AID BINAURAL GLASSES|971.94|971.94||
125|V5220|V5220 - BEHIND EAR BICROS HEARING AI|940.36|940.36||
125|V5210|V5210 - IN EAR BICROS HEARING AID|978.64|978.64||
125|V5200|V5200 - DISP FEE CONTRALATERAL MONAU|280.25|280.25||
125|V5190|V5190 - HEARING AID MONAURAL GLASSES|890.92|890.92||
125|V5180|V5180 - BEHIND EAR CROS HEARING AID|762.31|762.31||
125|V5170|V5170 - WITHIN EAR CROS HEARING AID|900.59|900.59||
125|V5160|V5160 - DISPENSING FEE BINAURAL|338.6|338.6||
125|V5150|V5150 - GLASSES BINAURAL HEARING AID|1294.93|1294.93||
125|V5140|V5140 - BEHIND EAR BINAUR HEARING AI|1212.79|1212.79||
125|V5130|V5130 - IN EAR BINAURAL HEARING AID|1166.33|1166.33||
125|V5120|V5120 - BODY-WORN BINAUR HEARING AID|1096.09|1096.09||
125|V5110|V5110 - HEARING AID DISPENSING FEE|282.85|282.85||
125|V5100|V5100 - BODY-WORN BILAT HEARING AID|1254.05|1254.05||
125|V5095|V5095 - IMPLANT MID EAR HEARING PROS|119.28|119.28||
125|V5090|V5090 - HEARING AID DISPENSING FEE|278.02|278.02||
125|V5080|V5080 - GLASSES BONE CONDUCTION|781.64|781.64||
125|V5070|V5070 - GLASSES AIR CONDUCTION|311.1|311.1||
125|V5060|V5060 - BEHIND EAR HEARING AID|559.75|559.75||
125|V5050|V5050 - HEARING AID MONAURAL IN EAR|669.77|669.77||
125|V5040|V5040 - BODY-WORN HEARING AID BONE|579.46|579.46||
125|V5030|V5030 - BODY-WORN HEARING AID AIR|762.31|762.31||
125|V5020|V5020 - CONFORMITY EVALUATION|48.32|48.32||
125|V5014|V5014 - HEARING AID REPAIR/MODIFYING|103.7|103.7||
125|V5011|V5011 - HEARING AID FITTING/CHECKING|85.86|85.86||
125|V5010|V5010 - ASSESSMENT FOR HEARING AID|55.01|55.01||
125|V5008|V5008 - HEARING SCREENING|42|42||
125|V2790|V2790 - AMNIOTIC MEMBRANE|527.75|527.75||
125|V2788|V2788 - PRESBYOPIA-CORRECT FUNCTION|346.6|346.6||
125|V2787|V2787 - ASTIGMATISM-CORRECT FUNCTION|226.97|226.97||
125|V2786|V2786 - OCCUPATIONAL MULTIFOCAL LENS|64.31|64.31||
125|V2785|V2785 - CORNEAL TISSUE PROCESSING|2412.59|2412.59||
125|V2784|V2784 - LENS POLYCARB OR EQUAL|54.78|54.78||
125|V2783|V2783 - LENS -  >= 1.66 P/>=1.80 G|84.24|84.24||
125|V2782|V2782 - LENS -  1.54-1.65 P/1.60-1.79G|74.7|74.7||
125|V2781|V2781 - PROGRESSIVE LENS PER LENS|78.64|78.64||
125|V2780|V2780 - OVERSIZE LENS/ES|19.18|19.18||
125|V2770|V2770 - OCCLUDER LENS/ES|23.74|23.74||
125|V2762|V2762 - POLARIZATION -  ANY LENS|69.19|69.19||
125|V2761|V2761 - MIRROR COATING|12.78|12.78||
125|V2760|V2760 - SCRATCH RESISTANT COATING|18.38|18.38||
125|V2756|V2756 - EYE GLASS CASE|10.76|10.76||
125|V2755|V2755 - UV LENS/ES|21.11|21.11||
125|V2750|V2750 - ANTI-REFLECTIVE COATING|29.21|29.21||
125|V2745|V2745 - TINT -  ANY COLOR/SOLID/GRAD|14.23|14.23||
125|V2744|V2744 - TINT PHOTOCHROMATIC LENS/ES|25.1|25.1||
125|V2730|V2730 - SPECIAL BASE CURVE|24.2|24.2||
125|V2718|V2718 - FRESNELL PRISM PRESS-ON LENS|32.77|32.77||
125|V2715|V2715 - PRISM LENS/ES|13.34|13.34||
125|V2710|V2710 - GLASS/PLASTIC SLAB OFF PRISM|73.58|73.58||
125|V2702|V2702 - DELUXE LENS FEATURE|27.64|27.64||
125|V2700|V2700 - BALANCE LENS|50.28|50.28||
125|V2632|V2632 - POST CHMBR INTRAOCULAR LENS|136.6|136.6||
125|V2631|V2631 - IRIS SUPPORT INTRAOCLR LENS|136.6|136.6||
125|V2630|V2630 - ANTER CHAMBER INTRAOCUL LENS|136.6|136.6||
125|V2629|V2629 - PROSTHETIC EYE OTHER TYPE|759.64|759.64||
125|V2628|V2628 - FABRICATION & FITTING|375.8|375.8||
125|V2627|V2627 - SCLERAL COVER SHELL|1643.64|1643.64||
125|V2626|V2626 - REDUCTION OF EYE PROSTHESIS|287.1|287.1||
125|V2625|V2625 - ENLARGEMNT OF EYE PROSTHESIS|452.52|452.52||
125|V2624|V2624 - POLISHING ARTIFICAL EYE|69.86|69.86||
125|V2623|V2623 - PLASTIC EYE PROSTH CUSTOM|1030.12|1030.12||
125|V2615|V2615 - TELESCOP/OTHR COMPOUND LENS|1763.2|1763.2||
125|V2610|V2610 - SINGLE LENS SPECTACLE MOUNT|249.66|249.66||
125|V2600|V2600 - HAND HELD LOW VISION AIDS|87.78|87.78||
125|V2531|V2531 - CONTACT LENS GAS PERMEABLE|628.36|628.36||
125|V2530|V2530 - CONTACT LENS GAS IMPERMEABLE|255.95|255.95||
125|V2523|V2523 - CNTCT LENS HYDROPHIL EXTEND|172.8|172.8||
125|V2522|V2522 - CNTCT LENS HYDROPHIL BIFOCL|202.78|202.78||
125|V2521|V2521 - CNTCT LENS HYDROPHILIC TORIC|208.37|208.37||
125|V2520|V2520 - CONTACT LENS HYDROPHILIC|119.68|119.68||
125|V2513|V2513 - CONTACT LENS EXTENDED WEAR|181.49|181.49||
125|V2512|V2512 - CNTCT LENS GAS PERMBL BIFOCL|216.18|216.18||
125|V2511|V2511 - CNTCT TORIC PRISM BALLAST|182.95|182.95||
125|V2510|V2510 - CNTCT GAS PERMEABLE SPHERICL|127.33|127.33||
125|V2503|V2503 - CNTCT LENS PMMA COLOR VISION|167.47|167.47||
125|V2502|V2502 - CONTACT LENS PMMA BIFOCAL|175.03|175.03||
125|V2501|V2501 - CNTCT LENS PMMA-TORIC/PRISM|142.08|142.08||
125|V2500|V2500 - CONTACT LENS PMMA SPHERICAL|93.28|93.28||
125|V2499|V2499 - VARIABLE ASPHERICITY LENS|33.52|33.52||
125|V2430|V2430 - LENS VARIABLE ASPHERICITY BI|133.96|133.96||
125|V2410|V2410 - LENS VARIAB ASPHERICITY SING|102.9|102.9||
125|V2399|V2399 - LENS TRIFOCAL SPECIALITY|73.97|73.97||
125|V2321|V2321 - LENTICULAR LENS -  TRIFOCAL|179.96|179.96||
125|V2320|V2320 - LENS TRIFOCAL ADD OVER 3.25D|60.12|60.12||
125|V2319|V2319 - LENS TRIFOCAL SEG WIDTH > 28|56.99|56.99||
125|V2318|V2318 - LENS ANISEIKONIC TRIFOCAL|168.34|168.34||
125|V2315|V2315 - LENS LENTICULAR TRIFOCAL|182.58|182.58||
125|V2314|V2314 - LENS SPHCYL TRIFOCAL OVER 12|164.46|164.46||
125|V2313|V2313 - LENS SPHC TRIFO 7.25-12/4.25|150.13|150.13||
125|V2312|V2312 - LENS SPHC TRIFO 7.25-12/2.25|109.99|109.99||
125|V2311|V2311 - LENS SPHC TRIFO 7.25-12/.25-|124.78|124.78||
125|V2310|V2310 - LENS SPHC TRIFOCAL 4.25-7/>6|131.03|131.03||
125|V2309|V2309 - LENS SPHC TRIFOCAL 4.25-7/4.|119.11|119.11||
125|V2308|V2308 - LENS SPHC TRIFOCAL 4.25-7/2.|101.82|101.82||
125|V2307|V2307 - LENS SPHCY TRIFOCAL 4.25-7/.|95.41|95.41||
125|V2306|V2306 - LENS SPHCYL TRIFOCAL 4.00/>6|96.23|96.23||
125|V2305|V2305 - LENS SPHCY TRIFOCAL 4.0/4.25|103.2|103.2||
125|V2304|V2304 - LENS SPHCY TRIFOCAL 4.0/2.25|84.16|84.16||
125|V2303|V2303 - LENS SPHCY TRIFOCAL 4.0/.12-|80.42|80.42||
125|V2302|V2302 - LENS SPHERE TRIFOCAL 7.12-20|97.07|97.07||
125|V2301|V2301 - LENS SPHERE TRIFOCAL 4.12-7.|88.61|88.61||
125|V2300|V2300 - LENS SPHERE TRIFOCAL 4.00D|76.4|76.4||
125|V2299|V2299 - LENS BIFOCAL SPECIALITY|40.28|40.28||
125|V2221|V2221 - LENTICULAR LENS -  BIFOCAL|110.71|110.71||
125|V2220|V2220 - LENS BIFOCAL ADD OVER 3.25D|41.44|41.44||
125|V2219|V2219 - LENS BIFOCAL SEG WIDTH OVER|51.1|51.1||
125|V2218|V2218 - LENS ANISEIKONIC BIFOCAL|116.08|116.08||
125|V2215|V2215 - LENS LENTICULAR BIFOCAL|113.46|113.46||
125|V2214|V2214 - LENS SPHCYL BIFOCAL OVER 12.|104.86|104.86||
125|V2213|V2213 - LENS SPHCYL BIFO 7.25-12/4.2|97.81|97.81||
125|V2212|V2212 - LENS SPHCYL BIFO 7.25-12/2.2|95.39|95.39||
125|V2211|V2211 - LENS SPHCY BIFO 7.25-12/.25-|87.66|87.66||
125|V2210|V2210 - LENS SPHCY BIFOCAL 4.25-7/OV|102.8|102.8||
125|V2209|V2209 - LENS SPHCY BIFOCAL 4.25-7/4.|79.9|79.9||
125|V2208|V2208 - LENS SPHCY BIFOCAL 4.25-7/2.|72.64|72.64||
125|V2207|V2207 - LENS SPHCY BIFOCAL 4.25-7D/.|71.76|71.76||
125|V2206|V2206 - LENS SPHCY BIFOCAL 4.00D/OVE|85.97|85.97||
125|V2205|V2205 - LENS SPHCY BIFOCAL 4.00D/4.2|70.61|70.61||
125|V2204|V2204 - LENS SPHCY BIFOCAL 4.00D/2.1|64.36|64.36||
125|V2203|V2203 - LENS SPHCYL BIFOCAL 4.00D/.1|59.35|59.35||
125|V2202|V2202 - LENS SPHERE BIFOCAL 7.12-20.|75.46|75.46||
125|V2201|V2201 - LENS SPHERE BIFOCAL 4.12-7.0|64.12|64.12||
125|V2200|V2200 - LENS SPHER BIFOC PLANO 4.00D|58.84|58.84||
125|V2121|V2121 - LENTICULAR LENS -  SINGLE|86.88|86.88||
125|V2118|V2118 - LENS ANISEIKONIC SINGLE|84.16|84.16||
125|V2115|V2115 - LENS LENTICULAR BIFOCAL|84.89|84.89||
125|V2114|V2114 - SPHEROCYLINDER OVER 12.00D|78.07|78.07||
125|V2113|V2113 - SPHEROCYLINDR 7.25D/4.25-6D|88.27|88.27||
125|V2112|V2112 - SPHEROCYLINDR 7.25D/2.25-4D|63.89|63.89||
125|V2111|V2111 - SPHEROCYLINDR 7.25D/.25-2.25|64.75|64.75||
125|V2110|V2110 - SPHEROCYLINDER 4.25D/OVER 6D|73.46|73.46||
125|V2109|V2109 - SPHEROCYLINDER 4.25D/4.25-6D|62.93|62.93||
125|V2108|V2108 - SPHEROCYLINDER 4.25D/2.12-4D|54.76|54.76||
125|V2107|V2107 - SPHEROCYLINDER 4.25D/12-2D|56.45|56.45||
125|V2106|V2106 - SPHEROCYLINDER 4.00D/>6.00D|53.71|53.71||
125|V2105|V2105 - SPHEROCYLINDER 4.00D/4.25-6D|52.92|52.92||
125|V2104|V2104 - SPHEROCYLINDR 4.00D/2.12-4D|43.22|43.22||
125|V2103|V2103 - SPHEROCYLINDR 4.00D/12-2.00D|39.04|39.04||
125|V2102|V2102 - SINGL VISN SPHERE 7.12-20.00|67.18|67.18||
125|V2101|V2101 - SINGLE VISN SPHERE 4.12-7.00|47.38|47.38||
125|V2100|V2100 - LENS SPHER SINGLE PLANO 4.00|44.95|44.95||
125|V2025|V2025 - EYEGLASSES DELUX FRAMES|78|78||
125|V2020|V2020 - VISION SVCS FRAMES PURCHASES|92.5|92.5||
125|T5001|T5001 - POSITION SEAT SPEC ORTH NEED|563.46|563.46||
125|T4544|T4544 - ADLT DISP UND/PULL ON ABV XL|0.91|0.91||
125|T4543|T4543 - ADULT DISP BRIEF/DIAP ABV XL|0.91|0.91||
125|T4542|T4542 - SMALL DISPOSABLE UNDERPAD|0.01|0.01||
125|T4541|T4541 - LARGE DISPOSABLE UNDERPAD|0.01|0.01||
125|T4540|T4540 - REUSABLE UNDERPAD CHAIR SIZE|0.01|0.01||
125|T4539|T4539 - REUSE DIAPER/BRIEF ANY SIZE|0.01|0.01||
125|T4538|T4538 - DIAPER SERV REUSABLE DIAPER|0.01|0.01||
125|T4537|T4537 - REUSABLE UNDERPAD BED SIZE|0.01|0.01||
125|T4536|T4536 - REUSABLE PULL-ON ANY SIZE|0.01|0.01||
125|T4535|T4535 - DISPOSABLE LINER/SHIELD/PAD|0.01|0.01||
125|T4534|T4534 - YOUTH SIZE PULL-ON|0.01|0.01||
125|T4533|T4533 - YOUTH SIZE BRIEF/DIAPER|0.01|0.01||
125|T4532|T4532 - PED SIZE PULL-ON LG|0.01|0.01||
125|T4531|T4531 - PED SIZE PULL-ON SM/MED|0.01|0.01||
125|T4530|T4530 - PED SIZE BRIEF/DIAPER LG|0.01|0.01||
125|T4529|T4529 - PED SIZE BRIEF/DIAPER SM/MED|0.01|0.01||
125|T4528|T4528 - ADULT SIZE PULL-ON XL|0.01|0.01||
125|T4527|T4527 - ADULT SIZE PULL-ON LG|0.01|0.01||
125|T4526|T4526 - ADULT SIZE PULL-ON MED|0.01|0.01||
125|T4525|T4525 - ADULT SIZE PULL-ON SM|0.01|0.01||
125|T4524|T4524 - ADULT SIZE BRIEF/DIAPER XL|0.01|0.01||
125|T4523|T4523 - ADULT SIZE BRIEF/DIAPER LG|0.01|0.01||
125|T4522|T4522 - ADULT SIZE BRIEF/DIAPER MED|0.01|0.01||
125|T4521|T4521 - ADULT SIZE BRIEF/DIAPER SM|0.01|0.01||
125|T2101|T2101 - BREAST MILK PROC/STORE/DIST|9.8|9.8||
125|T2049|T2049 - N-ET; STRETCHER VAN -  MILEAGE|2.3|2.3||
125|T2048|T2048 - BH LTC RES R&B -  PER DIEM|230.48|230.48||
125|T2046|T2046 - HOSPICE LONG TERM CARE -  R&B|90|90||
125|T2045|T2045 - HOSPICE GENERAL CARE|660|660||
125|T2044|T2044 - HOSPICE RESPITE CARE|660|660||
125|T2043|T2043 - HOSPICE CONTINUOUS HOME CARE|30|30||
125|T2042|T2042 - HOSPICE ROUTINE HOME CARE|90|90||
125|T2041|T2041 - SUPPORT BROKER WAIVER/15 MIN|0.01|0.01||
125|T2040|T2040 - FINANCIAL MGT WAIVER/15MIN|1.21|1.21||
125|T2039|T2039 - VEHICLE MOD WAIVER/SERVICE|0.01|0.01||
125|T2038|T2038 - COMM TRANS WAIVER/SERVICE|0.29|0.29||
125|T2037|T2037 - CAMP DAY WAIVER/SESSION|0.01|0.01||
125|T2036|T2036 - CAMP OVERNITE WAIVER/SESSION|0.01|0.01||
125|T2035|T2035 - UTILITY SERVICES WAIVER|0.01|0.01||
125|T2034|T2034 - CRISIS INTERVEN WAIVER/DIEM|153.48|153.48||
125|T2033|T2033 - RES -  NOS WAIVER PER DIEM|18.08|18.08||
125|T2032|T2032 - RES CARE -  NOS WAIVER/MONTH|371.35|371.35||
125|T2031|T2031 - ASSIST LIVING WAIVER/DIEM|69.76|69.76||
125|T2030|T2030 - ASSIST LIVING WAIVER/MONTH|109.44|109.44||
125|T2027|T2027 - SPEC CHILDCARE WAIVER 15 MIN|137.94|137.94||
125|T2026|T2026 - SPECIAL CHILDCARE WAIVER/D|157.02|157.02||
125|T2024|T2024 - SERV ASMNT/CARE PLAN WAIVER|11.21|11.21||
125|T2023|T2023 - TARGETED CASE MGMT PER MONTH|240|240||
125|T2022|T2022 - CASE MANAGEMENT -  PER MONTH|216|216||
125|T2021|T2021 - DAY HABIL WAIVER PER 15 MIN|4|4||
125|T2020|T2020 - DAY HABIL WAIVER PER DIEM|75.68|75.68||
125|T2019|T2019 - HABIL SUP EMPL WAIVER 15MIN|1.51|1.51||
125|T2018|T2018 - HABIL SUP EMPL WAIVER/DIEM|74.56|74.56||
125|T2017|T2017 - HABIL RES WAIVER 15 MIN|8.96|8.96||
125|T2016|T2016 - HABIL RES WAIVER PER DIEM|111.28|111.28||
125|T2015|T2015 - HABIL PREVOC WAIVER PER HR|2.56|2.56||
125|T2014|T2014 - HABIL PREVOC WAIVER -  PER D|68.03|68.03||
125|T2013|T2013 - HABIL ED WAIVER PER HOUR|82.08|82.08||
125|T2012|T2012 - HABIL ED WAIVER -  PER DIEM|212.04|212.04||
125|T2011|T2011 - PASRR LEVEL II|142.5|142.5||
125|T2010|T2010 - PASRR LEVEL I|6.76|6.76||
125|T2007|T2007 - NON-EMER TRANSPORT WAIT TIME|16.68|16.68||
125|T2005|T2005 - N-ET; STRETCHER VAN|192|192||
125|T2004|T2004 - N-ET; COMMERC CARRIER PASS|27.36|27.36||
125|T2003|T2003 - N-ET; ENCOUNTER/TRIP|9.35|9.35||
125|T2002|T2002 - N-ET; PER DIEM|48.01|48.01||
125|T2001|T2001 - N-ET; PATIENT ATTEND/ESCORT|1.15|1.15||
125|T1503|T1503 - MED ADMIN -  NOT ORAL/INJECT|13.79|13.79||
125|T1502|T1502 - MEDICATION ADMIN VISIT|2.4|2.4||
125|T1031|T1031 - LPN HOME CARE PER DIEM|48|48||
125|T1030|T1030 - RN HOME CARE PER DIEM|128.27|128.27||
125|T1029|T1029 - DWELLING LEAD INVESTIGATION|81.67|81.67||
125|T1028|T1028 - HOME ENVIRONMENT ASSESSMENT|383.6|383.6||
125|T1027|T1027 - FAMILY TRAINING & COUNSELING|4.8|4.8||
125|T1026|T1026 - PED COMPR CARE PKG -  PER HOUR|30.06|30.06||
125|T1025|T1025 - PED COMPR CARE PKG -  PER DIEM|132|132||
125|T1024|T1024 - TEAM EVALUATION & MANAGEMENT|12|12||
125|T1023|T1023 - PROGRAM INTAKE ASSESSMENT|12|12||
125|T1022|T1022 - CONTRACTED SERVICES PER DAY|60|60||
125|T1021|T1021 - HH AIDE OR CN AIDE PER VISIT|30|30||
125|T1020|T1020 - PERSONAL CARE SER PER DIEM|59.65|59.65||
125|T1019|T1019 - PERSONAL CARE SER PER 15 MIN|21.96|21.96||
125|T1018|T1018 - SCHOOL-BASED IEP SER BUNDLED|21.66|21.66||
125|T1017|T1017 - TARGETED CASE MANAGEMENT|29.68|29.68||
125|T1016|T1016 - CASE MANAGEMENT|16.46|16.46||
125|T1015|T1015 - CLINIC SERVICE|103.26|103.26||
125|T1014|T1014 - TELEHEALTH TRANSMIT -  PER MIN|0.01|0.01||
125|T1013|T1013 - SIGN LANG/ORAL INTERPRETER|26.33|26.33||
125|T1012|T1012 - ALCOHOL/SUBSTANCE ABUSE SKIL|4.32|4.32||
125|T1010|T1010 - MEALS WHEN RECEIVE SERVICES|6.46|6.46||
125|T1009|T1009 - CHILD SITTING SERVICES|4.33|4.33||
125|T1007|T1007 - TREATMENT PLAN DEVELOPMENT|159.05|159.05||
125|T1006|T1006 - FAMILY/COUPLE COUNSELING|43.78|43.78||
125|T1005|T1005 - RESPITE CARE SERVICE 15 MIN|6|6||
125|T1004|T1004 - NSG AIDE SERVICE UP TO 15MIN|6|6||
125|T1003|T1003 - LPN/LVN SERVICES UP TO 15MIN|8.4|8.4||
125|T1002|T1002 - RN SERVICES UP TO 15 MINUTES|12|12||
125|T1001|T1001 - NURSING ASSESSMENT/EVALUATN|24|24||
125|T1000|T1000 - PRIVATE DUTY/INDEPENDENT NSG|6|6||
125|S9996|S9996 - MEALS FOR CLINICAL TRIAL PAR|0.01|0.01||
125|S9992|S9992 - TRANSPORTATION COSTS TO AND|0.01|0.01||
125|S9991|S9991 - SERVICES PROVIDED AS PART OF|0.01|0.01||
125|S9990|S9990 - SERVICES PROVIDED AS PART OF|0.01|0.01||
125|S9988|S9988 - SERV PART OF PHASE I TRIAL|0.01|0.01||
125|S9986|S9986 - NOT MEDICALLY NECESSARY SVC|0.01|0.01||
125|S9982|S9982 - MED RECORD COPY PER PAGE|0.52|0.52||
125|S9981|S9981 - MED RECORD COPY ADMIN|7.42|7.42||
125|S9977|S9977 - MEALS PER DIEM|29.62|29.62||
125|S9976|S9976 - LODGING PER DIEM|106.93|106.93||
125|S9975|S9975 - TRANSPLANT RELATED PER DIEM|81.37|81.37||
125|S9901|S9901 - CHRISTIAN SCI NURSE VISIT|12|12||
125|S9900|S9900 - CHRISTIAN SCI PRACT VISIT|39.36|39.36||
125|S9810|S9810 - HT PHARM PER HOUR|42|42||
125|S9590|S9590 - HT IRRIGATION DIEM|12|12||
125|S9562|S9562 - HT INJ PALIVIZUMAB DIEM|12|12||
125|S9560|S9560 - HT INJ HORMONE DIEM|12|12||
125|S9559|S9559 - HIT INJ INTERFERON DIEM|12|12||
125|S9558|S9558 - HT INJ GROWTH HORM DIEM|12|12||
125|S9542|S9542 - HT INJ NOC PER DIEM|12|12||
125|S9538|S9538 - HIT BLOOD PRODUCTS DIEM|12|12||
125|S9537|S9537 - HT HEM HORM INJ DIEM|12|12||
125|S9529|S9529 - VENIPUNCTURE HOME/SNF|2.4|2.4||
125|S9504|S9504 - HIT ANTIBIOTIC Q4H DIEM|153.6|153.6||
125|S9503|S9503 - HIT ANTIBIOTIC Q6H DIEM|177.6|177.6||
125|S9502|S9502 - HIT ANTIBIOTIC Q8H DIEM|146.4|146.4||
125|S9501|S9501 - HIT ANTIBIOTIC Q12H DIEM|115.2|115.2||
125|S9500|S9500 - HIT ANTIBIOTIC Q24H DIEM|120|120||
125|S9497|S9497 - HIT ANTIBIOTIC Q3H DIEM|30|30||
125|S9494|S9494 - HIT ANTIBIOTIC TOTAL DIEM|30|30||
125|S9490|S9490 - HIT CORTICOSTEROID/DIEM|30|30||
125|S9485|S9485 - CRISIS INTERVENTION MENTAL H|83.15|83.15||
125|S9484|S9484 - CRISIS INTERVENTION PER HOUR|49.2|49.2||
125|S9482|S9482 - FAMILY STABILIZATION 15 MIN|11.96|11.96||
125|S9480|S9480 - INTENSIVE OUTPATIENT PSYCHIA|83.15|83.15||
125|S9476|S9476 - VESTIBULAR REHAB PER DIEM|59.54|59.54||
125|S9475|S9475 - AMBULATORY SETTING SUBSTANCE|83.15|83.15||
125|S9474|S9474 - ENTEROSTOMAL THERAPY BY A RE|60|60||
125|S9473|S9473 - PULMONARY REHABILITATION PRO|75.13|75.13||
125|S9472|S9472 - CARDIAC REHABILITATION PROGR|15.52|15.52||
125|S9470|S9470 - NUTRITIONAL COUNSELING -  DIET|30|30||
125|S9465|S9465 - DIABETIC MANAGEMENT PROGRAM - |30|30||
125|S9460|S9460 - DIABETIC MANAGEMENT PROGRAM - |30|30||
125|S9455|S9455 - DIABETIC MANAGEMENT PROGRAM - |18|18||
125|S9454|S9454 - STRESS MGMT CLASS|111.43|111.43||
125|S9453|S9453 - SMOKING CESSATION CLASS|18|18||
125|S9452|S9452 - NUTRITION CLASS|26.9|26.9||
125|S9451|S9451 - EXERCISE CLASS|30.79|30.79||
125|S9449|S9449 - WEIGHT MGMT CLASS|47.27|47.27||
125|S9447|S9447 - INFANT SAFETY CLASS|42.7|42.7||
125|S9446|S9446 - PT EDUCATION NOC GROUP|12.12|12.12||
125|S9445|S9445 - PT EDUCATION NOC INDIVID|42.7|42.7||
125|S9444|S9444 - PARENTING CLASS|48|48||
125|S9443|S9443 - LACTATION CLASS|85.8|85.8||
125|S9442|S9442 - BIRTHING CLASS|30.25|30.25||
125|S9441|S9441 - ASTHMA EDUCATION|19.51|19.51||
125|S9439|S9439 - VBAC CLASS|90|90||
125|S9438|S9438 - CESAREAN BIRTH CLASS|90|90||
125|S9437|S9437 - CHILDBIRTH REFRESHER CLASS|67.26|67.26||
125|S9436|S9436 - LAMAZE CLASS|103.61|103.61||
125|S9435|S9435 - MEDICAL FOODS FOR INBORN ERR|9.6|9.6||
125|S9434|S9434 - MOD SOLID FOOD SUPPL|10.8|10.8||
125|S9433|S9433 - MEDICAL FOOD ORAL 100% NUTR|31.31|31.31||
125|S9430|S9430 - PHARMACY COMP/DISP SERV|0.01|0.01||
125|S9401|S9401 - ANTICOAG CLINIC PER SESSION|79.52|79.52||
125|S9381|S9381 - HIT HIGH RISK/ESCORT|31.07|31.07||
125|S9379|S9379 - HIT NOC PER DIEM|30|30||
125|S9377|S9377 - HIT HYDRA OVER 3L DIEM|30|30||
125|S9376|S9376 - HIT HYDRA 3 LITER DIEM|30|30||
125|S9375|S9375 - HIT HYDRA 2 LITER DIEM|30|30||
125|S9374|S9374 - HIT HYDRA 1 LITER DIEM|30|30||
125|S9373|S9373 - HIT HYDRA TOTAL DIEM|30|30||
125|S9372|S9372 - HT INJ ANTICOAG DIEM|12|12||
125|S9370|S9370 - HT INJ ANTIEMETIC DIEM|12|12||
125|S9368|S9368 - HIT TPN OVER 3L DIEM|60|60||
125|S9367|S9367 - HIT TPN 3 LITER DIEM|60|60||
125|S9366|S9366 - HIT TPN 2 LITER DIEM|60|60||
125|S9365|S9365 - HIT TPN 1 LITER DIEM|60|60||
125|S9364|S9364 - HIT TPN TOTAL DIEM|60|60||
125|S9363|S9363 - HIT ANTI-SPASMOTIC DIEM|30|30||
125|S9361|S9361 - HIT DIURETIC INFUS DIEM|30|30||
125|S9359|S9359 - HIT ANTI-TNF PER DIEM|30|30||
125|S9357|S9357 - HIT ENZYME REPLACE DIEM|30|30||
125|S9355|S9355 - HIT CHELATION DIEM|30|30||
125|S9353|S9353 - HIT CONT INSULIN DIEM|30|30||
125|S9351|S9351 - HIT CONT ANTIEMETIC DIEM|30|30||
125|S9349|S9349 - HIT TOCOLYSIS DIEM|30|30||
125|S9348|S9348 - HIT SYMPATHOMIM DIEM|30|30||
125|S9347|S9347 - HIT LONGTERM INFUSION DIEM|30|30||
125|S9346|S9346 - HIT ALPHA-1-PROTEINAS DIEM|30|30||
125|S9345|S9345 - HIT ANTI-HEMOPHIL DIEM|30|30||
125|S9343|S9343 - HIT ENTERAL BOLUS NURS|4.99|4.99||
125|S9342|S9342 - HIT ENTERAL PUMP DIEM|4.8|4.8||
125|S9341|S9341 - HIT ENTERAL GRAV DIEM|2.4|2.4||
125|S9340|S9340 - HIT ENTERAL PER DIEM|7.2|7.2||
125|S9339|S9339 - HIT PERITON DIALYSIS DIEM|24|24||
125|S9338|S9338 - HIT IMMUNOTHERAPY DIEM|26.4|26.4||
125|S9336|S9336 - HIT CONT ANTICOAG DIEM|26.4|26.4||
125|S9335|S9335 - HT HEMODIALYSIS DIEM|108|108||
125|S9331|S9331 - HIT INTERMIT CHEMO DIEM|12|12||
125|S9330|S9330 - HIT CONT CHEM DIEM|26.4|26.4||
125|S9329|S9329 - HIT CHEMO PER DIEM|40.32|40.32||
125|S9328|S9328 - HIT PAIN IMP PUMP DIEM|26.4|26.4||
125|S9327|S9327 - HIT INT PAIN PER DIEM|12|12||
125|S9326|S9326 - HIT CONT PAIN PER DIEM|26.4|26.4||
125|S9325|S9325 - HIT PAIN MGMT PER DIEM|30|30||
125|S9214|S9214 - HM GEST DM PER DIEM|60|60||
125|S9213|S9213 - HM PREECLAMP PER DIEM|60|60||
125|S9212|S9212 - HM POSTPAR HYPER PER DIEM|60|60||
125|S9211|S9211 - HOME MGMT GEST HYPERTENSION|60|60||
125|S9209|S9209 - HOME MGMT PPROM|161.29|161.29||
125|S9208|S9208 - HOME MGMT PRETERM LABOR|60|60||
125|S9152|S9152 - SPEECH THERAPY -  RE-EVAL|95.98|95.98||
125|S9145|S9145 - INSULIN PUMP INITIATION|12|12||
125|S9141|S9141 - DIABETIC MANAGEMENT PROGRAM - |30|30||
125|S9140|S9140 - DIABETIC MANAGEMENT PROGRAM - |24|24||
125|S9131|S9131 - PT IN THE HOME PER DIEM|92.23|92.23||
125|S9129|S9129 - OCCUPATIONAL THERAPY -  IN THE|46.21|46.21||
125|S9128|S9128 - SPEECH THERAPY -  IN THE HOME - |46.21|46.21||
125|S9127|S9127 - SOCIAL WORK VISIT -  IN THE HO|60|60||
125|S9126|S9126 - HOSPICE CARE -  IN THE HOME -  P|66|66||
125|S9125|S9125 - RESPITE CARE -  IN THE HOME -  P|66|66||
125|S9124|S9124 - NURSING CARE -  IN THE HOME; B|36|36||
125|S9123|S9123 - NURSING CARE IN HOME RN|36|36||
125|S9122|S9122 - HOME HEALTH AIDE OR CERTIFIE|18|18||
125|S9117|S9117 - BACK SCHOOL VISIT|23.44|23.44||
125|S9110|S9110 - TELEMONITORING/HOME PER MNTH|30|30||
125|S9098|S9098 - HOME PHOTOTHERAPY VISIT|108|108||
125|S9097|S9097 - HOME VISIT WOUND CARE|96|96||
125|S9090|S9090 - VERTEBRAL AXIAL DECOMPRESSIO|21.8|21.8||
125|S9088|S9088 - SERVICES PROVIDED IN URGENT|28.15|28.15||
125|S9083|S9083 - URGENT CARE CENTER GLOBAL|102|102||
125|S9061|S9061 - MEDICAL SUPPLIES AND EQUIPME|30|30||
125|S9056|S9056 - COMA STIMULATION PER DIEM|22.97|22.97||
125|S9055|S9055 - PROCUREN OR OTHER GROWTH FAC|2.51|2.51||
125|S9034|S9034 - ESWL FOR GALLSTONES|1772.7|1772.7||
125|S9025|S9025 - OMNICARDIOGRAM/CARDIOINTEGRA|178.88|178.88||
125|S9024|S9024 - PARANASAL SINUS ULTRASOUND|87.06|87.06||23.08
125|S9001|S9001 - HOME UTERINE MONITOR WITH OR|150|150||
125|S8999|S8999 - RESUSCITATION BAG|54.43|54.43||
125|S8990|S8990 - PT OR MANIP FOR MAINT|31.22|31.22||
125|S8950|S8950 - COMPLEX LYMPHEDEMA THERAPY - |21.8|21.8||
125|S8948|S8948 - LOW-LEVEL LASER TRMT 15 MIN|24.24|24.24||
125|S8940|S8940 - HIPPOTHERAPY PER SESSION|84.85|84.85||
125|S8930|S8930 - AURICULAR ELECTROSTIMULATION|22.58|22.58||
125|S8490|S8490 - 100 INSULIN SYRINGES|25.4|25.4||
125|S8460|S8460 - CAMISOLE POST-MAST|28.22|28.22||
125|S8452|S8452 - SPLINT ELBOW|10.97|10.97||
125|S8451|S8451 - SPLINT WRIST OR ANKLE|10.97|10.97||
125|S8450|S8450 - SPLINT DIGIT|10.97|10.97||
125|S8431|S8431 - COMPRESSION BANDAGE|0.01|0.01||
125|S8430|S8430 - PADDING FOR COMPRSSN BDG|0.01|0.01||
125|S8429|S8429 - GRADIENT PRESSURE WRAP|0.3|0.3||
125|S8428|S8428 - READY GRADIENT GAUNTLET|4.39|4.39||
125|S8427|S8427 - READY GRADIENT GLOVE|4.39|4.39||
125|S8426|S8426 - CUSTOM GRAD GLOVE HEAVY|4.39|4.39||
125|S8425|S8425 - CUSTOM GRAD GLOVE MED|4.39|4.39||
125|S8424|S8424 - READY GRADIENT SLEEVE|4.39|4.39||
125|S8423|S8423 - CUSTOM GRAD SLEEVE HEAVY|4.39|4.39||
125|S8422|S8422 - CUSTOM GRAD SLEEVE MED|4.39|4.39||
125|S8421|S8421 - READY GRADIENT SLEEV/GLOV|4.39|4.39||
125|S8420|S8420 - CUSTOM GRADIENT SLEEV/GLOV|4.39|4.39||
125|S8270|S8270 - ENURESIS ALARM|100.54|100.54||
125|S8265|S8265 - HABERMAN FEEDER|25.52|25.52||
125|S8210|S8210 - MUCUS TRAP|3.07|3.07||
125|S8186|S8186 - SWIVEL ADAPTOR|2.99|2.99||
125|S8185|S8185 - FLUTTER DEVICE|2.75|2.75||
125|S8121|S8121 - O2 CONTENTS LIQUID LB|1.2|1.2||
125|S8120|S8120 - O2 CONTENTS GAS CUBIC FT|1.2|1.2||
125|S8110|S8110 - PEAK EXPIRATORY FLOW RATE (P|16.74|16.74||
125|S8101|S8101 - SPACER WITH MASK|6|6||
125|S8100|S8100 - SPACER WITHOUT MASK|6|6||
125|S8097|S8097 - ASTHMA KIT|18.19|18.19||
125|S8096|S8096 - PORTABLE PEAK FLOW METER|18.19|18.19||
125|S8092|S8092 - ELECTRON BEAM COMPUTED TOMOG|330|330||66
125|S8085|S8085 - FLUORINE-18 FLUORODEOXYGLUCO|1800|1800||450
125|S8080|S8080 - SCINTIMAMMOGRAPHY|38.76|38.76||
125|S8055|S8055 - US GUIDANCE FETAL REDUCT|76.97|76.97||27.08
125|S8042|S8042 - MRI LOW FIELD|510|510||102
125|S8040|S8040 - TOPOGRAPHIC BRAIN MAPPING|196.48|196.48||139.7
125|S8037|S8037 - MRCP|510|510||102
125|S8035|S8035 - MAGNETIC SOURCE IMAGING|382.5|382.5||113.4
125|S8030|S8030 - TANTALUM RING APPLICATION|13.68|13.68||
125|S5571|S5571 - INSULIN DISPOS PEN 3 ML|126.79|126.79||
125|S5570|S5570 - INSULIN DISPOS PEN 1.5 ML|0.91|0.91||
125|S5566|S5566 - INSULIN CARTRIDGE 300 U|122.18|122.18||
125|S5565|S5565 - INSULIN CARTRIDGE 150 U|1.14|1.14||
125|S5561|S5561 - INSULIN REUSE PEN 3 ML|45.26|45.26||
125|S5560|S5560 - INSULIN REUSE PEN 1.5 ML|1.16|1.16||
125|S5553|S5553 - INSULIN LONG ACTING 5 U|1.61|1.61||
125|S5552|S5552 - INSULIN INTERMED 5 U|0.89|0.89||
125|S5551|S5551 - INSULIN MOST RAPID 5 U|1.64|1.64||
125|S5550|S5550 - INSULIN RAPID 5 U|0.89|0.89||
125|S5523|S5523 - HIP MIDLINE CATH INSERT KIT|60|60||
125|S5522|S5522 - HIT PICC INSERT NO SUPP|60|60||
125|S5521|S5521 - HIT MIDLINE CATH INSERT KIT|12|12||
125|S5520|S5520 - HIT PICC INSERT KIT|30|30||
125|S5518|S5518 - HIT CATH REPAIR KIT|28.8|28.8||
125|S5517|S5517 - HIT DECLOTTING KIT|24|24||
125|S5502|S5502 - HIT INTERIM CATH CARE|3.6|3.6||
125|S5501|S5501 - HIT COMPLEX CATH CARE|3.6|3.6||
125|S5498|S5498 - HIT SIMPLE CATH CARE|2.4|2.4||
125|S5497|S5497 - HIT CATH CARE NOC|3.6|3.6||
125|S5190|S5190 - WELLNESS ASSESSMENT BY NONPH|27.05|27.05||
125|S5185|S5185 - MED REMINDER SERV PER MONTH|74.1|74.1||
125|S5180|S5180 - HH RESPIRATORY THRPY IN EVAL|34.25|34.25||
125|S5175|S5175 - LAUNDRY SERV - EXT - PROF - /ORDER|0.01|0.01||
125|S5170|S5170 - HOMEDELIVERED PREPARED MEAL|5.86|5.86||
125|S5165|S5165 - HOME MODIFICATIONS PER SERV|69.92|69.92||
125|S5162|S5162 - EMER RSPNS SYSTEM PURCHASE|39.9|39.9||
125|S5161|S5161 - EMER RSPNS SYS SERV PERMONTH|26.33|26.33||
125|S5160|S5160 - EMER RESPONSE SYS INSTAL&TST|45.98|45.98||
125|S5151|S5151 - UNSKILLED RESPITECARE /DIEM|9.54|9.54||
125|S5150|S5150 - UNSKILLED RESPITE CARE /15M|0.96|0.96||
125|S5145|S5145 - CHILD FOSTERCARE TH PER DIEM|96.9|96.9||
125|S5141|S5141 - ADULT FOSTER CARE PER MONTH|12.73|12.73||
125|S5140|S5140 - ADULT FOSTER CARE PER DIEM|44.4|44.4||
125|S5136|S5136 - ADULT COMPANIONCARE PER DIEM|18.85|18.85||
125|S5135|S5135 - ADULT COMPANIONCARE PER 15M|2.51|2.51||
125|S5131|S5131 - HOMEMAKER SERVICE NOS /DIEM|41.04|41.04||
125|S5130|S5130 - HOMAKER SERVICE NOS PER 15M|2.17|2.17||
125|S5126|S5126 - ATTENDANT CARE SERVICE /DIEM|19.07|19.07||
125|S5125|S5125 - ATTENDANT CARE SERVICE /15M|7.32|7.32||
125|S5121|S5121 - CHORE SERVICES PER DIEM|1.82|1.82||
125|S5120|S5120 - CHORE SERVICES PER 15 MIN|0.54|0.54||
125|S5116|S5116 - NONFAMILY HC TRAIN/SESSION|26.56|26.56||
125|S5115|S5115 - NONFAMILY HOMECARE TRAIN/15M|5.7|5.7||
125|S5111|S5111 - FAMILY HOMECARE TRAIN/SESSIO|87.64|87.64||
125|S5110|S5110 - FAMILY HOMECARE TRAINING 15M|7.91|7.91||
125|S5109|S5109 - HOMECARE TRAIN PT SESSION|22.57|22.57||
125|S5108|S5108 - HOMECARE TRAIN PT 15 MIN|22.57|22.57||
125|S5105|S5105 - CENTERBASED DAY CARE PERDIEM|67.26|67.26||
125|S5102|S5102 - ADULT DAY CARE PER DIEM|60|60||
125|S5101|S5101 - ADULT DAY CARE PER HALF DAY|15.74|15.74||
125|S5100|S5100 - ADULT DAYCARE SERVICES 15MIN|2.63|2.63||
125|S5035|S5035 - HIT ROUTINE DEVICE MAINT|19.2|19.2||
125|S5014|S5014 - D5W/0.45NS W KCL AND MGS04|11.4|11.4||
125|S5013|S5013 - 5%DEXTROSE/0.45%SALINE1000ML|11.42|11.42||
125|S5012|S5012 - 5% DEXTROSE WITH POTASSIUM|3.08|3.08||
125|S5010|S5010 - 5% DEXTROSE AND 0.45% SALINE|7.51|7.51||
125|S4995|S4995 - SMOKING CESSATION GUM|0.42|0.42||
125|S4993|S4993 - CONTRACEPTIVE PILLS FOR BC|1.39|1.39||
125|S4991|S4991 - NICOTINE PATCH NONLEGEND|2.51|2.51||
125|S4990|S4990 - NICOTINE PATCH LEGEND|2.51|2.51||
125|S4989|S4989 - CONTRACEPT IUD|457.84|457.84||
125|S4981|S4981 - INSERT LEVONORGESTREL IUS|66.64|66.64||
125|S4042|S4042 - OVULATION MGMT PER CYCLE|0.01|0.01||
125|S4040|S4040 - MONIT STORE CRYO EMBRYO 30 D|33.2|33.2||
125|S4037|S4037 - CRYO EMBRYO TRANSF CASE RATE|500.5|500.5||
125|S4035|S4035 - STIMULATED IUI CASE RATE|2267.2|2267.2||
125|S4028|S4028 - MICROSURG EPI SPERM ASP|1805.6|1805.6||
125|S4027|S4027 - STORE PREV FROZ EMBRYOS|16.74|16.74||
125|S4026|S4026 - PROCURE DONOR SPERM|727.22|727.22||
125|S4025|S4025 - DONOR SERV IVF CASE RATE|8567.75|8567.75||
125|S4023|S4023 - INCOMPL DONOR EGG CASE RATE|3542.4|3542.4||
125|S4022|S4022 - ASST OOCYTE FERT CASE RATE|893.71|893.71||
125|S4021|S4021 - IVF CANC P ASPIR CASE RATE|5431.42|5431.42||
125|S4020|S4020 - IVF CANC A ASPIR CASE RATE|1914.98|1914.98||
125|S4018|S4018 - F EMB TRNS CANC CASE RATE|625.92|625.92||
125|S4017|S4017 - IVF CANC A STIM CASE RATE|601.28|601.28||
125|S4016|S4016 - FROZEN IVF CASE RATE|3648.19|3648.19||
125|S4015|S4015 - COMPLETE IVF NOS CASE RATE|7498.56|7498.56||
125|S4013|S4013 - COMPL GIFT CASE RATE|1485|1485||
125|S4011|S4011 - IVF PACKAGE|5944.7|5944.7||
125|S4005|S4005 - INTERIM LABOR FACILITY GLOBA|630.85|630.85||
125|S3900|S3900 - SURFACE EMG|85.46|85.46||23.69
125|S3870|S3870 - CGH TEST DEVELOPMENTAL DELAY|428.57|428.57||
125|S3866|S3866 - SPEC GENE TEST HYP CARDIOMY|845.88|845.88||
125|S3865|S3865 - COMP GENET TEST HYP CARDIOMY|5199.54|5199.54||
125|S3861|S3861 - GENETIC TEST BRUGADA|2726.88|2726.88||
125|S3854|S3854 - GENE PROFILE PANEL BREAST|3178.51|3178.51||634.5
125|S3708|S3708 - GASTROINTESTINAL FAT ABSORPT|6.84|6.84||
125|S3655|S3655 - ANTISPERM ANTIBODIES TEST|188.15|188.15||
125|S3652|S3652 - SALIVA TEST -  HORMONE LEVEL;|85.5|85.5||
125|S3650|S3650 - SALIVA TEST -  HORMONE LEVEL;|236.74|236.74||
125|S3645|S3645 - HIV-1 ANTIBODY TESTING OF OR|22.19|22.19||
125|S3630|S3630 - EOSINOPHIL BLOOD COUNT|4.67|4.67||
125|S3620|S3620 - NEWBORN METABOLIC SCREENING|4.6|4.6||
125|S3601|S3601 - STAT LAB HOME/NF|38.33|38.33||
125|S3600|S3600 - STAT LAB|2.1|2.1||
125|S3005|S3005 - EVAL SELF-ASSESS DEPRESSION|2.62|2.62||
125|S3000|S3000 - BILAT DIL RETINAL EXAM|60.05|60.05||
125|S2900|S2900 - ROBOTIC SURGICAL SYSTEM|479.92|479.92||
125|S2411|S2411 - FETOSCOP LASER THER TTTS|5706.89|5706.89||
125|S2405|S2405 - FETAL SURG SACROCOC TERATOMA|7.75|7.75||
125|S2404|S2404 - FETAL SURG MYELOMENINGO|5904.18|5904.18||
125|S2402|S2402 - FETAL SURG CONG CYST MALF|185.82|185.82||
125|S2351|S2351 - DISKECTOMY -  ANTERIOR -  WITH D|208.98|208.98||
125|S2350|S2350 - DISKECTOMY -  ANTERIOR -  WITH D|1098.61|1098.61||
125|S2348|S2348 - DECOMPRESS DISC RF LUMBAR|71.82|71.82||
125|S2342|S2342 - NASAL ENDOSCOP PO DEBRID|257.03|257.03||
125|S2341|S2341 - CHEMODENERV ADDUCT VOCAL|169.84|169.84||
125|S2340|S2340 - CHEMODENERVATION OF ABDUCTOR|186.29|186.29||
125|S2325|S2325 - HIP CORE DECOMPRESSION|2622.71|2622.71||
125|S2300|S2300 - ARTHROSCOPY -  SHOULDER -  SURGI|767.48|767.48||
125|S2265|S2265 - INDUCED ABORTION 25-28 WKS|993.6|993.6||
125|S2260|S2260 - INDUCED ABORTION 17-24 WEEKS|329.71|329.71||
125|S2235|S2235 - IMPLANT AUDITORY BRAIN IMP|460.8|460.8||
125|S2230|S2230 - IMPLANT SEMI-IMP HEAR|621|621||
125|S2225|S2225 - MYRINGOTOMY LASER-ASSIST|120.59|120.59||
125|S2209|S2209 - MINIMALLY INVASIVE DIRECT CO|1860.35|1860.35||
125|S2208|S2208 - MINIMALLY INVASIVE DIRECT CO|1616.86|1616.86||
125|S2207|S2207 - MINIMALLY INVASIVE DIRECT CO|1652.84|1652.84||
125|S2206|S2206 - MINIMALLY INVASIVE DIRECT CO|1860.35|1860.35||
125|S2205|S2205 - MINIMALLY INVASIVE DIRECT CO|1616.86|1616.86||
125|S2202|S2202 - ECHOSCLEROTHERAPY|251.89|251.89||
125|S2150|S2150 - BMT HARV/TRANSPL 28D PKG|102.08|102.08||
125|S2142|S2142 - CORD BLOOD-DERIVED STEM-CELL|131.21|131.21||
125|S2140|S2140 - CORD BLOOD HARVESTING|128.89|128.89||
125|S2118|S2118 - TOTAL HIP RESURFACING|6963.43|6963.43||
125|S2117|S2117 - ARTHROEREISIS -  SUBTALAR|4286.2|4286.2||
125|S2115|S2115 - PERIACETABULAR OSTEOTOMY|1089.14|1089.14||
125|S2112|S2112 - KNEE ARTHROSCP HARV|486.54|486.54||
125|S2095|S2095 - TRANSCATH EMBOLIZ MICROSPHER|784.5|784.5||
125|S2083|S2083 - ADJUSTMENT GASTRIC BAND|148.51|148.51||
125|S2080|S2080 - LAUP|1309.86|1309.86||
125|S2079|S2079 - LAP ESOPHAGOMYOTOMY|978.58|978.58||
125|S2070|S2070 - CYSTO LASER TX URETERAL CALC|276.7|276.7||
125|S2068|S2068 - BREAST DIEP OR SIEA FLAP|3355.54|3355.54||
125|S2067|S2067 - BREAST 'STACKED' DIEP/GAP|3355.54|3355.54||
125|S2066|S2066 - BREAST GAP FLAP RECONST|3355.54|3355.54||
125|S2055|S2055 - HARVESTING OF DONOR MULTIVIS|950.04|950.04||
125|S2054|S2054 - TRANSPLANTATION OF MULTIVISC|3763.19|3763.19||
125|S2053|S2053 - TRANSPLANTATION OF SMALL INT|3763.19|3763.19||
125|S1090|S1090 - MOMETASONE SINUS IMPLANT|950.18|950.18||
125|S1040|S1040 - CRANIAL REMOLDING ORTHOSIS|1440|1440||
125|S1031|S1031 - GLUC MONITOR RENTAL|60.14|60.14||6.01
125|S1030|S1030 - GLUC MONITOR PURCHASE|60.14|60.14||6.01
125|S1016|S1016 - NON-PVC INTRAVENOUS ADMINIST|24|24||
125|S1015|S1015 - IV TUBING EXTENSION SET|12|12||
125|S0812|S0812 - PHOTOTHERAP KERATECT|1038.31|1038.31||
125|S0810|S0810 - PHOTOREFRACTIVE KERATECTOMY|475.91|475.91||
125|S0800|S0800 - LASER IN SITU KERATOMILEUSIS|1038.31|1038.31||
125|S0630|S0630 - REMOVAL OF SUTURES|68.5|68.5||
125|S0622|S0622 - PHYS EXAM FOR COLLEGE|35.18|35.18||
125|S0621|S0621 - ROUTINE OPHTHALMOLOGICAL EXA|45.6|45.6||
125|S0620|S0620 - ROUTINE OPHTHALMOLOGICAL EXA|45.6|45.6||
125|S0618|S0618 - AUDIOMETRY FOR HEARING AID|51.62|51.62||
125|S0613|S0613 - ANN BREAST EXAM|28.67|28.67||
125|S0612|S0612 - ANNUAL GYNECOLOGICAL EXAMINA|84|84||
125|S0610|S0610 - ANNUAL GYNECOLOGICAL EXAMINA|84|84||
125|S0601|S0601 - SCREENING PROCTOSCOPY|64.12|64.12||
125|S0595|S0595 - NEW LENSES IN PTS OLD FRAME|7.2|7.2||
125|S0592|S0592 - COMP CONT LENS EVAL|70.74|70.74||
125|S0581|S0581 - NONSTND LENS|44.16|44.16||
125|S0580|S0580 - POLYCARB LENS|8.64|8.64||
125|S0518|S0518 - SUNGLASS FRAMES|28.8|28.8||
125|S0516|S0516 - SAFETY FRAMES|48.48|48.48||
125|S0515|S0515 - SCLERAL LENS LIQUID BANDAGE|996.22|996.22||
125|S0514|S0514 - COLOR CONT LENS|58.67|58.67||
125|S0512|S0512 - DAILY CONT LENS|37.2|37.2||
125|S0510|S0510 - NON-PRSCRP LENS|60|60||
125|S0508|S0508 - TRIFOC PRSCRP LENS|30|30||
125|S0506|S0506 - BIFOC PRSCP LENS|22.8|22.8||
125|S0504|S0504 - SINGL PRSCRP LENS|18|18||
125|S0500|S0500 - DISPOS CONT LENS|37.2|37.2||
125|S0400|S0400 - GLOBAL ESWL KIDNEY|774.05|774.05||
125|S0395|S0395 - IMPRESSION CASTING FT|68.46|68.46||
125|S0390|S0390 - ROUT FOOT CARE PER VISIT|32.66|32.66||
125|S0354|S0354 - CANCER TREATMENT PLAN CHANGE|4.96|4.96||
125|S0353|S0353 - CANCER TREATMENT PLAN INITIAL|3.61|3.61||
125|S0342|S0342 - LIFESTYLE MOD 4TH STAGE|66.12|66.12||
125|S0341|S0341 - LIFESTYLE MOD 2 OR 3 STAGE|13.68|13.68||
125|S0340|S0340 - LIFESTYLE MOD 1ST STAGE|327.94|327.94||
125|S0320|S0320 - RN TELEPHONE CALLS TO DMP|77.51|77.51||
125|S0317|S0317 - DISEASE MGMT PER DIEM|210|210||
125|S0316|S0316 - FOLLOW-UP/REASSESSMENT|24|24||
125|S0315|S0315 - DISEASE MANAGEMENT PROGRAM|102|102||
125|S0310|S0310 - HOSPITALIST VISIT|25.92|25.92||
125|S0302|S0302 - COMPLETED EPSDT|83.16|83.16||
125|S0285|S0285 - CNSLT BEFORE SCREEN COLONOSC|77.51|77.51||
125|S0281|S0281 - MEDICAL HOME -  MAINTENANCE|0.01|0.01||
125|S0280|S0280 - MEDICAL HOME -  INITIAL PLAN|0.01|0.01||
125|S0274|S0274 - NURSE PRACTR VISIT OUTS CAP|21.66|21.66||
125|S0265|S0265 - GENETIC COUNSEL 15 MINS|90.52|90.52||
125|S0260|S0260 - H&P FOR SURGERY|78.43|78.43||
125|S0257|S0257 - END OF LIFE COUNSELING|20.65|20.65||
125|S0255|S0255 - HOSPICE REFER VISIT NONMD|105.58|105.58||
125|S0250|S0250 - COMP GERIATR ASSMT TEAM|0.01|0.01||
125|S0221|S0221 - MEDICAL CONFERENCE -  60 MIN|56.48|56.48||
125|S0220|S0220 - MEDICAL CONFERENCE BY PHYSIC|63.36|63.36||
125|S0215|S0215 - NONEMERG TRANSP MILEAGE|2.65|2.65||
125|S0209|S0209 - WC VAN MILEAGE PER MI|2.52|2.52||
125|S0208|S0208 - PARAMED INTRCEPT NONVOL|232.48|232.48||
125|S0207|S0207 - PARAMEDICINTERCEP NONHOSPALS|448.73|448.73||
125|S0201|S0201 - PARTIAL HOSPITALIZATION SERV|402.37|402.37||
125|S0199|S0199 - MED ABORTION INC ALL EX DRUG|383.33|383.33||
125|S0197|S0197 - PRENATAL VITAMINS 30 DAY|4.97|4.97||
125|S0194|S0194 - VITAMIN SUPPL 100 CAPS|66.97|66.97||
125|S0191|S0191 - MISOPROSTOL -  ORAL -  200 MCG|1.42|1.42||
125|S0190|S0190 - MIFEPRISTONE -  ORAL -  200 MG|81.67|81.67||
125|S0189|S0189 - TESTOSTERONE PELLET 75 MG|112.06|112.06||
125|S0187|S0187 - TAMOXIFEN 10 MG|1.88|1.88||
125|S0183|S0183 - PROCHLORPERAZINE 5 MG|0.6|0.6||
125|S0182|S0182 - PROCARBAZINE -  ORAL|97.54|97.54||
125|S0179|S0179 - MEGESTROL 20 MG|0.67|0.67||
125|S0178|S0178 - LOMUSTINE 10 MG|83.12|83.12||
125|S0177|S0177 - LEVAMISOLE 50 MG|6.34|6.34||
125|S0176|S0176 - HYDROXYUREA 500 MG|1.27|1.27||
125|S0175|S0175 - FLUTAMIDE 125 MG|2.08|2.08||
125|S0174|S0174 - DOLASETRON 50 MG|86.11|86.11||
125|S0172|S0172 - CHLORAMBUCIL 2 MG|24.23|24.23||
125|S0171|S0171 - BUMETANIDE 0.5 MG|1.01|1.01||
125|S0170|S0170 - ANASTROZOLE 1 MG|13.43|13.43||
125|S0169|S0169 - CALCITROL|0.91|0.91||
125|S0166|S0166 - INJ OLANZAPINE 2.5MG|10.34|10.34||
125|S0164|S0164 - INJECTION PANTROPRAZOLE|5.98|5.98||
125|S0160|S0160 - DEXTROAMPHETAMINE|2.89|2.89||
125|S0157|S0157 - BECAPLERMIN GEL 1% -  0.5 GM|40.44|40.44||
125|S0156|S0156 - EXEMESTANE -  25 MG|20.15|20.15||
125|S0155|S0155 - EPOPROSTENOL DILUTANT|14.05|14.05||
125|S0148|S0148 - PEG INTERFERON ALFA-2B/10|179.8|179.8||
125|S0145|S0145 - PEG INTERFERON ALFA-2A/180|1185.32|1185.32||
125|S0142|S0142 - COLISTIMETHATE INH SOL MG|3.07|3.07||
125|S0140|S0140 - SAQUINAVIR -  200 MG|1.45|1.45||
125|S0139|S0139 - MINOXIDIL -  10 MG|1.28|1.28||
125|S0138|S0138 - FINASTERIDE -  5 MG|3.12|3.12||
125|S0137|S0137 - DIDANOSINE -  25 MG|0.77|0.77||
125|S0136|S0136 - CLOZAPINE -  25 MG|1.32|1.32||
125|S0132|S0132 - INJ GANIRELIX ACETAT 250 MCG|258.76|258.76||
125|S0128|S0128 - INJ FOLLITROPIN BETA 75 IU|178.46|178.46||
125|S0126|S0126 - INJ FOLLITROPIN ALFA 75 IU|188.59|188.59||
125|S0122|S0122 - INJ MENOTROPINS 75 IU|198.35|198.35||
125|S0119|S0119 - ONDANSETRON 4 MG|23.53|23.53||
125|S0117|S0117 - TRETINOIN TOPICAL 5 G|26.69|26.69||
125|S0109|S0109 - METHADONE ORAL 5MG|0.38|0.38||
125|S0108|S0108 - MERCAPTOPURINE 50 MG|4.07|4.07||
125|S0106|S0106 - BUPROPION HCL SR 60 TABLETS|115.54|115.54||
125|S0104|S0104 - ZIDOVUDINE -  ORAL -  100 MG|2.02|2.02||
125|S0093|S0093 - MORPHINE 500 MG|6.41|6.41||
125|S0092|S0092 - HYDROMORPHONE 250 MG|63.82|63.82||
125|S0091|S0091 - GRANISETRON 1MG|58.78|58.78||
125|S0090|S0090 - SILDENAFIL CITRATE -  25 MG|73.56|73.56||
125|S0088|S0088 - IMATINIB 100 MG|100.73|100.73||
125|S0081|S0081 - INJECTION -  PIPERACILLIN SODI|2.08|2.08||
125|S0080|S0080 - INJECTION -  PENTAMIDINE ISETH|199.46|199.46||
125|S0078|S0078 - INJECTION -  FOSPHENYTOIN SODI|27.43|27.43||
125|S0077|S0077 - INJECTION -  CLINDAMYCIN PHOSP|0.91|0.91||
125|S0074|S0074 - INJECTION -  CEFOTETAN DISODIU|11.5|11.5||
125|S0073|S0073 - INJECTION -  AZTREONAM -  500 MG|17.33|17.33||
125|S0040|S0040 - INJECTION -  TICARCILLIN DISOD|15.94|15.94||
125|S0039|S0039 - INJECTION -  SULFAMETHOXAZOLE|14.99|14.99||
125|S0034|S0034 - INJECTION -  OFLOXACIN -  400 MG|26.29|26.29||
125|S0032|S0032 - INJECTION -  NAFCILLIN SODIUM|27.59|27.59||
125|S0030|S0030 - INJECTION -  METRONIDAZOLE|2.33|2.33||
125|S0028|S0028 - INJECTION -  FAMOTIDINE -  20 MG|1.07|1.07||
125|S0023|S0023 - INJECTION -  CIMETIDINE HYDROC|2.86|2.86||
125|S0021|S0021 - INJECTION -  CEFOPERAZONE SOD|17.93|17.93||
125|S0020|S0020 - INJECTION -  BUPIVICAINE HYDRO|3.25|3.25||
125|S0017|S0017 - INJECTION -  AMINOCAPROIC ACID|7.1|7.1||
125|S0014|S0014 - TACRINE HYDROCHLORIDE -  10 MG|2.9|2.9||
125|S0012|S0012 - BUTORPHANOL TARTRATE -  NASAL|95.94|95.94||
125|R0076|R0076 - TRANSPORT PORTABLE EKG|32.05|32.05||
125|R0075|R0075 - TRANSPORT PORT X-RAY MULTIPL|178.82|178.82||
125|R0070|R0070 - TRANSPORT PORTABLE X-RAY|80.5|80.5||
125|Q9989|Q9989 - USTEKINUMAB -  IV INJECT - 1 MG|15.46|15.46||
125|Q9986|Q9986 - MAKENA -  10 MG|36.54|36.54||
125|Q9985|Q9985 - INJ HYDROXYPROGST CAPOAT NOS|18.42|18.42||
125|Q9984|Q9984 - KYLEENA -  19.5 MG|1030|1030||
125|Q9983|Q9983 - FLORBETABEN F18 DIAGNOSTIC|1115.52|1115.52||
125|Q9982|Q9982 - FLUTEMETAMOL F18 DIAGNOSTIC|3944.16|3944.16||
125|Q9969|Q9969 - NON-HEU TC-99M ADD-ON/DOSE|2.28|2.28||
125|Q9968|Q9968 - VISUALIZATION ADJUNCT|17.86|17.86||
125|Q9967|Q9967 - LOCM 300-399MG/ML IODINE - 1ML|0.21|0.21||
125|Q9966|Q9966 - LOCM 200-299MG/ML IODINE - 1ML|0.54|0.54||
125|Q9965|Q9965 - LOCM 100-199MG/ML IODINE - 1ML|1.37|1.37||
125|Q9964|Q9964 - HOCM>= 400MG/ML IODINE -  1ML|0.38|0.38||
125|Q9963|Q9963 - HOCM 350-399MG/ML IODINE - 1ML|0.34|0.34||
125|Q9962|Q9962 - HOCM 300-349MG/ML IODINE - 1ML|0.31|0.31||
125|Q9961|Q9961 - HOCM 250-299MG/ML IODINE - 1ML|0.46|0.46||
125|Q9960|Q9960 - HOCM 200-249MG/ML IODINE - 1ML|0.42|0.42||
125|Q9959|Q9959 - HOCM 150-199MG/ML IODINE - 1ML|0.11|0.11||
125|Q9958|Q9958 - HOCM <=149 MG/ML IODINE -  1ML|0.13|0.13||
125|Q9957|Q9957 - INJ PERFLUTREN LIP MICROS - ML|82.04|82.04||
125|Q9956|Q9956 - INJ OCTAFLUOROPROPANE MIC - ML|54.7|54.7||
125|Q9955|Q9955 - INJ PERFLEXANE LIP MICROS - ML|16.14|16.14||
125|Q9954|Q9954 - ORAL MR CONTRAST -  100 ML|12.52|12.52||
125|Q9953|Q9953 - INJ FE-BASED MR CONTRAST - 1ML|17.46|17.46||
125|Q9951|Q9951 - LOCM >= 400 MG/ML IODINE - 1ML|0.6|0.6||
125|Q9950|Q9950 - INJ SULF HEXA LIPID MICROSPH|34.18|34.18||
125|Q5104|Q5104 - INJECTION -  RENFLEXIS -  10 MG|114.72|114.72||
125|Q5103|Q5103 - INJECTION -  INFLECTRA -  10 MG|113.63|113.63||
125|Q5101|Q5101 - INJECTION -  ZARXIO -  1 MCG|1.11|1.11||
125|Q5010|Q5010 - HOSPICE HOME CARE IN HOSPICE|98.57|98.57||
125|Q5009|Q5009 - HOSPICE/HOME HLTH -  PLACE NOS|140.75|140.75||
125|Q5008|Q5008 - HOSPICE IN INPATIENT PSYCH|102.6|102.6||
125|Q5007|Q5007 - HOSPICE IN LTCH|102.6|102.6||
125|Q5006|Q5006 - HOSPICE IN HOSPICE FACILITY|464.94|464.94||
125|Q5005|Q5005 - HOSPICE -  INPATIENT HOSPITAL|451.56|451.56||
125|Q5004|Q5004 - HOSPICE IN SNF|152.57|152.57||
125|Q5003|Q5003 - HOSPICE IN LT/NON-SKILLED NF|165.22|165.22||
125|Q5002|Q5002 - HOSPICE/HOME HLTH IN ASST LV|46.3|46.3||
125|Q5001|Q5001 - HOSPICE OR HOME HLTH IN HOME|72.89|72.89||
125|Q4180|Q4180 - REVITA -  PER SQ CM|151.48|151.48||
125|Q4175|Q4175 - MIRODERM|77.2|77.2||
125|Q4172|Q4172 - PURAPLY OR PURAPLY AM|113.66|113.66||
125|Q4167|Q4167 - TRUSKIN -  PER SQ CENTIMETER|120.46|120.46||
125|Q4163|Q4163 - WOUNDEX -  BIOSKIN -  PER SQ CM|144|144||
125|Q4160|Q4160 - NUSHIELD 1 SQUARE CM|248.51|248.51||
125|Q4159|Q4159 - AFFINITY1 SQUARE CM|1027.34|1027.34||
125|Q4157|Q4157 - REVITALON 1 SQUARE CM|208.72|208.72||
125|Q4156|Q4156 - NEOX 100 OR CLARIX 100|177.79|177.79||
125|Q4154|Q4154 - BIOVANCE 1 SQUARE CM|349.9|349.9||
125|Q4152|Q4152 - DERMAPURE 1 SQUARE CM|114.54|114.54||
125|Q4149|Q4149 - EXCELLAGEN -  0.1 CC|35.86|35.86||
125|Q4148|Q4148 - NEOX NEOX RT OR CLARIX CORD|262.45|262.45||
125|Q4147|Q4147 - ARCHITECT ECM PX FX 1 SQ CM|56.9|56.9||
125|Q4145|Q4145 - EPIFIX -  INJ -  1 MG|23.76|23.76||
125|Q4140|Q4140 - BIODFENCE 1 CM|192.36|192.36||
125|Q4139|Q4139 - AMNIO OR BIODMATRIX -  INJ 1CC|2184|2184||
125|Q4138|Q4138 - BIODFENCE DRYFLEX -  1 CM|225.53|225.53||
125|Q4136|Q4136 - EZDERM|3.97|3.97||
125|Q4133|Q4133 - GRAFIX STRAVIX PRIME PL SQCM|218.27|218.27||
125|Q4132|Q4132 - GRAFIX CORE -  GRAFIXPL CORE|222.23|222.23||
125|Q4131|Q4131 - EPIFIX OR EPICORD|261.19|261.19||
125|Q4130|Q4130 - STRATTICE TM|13.38|13.38||
125|Q4128|Q4128 - FLEXHD/ALLOPATCHHD/MATRIXHD|35.02|35.02||
125|Q4127|Q4127 - TALYMED|37.52|37.52||
125|Q4126|Q4126 - MEMODERM/DERMA/TRANZ/INTEGUP|97.12|97.12||
125|Q4125|Q4125 - ARTHROFLEX|166.7|166.7||
125|Q4124|Q4124 - OASIS TRI-LAYER WOUND MATRIX|14.62|14.62||
125|Q4123|Q4123 - ALLOSKIN|36.19|36.19||
125|Q4122|Q4122 - DERMACELL|73.39|73.39||
125|Q4121|Q4121 - THERASKIN|69.68|69.68||
125|Q4118|Q4118 - MATRISTEM MICROMATRIX|3.83|3.83||
125|Q4116|Q4116 - ALLODERM|50.71|50.71||
125|Q4115|Q4115 - ALLOSKIN|15.42|15.42||
125|Q4114|Q4114 - INTEGRA FLOWABLE WOUND MATRI|1873.15|1873.15||
125|Q4113|Q4113 - GRAFTJACKET XPRESS|313.09|313.09||
125|Q4112|Q4112 - CYMETRA INJECTABLE|313.09|313.09||
125|Q4111|Q4111 - GAMMAGRAFT|12.76|12.76||
125|Q4110|Q4110 - PRIMATRIX|63.62|63.62||
125|Q4108|Q4108 - INTEGRA MATRIX|37.52|37.52||
125|Q4107|Q4107 - GRAFTJACKET|155.55|155.55||
125|Q4106|Q4106 - DERMAGRAFT|53.37|53.37||
125|Q4105|Q4105 - INTEGRA DRT OR OMNIGRAFT|50.82|50.82||
125|Q4104|Q4104 - INTEGRA BMWD|39.53|39.53||
125|Q4103|Q4103 - OASIS BURN MATRIX|1.85|1.85||
125|Q4102|Q4102 - OASIS WOUND MATRIX|17.96|17.96||
125|Q4101|Q4101 - APLIGRAF|50.37|50.37||
125|Q4081|Q4081 - EPOETIN ALFA -  100 UNITS ESRD|2.12|2.12||
125|Q4074|Q4074 - ILOPROST NON-COMP UNIT DOSE|220.1|220.1||
125|Q4049|Q4049 - FINGER SPLINT -  STATIC|2.52|2.52||
125|Q4048|Q4048 - CAST SUP SHT LEG SPLNT PED F|11.15|11.15||
125|Q4047|Q4047 - CAST SUP SHT LEG SPLNT PED P|6.91|6.91||
125|Q4046|Q4046 - CAST SUP SHT LEG SPLNT FBRGL|22.3|22.3||
125|Q4045|Q4045 - CAST SUP SHT LEG SPLNT PLSTR|13.86|13.86||
125|Q4044|Q4044 - CAST SUP LNG LEG SPLNT PED F|20.39|20.39||
125|Q4043|Q4043 - CAST SUP LNG LEG SPLNT PED P|11.95|11.95||
125|Q4042|Q4042 - CAST SUP LNG LEG SPLNT FBRGL|40.76|40.76||
125|Q4041|Q4041 - CAST SUP LNG LEG SPLNT PLSTR|23.88|23.88||
125|Q4040|Q4040 - CAST SUP SHRT LEG PED FBRGLS|24.59|24.59||
125|Q4039|Q4039 - CAST SUP SHRT LEG PED PLSTER|9.84|9.84||
125|Q4038|Q4038 - CAST SUP SHRT LEG FIBERGLASS|49.19|49.19||
125|Q4037|Q4037 - CAST SUP SHRT LEG PLASTER|19.62|19.62||
125|Q4036|Q4036 - CAST SUP LNGLEG CYLNDR PED F|40.04|40.04||
125|Q4035|Q4035 - CAST SUP LNGLEG CYLNDR PED P|16.09|16.09||
125|Q4034|Q4034 - CAST SUP LNG LEG CYLINDER FB|80.05|80.05||
125|Q4033|Q4033 - CAST SUP LNG LEG CYLINDER PL|32.2|32.2||
125|Q4032|Q4032 - CAST SUP LNG LEG PED FBRGLS|45.42|45.42||
125|Q4031|Q4031 - CAST SUP LNG LEG PED PLASTER|17.24|17.24||
125|Q4030|Q4030 - CAST SUP LONG LEG FIBERGLASS|90.85|90.85||
125|Q4029|Q4029 - CAST SUP LONG LEG PLASTER|34.51|34.51||
125|Q4028|Q4028 - CAST SUP HIP SPICA PED FBRGL|70.49|70.49||
125|Q4027|Q4027 - CAST SUP HIP SPICA PED PLSTR|22.57|22.57||
125|Q4026|Q4026 - CAST SUP HIP SPICA FIBERGLAS|140.9|140.9||
125|Q4025|Q4025 - CAST SUP HIP SPICA PLASTER|45.12|45.12||
125|Q4024|Q4024 - CAST SUP SHT ARM SPLNT PED F|7.27|7.27||
125|Q4023|Q4023 - CAST SUP SHT ARM SPLNT PED P|4.04|4.04||
125|Q4022|Q4022 - CAST SUP SHT ARM SPLINT FBRG|14.52|14.52||
125|Q4021|Q4021 - CAST SUP SHT ARM SPLINT PLST|8.05|8.05||
125|Q4020|Q4020 - CAST SUP LNG ARM SPLNT PED F|8.69|8.69||
125|Q4019|Q4019 - CAST SUP LNG ARM SPLNT PED P|5.45|5.45||
125|Q4018|Q4018 - CAST SUP LNG ARM SPLINT FBRG|17.33|17.33||
125|Q4017|Q4017 - CAST SUP LNG ARM SPLINT PLST|10.87|10.87||
125|Q4016|Q4016 - CAST SUP GAUNTLET PED FBRGLS|15.85|15.85||
125|Q4015|Q4015 - CAST SUP GAUNTLET PED PLSTER|9.42|9.42||
125|Q4014|Q4014 - CAST SUP GAUNTLET FIBERGLASS|31.72|31.72||
125|Q4013|Q4013 - CAST SUP GAUNTLET PLASTER|18.82|18.82||
125|Q4012|Q4012 - CAST SUP SHT ARM PED FBRGLAS|11.64|11.64||
125|Q4011|Q4011 - CAST SUP SHT ARM PED PLASTER|5.15|5.15||
125|Q4010|Q4010 - CAST SUP SHT ARM ADULT FBRGL|23.26|23.26||
125|Q4009|Q4009 - CAST SUP SHT ARM ADULT PLSTR|10.34|10.34||
125|Q4008|Q4008 - CAST SUP LONG ARM PED FBRGLS|17.42|17.42||
125|Q4007|Q4007 - CAST SUP LONG ARM PED PLSTER|7.74|7.74||
125|Q4006|Q4006 - CAST SUP LONG ARM ADULT FBRG|34.87|34.87||
125|Q4005|Q4005 - CAST SUP LONG ARM ADULT PLST|15.48|15.48||
125|Q4004|Q4004 - CAST SUP SHOULDER CAST FBRGL|145.32|145.32||
125|Q4003|Q4003 - CAST SUP SHOULDER CAST PLSTR|41.98|41.98||
125|Q4002|Q4002 - CAST SUP BODY CAST FIBERGLAS|220.9|220.9||
125|Q4001|Q4001 - CAST SUP BODY CAST PLASTER|58.46|58.46||
125|Q3031|Q3031 - COLLAGEN SKIN TEST|56.17|56.17||
125|Q3028|Q3028 - INJ BETA INTERFERON SQ 1 MCG|31.13|31.13||
125|Q3027|Q3027 - INJ BETA INTERFERON IM 1 MCG|81.78|81.78||
125|Q3014|Q3014 - TELEHEALTH FACILITY FEE|41.99|41.99||
125|Q3001|Q3001 - BRACHYTHERAPY RADIOELEMENTS|55.66|55.66||
125|Q2050|Q2050 - DOXORUBICIN INJ 10MG|613.14|613.14||
125|Q2049|Q2049 - IMPORTED LIPODOX INJ|573.3|573.3||
125|Q2043|Q2043 - SIPULEUCEL-T AUTO CD54+|68178.34|68178.34||
125|Q2039|Q2039 - INFLUENZA VIRUS VACCINE -  NOS|19.91|19.91||
125|Q2038|Q2038 - FLUZONE VACC -  3 YRS & > -  IM|15.22|15.22||
125|Q2037|Q2037 - FLUVIRIN VACC -  3 YRS & > -  IM|28.83|28.83||
125|Q2036|Q2036 - FLULAVAL VACC -  3 YRS & > -  IM|10.84|10.84||
125|Q2035|Q2035 - AFLURIA VACC -  3 YRS & > -  IM|28.83|28.83||
125|Q2034|Q2034 - AGRIFLU VACCINE|11.52|11.52||
125|Q2028|Q2028 - INJ -  SCULPTRA -  0.5 MG|0.78|0.78||
125|Q2026|Q2026 - RADIESSE INJECTION|38.26|38.26||
125|Q2017|Q2017 - TENIPOSIDE -  50 MG|2983.16|2983.16||
125|Q2009|Q2009 - FOSPHENYTOIN INJ PE|1.84|1.84||
125|Q2004|Q2004 - BLADDER CALCULI IRRIG SOL|105.83|105.83||
125|Q0515|Q0515 - SERMORELIN ACETATE INJECTION|1.79|1.79||
125|Q0514|Q0514 - DISP FEE INHAL DRUGS/90 DAYS|107.58|107.58||
125|Q0513|Q0513 - DISP FEE INHAL DRUGS/30 DAYS|53.79|53.79||
125|Q0512|Q0512 - PX SUP FEE ANTI-CAN SUB PRES|0.01|0.01||
125|Q0511|Q0511 - SUP FEE ANTIEM - ANTICA - IMMUNO|0.01|0.01||
125|Q0510|Q0510 - DISPENS FEE IMMUNOSUPRESSIVE|0.01|0.01||
125|Q0506|Q0506 - LITH-ION BATT ELEC/PNEUM VAD|991.21|991.21||
125|Q0504|Q0504 - PWR ADPT PNEUM VAD -  REP VEH|796.28|796.28||
125|Q0503|Q0503 - BATTERY PNEUM VAD REPLACEMNT|1509.08|1509.08||
125|Q0502|Q0502 - MOBILITY CART PNEUM VAD -  REP|754.52|754.52||
125|Q0501|Q0501 - SHWR COV ELEC/COMBO VAD -  REP|592.66|592.66||
125|Q0500|Q0500 - FILTERS ELEC/COMBO VAD -  REP|35.45|35.45||
125|Q0499|Q0499 - BELT/VEST ELEC/COMBO VAD REP|193.68|193.68||
125|Q0498|Q0498 - HOLSTER ELEC/COMBO VAD -  REP|596.09|596.09||
125|Q0497|Q0497 - BAT CLPS ELEC/COMB VAD -  REP|543.26|543.26||
125|Q0496|Q0496 - BATTERY ELEC/COMBO VAD -  REP|1739.87|1739.87||
125|Q0495|Q0495 - CHARGER ELEC/COMBO VAD -  REP|4847.54|4847.54||
125|Q0494|Q0494 - EMR HD PMP ELEC/COMBO -  REP|248.99|248.99||
125|Q0493|Q0493 - EMR PWR CBL COMBO VAD -  REP|294.22|294.22||
125|Q0492|Q0492 - EMR PWR CBL ELEC VAD -  REP|103.38|103.38||
125|Q0491|Q0491 - EMR PWR SOURCE COMBO VAD REP|1282.74|1282.74||
125|Q0490|Q0490 - EMR PWR SOURCE ELEC VAD -  REP|815.96|815.96||
125|Q0489|Q0489 - PWR PCK BASE COMBO VAD -  REP|18863.74|18863.74||
125|Q0488|Q0488 - PWR PACK BASE ELEC VAD -  REP|128.82|128.82||
125|Q0487|Q0487 - LEADS ANY TYPE VAD -  REP ONLY|396.14|396.14||
125|Q0486|Q0486 - MON CABLE ELEC/PNEUM VAD REP|339.54|339.54||
125|Q0485|Q0485 - MONITOR CABLE ELEC VAD -  REP|407.96|407.96||
125|Q0484|Q0484 - MONITOR ELEC OR COMB VAD REP|4225.51|4225.51||
125|Q0483|Q0483 - MONITOR ELEC VAD -  REP|21758.86|21758.86||
125|Q0482|Q0482 - MICROPRCSR CU COMBO VAD -  REP|5281.86|5281.86||
125|Q0481|Q0481 - MICROPRCSR CU ELEC VAD -  REP|16863.16|16863.16||
125|Q0480|Q0480 - DRIVER PNEUMATIC VAD -  REP|104520.36|104520.36||
125|Q0479|Q0479 - POWER MODULE COMBO VAD -  REP|14016.25|14016.25||
125|Q0478|Q0478 - POWER ADAPTER -  COMBO VAD|213.26|213.26||
125|Q0477|Q0477 - PWR MODULE PT CABLE LVAD RPL|83.54|83.54||
125|Q0180|Q0180 - DOLASETRON MESYLATE ORAL|114.16|114.16||
125|Q0177|Q0177 - HYDROXYZINE PAMOATE 25MG|0.29|0.29||
125|Q0175|Q0175 - PERPHENAZINE 4MG ORAL|2.38|2.38||
125|Q0174|Q0174 - THIETHYLPERAZINE MALEATE10MG|0.61|0.61||
125|Q0173|Q0173 - TRIMETHOBENZAMIDE HCL 250MG|0.35|0.35||
125|Q0169|Q0169 - PROMETHAZINE HCL 12.5MG ORAL|0.03|0.03||
125|Q0167|Q0167 - DRONABINOL 2.5MG ORAL|6.59|6.59||
125|Q0166|Q0166 - GRANISETRON HCL 1 MG ORAL|3.16|3.16||
125|Q0164|Q0164 - PROCHLORPERAZINE MALEATE 5MG|0.07|0.07||
125|Q0163|Q0163 - DIPHENHYDRAMINE HCL 50MG|0.44|0.44||
125|Q0162|Q0162 - ONDANSETRON ORAL|0.1|0.1||
125|Q0161|Q0161 - CHLORPROMAZINE HCL 5 MG ORAL|2.72|2.72||
125|Q0144|Q0144 - AZITHROMYCIN DIHYDRATE -  ORAL|29.02|29.02||
125|Q0139|Q0139 - FERUMOXYTOL -  ESRD USE|1.55|1.55||
125|Q0138|Q0138 - FERUMOXYTOL -  NON-ESRD|1.55|1.55||
125|Q0115|Q0115 - POST-COITAL MUCOUS EXAM|40.75|40.75||13.84
125|Q0114|Q0114 - FERN TEST|15.88|15.88||10.01
125|Q0113|Q0113 - PINWORM EXAMINATIONS|8.59|8.59||7.57
125|Q0112|Q0112 - POTASSIUM HYDROXIDE PREPS|9.5|9.5||5.98
125|Q0111|Q0111 - WET MOUNTS/ W PREPARATIONS|23.88|23.88||5.98
125|Q0092|Q0092 - SET UP PORT XRAY EQUIPMENT|38.08|38.08||
125|Q0091|Q0091 - OBTAINING SCREEN PAP SMEAR|69.06|69.06||
125|Q0085|Q0085 - CHEMO BY BOTH INFUSION AND O|175.42|175.42||
125|Q0084|Q0084 - CHEMOTHERAPY BY INFUSION|126.78|126.78||
125|Q0083|Q0083 - CHEMO BY OTHER THAN INFUSION|95.02|95.02||
125|Q0081|Q0081 - INFUSION THER OTHER THAN CHE|13.61|13.61||
125|Q0035|Q0035 - CARDIOKYMOGRAPHY|30.22|30.22||14.3
125|P9615|P9615 - URINE SPECIMEN COLLECT MULT|4.89|4.89||3.06
125|P9612|P9612 - CATHETERIZE FOR URINE SPEC|4.89|4.89||3.06
125|P9604|P9604 - ONE-WAY ALLOW PRORATED TRIP|16.3|16.3||10.04
125|P9603|P9603 - ONE-WAY ALLOW PRORATED MILES|1.63|1.63||1.01
125|P9060|P9060 - FR FRZ PLASMA DONOR RETESTED|20.52|20.52||4.1
125|P9059|P9059 - PLASMA -  FRZ BETWEEN 8-24HOUR|83.76|83.76||16.75
125|P9058|P9058 - RBC -  L/R -  CMV-NEG -  IRRAD|107.86|107.86||21.58
125|P9057|P9057 - RBC -  FRZ/DEG/WSH -  L/R -  IRRAD|813.12|813.12||162.62
125|P9056|P9056 - BLOOD -  L/R -  IRRADIATED|176.09|176.09||35.22
125|P9055|P9055 - PLT -  APH/PHER -  L/R -  CMV-NEG|275.56|275.56||55.12
125|P9054|P9054 - BLOOD -  L/R -  FROZ/DEGLY/WASH|206.35|206.35||41.27
125|P9053|P9053 - PLT -  PHER -  L/R CMV-NEG -  IRR|824.52|824.52||164.9
125|P9052|P9052 - PLATELETS -  HLA-M -  L/R -  UNIT|740.9|740.9||148.18
125|P9051|P9051 - BLOOD -  L/R -  CMV-NEG|303.82|303.82||60.77
125|P9050|P9050 - GRANULOCYTES -  PHERESIS UNIT|1168.52|1168.52||233.58
125|P9048|P9048 - PLASMAPROTEIN FRACT - 5% - 250ML|63.22|63.22||
125|P9047|P9047 - ALBUMIN (HUMAN) -  25% -  50ML|87.11|87.11||
125|P9046|P9046 - ALBUMIN (HUMAN) -  25% -  20 ML|36.66|36.66||
125|P9045|P9045 - ALBUMIN (HUMAN) -  5% -  250 ML|89.19|89.19||
125|P9044|P9044 - CRYOPRECIPITATEREDUCEDPLASMA|96.07|96.07||19.21
125|P9043|P9043 - PLASMA PROTEIN FRACT - 5% - 50ML|26.92|26.92||
125|P9041|P9041 - ALBUMIN (HUMAN) - 5% -  50ML|19.23|19.23||
125|P9040|P9040 - RBC LEUKOREDUCED IRRADIATED|405.46|405.46||81.1
125|P9039|P9039 - RBC DEGLYCEROLIZED|298.45|298.45||59.69
125|P9038|P9038 - RBC IRRADIATED|19.55|19.55||3.91
125|P9037|P9037 - PLATE PHERES LEUKOREDU IRRAD|1212.5|1212.5||242.5
125|P9036|P9036 - PLATELET PHERESIS IRRADIATED|702.05|702.05||140.41
125|P9035|P9035 - PLATELET PHERES LEUKOREDUCED|830.64|830.64||166.13
125|P9034|P9034 - PLATELETS -  PHERESIS|683.12|683.12||136.62
125|P9033|P9033 - PLATELETS LEUKOREDUCED IRRAD|515.38|515.38||103.08
125|P9032|P9032 - PLATELETS -  IRRADIATED|69.94|69.94||13.99
125|P9031|P9031 - PLATELETS LEUKOCYTES REDUCED|210.34|210.34||42.07
125|P9023|P9023 - FROZEN PLASMA -  POOLED -  SD|1.02|1.02||1.02
125|P9022|P9022 - WASHED RED BLOOD CELLS UNIT|248.59|248.59||49.72
125|P9021|P9021 - RED BLOOD CELLS UNIT|110.38|110.38||22.08
125|P9020|P9020 - PLAELET RICH PLASMA UNIT|350.77|350.77||70.15
125|P9019|P9019 - PLATELETS -  EACH UNIT|236.93|236.93||47.39
125|P9017|P9017 - PLASMA 1 DONOR FRZ W/IN 8 HR|97.43|97.43||19.49
125|P9016|P9016 - RBC LEUKOCYTES REDUCED|360.26|360.26||72.05
125|P9012|P9012 - CRYOPRECIPITATE EACH UNIT|11.52|11.52||2.3
125|P9011|P9011 - BLOOD SPLIT UNIT|60.23|60.23||60.23
125|P9010|P9010 - WHOLE BLOOD FOR TRANSFUSION|42.12|42.12||42.12
125|P7001|P7001 - CULTURE BACTERIAL URINE|17.77|17.77||17.77
125|P3001|P3001 - SCREENING PAP SMEAR BY PHYS|51.23|51.23||31.9
125|P3000|P3000 - SCREEN PAP BY TECH W MD SUPV|23.88|23.88||14.78
125|P2038|P2038 - BLOOD MUCOPROTEIN|9.96|9.96||7.04
125|P2033|P2033 - BLOOD THYMOL TURBIDITY|9.96|9.96||
125|P2031|P2031 - HAIR ANALYSIS|9.96|9.96||19.87
125|P2029|P2029 - CONGO RED BLOOD TEST|9.96|9.96||
125|P2028|P2028 - CEPHALIN FLOCULATION TEST|9.96|9.96||15.96
125|M0300|M0300 - IV CHELATIONTHERAPY|89.84|89.84||
125|M0100|M0100 - INTRAGASTRIC HYPOTHERMIA|6.84|6.84||
125|M0076|M0076 - PROLOTHERAPY|202.32|202.32||
125|L9900|L9900 - O&P SUPPLY/ACCESSORY/SERVICE|71.12|71.12||
125|L8696|L8696 - EXT ANTENNA PHREN NERVE STIM|188.66|188.66||
125|L8695|L8695 - EXTERNAL RECHARG SYS EXTERN|14.5|14.5||
125|L8694|L8694 - AOI TRANSDUCER/ACTUATOR REPL|831.02|831.02||
125|L8693|L8693 - AUD OSSEO DEV -  ABUTMENT|1319.78|1319.78||
125|L8692|L8692 - NON-OSSEOINTEGRATED SND PROC|2077.51|2077.51||
125|L8691|L8691 - AOI SND PROC REPL EXCL ACTUA|2320.92|2320.92||
125|L8690|L8690 - AUD OSSEO DEV -  INT/EXT COMP|4140.53|4140.53||
125|L8689|L8689 - EXTERNAL RECHARG SYS INTERN|1501.34|1501.34||
125|L8688|L8688 - IMPLT NROSTM PLS GEN DUA NON|4756.64|4756.64||
125|L8687|L8687 - IMPLT NROSTM PLS GEN DUA REC|7454.52|7454.52||
125|L8686|L8686 - IMPLT NROSTM PLS GEN SNG NON|3654.96|3654.96||
125|L8685|L8685 - IMPLT NROSTM PLS GEN SNG REC|5727.95|5727.95||
125|L8684|L8684 - RADIOF TRSMTR IMPLT SCRL NEU|599.78|599.78||
125|L8683|L8683 - RADIOFQ TRSMTR FOR IMPLT NEU|4567.42|4567.42||
125|L8682|L8682 - IMPLT NEUROSTIM RADIOFQ REC|5188.92|5188.92||
125|L8681|L8681 - PT PRGRM FOR IMPLT NEUROSTIM|983.06|983.06||
125|L8680|L8680 - IMPLT NEUROSTIM ELCTR EACH|201.23|201.23||
125|L8679|L8679 - IMP NEUROSTI PLS GN ANY TYPE|7262.5|7262.5||
125|L8670|L8670 - VASCULAR GRAFT -  SYNTHETIC|479.11|479.11||
125|L8659|L8659 - INTERPHALANGEAL JOINT REPL|1679.54|1679.54||
125|L8658|L8658 - INTERPHALANGEAL JOINT SPACER|269.99|269.99||
125|L8642|L8642 - HALLUX IMPLANT|258.35|258.35||
125|L8641|L8641 - METATARSAL JOINT IMPLANT|314.72|314.72||
125|L8631|L8631 - MCP JOINT REPL 2 PC OR MORE|1946.02|1946.02||
125|L8630|L8630 - METACARPOPHALANGEAL IMPLANT|289.97|289.97||
125|L8629|L8629 - CID TRANSMIT COIL AND CABLE|155.84|155.84||
125|L8628|L8628 - CID EXT CONTROLLER REPL|1076.75|1076.75||
125|L8627|L8627 - CID EXT SPEECH PROCESS REPL|5991.58|5991.58||
125|L8625|L8625 - CHARGER COCH IMPL/AOI BATTRY REP EA|166.2|166.2||
125|L8624|L8624 - LITH ION BATT CID -  EAR LEVEL|140.33|140.33||
125|L8623|L8623 - LITH ION BATT CID - NON-EARLVL|56.29|56.29||
125|L8622|L8622 - REPL ALKALINE BATTERY|0.28|0.28||
125|L8621|L8621 - REPL ZINC AIR BATTERY|0.53|0.53||
125|L8619|L8619 - COCH IMP EXT PROC/CONTR RPLC|7068.3|7068.3||
125|L8618|L8618 - COCH IMPLANT TRAN CABLE REPL|22.81|22.81||
125|L8617|L8617 - COCH IMPLANT TRANS COIL REPL|79.88|79.88||
125|L8616|L8616 - COCH IMPLANT MICROPHONE REPL|91.43|91.43||
125|L8615|L8615 - COCH IMPLANT HEADSET REPLACE|392.56|392.56||
125|L8614|L8614 - COCHLEAR DEVICE|16477.66|16477.66||
125|L8613|L8613 - OSSICULAR IMPLANT|260.33|260.33||
125|L8612|L8612 - AQUEOUS SHUNT PROSTHESIS|581.46|581.46||
125|L8610|L8610 - OCULAR IMPLANT|551.3|551.3||
125|L8609|L8609 - ARTIFICIAL CORNEA|5670.91|5670.91||
125|L8607|L8607 - INJ VOCAL CORD BULKING AGENT|37.34|37.34||
125|L8606|L8606 - SYNTHETIC IMPLNT URINARY 1ML|198.13|198.13||
125|L8605|L8605 - INJ BULKING AGENT ANAL CANAL|623.4|623.4||
125|L8604|L8604 - DEXTRANOMER/HYALURONIC ACID|2849.84|2849.84||
125|L8603|L8603 - COLLAGEN IMP URINARY 2.5 ML|377.46|377.46||
125|L8600|L8600 - IMPLANT BREAST SILICONE/EQ|537.46|537.46||
125|L8515|L8515 - GEL CAP APP DEVICE FOR TRACH|54.92|54.92||
125|L8514|L8514 - REPL TRACH PUNCTURE DILATOR|82.08|82.08||
125|L8513|L8513 - TRACH PROS CLEANING DEVICE|4.54|4.54||
125|L8512|L8512 - GEL CAP FOR TRACH VOICE PROS|1.91|1.91||
125|L8511|L8511 - INDWELLING TRACH INSERT|63.31|63.31||
125|L8510|L8510 - VOICE AMPLIFIER|219.96|219.96||
125|L8509|L8509 - TRACH-ESOPH VOICE PROS MD IN|95.06|95.06||
125|L8507|L8507 - TRACH-ESOPH VOICE PROS PT IN|36.46|36.46||
125|L8505|L8505 - ARTIFICIAL LARYNX -  ACCESSORY|2.87|2.87||
125|L8501|L8501 - TRACHEOSTOMY SPEAKING VALVE|126.16|126.16||
125|L8500|L8500 - ARTIFICIAL LARYNX|568.02|568.02||
125|L8485|L8485 - PROS SOCK SINGLE PLY UPPER L|9.58|9.58||
125|L8480|L8480 - PROS SOCK SINGLE PLY AK|7.92|7.92||
125|L8470|L8470 - PROS SOCK SINGLE PLY BK|5.75|5.75||
125|L8465|L8465 - SHRINKER UPPER LIMB|55.98|55.98||
125|L8460|L8460 - SHRINKER ABOVE KNEE|62.81|62.81||
125|L8440|L8440 - SHRINKER BELOW KNEE|45.13|45.13||
125|L8435|L8435 - PROS SOCK MULTI PLY UPPER LM|21.29|21.29||
125|L8430|L8430 - PROSTHETIC SOCK MULTI PLY AK|23.71|23.71||
125|L8420|L8420 - PROSTHETIC SOCK MULTI PLY BK|21.58|21.58||
125|L8417|L8417 - PROS SHEATH/SOCK W GEL CUSHN|65.45|65.45||
125|L8415|L8415 - SHEATH UPPER LIMB|18.46|18.46||
125|L8410|L8410 - SHEATH ABOVE KNEE|18.56|18.56||
125|L8400|L8400 - SHEATH BELOW KNEE|16.32|16.32||
125|L8330|L8330 - TRUSS ADD TO STD PAD SCROTAL|55.8|55.8||
125|L8320|L8320 - TRUSS ADDITION TO STD PAD WA|56.29|56.29||
125|L8310|L8310 - TRUSS DOUBLE W/ STANDARD PAD|128.89|128.89||
125|L8300|L8300 - TRUSS SINGLE W/ STANDARD PAD|83.83|83.83||
125|L8049|L8049 - REPAIR MAXILLOFACIAL PROSTH|34.03|34.03||
125|L8047|L8047 - NASAL SEPTAL PROSTHESIS|1168.15|1168.15||573.22
125|L8046|L8046 - PARTIAL FACIAL PROSTHESIS|2279.36|2279.36||1118.47
125|L8045|L8045 - AURICULAR PROSTHESIS|2212.48|2212.48||1140.73
125|L8044|L8044 - HEMI-FACIAL PROSTHESIS|3533|3533||1733.62
125|L8043|L8043 - UPPER FACIAL PROSTHESIS|3191.11|3191.11||1565.86
125|L8042|L8042 - ORBITAL PROSTHESIS|2849.21|2849.21||1398.08
125|L8041|L8041 - MIDFACIAL PROSTHESIS|2535.8|2535.8||1244.29
125|L8040|L8040 - NASAL PROSTHESIS|2103.86|2103.86||1032.32
125|L8039|L8039 - BREAST PROSTHESIS NOS|107.35|107.35||
125|L8035|L8035 - CUSTOM BREAST PROSTHESIS|3188.75|3188.75||
125|L8032|L8032 - REUSABLE NIPPLE PROSTHESIS|34.09|34.09||
125|L8031|L8031 - BREAST PROSTHESIS W ADHESIVE|283.82|283.82||
125|L8030|L8030 - BREAST PROSTHES W/O ADHESIVE|283.82|283.82||
125|L8020|L8020 - MASTECTOMY FORM|196.22|196.22||
125|L8015|L8015 - EXT BREASTPROSTHESIS GARMENT|52.16|52.16||
125|L8010|L8010 - MASTECTOMY SLEEVE|24.1|24.1||
125|L8002|L8002 - BRST PRSTH BRA & BILAT FORM|143.6|143.6||
125|L8001|L8001 - BREAST PROSTHESIS BRA & FORM|109.18|109.18||
125|L8000|L8000 - MASTECTOMY BRA|37.86|37.86||
125|L7902|L7902 - TENSION RING -  VAC ERECT DEV|17.24|17.24||
125|L7900|L7900 - MALE VACUUM ERECTION SYSTEM|232.3|232.3||
125|L7700|L7700 - PROS SOC INSERT GASKET/SEAL|98.21|98.21||
125|L7600|L7600 - PROSTHETIC DONNING SLEEVE|58.22|58.22||
125|L7520|L7520 - REPAIR PROSTHESIS PER 15 MIN|18.28|18.28||
125|L7510|L7510 - PROSTHETIC DEVICE REPAIR REP|142.09|142.09||
125|L7405|L7405 - ADD UE PROST S/D ACRYLIC|632.69|632.69||
125|L7404|L7404 - ADD UE PROST A/E ACRYLIC|483.76|483.76||
125|L7403|L7403 - ADD UE PROST B/E ACRYLIC|320.54|320.54||
125|L7402|L7402 - ADD UE PROST S/D ULTLITE MAT|322.48|322.48||
125|L7401|L7401 - ADD UE PROST A/E ULTLITE MAT|298.64|298.64||
125|L7400|L7400 - ADD UE PROST BE/WD -  ULTLITE|266.77|266.77||
125|L7368|L7368 - LITHIUM ION BATTERY CHARGER|439.27|439.27||
125|L7367|L7367 - REPLACEMNT LITHIUM IONBATTER|338.86|338.86||
125|L7366|L7366 - BATTERY CHRGR 12 VOLT UTAH/E|461.99|461.99||
125|L7364|L7364 - TWELVE VOLT BATTERY UTAH/EQU|342.96|342.96||
125|L7362|L7362 - BATTERY CHRGR SIX VOLT OTTO|215.64|215.64||
125|L7360|L7360 - SIX VOLT BAT OTTO BOCK/EQ EA|205.37|205.37||
125|L7259|L7259 - ELECTRONIC WRIST ROTATOR ANY|2750.69|2750.69||
125|L7191|L7191 - ELBOW CHILD MYOELECTRONIC CT|7955.41|7955.41||
125|L7190|L7190 - ELBOW ADOLESCENT MYOELECTRON|6643.86|6643.86||
125|L7186|L7186 - ELECTRON ELBOW CHILD SWITCH|7613.27|7613.27||
125|L7185|L7185 - ELECTRON ELBOW ADOLESCENT SW|6325.44|6325.44||
125|L7181|L7181 - ELECTRONIC ELBO SIMULTANEOUS|34874.38|34874.38||
125|L7180|L7180 - ELECTRONIC ELBOW SEQUENTIAL|28116.2|28116.2||
125|L7170|L7170 - ELECTRONIC ELBOW HOSMER SWIT|6405.42|6405.42||
125|L7045|L7045 - PEDIATRIC ELECTRIC HOOK|1391.16|1391.16||
125|L7040|L7040 - PREHENSILE ACTUATOR|2426.44|2426.44||
125|L7009|L7009 - ADULT ELECTRIC HOOK|3021.86|3021.86||
125|L7008|L7008 - PEDIATRIC ELECTRIC HAND|4661.38|4661.38||
125|L7007|L7007 - ADULT ELECTRIC HAND|2961.68|2961.68||
125|L6975|L6975 - INTERSCAP-THOR MYOELECTRONIC|14153.12|14153.12||
125|L6970|L6970 - INTERSCAPULAR-THOR SWITCH CT|12940.86|12940.86||
125|L6965|L6965 - SHLDR DISARTIC MYOELECTRONIC|12419.05|12419.05||
125|L6960|L6960 - SHLDR DISARTIC SWITCH CONTRO|11644.3|11644.3||
125|L6955|L6955 - ABOVE ELBOW MYOELECTRONIC CT|10279.66|10279.66||
125|L6950|L6950 - ABOVE ELBOW SWITCH CONTROL|8583.29|8583.29||
125|L6945|L6945 - ELBOW DISART MYOELECTRONIC C|9226.97|9226.97||
125|L6940|L6940 - ELBOW DISARTICULATION SWITCH|7551.46|7551.46||
125|L6935|L6935 - BELOW ELBOW MYOELECTRONIC CT|7852.42|7852.42||
125|L6930|L6930 - BELOW ELBOW SWITCH CONTROL|5779.62|5779.62||
125|L6925|L6925 - WRIST DISART MYOELECTRONIC C|7732.43|7732.43||
125|L6920|L6920 - WRIST DISARTICUL SWITCH CTRL|5744|5744||
125|L6915|L6915 - HAND RESTORATION REPLACMNT G|658.82|658.82||
125|L6910|L6910 - HAND RESTORATION NO FINGERS|1306.69|1306.69||
125|L6905|L6905 - HAND RESTORATION MULTIPLE FI|1528.12|1528.12||
125|L6900|L6900 - HAND RESTORAT THUMB/1 FINGER|1536.86|1536.86||
125|L6895|L6895 - CUSTOM GLOVE FOR TERM DEVICE|538.55|538.55||
125|L6890|L6890 - PREFAB GLOVE FOR TERM DEVICE|146.4|146.4||
125|L6885|L6885 - REPLC SOCKT SHLDR DIS/INTERC|3031.91|3031.91||
125|L6884|L6884 - REPLC SOCKT ABOVE ELBOW DISA|2027.15|2027.15||
125|L6883|L6883 - REPLC SOCKT BELOW E/W DISA|1365.82|1365.82||
125|L6882|L6882 - MICROPROCESSOR CONTROL UPLMB|2699.17|2699.17||
125|L6881|L6881 - TERM DEV AUTO GRASP FEATURE|3558.3|3558.3||
125|L6880|L6880 - ELEC HAND IND ART DIGITS|20795.54|20795.54||
125|L6810|L6810 - TERM DEV PRECISION PINCH DEV|165.98|165.98||
125|L6805|L6805 - TERM DEV MODIFIER WRIST UNIT|292.84|292.84||
125|L6722|L6722 - HOOK/HAND -  HVY DTY -  VOL CLOS|1764.74|1764.74||
125|L6721|L6721 - HOOK/HAND -  HVY DTY -  VOL OPEN|2047.12|2047.12||
125|L6715|L6715 - TERM DEVICE -  MULTI ART DIGIT|2747.92|2747.92||
125|L6714|L6714 - PED TERM DEV -  HAND -  VOL CLOS|1151.76|1151.76||
125|L6713|L6713 - PED TERM DEV -  HAND -  VOL OPEN|1359.78|1359.78||
125|L6712|L6712 - PED TERM DEV -  HOOK -  VOL CLOS|1077.42|1077.42||
125|L6711|L6711 - PED TERM DEV -  HOOK -  VOL OPEN|585.17|585.17||
125|L6709|L6709 - TERM DEV MECH HAND VOL CLOSE|1042.76|1042.76||
125|L6708|L6708 - TERM DEV MECH HAND VOL OPEN|723.62|723.62||
125|L6707|L6707 - TERM DEV MECH HOOK VOL CLOSE|1106.9|1106.9||
125|L6706|L6706 - TERM DEV MECH HOOK VOL OPEN|300.31|300.31||
125|L6704|L6704 - TERM DEV -  SPORT/REC/WORK ATT|504.06|504.06||
125|L6703|L6703 - TERM DEV -  PASSIVE HAND MITT|312.9|312.9||
125|L6698|L6698 - BELOW/ABOVE ELBOW LOCK MECH|494.92|494.92||
125|L6697|L6697 - CUS ELBO SKT IN NOT CON/ATYP|1144.9|1144.9||
125|L6696|L6696 - CUS ELBO SKT IN FOR CON/ATYP|1144.9|1144.9||
125|L6695|L6695 - ELBOW SOCKET INS USE W/O LCK|509.98|509.98||
125|L6694|L6694 - ELBOW SOCKET INS USE W/LOCK|612|612||
125|L6693|L6693 - LOCKINGELBOW FOREARM CNTRBAL|2470.99|2470.99||
125|L6692|L6692 - SILICONE GEL INSERT OR EQUAL|481.32|481.32||
125|L6691|L6691 - REMOVABLE INSERT EACH|298.2|298.2||
125|L6690|L6690 - FRAME TYP SOCK INTERSCAP-THO|644.28|644.28||
125|L6689|L6689 - FRAME TYP SOCKET SHOULDER DI|591.23|591.23||
125|L6688|L6688 - FRAME TYP SOCK ABOVE ELB/DIS|493.46|493.46||
125|L6687|L6687 - FRAME TYP SOCKET BEL ELBOW/W|496.46|496.46||
125|L6686|L6686 - SUCTION SOCKET|677.5|677.5||
125|L6684|L6684 - TEST SOCKET SHLDR DISART/THO|300.01|300.01||
125|L6682|L6682 - TEST SOCK ELBW DISART/ABOVE|220.78|220.78||
125|L6680|L6680 - TEST SOCK WRIST DISART/BEL E|199.68|199.68||
125|L6677|L6677 - UE TRIPLE CONTROL HARNESS|258.23|258.23||
125|L6676|L6676 - HARNESS FIGURE OF 8 DUAL CON|119.47|119.47||
125|L6675|L6675 - HARNESS FIGURE OF 8 SING CON|103.37|103.37||
125|L6672|L6672 - HARNESS CHEST/SHLDER SADDLE|173.93|173.93||
125|L6670|L6670 - HOOK TO HAND CABLE ADAPTER|43.84|43.84||
125|L6665|L6665 - TEFLON OR EQUAL CABLE LINING|39.64|39.64||
125|L6660|L6660 - HEAVY DUTY CONTROL CABLE|79.01|79.01||
125|L6655|L6655 - STANDARD CONTROL CABLE EXTRA|70.49|70.49||
125|L6650|L6650 - SHOULDER UNIVERSAL JOINT|358.67|358.67||
125|L6648|L6648 - EXT PWRD SHLDER LOCK/UNLOCK|2831.24|2831.24||
125|L6647|L6647 - SHOULDER LOCK ACTUATOR|451.93|451.93||
125|L6646|L6646 - MULTIPO LOCKING SHOULDER JNT|2745.17|2745.17||
125|L6645|L6645 - SHOULDER FLEXION-ABDUCTION J|345.46|345.46||
125|L6642|L6642 - EXCURSION AMPLIFIER LEVER TY|187.15|187.15||
125|L6641|L6641 - EXCURSION AMPLIFIER PULLEY T|138.07|138.07||
125|L6640|L6640 - SHOULDER ABDUCTION JOINT PAI|287.26|287.26||
125|L6638|L6638 - ELEC LOCK ON MANUAL PW ELBOW|2176.58|2176.58||
125|L6637|L6637 - NUDGE CONTROL ELBOW LOCK|323.34|323.34||
125|L6635|L6635 - LIFT ASSIST FOR ELBOW|151.6|151.6||
125|L6632|L6632 - LATEX SUSPENSION SLEEVE EACH|64.43|64.43||
125|L6630|L6630 - STAINLESS STEEL ANY WRIST|185.5|185.5||
125|L6629|L6629 - LAMINATION COLLAR W/ COUPLIN|125.92|125.92||
125|L6628|L6628 - QUICK DISCONN HOOK ADAPTER O|412.31|412.31||
125|L6625|L6625 - ROTATION WRST W/ CABLE LOCK|523.03|523.03||
125|L6624|L6624 - FLEX/EXT/ROTATION WRIST UNIT|3277.9|3277.9||
125|L6623|L6623 - SPRING-ASS ROT WRST W/ LATCH|736.13|736.13||
125|L6621|L6621 - FLEX/EXT WRIST W/WO FRICTION|1990.79|1990.79||
125|L6620|L6620 - FLEXION/EXTENSION WRIST UNIT|263.9|263.9||
125|L6616|L6616 - DISCONNECT INSERT LOCKING WR|61.12|61.12||
125|L6615|L6615 - DISCONNECT LOCKING WRIST UNI|164.94|164.94||
125|L6611|L6611 - ADDITIONAL SWITCH -  EXT POWER|358.33|358.33||
125|L6610|L6610 - FLEXIBLE METAL HINGE PAIR|153.08|153.08||
125|L6605|L6605 - SINGLE PIVOT HINGE PAIR|159.41|159.41||
125|L6600|L6600 - POLYCENTRIC HINGE PAIR|161.45|161.45||
125|L6590|L6590 - SHDR FAIR LEAD CABLE DIRECT|2386.06|2386.06||
125|L6588|L6588 - SHDR FAIR LEAD CABLE MOLDED|2512.06|2512.06||
125|L6586|L6586 - ELBOW FAIR LEAD CABLE DIR FO|1911.8|1911.8||
125|L6584|L6584 - ELBOW FAIR LEAD CABLE MOLDED|2042.87|2042.87||
125|L6582|L6582 - WRIST/ELBOW BOWDEN CBL DIR F|1302.64|1302.64||
125|L6580|L6580 - WRIST/ELBOW BOWDEN CABLE MOL|1438.21|1438.21||
125|L6570|L6570 - SCAP THORAC PROSTH TISS SHAP|3767.12|3767.12||
125|L6550|L6550 - SHLDR DISAR PROSTH TISS SHAP|3355.33|3355.33||
125|L6500|L6500 - ABOVE ELBOW PROSTH TISS SHAP|2791.42|2791.42||
125|L6450|L6450 - ELB DISART PROSTH TISS SHAP|2668.13|2668.13||
125|L6400|L6400 - BELOW ELBOW PROSTH TISS SHAP|1997.14|1997.14||
125|L6388|L6388 - POSTOP APPLICAT RIGID DSG ON|378.38|378.38||
125|L6386|L6386 - POSTOP EA CAST CHG & REALIGN|345.64|345.64||
125|L6384|L6384 - POSTOP DSG CAST CHG SHLDER/T|2188|2188||
125|L6382|L6382 - POSTOP DSG CAST CHG ELB DIS/|1581.61|1581.61||
125|L6380|L6380 - POSTOP DSG CAST CHG WRST/ELB|1051.3|1051.3||
125|L6370|L6370 - THORACIC PASSIVE RESTOR CAP|1814.21|1814.21||
125|L6360|L6360 - THORACIC PASSIVE RESTOR COMP|3031.91|3031.91||
125|L6350|L6350 - THORACIC INTERN LOCK ELBOW|3371.26|3371.26||
125|L6320|L6320 - SHOULDER PASSIVE RESTOR CAP|1512.5|1512.5||
125|L6310|L6310 - SHOULDER PASSIVE RESTOR COMP|2768.76|2768.76||
125|L6300|L6300 - SHLDER DISART INT LOCK ELBOW|3206.62|3206.62||
125|L6250|L6250 - ELBOW INTER LOC ELBOW FORARM|2460.19|2460.19||
125|L6205|L6205 - ELBOW MOLDED W/ EXPAND INTER|3134.26|3134.26||
125|L6200|L6200 - ELBOW MOLD OUTSID LOCK HINGE|2348.03|2348.03||
125|L6130|L6130 - ELBOW STUMP ACTIVATED LOCK H|2228.08|2228.08||
125|L6120|L6120 - ELBOW MOLD DOUB SPLT SOC STE|2047.52|2047.52||
125|L6110|L6110 - ELBOW MOLD SOCK SUSPENSION T|1756.98|1756.98||
125|L6100|L6100 - ELB MOLD SOCK FLEX HINGE PAD|1656.49|1656.49||
125|L6055|L6055 - WRST MOLD SOCK W/EXP INTERFA|2278.75|2278.75||
125|L6050|L6050 - WRST MLD SCK FLX HNG TRI PAD|1634.98|1634.98||
125|L6026|L6026 - PART HAND MYO EXCLU TERM DEV|4302.52|4302.52||
125|L6020|L6020 - PART HAND NO FINGERS|1186.52|1186.52||
125|L6010|L6010 - PART HAND LITTLE/RING|1272.62|1272.62||
125|L6000|L6000 - PART HAND THUMB REM|1143.59|1143.59||
125|L5990|L5990 - USER ADJUSTABLE HEEL HEIGHT|1579.06|1579.06||
125|L5988|L5988 - VERTICAL SHOCK REDUCING PYLO|1738.75|1738.75||
125|L5987|L5987 - SHANK FT W VERT LOAD PYLON|6261.29|6261.29||
125|L5986|L5986 - MULTI-AXIAL ROTATION UNIT|545.41|545.41||
125|L5985|L5985 - LWR EXT DYNAMIC PROSTH PYLON|245.78|245.78||
125|L5984|L5984 - ENDOSKELETAL AXIAL ROTATION|490.31|490.31||
125|L5982|L5982 - EXOSKELETAL AXIAL ROTATION U|497.58|497.58||
125|L5981|L5981 - FLEX-WALK SYS LOW EXT PROSTH|2578.04|2578.04||
125|L5980|L5980 - FLEX FOOT SYSTEM|3191.18|3191.18||
125|L5979|L5979 - MULTI-AXIAL ANKLE/FT PROSTH|1963.88|1963.88||
125|L5978|L5978 - FT PROSTH MULTIAXIAL ANKL/FT|251.17|251.17||
125|L5976|L5976 - ENERGY STORING FOOT|482|482||
125|L5975|L5975 - COMBO ANKLE/FOOT PROSTHESIS|403.52|403.52||
125|L5974|L5974 - FOOT SINGLE AXIS ANKLE/FOOT|200.57|200.57||
125|L5973|L5973 - ANK-FOOT SYS DORS-PLANT FLEX|14974.6|14974.6||
125|L5972|L5972 - FLEXIBLE KEEL FOOT|326.51|326.51||
125|L5971|L5971 - SACH FOOT -  REPLACEMENT|174.8|174.8||
125|L5970|L5970 - FOOT EXTERNAL KEEL SACH FOOT|174.8|174.8||
125|L5968|L5968 - MULTIAXIAL ANKLE W DORSIFLEX|3162.9|3162.9||
125|L5966|L5966 - HIP FLEXIBLE COVER SYSTEM|1027.1|1027.1||
125|L5964|L5964 - ABOVE KNEE FLEX COVER SYSTEM|806.06|806.06||
125|L5962|L5962 - BELOW KNEE FLEX COVER SYSTEM|546.06|546.06||
125|L5961|L5961 - ENDO POLY HIP -  PNEU/HYD/ROT|3956.53|3956.53||
125|L5960|L5960 - ENDO HIP ULTRA-LIGHT MATERIA|829.74|829.74||
125|L5950|L5950 - ENDO AK ULTRA-LIGHT MATERIAL|675.04|675.04||
125|L5940|L5940 - ENDO BK ULTRA-LIGHT MATERIAL|431.74|431.74||
125|L5930|L5930 - HIGH ACTIVITY KNEE FRAME|2929.6|2929.6||
125|L5925|L5925 - ABOVE KNEE MANUAL LOCK|385.6|385.6||
125|L5920|L5920 - ENDO AK/HIP ALIGNABLE SYSTEM|456.68|456.68||
125|L5910|L5910 - ENDO BELOW KNEE ALIGNABLE SY|311.71|311.71||
125|L5859|L5859 - KNEE-SHIN PRO FLEX/EXT CONT|12628.61|12628.61||
125|L5858|L5858 - STANCE PHASE ONLY|16176.18|16176.18||
125|L5857|L5857 - ELEC KNEE-SHIN SWING ONLY|7414.02|7414.02||
125|L5856|L5856 - ELEC KNEE-SHIN SWING/STANCE|20894.2|20894.2||
125|L5855|L5855 - MECH HIP EXTENSION ASSIST|295.86|295.86||
125|L5850|L5850 - ENDO AK/HIP KNEE EXTENS ASSI|110.11|110.11||
125|L5848|L5848 - KNEE-SHIN SYS HYDRAUL STANCE|935.92|935.92||
125|L5845|L5845 - KNEE-SHIN SYS STANCE FLEXION|1560.06|1560.06||
125|L5840|L5840 - MULTI-AXIAL KNEE/SHIN SYSTEM|3019.78|3019.78||
125|L5830|L5830 - ENDO KNEE-SHIN PNEUM/SWG PHA|1633.19|1633.19||
125|L5828|L5828 - ENDO KNEE-SHIN FLUID SWG/STA|2430.53|2430.53||
125|L5826|L5826 - MINIATURE KNEE JOINT|2718.1|2718.1||
125|L5824|L5824 - ENDO KNEE-SHIN FLUID SWING P|1319.93|1319.93||
125|L5822|L5822 - ENDO KNEE-SHIN PNEUM SWG FRC|1465.67|1465.67||
125|L5818|L5818 - ENDO KNEE-SHIN FRCT SWG & ST|826.54|826.54||
125|L5816|L5816 - ENDO KNEE-SHIN POLYC MCH STA|736.38|736.38||
125|L5814|L5814 - ENDO KNEE-SHIN HYDRAL SWG PH|3232.48|3232.48||
125|L5812|L5812 - ENDO KNEE-SHIN FRCT SWG & ST|486.55|486.55||
125|L5811|L5811 - ENDO KNEE-SHIN MNL LCK ULTRA|627.72|627.72||
125|L5810|L5810 - ENDOSKEL KNEE-SHIN MNL LOCK|419.04|419.04||
125|L5795|L5795 - EXOSKEL HIP ULTRA-LIGHT MATE|1232.15|1232.15||
125|L5790|L5790 - EXOSKELETAL AK ULTRA-LIGHT M|618.86|618.86||
125|L5785|L5785 - EXOSKELETAL BK ULTRALT MATER|553.92|553.92||
125|L5782|L5782 - HD LOW LIMB PROS VACUUM PUMP|3671.4|3671.4||
125|L5781|L5781 - LOWER LIMB PROS VACUUM PUMP|3482.54|3482.54||
125|L5780|L5780 - KNEE-SHIN PNEUM/HYDRA PNEUM|985.42|985.42||
125|L5728|L5728 - KNEE-SHIN FLUID SWG & STANCE|2048|2048||
125|L5726|L5726 - KNEE-SHIN EXT JNTS FLD SWG E|1497.23|1497.23||
125|L5724|L5724 - KNEE-SHIN EXO FLUID SWING PH|1299.13|1299.13||
125|L5722|L5722 - KNEE-SHIN PNEUM SWG FRCT EXO|828.34|828.34||
125|L5718|L5718 - KNEE-SHIN EXO FRCT SWG & STA|784.07|784.07||
125|L5716|L5716 - KNEE-SHIN EXO MECH STANCE PH|627.3|627.3||
125|L5714|L5714 - KNEE-SHIN EXO VARIABLE FRICT|387.18|387.18||
125|L5712|L5712 - KNEE-SHIN EXO FRICT SWG & ST|376.94|376.94||
125|L5711|L5711 - KNEE-SHIN EXO MNL LOCK ULTRA|449.87|449.87||
125|L5710|L5710 - KNE-SHIN EXO SNG AXI MNL LOC|321.89|321.89||
125|L5707|L5707 - CUSTOM SHAPE CVR HIP DISART|1065.3|1065.3||
125|L5706|L5706 - CUSTOM SHAPE CVR KNEE DISART|808.06|808.06||
125|L5705|L5705 - CUSTOM SHAPE COVER AK|824.34|824.34||
125|L5704|L5704 - CUSTOM SHAPE COVER BK|461.34|461.34||
125|L5703|L5703 - SYMES ANKLE W/O (SACH) FOOT|1938.98|1938.98||
125|L5702|L5702 - REPLACE SOCKET HIP|3746.76|3746.76||
125|L5701|L5701 - REPLACE SOCKET ABOVE KNEE|2961.53|2961.53||
125|L5700|L5700 - REPLACE SOCKET BELOW KNEE|2466.04|2466.04||
125|L5699|L5699 - SHOULDER HARNESS|203.53|203.53||
125|L5698|L5698 - AK/KNEE DISARTIC SILESIAN BA|112.99|112.99||
125|L5697|L5697 - AK/KNEE DISARTIC PELVIC BAND|69.1|69.1||
125|L5696|L5696 - AK/KNEE DISARTIC PELVIC JOIN|159.25|159.25||
125|L5695|L5695 - AK SLEEVE SUSP NEOPRENE/EQUA|144.14|144.14||
125|L5694|L5694 - AK PELVIC CONTROL BELT PAD/L|156.14|156.14||
125|L5692|L5692 - AK PELVIC CONTROL BELT LIGHT|114.37|114.37||
125|L5690|L5690 - BK WAIST BELT PADDED AND LIN|84.23|84.23||
125|L5688|L5688 - BK WAIST BELT WEBBING|52.58|52.58||
125|L5686|L5686 - BK BACK CHECK|43.97|43.97||
125|L5685|L5685 - BELOW KNEE SUS/SEAL SLEEVE|111.48|111.48||
125|L5684|L5684 - BK FORK STRAP|41.42|41.42||
125|L5683|L5683 - INITIAL CUSTOM SOCKET INSERT|1144.9|1144.9||
125|L5682|L5682 - BK THIGH LACER GLUT/ISCHIA M|538.26|538.26||
125|L5681|L5681 - INTL CUSTM CONG/LATYP INSERT|1144.9|1144.9||
125|L5680|L5680 - BK THIGH LACER NON-MOLDED|285.28|285.28||
125|L5679|L5679 - SOCKET INSERT W/O LOCK MECH|509.98|509.98||
125|L5678|L5678 - BK JOINT COVERS PAIR|34.18|34.18||
125|L5677|L5677 - BK KNEE JOINTS POLYCENTRIC P|424.37|424.37||
125|L5676|L5676 - BK KNEE JOINTS SINGLE AXIS P|311.89|311.89||
125|L5673|L5673 - SOCKET INSERT W LOCK MECH|612|612||
125|L5672|L5672 - BK REMOVABLE MEDIAL BRIM SUS|256.64|256.64||
125|L5671|L5671 - BK/AK LOCKING MECHANISM|494.92|494.92||
125|L5670|L5670 - BK MOLDED SUPRACONDYLAR SUSP|233.56|233.56||
125|L5668|L5668 - BK MOLDED DISTAL CUSHION|97.18|97.18||
125|L5666|L5666 - BELOW KNEE CUFF SUSPENSION|60.25|60.25||
125|L5665|L5665 - MULTI-DUROMETER BELOW KNEE|440.7|440.7||
125|L5661|L5661 - MULTI-DUROMETER SYMES|523.76|523.76||
125|L5658|L5658 - SOCKET INSERT ABOVE KNEE|312.95|312.95||
125|L5656|L5656 - SOCKET INSERT KNEE ARTICULAT|324.49|324.49||
125|L5655|L5655 - SOCKET INSERT BELOW KNEE|241.9|241.9||
125|L5654|L5654 - SOCKET INSERT SYMES|285.44|285.44||
125|L5653|L5653 - KNEE DISART EXPAND WALL SOCK|500.92|500.92||
125|L5652|L5652 - SUCTION SUSP AK/KNEE DISART|375.25|375.25||
125|L5651|L5651 - AK FLEX INNER SOCKET EXT FRA|1033.62|1033.62||
125|L5650|L5650 - TOT CONTACT AK/KNEE DISART S|420.18|420.18||
125|L5649|L5649 - ISCH CONTAINMT/NARROW M-L SO|2053.32|2053.32||
125|L5648|L5648 - ABOVE KNEE CUSHION SOCKET|566.66|566.66||
125|L5647|L5647 - BELOW KNEE SUCTION SOCKET|684.64|684.64||
125|L5646|L5646 - BELOW KNEE CUSHION SOCKET|471.59|471.59||
125|L5645|L5645 - BK FLEX INNER SOCKET EXT FRA|686.74|686.74||
125|L5644|L5644 - ABOVE KNEE WOOD SOCKET|508.36|508.36||
125|L5643|L5643 - HIP FLEX INNER SOCKET EXT FR|1339.61|1339.61||
125|L5642|L5642 - ABOVE KNEE LEATHER SOCKET|533.26|533.26||
125|L5640|L5640 - KNEE DISARTICULAT LEATHER SO|550.36|550.36||
125|L5639|L5639 - BELOW KNEE WOOD SOCKET|964.99|964.99||
125|L5638|L5638 - BELOW KNEE LEATHER SOCKET|433.14|433.14||
125|L5637|L5637 - BELOW KNEE TOTAL CONTACT|248.64|248.64||
125|L5636|L5636 - SYMES TYPE MEDIAL OPENING SO|219.3|219.3||
125|L5634|L5634 - SYMES TYPE POSTER OPENING SO|261.82|261.82||
125|L5632|L5632 - SYMES TYPE PTB BRIM DESIGN S|211.06|211.06||
125|L5631|L5631 - AK/KNEE DISARTIC ACRYLIC SOC|378.17|378.17||
125|L5630|L5630 - SYME TYP EXPANDABL WALL SCKT|386.27|386.27||
125|L5629|L5629 - BELOW KNEE ACRYLIC SOCKET|273.53|273.53||
125|L5628|L5628 - TEST SOCKET HEMIPELVECTOMY|438.79|438.79||
125|L5626|L5626 - TEST SOCKET HIP DISARTICULAT|410.36|410.36||
125|L5624|L5624 - TEST SOCKET ABOVE KNEE|312.9|312.9||
125|L5622|L5622 - TEST SOCKET KNEE DISARTICULA|312.02|312.02||
125|L5620|L5620 - TEST SOCKET BELOW KNEE|239.28|239.28||
125|L5618|L5618 - TEST SOCKET SYMES|257.63|257.63||
125|L5617|L5617 - AK/BK SELF-ALIGNING UNIT EA|486.98|486.98||
125|L5616|L5616 - AK UNIV MULTIPLEX SYS FRICT|1171.62|1171.62||
125|L5614|L5614 - 4-BAR LINK ABOVE KNEE W/SWNG|1468.73|1468.73||
125|L5613|L5613 - AK 4 BAR LING W/HYDRAUL SWIG|2168.09|2168.09||
125|L5611|L5611 - AK 4 BAR LINK W/FRIC SWING|1386.72|1386.72||
125|L5610|L5610 - ABOVE KNEE HYDRACADENCE|1781.95|1781.95||
125|L5600|L5600 - HIP DISART SACH LAMINAT MOLD|3929.21|3929.21||
125|L5595|L5595 - HIP DISARTIC SACH THERMOPLS|3655.24|3655.24||
125|L5590|L5590 - PREP AK ISCHIAL LAMINATED|2069.04|2069.04||
125|L5585|L5585 - PREP AK ISCHIAL OPEN END|2498.64|2498.64||
125|L5580|L5580 - PREP AK ISCHIAL THERMO MOLD|2030.33|2030.33||
125|L5570|L5570 - PREP AK ISCHIAL DIRECT FORM|1739.15|1739.15||
125|L5560|L5560 - PREP AK ISCHIAL PLAST MOLDED|1672.82|1672.82||
125|L5540|L5540 - PREP BK PTB LAMINATED SOCKET|1557.82|1557.82||
125|L5535|L5535 - PREP BK PTB OPEN END SOCKET|1459.57|1459.57||
125|L5530|L5530 - PREP BK PTB THERMOPLS MOLDED|1486.61|1486.61||
125|L5520|L5520 - PERP BK PTB THERMOPLS DIRECT|1237.72|1237.72||
125|L5510|L5510 - PREP BK PTB PLASTER MOLDED|1253.05|1253.05||
125|L5505|L5505 - INIT AK ISCHAL PLSTR DIRECT|1528.81|1528.81||
125|L5500|L5500 - INIT BK PTB PLASTER DIRECT|1105.4|1105.4||
125|L5460|L5460 - POSTOP APP NON-WGT BEAR DSG|469.45|469.45||
125|L5450|L5450 - POSTOP APP NON-WGT BEAR DSG|352.36|352.36||
125|L5430|L5430 - POSTOP DSG AK EA ADD CAST CH|433.1|433.1||
125|L5420|L5420 - POSTOP DSG & 1 CAST CHG AK/D|1436.39|1436.39||
125|L5410|L5410 - POSTOP DSG BK EA ADD CAST CH|359.62|359.62||
125|L5400|L5400 - POSTOP DRESS & 1 CAST CHG BK|1172.11|1172.11||
125|L5341|L5341 - HEMIPELVECTOMY CANADIAN SACH|4552.06|4552.06||
125|L5331|L5331 - HIP DISART CANADIAN SACH FT|4372.75|4372.75||
125|L5321|L5321 - AK OPEN END SACH|3431.76|3431.76||
125|L5312|L5312 - KNEE DISART -  SACH FT -  ENDO|3388.92|3388.92||
125|L5301|L5301 - BK MOLD SOCKET SACH FT ENDO|2367.5|2367.5||
125|L5280|L5280 - HEMIPELVECT CANAD SING AXIS|4411.87|4411.87||
125|L5270|L5270 - TILT TABLE LOCKING HIP SING|4445.92|4445.92||
125|L5250|L5250 - HIP CANAD SING AXI CONS FRIC|4465.73|4465.73||
125|L5230|L5230 - FEM FOCAL DEFIC CONSTANT FRI|3274.21|3274.21||
125|L5220|L5220 - NO KNEE JOINT WITH ARTIC ALI|2374|2374||
125|L5210|L5210 - NO KNEE/ANKLE JOINTS W/ FT B|2088.53|2088.53||
125|L5200|L5200 - KNE SING AXIS FRIC SHIN SACH|3148.22|3148.22||
125|L5160|L5160 - MOLD SOCKET BENT KNEE SHIN S|3287.47|3287.47||
125|L5150|L5150 - MOLD SCKT EXT KNEE SHIN SACH|3022.48|3022.48||
125|L5105|L5105 - PLAST SOCKET JTS/THGH LACER|2989.99|2989.99||
125|L5100|L5100 - MOLDED SOCKET SHIN SACH FOOT|2071.2|2071.2||
125|L5060|L5060 - SYMES MET FR LEATH SOCKET AR|2377.24|2377.24||
125|L5050|L5050 - ANK SYMES MOLD SCKT SACH FT|2066.63|2066.63||
125|L5020|L5020 - TIBIAL TUBERCLE HGT W/ TOE F|1868.26|1868.26||
125|L5010|L5010 - MOLD SOCKET ANK HGT W/ TOE F|1100.12|1100.12||
125|L5000|L5000 - SHO INSERT W ARCH TOE FILLER|455.5|455.5||
125|L4631|L4631 - AFO -  WALK BOOT TYPE -  CUS FAB|1296.35|1296.35||
125|L4398|L4398 - FOOT DROP SPLINT PRE OTS|67.1|67.1||
125|L4397|L4397 - STATIC OR DYNAMI AFO PRE OTS|145.81|145.81||
125|L4396|L4396 - STATIC OR DYNAMI AFO PRE CST|145.81|145.81||
125|L4394|L4394 - REPLACE FOOT DROP SPINT|14.93|14.93||
125|L4392|L4392 - REPLACE AFO SOFT INTERFACE|20.46|20.46||
125|L4387|L4387 - NON-PNEUM WALK BOOT PRE OTS|137.72|137.72||
125|L4386|L4386 - NON-PNEUM WALK BOOT PRE CST|137.72|137.72||
125|L4370|L4370 - PNEUM FULL LEG SPLNT PRE OTS|152.52|152.52||
125|L4361|L4361 - PNEUMA/VAC WALK BOOT PRE OTS|237.67|237.67||
125|L4360|L4360 - PNEUMAT WALKING BOOT PRE CST|237.67|237.67||
125|L4350|L4350 - ANKLE CONTROL ORTHO PRE OTS|84.95|84.95||
125|L4210|L4210 - ORTH DEV REPAIR/REPL MINOR P|24|24||
125|L4205|L4205 - ORTHO DVC REPAIR PER 15 MIN|14.4|14.4||
125|L4130|L4130 - REPLACE PRETIBIAL SHELL|471.52|471.52||
125|L4110|L4110 - REPL LEATH CUFF KAFO-AFO CAL|68.51|68.51||
125|L4100|L4100 - REPL LEATH CUFF KAFO PROX TH|86.21|86.21||
125|L4090|L4090 - REPL MET BAND KAFO-AFO CALF/|76.44|76.44||
125|L4080|L4080 - REPL MET BAND KAFO-AFO PROX|86.35|86.35||
125|L4070|L4070 - REPLACE PROX & DIST UPRIGHT|244.94|244.94||
125|L4060|L4060 - REPLACE HIGH ROLL CUFF|256.74|256.74||
125|L4055|L4055 - REPLACE NON-MOLDED CALF LACE|215.98|215.98||
125|L4050|L4050 - REPLACE MOLDED CALF LACER|333.53|333.53||
125|L4045|L4045 - REPLACE NON-MOLDED THIGH LAC|265.01|265.01||
125|L4040|L4040 - REPLACE MOLDED THIGH LACER|329.77|329.77||
125|L4030|L4030 - REPLACE SOCKET BRIM CUST FIT|407.88|407.88||
125|L4020|L4020 - REPLACE QUADLAT SOCKET BRIM|740.8|740.8||
125|L4010|L4010 - REPLACE TRILATERAL SOCKET BR|593.08|593.08||
125|L4002|L4002 - REPLACE STRAP -  ANY ORTHOSIS|30|30||
125|L4000|L4000 - REPL GIRDLE MILWAUKEE ORTH|1053.9|1053.9||
125|L3995|L3995 - SOCK FRACTURE OR EQUAL EACH|27.05|27.05||
125|L3984|L3984 - UPPER EXT FX ORTHOSIS WRIST|322.3|322.3||
125|L3982|L3982 - UPPER EXT FX ORTHOSIS RAD/UL|301.94|301.94||
125|L3981|L3981 - UE FX ORTH SHOUL CAP FOREARM|795.77|795.77||
125|L3980|L3980 - UP EXT FX ORTHOS HUMERAL NOS|244.39|244.39||
125|L3978|L3978 - SEWHFO AIRPLANE W/JNT(S) CF|1568.22|1568.22||
125|L3977|L3977 - SEWHFO CAP DESGN W/JNT(S) CF|1488.59|1488.59||
125|L3976|L3976 - SEWHFO AIRPLANE W/O JNTS CF|1328.27|1328.27||
125|L3975|L3975 - SEWHFO CAP DESIGN W/O JNT CF|1328.27|1328.27||
125|L3973|L3973 - SEWHO AIRPLANE W/JNT(S) CF|1568.22|1568.22||
125|L3971|L3971 - SEWHO CAP DESIGN W/JNT(S) CF|1488.59|1488.59||
125|L3967|L3967 - SEWHO AIRPLANE W/O JNTS CF|1568.22|1568.22||
125|L3962|L3962 - SEWHO ERBS PALSEY DESIGN ABD|678.52|678.52||
125|L3961|L3961 - SEWHO CAP DESIGN W/O JNTS CF|1328.27|1328.27||
125|L3960|L3960 - SEWHO AIRPLAN DESIG ABDU POS|651.66|651.66||
125|L3956|L3956 - ADD JOINT UPPER EXT ORTHOSIS|27.97|27.97||
125|L3935|L3935 - FO NONTORSION JOINT CF|174.68|174.68||
125|L3933|L3933 - FO W/O JOINTS CF|168.68|168.68||
125|L3931|L3931 - WHFO NONTORSION JOINT PREFAB|161|161||
125|L3930|L3930 - HFO NONTORSION JNTS PRE OTS|66.55|66.55||
125|L3929|L3929 - HFO NONTORSION JNTS PRE CST|66.55|66.55||
125|L3927|L3927 - FO PIP DIP NO JT SPR PRE OTS|27.67|27.67||
125|L3925|L3925 - FO PIP DIP JNT/SPRNG PRE OTS|41.76|41.76||
125|L3924|L3924 - HFO WITHOUT JOINTS PRE OTS|68.77|68.77||
125|L3923|L3923 - HFO WITHOUT JOINTS PRE CST|68.77|68.77||
125|L3921|L3921 - HFO W/JOINT(S) CF|253.92|253.92||
125|L3919|L3919 - HO W/O JOINTS CF|214.13|214.13||
125|L3918|L3918 - METACARP FX ORTHOSIS PRE OTS|83.52|83.52||
125|L3917|L3917 - METACARP FX ORTHOSIS PRE CST|83.52|83.52||
125|L3916|L3916 - WHO NONTORSION JNTS PRE OTS|420.25|420.25||
125|L3915|L3915 - WHO NONTORSION JNTS PRE CST|420.25|420.25||
125|L3913|L3913 - HFO W/O JOINTS CF|214.13|214.13||
125|L3912|L3912 - HFO FLEXION GLOVE PRE OTS|75.98|75.98||
125|L3908|L3908 - WHO COCK-UP NONMOLDE PRE OTS|47.36|47.36||
125|L3906|L3906 - WHO W/O JOINTS CF|333.5|333.5||
125|L3905|L3905 - WHO W/NONTORSION JNT(S) CF|784.02|784.02||
125|L3904|L3904 - WHFO ELECTRIC CUSTOM FITTED|2819.04|2819.04||
125|L3901|L3901 - HINGE EXT/FLEX WRIST FINGER|1384.79|1384.79||
125|L3900|L3900 - HINGE EXTENSION/FLEX WRIST/F|1235.03|1235.03||
125|L3891|L3891 - TORSION MECHANISM WRIST/ELBO|158.36|158.36||
125|L3809|L3809 - WHFO W/O JOINTS PRE OTS|197.7|197.7||
125|L3808|L3808 - WHFO -  RIGID W/O JOINTS|264.06|264.06||
125|L3807|L3807 - WHFO W/O JOINTS PRE CST|197.7|197.7||
125|L3806|L3806 - WHFO W/JOINT(S) CUSTOM FAB|359.11|359.11||
125|L3766|L3766 - EWHFO W/JOINT(S) CF|1073.46|1073.46||
125|L3765|L3765 - EWHFO RIGID W/O JNTS CF|1013.71|1013.71||
125|L3764|L3764 - EWHO W/JOINT(S) CF|625.98|625.98||
125|L3763|L3763 - EWHO RIGID W/O JNTS CF|627.68|627.68||
125|L3762|L3762 - EO RIGID W/O JOINTS PRE OTS|85.02|85.02||
125|L3761|L3761 - EO -  ADJ LOCK JOINT PREFAB OT|399.7|399.7||
125|L3760|L3760 - EO ADJ JT PREFAB CUSTOM FIT|395.35|395.35||
125|L3740|L3740 - CUFFS ADJ LOCK W/ ACTIVE CON|846|846||
125|L3730|L3730 - FOREARM/ARM CUFFS EXT/FLEX A|752.77|752.77||
125|L3720|L3720 - FOREARM/ARM CUFFS FREE MOTIO|571.86|571.86||
125|L3710|L3710 - EO ELAS W/METAL JNTS PRE OTS|114.62|114.62||
125|L3702|L3702 - EO W/O JOINTS CF|228.29|228.29||
125|L3678|L3678 - SO HARD PLAS STABILI PRE OTS|96|96||
125|L3677|L3677 - SO HARD PLAS STABILI PRE CST|77.53|77.53||
125|L3675|L3675 - SO VEST CANVAS/WEB PRE OTS|138.74|138.74||
125|L3674|L3674 - SO AIRPLANE W/WO JOINT CF|934.5|934.5||
125|L3671|L3671 - SO CAP DESIGN W/O JNTS CF|712.34|712.34||
125|L3670|L3670 - SO ACRO/CLAV CAN WEB PRE OTS|113.24|113.24||
125|L3660|L3660 - SO 8 AB RSTR CAN/WEB PRE OTS|81.25|81.25||
125|L3650|L3650 - SO 8 ABD RESTRAINT PRE OTS|47.33|47.33||
125|L3640|L3640 - SHOE DENNIS BROWNE SPLINT BO|37.54|37.54||
125|L3630|L3630 - TRANS SHOE SOLID STIRRUP NEW|87.28|87.28||
125|L3620|L3620 - TRANS SHOE SOLID STIRRUP EXI|66.3|66.3||
125|L3610|L3610 - TRANS SHOE CALIPER PLATE NEW|87.28|87.28||
125|L3600|L3600 - TRANS SHOE CALIP PLATE EXIST|66.3|66.3||
125|L3595|L3595 - ORTHO SHOE ADD MARCH BAR|36.46|36.46||
125|L3590|L3590 - O SHOE CONVERT TO SOF COUNTE|46.4|46.4||
125|L3580|L3580 - O SHOE ADD INSTEP VELCRO CLO|56.34|56.34||
125|L3570|L3570 - O SHOE ADD INSTEP EXTENSION|74.04|74.04||
125|L3560|L3560 - O SHOE ADD HORSESHOE TOE TAP|19.86|19.86||
125|L3550|L3550 - O SHOE ADD STANDARD TOE TAP|7.75|7.75||
125|L3540|L3540 - ORTHO SHOE ADD FULL SOLE|44.2|44.2||
125|L3530|L3530 - ORTHO SHOE ADD HALF SOLE|27.62|27.62||
125|L3520|L3520 - O SHOE ADD FELT W LEATH INSL|27.62|27.62||
125|L3510|L3510 - ORTHOPEDIC SHOE ADD RUB INSL|25.44|25.44||
125|L3500|L3500 - ORTHO SHOE ADD LEATHER INSOL|25.44|25.44||
125|L3485|L3485 - SHOE HEEL PAD REMOVABLE FOR|10.74|10.74||
125|L3480|L3480 - SHOE HEEL PAD & DEPRESS FOR|54.12|54.12||
125|L3470|L3470 - SHOE HEEL THOMAS EXTEND TO B|54.12|54.12||
125|L3465|L3465 - SHOE HEEL THOMAS WITH WEDGE|50.82|50.82||
125|L3460|L3460 - SHOE HEEL NEW RUBBER STANDAR|29.82|29.82||
125|L3455|L3455 - SHOE HEEL NEW LEATHER STANDA|35.36|35.36||
125|L3450|L3450 - SHOE HEEL SACH CUSHION TYPE|91.68|91.68||
125|L3440|L3440 - HEEL LEATHER REINFORCED|66.3|66.3||
125|L3430|L3430 - SHO HEEL COUNT PLAST REINFOR|139.2|139.2||
125|L3420|L3420 - FULL SOLE/HEEL WEDGE BTWEEN|47.5|47.5||
125|L3410|L3410 - SHOE METATARSAL BAR BETWEEN|80.66|80.66||
125|L3400|L3400 - SHOE METATARSAL BAR WEDGE RO|35.36|35.36||
125|L3390|L3390 - SHOE OUTFLARE WEDGE|43.09|43.09||
125|L3380|L3380 - SHOE CLUBFOOT WEDGE|43.09|43.09||
125|L3370|L3370 - SHOE SOLE WEDGE BETWEEN SOLE|43.09|43.09||
125|L3360|L3360 - SHOE SOLE WEDGE OUTSIDE SOLE|30.94|30.94||
125|L3350|L3350 - SHOE HEEL WEDGE|19.86|19.86||
125|L3340|L3340 - SHOE WEDGE SACH|74.04|74.04||
125|L3334|L3334 - SHOE LIFTS ELEVATION HEEL /I|33.14|33.14||
125|L3332|L3332 - SHOE LIFTS TAPERED TO ONE-HA|64.07|64.07||
125|L3330|L3330 - LIFTS ELEVATION METAL EXTENS|491.62|491.62||
125|L3320|L3320 - SHOE LIFT ELEV HEEL/SOLE COR|70.85|70.85||
125|L3310|L3310 - SHOE LIFT ELEV HEEL/SOLE NEO|70.73|70.73||
125|L3300|L3300 - SHO LIFT TAPER TO METATARSAL|45.29|45.29||
125|L3265|L3265 - PLASTAZOTE SANDAL EACH|11.62|11.62||
125|L3260|L3260 - AMBULATORY SURGICAL BOOT EAC|10.74|10.74||
125|L3257|L3257 - ORTH FOOT ADD CHARGE SPLIT S|18.88|18.88||
125|L3255|L3255 - ORTH FOOT NON-STANDARD SIZE/|22.98|22.98||
125|L3254|L3254 - ORTH FOOT NON-STNDARD SIZE/W|17.02|17.02||
125|L3253|L3253 - SHOE MOLDED PLASTAZOTE CUST|26.14|26.14||
125|L3252|L3252 - SHOE MOLDED PLASTAZOTE CUST|104.82|104.82||
125|L3251|L3251 - SHOE MOLDED TO PT SILICONE S|26.42|26.42||
125|L3250|L3250 - CUSTOM MOLD SHOE REMOV PROST|191.35|191.35||
125|L3230|L3230 - CUSTOM SHOES DEPTH INLAY|98.44|98.44||
125|L3225|L3225 - MAN'S SHOE OXFORD BRACE|54.65|54.65||
125|L3224|L3224 - WOMAN'S SHOE OXFORD BRACE|47.51|47.51||
125|L3222|L3222 - MENS SHOES HIGHTOP DEPTH INL|83.63|83.63||
125|L3221|L3221 - ORTHOPEDIC MENS SHOES DPTH I|75.49|75.49||
125|L3219|L3219 - ORTHOPEDIC MENS SHOES OXFORD|63.01|63.01||
125|L3217|L3217 - LADIES SHOES HIGHTOP DEPTH I|73.46|73.46||
125|L3216|L3216 - ORTHOPED LADIES SHOES DPTH I|67.94|67.94||
125|L3215|L3215 - ORTHOPEDIC FTWEAR LADIES OXF|56.04|56.04||
125|L3214|L3214 - BENESCH BOOT PAIR JUNIOR|44.14|44.14||
125|L3213|L3213 - BENESCH BOOT PAIR CHILD|41.52|41.52||
125|L3212|L3212 - BENESCH BOOT PAIR INFANT|34.26|34.26||
125|L3211|L3211 - SURGICAL BOOT EACH JUNIOR|24.68|24.68||
125|L3209|L3209 - SURGICAL BOOT EACH CHILD|23.23|23.23||
125|L3208|L3208 - SURGICAL BOOT EACH INFANT|16.26|16.26||
125|L3207|L3207 - HIGHTOP W/ SUPP/PRONATOR JUN|31.07|31.07||
125|L3206|L3206 - HIGHTOP W/ SUPP/PRONATOR CHI|30.49|30.49||
125|L3204|L3204 - HIGHTOP W/ SUPP/PRONATOR INF|29.33|29.33||
125|L3203|L3203 - OXFORD W/ SUPINATOR/PRONATOR|29.33|29.33||
125|L3202|L3202 - OXFORD W/ SUPINAT/PRONATOR C|30.2|30.2||
125|L3201|L3201 - OXFORD W SUPINAT/PRONAT INF|30.78|30.78||
125|L3170|L3170 - FOOT PLAS HEEL STABI PRE OTS|44.2|44.2||
125|L3160|L3160 - SHOE STYLED POSITIONING DEV|5.45|5.45||
125|L3150|L3150 - ABDUCT ROTATION BAR W/O SHOE|70.73|70.73||
125|L3140|L3140 - ABDUCTION ROTATION BAR SHOE|77.35|77.35||
125|L3100|L3100 - HALLUS-VALGUS NT DYN PRE OTS|37.54|37.54||
125|L3090|L3090 - ARCH SUPP ATT TO SHOE LONG/M|35.36|35.36||
125|L3080|L3080 - ARCH SUPP ATT TO SHOE METATA|27.62|27.62||
125|L3070|L3070 - ARCH SUPRT ATT TO SHO LONGIT|27.62|27.62||
125|L3060|L3060 - FOOT ARCH SUPP LONGITUD/META|64.07|64.07||
125|L3050|L3050 - FOOT ARCH SUPP PREMOLD METAT|40.88|40.88||
125|L3040|L3040 - FT ARCH SUPRT PREMOLD LONGIT|40.88|40.88||
125|L3031|L3031 - FOOT LAMIN/PREPREG COMPOSITE|106.38|106.38||
125|L3030|L3030 - FOOT ARCH SUPPORT REMOV PREM|66.3|66.3||
125|L3020|L3020 - FOOT LONGITUD/METATARSAL SUP|172.36|172.36||
125|L3010|L3010 - FOOT LONGITUDINAL ARCH SUPPO|151.36|151.36||
125|L3003|L3003 - FOOT INSERT SILICONE GEL EAC|151.36|151.36||
125|L3002|L3002 - FOOT INSERT PLASTAZOTE OR EQ|140.3|140.3||
125|L3001|L3001 - FOOT INSERT REMOV MOLDED SPE|114.89|114.89||
125|L3000|L3000 - FT INSERT UCB BERKELEY SHELL|272.89|272.89||
125|L2861|L2861 - TORSION MECHANISM KNEE/ANKLE|157.49|157.49||
125|L2850|L2850 - FEMORAL LGTH SOCK FX OR EQUA|50.03|50.03||
125|L2840|L2840 - TIBIAL LENGTH SOCK FX OR EQU|44.03|44.03||
125|L2830|L2830 - SOFT INTERFACE ABOVE KNEE SE|78.9|78.9||
125|L2820|L2820 - SOFT INTERFACE BELOW KNEE SE|70.15|70.15||
125|L2810|L2810 - KNEE CONTROL CONDYLAR PAD|63.1|63.1||
125|L2800|L2800 - KNEE CAP MEDIAL OR LATERAL P|86.17|86.17||
125|L2795|L2795 - KNEE CONTROL FULL KNEECAP|68.64|68.64||
125|L2785|L2785 - DROP LOCK RETAINER EACH|34.14|34.14||
125|L2780|L2780 - NON-CORROSIVE FINISH|58.07|58.07||
125|L2768|L2768 - ORTHO SIDEBAR DISCONNECT|113.2|113.2||
125|L2760|L2760 - EXTENSION PER EXTENSION PER|49.09|49.09||
125|L2755|L2755 - CARBON GRAPHITE LAMINATION|113.53|113.53||
125|L2750|L2750 - PLATING CHROME/NICKEL PR BAR|67.52|67.52||
125|L2680|L2680 - THORAC CONT LAT SUPPORT UPRI|126.42|126.42||
125|L2670|L2670 - THORAC CONT PARASPINAL UPRIG|137.81|137.81||
125|L2660|L2660 - THORACIC CONTROL THORACIC BA|150.58|150.58||
125|L2650|L2650 - PELV & THOR CONTROL GLUTEAL|96.95|96.95||
125|L2640|L2640 - PELVIC CONTROL BAND & BELT B|271.5|271.5||
125|L2630|L2630 - PELVIC CONTROL BAND & BELT U|200.05|200.05||
125|L2628|L2628 - METAL FRAME RECIPRO HIP & CA|1629.98|1629.98||
125|L2627|L2627 - PLASTIC MOLD RECIPRO HIP & C|1387.6|1387.6||
125|L2624|L2624 - HIP ADJ FLEX EXT ABDUCT CONT|336.8|336.8||
125|L2622|L2622 - HIP JOINT ADJUSTABLE FLEXION|247.74|247.74||
125|L2620|L2620 - PELVIC CONTROL HIP HEAVY DUT|216.01|216.01||
125|L2610|L2610 - HIP CLEVIS/THRUST BEARING LO|196.19|196.19||
125|L2600|L2600 - HIP CLEVIS/THRUST BEARING FR|165.91|165.91||
125|L2580|L2580 - PELVIC CONTROL PELVIC SLING|486.35|486.35||
125|L2570|L2570 - HIP CLEVIS TYPE 2 POSIT JNT|513.06|513.06||
125|L2550|L2550 - THIGH/WGHT BEAR HIGH ROLL CU|232.03|232.03||
125|L2540|L2540 - THIGH/WGHT BEAR LACER MOLDED|341.56|341.56||
125|L2530|L2530 - THIGH/WGHT BEAR LACER NON-MO|189.82|189.82||
125|L2526|L2526 - TH/WGHT BEAR NAR M-L BRIM CU|688.24|688.24||
125|L2525|L2525 - TH/WGHT BEAR NAR M-L BRIM MO|1276.84|1276.84||
125|L2520|L2520 - TH/WGHT BEAR QUAD-LAT BRIM C|372.17|372.17||
125|L2510|L2510 - TH/WGHT BEAR QUAD-LAT BRIM M|682.37|682.37||
125|L2500|L2500 - THI/GLUT/ISCHIA WGT BEARING|254.87|254.87||
125|L2492|L2492 - KNEE LIFT LOOP DROP LOCK RIN|82.38|82.38||
125|L2430|L2430 - KNEE JNT RATCHET LOCK EA JNT|124.51|124.51||
125|L2425|L2425 - KNEE DISC/DIAL LOCK/ADJ FLEX|124.51|124.51||
125|L2415|L2415 - KNEE JOINT CAM LOCK EACH JOI|105.54|105.54||
125|L2405|L2405 - KNEE JOINT DROP LOCK EA JNT|75.73|75.73||
125|L2397|L2397 - SUSPENSION SLEEVE LOWER EXT|94.68|94.68||
125|L2395|L2395 - OFFSET KNEE JOINT HEAVY DUTY|135.02|135.02||
125|L2390|L2390 - OFFSET KNEE JOINT EACH|88.44|88.44||
125|L2387|L2387 - ADD LE POLY KNEE CUSTOM KAFO|146.86|146.86||
125|L2385|L2385 - STRAIGHT KNEE JOINT HEAVY DU|108.2|108.2||
125|L2380|L2380 - TORSION STRAIGHT KNEE JOINT|99.46|99.46||
125|L2375|L2375 - TORSION ANK & HALF SOLID STI|91.28|91.28||
125|L2370|L2370 - PATTEN BOTTOM|207.38|207.38||
125|L2360|L2360 - EXTENDED STEEL SHANK|41.8|41.8||
125|L2350|L2350 - PROSTHETIC TYPE SOCKET MOLDE|719.86|719.86||
125|L2340|L2340 - PRE-TIBIAL SHELL MOLDED TO P|440.36|440.36||
125|L2335|L2335 - ANTERIOR SWING BAND|186.61|186.61||
125|L2330|L2330 - LACER MOLDED TO PATIENT MODE|317.22|317.22||
125|L2320|L2320 - NON-MOLDED LACER|166.22|166.22||
125|L2310|L2310 - ABDUCTION BAR-STRAIGHT|99.38|99.38||
125|L2300|L2300 - ABDUCTION BAR JOINTED ADJUST|221.38|221.38||
125|L2280|L2280 - MOLDED INNER BOOT|392.17|392.17||
125|L2275|L2275 - PLASTIC MOD LOW EXT PAD/LINE|105.58|105.58||
125|L2270|L2270 - VARUS/VALGUS STRAP PADDED/LI|43.39|43.39||
125|L2265|L2265 - LONG TONGUE STIRRUP|95.14|95.14||
125|L2260|L2260 - REINFORCED SOLID STIRRUP|161.95|161.95||
125|L2250|L2250 - FOOT PLATE MOLDED STIRRUP AT|287.06|287.06||
125|L2240|L2240 - ROUND CALIPER AND PLATE ATTA|67.56|67.56||
125|L2232|L2232 - ROCKER BOTTOM -  CONTACT AFO|83.93|83.93||
125|L2230|L2230 - SPLIT FLAT CALIPER STIRR & P|61.98|61.98||
125|L2220|L2220 - DORSI & PLANTAR FLEX ASS/RES|71.56|71.56||
125|L2210|L2210 - DORSIFLEXION ASSIST EACH JOI|62.33|62.33||
125|L2200|L2200 - LIMITED ANKLE MOTION EA JNT|38.41|38.41||
125|L2192|L2192 - PELVIC BAND & BELT THIGH FLA|288.06|288.06||
125|L2190|L2190 - WAIST BELT|83.8|83.8||
125|L2188|L2188 - QUADRILATERAL BRIM|322.6|322.6||
125|L2186|L2186 - ADJ MOTION KNEE JNT LERMAN T|147.86|147.86||
125|L2184|L2184 - LIMITED MOTION KNEE JOINT|133.44|133.44||
125|L2182|L2182 - DROP LOCK KNEE|74.04|74.04||
125|L2180|L2180 - PLAS SHOE INSERT W ANK JOINT|94.61|94.61||
125|L2136|L2136 - KAFO FEMORAL FX CAST RIGID|955.39|955.39||
125|L2134|L2134 - KAFO FEM FX CAST SEMI-RIGID|781.36|781.36||
125|L2132|L2132 - KAFO FEMORAL FX CAST SOFT|651.7|651.7||
125|L2128|L2128 - KAFO FEM FX CAST MOLDED TO P|1385.29|1385.29||
125|L2126|L2126 - KAFO FEM FX CAST THERMOPLAS|1099.25|1099.25||
125|L2116|L2116 - AFO TIBIAL FRACTURE RIGID|617.81|617.81||
125|L2114|L2114 - AFO TIB FX SEMI-RIGID|468.92|468.92||
125|L2112|L2112 - AFO TIBIAL FRACTURE SOFT|409.85|409.85||
125|L2108|L2108 - AFO TIB FX CAST MOLDED TO PT|863.17|863.17||
125|L2106|L2106 - AFO TIB FX CAST PLASTER MOLD|549.29|549.29||
125|L2090|L2090 - HKAFO UNILAT TORSION BALL BR|380.8|380.8||
125|L2080|L2080 - HKAFO UNILAT TORSION CABLE|308.94|308.94||
125|L2070|L2070 - HKAFO TORSION UNILAT ROT STR|144.86|144.86||
125|L2060|L2060 - HKAFO TORSION BALL BEARING J|504.28|504.28||
125|L2050|L2050 - HKAFO TORSION CABLE HIP PELV|392.92|392.92||
125|L2040|L2040 - HKAFO TORSION BIL ROT STRAPS|147.55|147.55||
125|L2038|L2038 - KAFO W/O JOINT MULTI-AXIS AN|1155.05|1155.05||
125|L2037|L2037 - KAFO PLAS SING FREE KNEE MOL|1381.3|1381.3||
125|L2036|L2036 - KAFO PLAS DOUB FREE KNEE MOL|1498.87|1498.87||
125|L2035|L2035 - KAFO PLASTIC PEDIATRIC SIZE|150.48|150.48||
125|L2034|L2034 - KAFO PLA SIN UP W/WO K/A CUS|1783.68|1783.68||
125|L2030|L2030 - KAFO DBL SOLID STIRRUP W/O J|818.41|818.41||
125|L2020|L2020 - KAFO DBL SOLID STIRRUP BAND/|943.32|943.32||
125|L2010|L2010 - KAFO SNG SOLID STIRRUP W/O J|746.98|746.98||
125|L2005|L2005 - KAFO SNG/DBL MECHANICAL ACT|3559.63|3559.63||
125|L2000|L2000 - KAFO SING FRE STIRR THI/CALF|819.42|819.42||
125|L1990|L1990 - AFO DOUB SOLID STIRRUP CALF|380.95|380.95||
125|L1980|L1980 - AFO SING SOLID STIRRUP CALF|296.48|296.48||
125|L1971|L1971 - AFO W/ANKLE JOINT -  PREFAB|407.17|407.17||
125|L1970|L1970 - AFO PLASTIC MOLDED W/ANKLE J|662.32|662.32||
125|L1960|L1960 - AFO POS SOLID ANK PLASTIC MO|447.79|447.79||
125|L1951|L1951 - AFO SPIRAL PREFABRICATED|729.54|729.54||
125|L1950|L1950 - AFO SPIRAL MOLDED TO PT PLAS|601.74|601.74||
125|L1945|L1945 - AFO MOLDED PLAS RIG ANT TIB|793.14|793.14||
125|L1940|L1940 - AFO MOLDED TO PATIENT PLASTI|431.89|431.89||
125|L1932|L1932 - AFO RIG ANT TIB PREFAB TCF/=|775.18|775.18||
125|L1930|L1930 - AFO PLASTIC|191.11|191.11||
125|L1920|L1920 - AFO SING UPRIGHT W/ ADJUST S|282.44|282.44||
125|L1910|L1910 - AFO SING BAR CLASP ATTACH SH|216.05|216.05||
125|L1907|L1907 - AFO SUPRAMALLEOLAR CUSTOM|488.8|488.8||
125|L1906|L1906 - AFO MULTILIG ANK SUP PRE OTS|111.01|111.01||
125|L1904|L1904 - AFO MOLDED ANKLE GAUNTLET|379.9|379.9||
125|L1902|L1902 - AFO ANKLE GAUNTLET PRE OTS|66.37|66.37||
125|L1900|L1900 - AFO SPRNG WIR DRSFLX CALF BD|244.34|244.34||
125|L1860|L1860 - KO SUPRACONDYLAR SOCKET MOLD|901.93|901.93||
125|L1852|L1852 - KO DOUBLE UPRIGHT PREFAB OTS|813.66|813.66||
125|L1851|L1851 - KO SINGLE UPRIGHT PREFAB OTS|779.42|779.42||
125|L1850|L1850 - KO SWEDISH TYPE PRE OTS|232.55|232.55||
125|L1848|L1848 - KO DBL UPRIGHT W/AIR PRE OTS|499.66|499.66||
125|L1847|L1847 - KO DBL UPRIGHT W/AIR PRE CST|499.66|499.66||
125|L1846|L1846 - KO W ADJ FLEX/EXT ROTAT MOLD|1032.4|1032.4||
125|L1845|L1845 - KO DOUBLE UPRIGHT PRE CST|813.66|813.66||
125|L1844|L1844 - KO W/ADJ JT ROT CNTRL MOLDED|1350.58|1350.58||
125|L1843|L1843 - KO SINGLE UPRIGHT PRE CST|779.42|779.42||
125|L1840|L1840 - KO DEROT ANT CRUCIATE CUSTOM|809.88|809.88||
125|L1836|L1836 - KO RIGID W/O JOINTS PRE OTS|115.91|115.91||
125|L1834|L1834 - KO W/0 JOINT RIGID MOLDED TO|770.46|770.46||
125|L1833|L1833 - KO ADJ JNT POS R SUP PRE OTS|654.89|654.89||
125|L1832|L1832 - KO ADJ JNT POS R SUP PRE CST|654.89|654.89||
125|L1831|L1831 - KNEE ORTH POS LOCKING JOINT|255.66|255.66||
125|L1830|L1830 - KO IMMOB CANVAS LONG PRE OTS|87.62|87.62||
125|L1820|L1820 - KO ELAS W/ CONDYLE PADS & JO|104.75|104.75||
125|L1812|L1812 - KO ELASTIC W/JOINTS PRE OTS|105.17|105.17||
125|L1810|L1810 - KO ELASTIC WITH JOINTS|105.17|105.17||
125|L1755|L1755 - LEGG PERTHES PATTEN BOTTOM T|1332.56|1332.56||
125|L1730|L1730 - LEGG PERTHES ORTH SCOTTISH R|915.52|915.52||
125|L1720|L1720 - LEGG PERTHES ORTHOSIS TRILAT|1213.45|1213.45||
125|L1710|L1710 - LEGG PERTHES ORTH NEWINGTON|1642.68|1642.68||
125|L1700|L1700 - LEG PERTHES ORTH TORONTO TYP|1397.51|1397.51||
125|L1690|L1690 - COMBINATION BILATERAL HO|1679.82|1679.82||
125|L1686|L1686 - HO POST-OP HIP ABDUCTION|804.62|804.62||
125|L1685|L1685 - POST-OP HIP ABDUCT CUSTOM FA|1199.38|1199.38||
125|L1680|L1680 - PELVIC & HIP CONTROL THIGH C|1136.66|1136.66||
125|L1660|L1660 - HO ABDUCTION STATIC PLASTIC|138.26|138.26||
125|L1652|L1652 - HO BI THIGHCUFFS W SPRDR BAR|309.67|309.67||
125|L1650|L1650 - HO ABDUCTION HIP ADJUSTABLE|197.7|197.7||
125|L1640|L1640 - PELV BAND/SPREAD BAR THIGH C|372.77|372.77||
125|L1630|L1630 - ABDUCT CONTROL HIP SEMI-FLEX|139.38|139.38||
125|L1620|L1620 - HO FLEX PAVLIK HARNS PRE CST|116.78|116.78||
125|L1610|L1610 - HO FREJKA COV ONLY PRE CST|35.46|35.46||
125|L1600|L1600 - HO FLEX FREJKA W/COV PRE CST|104.1|104.1||
125|L1310|L1310 - POST-OPERATIVE BODY JACKET|1388.63|1388.63||
125|L1300|L1300 - BODY JACKET MOLD TO PATIENT|1349.5|1349.5||
125|L1290|L1290 - LATERAL TROCHANTERIC PAD|80.72|80.72||
125|L1280|L1280 - RIB GUSSET (ELASTIC) EACH|71.2|71.2||
125|L1270|L1270 - ABDOMINAL PAD|79.88|79.88||
125|L1260|L1260 - ANTERIOR THORACIC DEROTATION|79.98|79.98||
125|L1250|L1250 - ANTERIOR ASIS PAD|77.82|77.82||
125|L1240|L1240 - LUMBAR DEROTATION PAD|79.03|79.03||
125|L1230|L1230 - MILWAUKEE TYPE SUPERSTRUCTUR|459.24|459.24||
125|L1220|L1220 - ANTERIOR THORACIC EXTENSION|178.98|178.98||
125|L1210|L1210 - LATERAL THORACIC EXTENSION|211.39|211.39||
125|L1200|L1200 - FURNSH INITIAL ORTHOSIS ONLY|1403.99|1403.99||
125|L1120|L1120 - COVERS FOR UPRIGHT EACH|35.27|35.27||
125|L1110|L1110 - RING FLANGE PLAS/LEATHER MOL|221.41|221.41||
125|L1100|L1100 - RING FLANGE PLASTIC/LEATHER|130.72|130.72||
125|L1090|L1090 - LUMBAR SLING|74.05|74.05||
125|L1085|L1085 - OUTRIGGER BIL W/ VERT EXTENS|158.53|158.53||
125|L1080|L1080 - OUTRIGGER|57.07|57.07||
125|L1070|L1070 - TRAPEZIUS SLING|82.36|82.36||
125|L1060|L1060 - THORACIC PAD|80.56|80.56||
125|L1050|L1050 - STERNAL PAD|71.41|71.41||
125|L1040|L1040 - LUMBAR OR LUMBAR RIB PAD|82.48|82.48||
125|L1030|L1030 - LUMBAR BOLSTER PAD|68.52|68.52||
125|L1025|L1025 - KYPHOSIS PAD FLOATING|102.58|102.58||
125|L1020|L1020 - KYPHOSIS PAD|90.25|90.25||
125|L1010|L1010 - CTLSO AXILLA SLING|66.05|66.05||
125|L1005|L1005 - TENSION BASED SCOLIOSIS ORTH|2780.36|2780.36||
125|L1001|L1001 - CTLSO INFANT IMMOBILIZER|68.4|68.4||
125|L1000|L1000 - CTLSO MILWAUKE INITIAL MODEL|1640.17|1640.17||
125|L0984|L0984 - PROTECT BODY SOCK EA PRE OTS|49.06|49.06||
125|L0982|L0982 - STOCKING SUP GRIPS 4 PRE OTS|15.37|15.37||
125|L0980|L0980 - PERONEAL STRAPS PAIR PRE OTS|14.11|14.11||
125|L0978|L0978 - AXILLARY CRUTCH EXTENSION|155.51|155.51||
125|L0976|L0976 - LSO FULL CORSET|172.24|172.24||
125|L0974|L0974 - TLSO FULL CORSET|192.85|192.85||
125|L0972|L0972 - LSO CORSET FRONT|94.38|94.38||
125|L0970|L0970 - TLSO CORSET FRONT|92.33|92.33||
125|L0861|L0861 - HALO REPL LINER/INTERFACE|187.24|187.24||
125|L0859|L0859 - MRI COMPATIBLE SYSTEM|984.18|984.18||
125|L0830|L0830 - HALO CERV INTO MILWAUKEE TYP|2533.31|2533.31||
125|L0820|L0820 - HALO CERVICAL INTO BODY JACK|1754.51|1754.51||
125|L0810|L0810 - HALO CERVICAL INTO JCKT VEST|2168.84|2168.84||
125|L0710|L0710 - CTLSO A-P-L CONTROL W/ INTER|2041.55|2041.55||
125|L0700|L0700 - CTLSO A-P-L CONTROL MOLDED|1870.3|1870.3||
125|L0651|L0651 - LSO SAG-CO SHELL PNL PRE OTS|1182.59|1182.59||
125|L0650|L0650 - LSO SC R ANT/POS PNL PRE OTS|1182.59|1182.59||
125|L0649|L0649 - LSO SC R POS/LAT PNL PRE OTS|249.11|249.11||
125|L0648|L0648 - LSO SAG R AN/POS PNL PRE OTS|891.78|891.78||
125|L0643|L0643 - LSO SAG CTR RIGI POS PRE OTS|140.68|140.68||
125|L0642|L0642 - LO SAG RI AN/POS PNL PRE OTS|357.1|357.1||
125|L0641|L0641 - LO RIG POS PNL L1-L5 PRE OTS|67.72|67.72||
125|L0640|L0640 - LSO S/C SHELL/PANEL CUSTOM|908.99|908.99||
125|L0639|L0639 - LSO S/C SHELL/PANEL PREFAB|1182.59|1182.59||
125|L0638|L0638 - LSO SAG-CORONAL PANEL CUSTOM|1145.72|1145.72||
125|L0637|L0637 - LSO SC R ANT/POS PNL PRE CST|1182.59|1182.59||
125|L0636|L0636 - LSO SAGITTAL RIGID PANEL CUS|1363.02|1363.02||
125|L0635|L0635 - LSO SAGIT RIGID PANEL PREFAB|923.72|923.72||
125|L0634|L0634 - LSO FLEXION CONTROL CUSTOM|420|420||
125|L0633|L0633 - LSO SC R POS/LAT PNL PRE CST|249.11|249.11||
125|L0632|L0632 - LSO SAG RIGID FRAME CUST|54|54||
125|L0631|L0631 - LSO SAG R AN/POS PNL PRE CST|891.78|891.78||
125|L0630|L0630 - LSO R POST PNL SJ-T9 PRE CST|140.68|140.68||
125|L0629|L0629 - LSO FLEX W/RIGID STAYS CUST|207.6|207.6||
125|L0628|L0628 - LSO FLEX NO RI STAYS PRE OTS|72.85|72.85||
125|L0627|L0627 - LO SAG RI AN/POS PNL PRE CST|357.1|357.1||
125|L0626|L0626 - LO SAG RIG PNL STAYS PRE CST|67.72|67.72||
125|L0625|L0625 - LO FLEX L1-BELOW L5 PRE OTS|47.87|47.87||
125|L0624|L0624 - SIO PANEL CUSTOM|48|48||
125|L0623|L0623 - SIO RIG PNL PELV/SAC PRE OTS|86.4|86.4||
125|L0622|L0622 - SIO FLEX PELVISACRAL CUSTOM|210.04|210.04||
125|L0621|L0621 - SIO FLEX PELVIC/SACR PRE OTS|77.46|77.46||
125|L0492|L0492 - TLSO 3 PIECE RIGID SHELL|432.37|432.37||
125|L0491|L0491 - TLSO 2 PIECE RIGID SHELL|667.13|667.13||
125|L0490|L0490 - TLSO RIGID PLASTIC PRE ONE|245.72|245.72||
125|L0488|L0488 - TLSO RIGID LINED PRE ONE PIE|872.03|872.03||
125|L0486|L0486 - TLSO RIGIDLINED CUST FAB TWO|1523.2|1523.2||
125|L0484|L0484 - TLSO RIGID PLASTIC CUST FAB|1537.62|1537.62||
125|L0482|L0482 - TLSO RIGID LINED CUSTOM FAB|1318.74|1318.74||
125|L0480|L0480 - TLSO RIGID PLASTIC CUSTOM FA|1150.37|1150.37||
125|L0472|L0472 - TLSO RIGID FRAME HYPEREX PRE|372.01|372.01||
125|L0470|L0470 - TLSO RIGID FRAME PRE SUBCLAV|592.67|592.67||
125|L0469|L0469 - TLSO RIG FRAM PELVIC PRE OTS|416.29|416.29||
125|L0468|L0468 - TLSO RIG FRAM PELVIC PRE CST|416.29|416.29||
125|L0467|L0467 - TLSO R FRAM SOFT PRE OTS|332.03|332.03||
125|L0466|L0466 - TLSO R FRAM SOFT ANT PRE CST|332.03|332.03||
125|L0464|L0464 - TLSO 4MOD SACRO-SCAP PRE|1291.24|1291.24||
125|L0462|L0462 - TLSO 3MOD SACRO-SCAP PRE|1084.63|1084.63||
125|L0460|L0460 - TLSO 2 SHL SYMPHYS-STERN CST|872.03|872.03||
125|L0458|L0458 - TLSO 2MOD SYMPHIS-XIPHO PRE|774.72|774.72||
125|L0457|L0457 - TLSO FLEX TRNK SJ-SS PRE OTS|863.98|863.98||
125|L0456|L0456 - TLSO FLEX TRNK SJ-SS PRE CST|863.98|863.98||
125|L0455|L0455 - TLSO FLEX TRNK SJ-T9 PRE OTS|301.27|301.27||
125|L0454|L0454 - TLSO TRNK SJ-T9 PRE CST|301.27|301.27||
125|L0452|L0452 - TLSO FLEX CUSTOM FAB THORACI|168|168||
125|L0450|L0450 - TLSO FLEX TRUNK/THOR PRE OTS|163.34|163.34||
125|L0220|L0220 - THOR RIB BELT CUSTOM FABRICA|98.95|98.95||
125|L0200|L0200 - CERV COL SUPP ADJ BAR & THOR|417.19|417.19||
125|L0190|L0190 - CERV COLLAR SUPP ADJ CERV BA|454.34|454.34||
125|L0180|L0180 - CER POST COL OCC/MAN SUP ADJ|301.81|301.81||
125|L0174|L0174 - CERV SR 2PC THOR EXT PRE OTS|221.93|221.93||
125|L0172|L0172 - CERV COL SR FOAM 2PC PRE OTS|123.54|123.54||
125|L0170|L0170 - CERVICAL COLLAR MOLDED TO PT|609.29|609.29||
125|L0160|L0160 - CERV SR WIRE OCC/MAN PRE OTS|143.99|143.99||
125|L0150|L0150 - CERV SEMI-RIG ADJ MOLDED CHN|101.12|101.12||
125|L0140|L0140 - CERVICAL SEMI-RIGID ADJUSTAB|60.65|60.65||
125|L0130|L0130 - FLEX THERMOPLASTIC COLLAR MO|175.74|175.74||
125|L0120|L0120 - CERV FLEX N/ADJ FOAM PRE OTS|24.3|24.3||
125|L0113|L0113 - CRANIAL CERVICAL TORTICOLLIS|247.74|247.74||
125|L0112|L0112 - CRANIAL CERVICAL ORTHOSIS|1215.83|1215.83||
125|K0891|K0891 - PWC GP5 PED MULT POW OPT S/B|9298.52|9298.52||929.84
125|K0890|K0890 - PWC GP5 PED SING POW OPT S/B|6236.48|6236.48||623.64
125|K0886|K0886 - PWC GP4 HD MULT POW S/B|8583.72|8583.72||858.37
125|K0885|K0885 - PWC GP4 STD MULT POW OPT CAP|9294.12|9294.12||929.41
125|K0884|K0884 - PWC GP4 STD MULT POW OPT S/B|7789.31|7789.31||778.93
125|K0880|K0880 - PWC GP4 VHD SING POW OPT S/B|13018.44|13018.44||1301.84
125|K0879|K0879 - PWC GP4 HD SING POW OPT S/B|8319|8319||831.9
125|K0878|K0878 - PWC GP4 STD SING POW OPT CAP|6160.08|6160.08||616.01
125|K0877|K0877 - PWC GP4 STD SING POW OPT S/B|6160.08|6160.08||616.01
125|K0869|K0869 - PWC GP 4 STD CAP CHAIR|7013.76|7013.76||701.38
125|K0868|K0868 - PWC GP 4 STD SEAT/BACK|10630.5|10630.5||1063.04
125|K0864|K0864 - PWC GP3 XHD MULT POW OPT S/B|15498|15498||1549.8
125|K0863|K0863 - PWC GP3 VHD MULT POW OPT S/B|13023.46|13023.46||1302.35
125|K0862|K0862 - PWC GP3 HD MULT POW OPT S/B|9116.1|9116.1||911.62
125|K0861|K0861 - PWC GP3 STD MULT POW OPT S/B|7359.22|7359.22||735.92
125|K0860|K0860 - PWC GP3 VHD SING POW OPT S/B|13023.46|13023.46||1302.35
125|K0859|K0859 - PWC GP3 HD SING POW OPT CAP|8693.92|8693.92||869.39
125|K0858|K0858 - PWC GP3 HD SING POW OPT S/B|9116.1|9116.1||911.62
125|K0857|K0857 - PWC GP3 STD SING POW OPT CAP|7494.76|7494.76||749.47
125|K0856|K0856 - PWC GP3 STD SING POW OPT S/B|7347.42|7347.42||734.75
125|K0855|K0855 - PWC GP 3 XHD CAP CHAIR|11794.06|11794.06||1179.41
125|K0854|K0854 - PWC GP 3 XHD SEAT/BACK|12485.08|12485.08||1248.5
125|K0853|K0853 - PWC GP 3 VHD CAP CHAIR|9424.26|9424.26||942.43
125|K0852|K0852 - PWC GP 3 VHD SEAT/BACK|9174.24|9174.24||917.42
125|K0851|K0851 - PWC GP 3 HD CAP CHAIR|7634.44|7634.44||763.44
125|K0850|K0850 - PWC GP 3 HD SEAT/BACK|7940.08|7940.08||794
125|K0849|K0849 - PWC GP 3 STD CAP CHAIR|6581.16|6581.16||658.12
125|K0848|K0848 - PWC GP 3 STD SEAT/BACK|6845.14|6845.14||684.52
125|K0843|K0843 - PWC GP2 HD MULT POW OPT S/B|4035.24|4035.24||403.52
125|K0842|K0842 - PWC GP2 STD MULT POW OPT CAP|3399.22|3399.22||339.92
125|K0841|K0841 - PWC GP2 STD MULT POW OPT S/B|3404.16|3404.16||340.42
125|K0840|K0840 - PWC GP2 XHD SING POW OPT S/B|7901.74|7901.74||790.18
125|K0839|K0839 - PWC GP2 VHD SING POW OPT S/B|5146.66|5146.66||514.67
125|K0838|K0838 - PWC GP 2 HD SING POW OPT CAP|3434.04|3434.04||343.4
125|K0837|K0837 - PWC GP 2 HD SING POW OPT S/B|3874.5|3874.5||387.46
125|K0836|K0836 - PWC GP2 STD SING POW OPT CAP|3133.18|3133.18||313.32
125|K0835|K0835 - PWC GP2 STD SING POW OPT S/B|3020.76|3020.76||302.08
125|K0831|K0831 - PWC GP2 STD SEAT ELEVATE CAP|1996.2|1996.2||199.62
125|K0830|K0830 - PWC GP2 STD SEAT ELEVATE S/B|1996.2|1996.2||199.62
125|K0829|K0829 - PWC GP 2 XTRA HD CAP CHAIR|7502.32|7502.32||750.23
125|K0828|K0828 - PWC GP 2 XTRA HD SEAT/BACK|7479.54|7479.54||747.96
125|K0827|K0827 - PWC GP VHD CAP CHAIR|5648.5|5648.5||564.85
125|K0826|K0826 - PWC GP 2 VHD SEAT/BACK|6416.1|6416.1||641.62
125|K0825|K0825 - PWC GP 2 HD CAP CHAIR|3476.26|3476.26||347.63
125|K0824|K0824 - PWC GP 2 HD SEAT/BACK|3839.14|3839.14||383.92
125|K0823|K0823 - PWC GP 2 STD CAP CHAIR|2462.04|2462.04||246.2
125|K0822|K0822 - PWC GP 2 STD SEAT/BACK|2635.2|2635.2||263.52
125|K0821|K0821 - PWC GP 2 STD PORT CAP CHAIR|2460.88|2460.88||246.08
125|K0820|K0820 - PWC GP 2 STD PORT SEAT/BACK|2312.2|2312.2||231.22
125|K0816|K0816 - PWC GP 1 STD CAP CHAIR|2458.44|2458.44||245.84
125|K0815|K0815 - PWC GP 1 STD SEAT/BACK|2632.5|2632.5||263.26
125|K0814|K0814 - PWC GP 1 STD PORT CAP CHAIR|2369.26|2369.26||236.93
125|K0813|K0813 - PWC GP 1 STD PORT SEAT/BACK|2260.72|2260.72||226.07
125|K0808|K0808 - POV GROUP 2 VHD 451-600 LBS|2816.47|2816.47||281.65
125|K0807|K0807 - POV GROUP 2 HD 301-450 LBS|1821.98|1821.98||182.2
125|K0806|K0806 - POV GROUP 2 STD UP TO 300LBS|1175.66|1175.66||117.56
125|K0802|K0802 - POV GROUP 1 VHD 451-600 LBS|1768.6|1768.6||176.86
125|K0801|K0801 - POV GROUP 1 HD 301-450 LBS|1336.75|1336.75||133.68
125|K0800|K0800 - POV GROUP 1 STD UP TO 300LBS|743.75|743.75||74.38
125|K0744|K0744 - ABSORP DRG <= 16 SUC PUMP|23.44|23.44||
125|K0743|K0743 - PORTABLE HOME SUCTION PUMP|953.93|953.93||95.3
125|K0740|K0740 - REPAIR/SVC OXYGEN EQUIPMENT|12|12||
125|K0739|K0739 - REPAIR/SVC DME NON-OXYGEN EQ|12|12||
125|K0738|K0738 - PORTABLE GAS OXYGEN SYSTEM|336.96|336.96||33.7
125|K0733|K0733 - 12-24HR SEALED LEAD ACID|24.1|24.1||2.41
125|K0730|K0730 - CTRL DOSE INH DRUG DELIV SYS|1727.28|1727.28||172.73
125|K0672|K0672 - REMOVABLE SOFT INTERFACE LE|73.67|73.67||
125|K0669|K0669 - SEAT/BACK CUS NO DMEPDAC VER|146.69|146.69||
125|K0609|K0609 - REPL ELECTRODE FOR AED|807.64|807.64||
125|K0608|K0608 - REPL GARMENT FOR AED|121.44|121.44||12.17
125|K0607|K0607 - REPL BATT FOR AED|194.68|194.68||19.46
125|K0606|K0606 - AED GARMENT W ELEC ANALYSIS|25231.24|25231.24||2523.12
125|K0605|K0605 - REPL BATT LITHIUM 4.5 V|13.81|13.81||0.67
125|K0604|K0604 - REPL BATT LITHIUM 3.6 V|5.78|5.78||0.28
125|K0603|K0603 - REPL BATT ALKALINE 1.5 V|0.54|0.54||0.02
125|K0602|K0602 - REPL BATT SILVER OXIDE 3 V|6|6||0.29
125|K0601|K0601 - REPL BATT SILVER OXIDE 1.5 V|1.07|1.07||0.05
125|K0554|K0554 - THER CGM RECEIVER/MONITOR|224.08|224.08||22.42
125|K0553|K0553 - THER CGM SUPPLY ALLOWANCE|226|226||
125|K0552|K0552 - SUP/EXT NON-INS INF PUMP SYR|2.34|2.34||
125|K0462|K0462 - TEMPORARY REPLACEMENT EQPMNT|98.39|98.39||
125|K0455|K0455 - PUMP UNINTERRUPTED INFUSION|2574.28|2574.28||257.42
125|K0195|K0195 - ELEVATING WHLCHAIR LEG RESTS|95.58|95.58||9.56
125|K0105|K0105 - IV HANGER|85.12|85.12||8.52
125|K0098|K0098 - DRIVE BELT FOR PWC -  REPL|20.39|20.39||2.04
125|K0077|K0077 - FR CSTR ASMB SOL TIRE REP EA|47.15|47.15||4.72
125|K0073|K0073 - CASTER PIN LOCK EACH|30.18|30.18||3.01
125|K0072|K0072 - FR CSTR SEMI-PNE TIRE REP EA|57.95|57.95||5.8
125|K0071|K0071 - FR CSTR COMP PNE TIRE REP EA|92.45|92.45||9.24
125|K0070|K0070 - RR WHL COMPL PNE TIRE REP EA|143.2|143.2||14.32
125|K0069|K0069 - RR WHL COMPL SOL TIRE REP EA|81.34|81.34||8.14
125|K0065|K0065 - SPOKE PROTECTORS|39.16|39.16||3.91
125|K0056|K0056 - SEAT HT <17 OR >=21 LTWT WC|82.25|82.25||8.23
125|K0053|K0053 - ELEVATE FOOTREST ARTICULATE|71.94|71.94||7.19
125|K0052|K0052 - SWINGAWAY DETACH FTREST REPL|61.98|61.98||6.2
125|K0051|K0051 - CAM REL ASM FT/LEGRST REP EA|42.11|42.11||4.21
125|K0050|K0050 - RATCHET ASSEMBLY REPLACEMENT|26.62|26.62||2.66
125|K0047|K0047 - ELEV LEGRST UPR HANGR REP EA|57.37|57.37||5.74
125|K0046|K0046 - ELEV LGRST LWR EXTEN REPL EA|16.24|16.24||1.62
125|K0045|K0045 - FTRST COMPL ASSEMBLY REPL EA|46.15|46.15||4.62
125|K0044|K0044 - FTRST UPR HANGER BRAC REP EA|14.03|14.03||1.4
125|K0043|K0043 - FTRST LOWR EXTEN TUBE REP EA|16.13|16.13||1.61
125|K0042|K0042 - STANDARD SIZE FTPLATE REP EA|26.12|26.12||2.62
125|K0041|K0041 - LARGE SIZE FOOTPLATE EACH|40.68|40.68||4.07
125|K0040|K0040 - ADJUSTABLE ANGLE FOOTPLATE|46.01|46.01||4.6
125|K0039|K0039 - LEG STRAP H STYLE EACH|42.56|42.56||4.26
125|K0038|K0038 - LEG STRAP EACH|19.82|19.82||1.98
125|K0037|K0037 - HI MOUNT FLIP-UP FOOTREST EA|37.32|37.32||3.71
125|K0020|K0020 - FIXED ADJUST ARMREST PAIR|38.87|38.87||3.89
125|K0019|K0019 - ARM PAD REPL -  EACH|11.08|11.08||1.1
125|K0018|K0018 - DETACH ADJUST ARMRST UPPER|22.42|22.42||2.24
125|K0017|K0017 - DETACH ADJUST ARMREST BASE|39.66|39.66||3.97
125|K0015|K0015 - DETACH NON-ADJ HT ARMRST REP|123.3|123.3||12.34
125|K0014|K0014 - OTHER POWER WHLCHR BASE|10765.25|10765.25||1076.52
125|K0012|K0012 - LTWT PORTBL POWER WHLCHR|3157.66|3157.66||315.77
125|K0011|K0011 - STND WT PWR WHLCHR W CONTROL|5132.44|5132.44||513.24
125|K0010|K0010 - STND WT FRAME POWER WHLCHR|3627.9|3627.9||362.8
125|K0009|K0009 - OTHER MANUAL WHEELCHAIR/BASE|745.02|745.02||74.51
125|K0007|K0007 - EXTRA HEAVY DUTY WHEELCHAIR|848.88|848.88||84.89
125|K0006|K0006 - HEAVY DUTY WHEELCHAIR|602.2|602.2||60.22
125|K0005|K0005 - ULTRALIGHTWEIGHT WHEELCHAIR|1852.33|1852.33||185.21
125|K0004|K0004 - HIGH STRENGTH LTWT WHLCHR|407.26|407.26||40.73
125|K0003|K0003 - LIGHTWEIGHT WHEELCHAIR|330.3|330.3||33.04
125|K0002|K0002 - STND HEMI (LOW SEAT) WHLCHR|380.44|380.44||38.04
125|K0001|K0001 - STANDARD WHEELCHAIR|218.34|218.34||21.84
125|J9600|J9600 - PORFIMER SODIUM INJECTION|24414.35|24414.35||
125|J9400|J9400 - INJ -  ZIV-AFLIBERCEPT -  1 MG|13.2|13.2||
125|J9395|J9395 - INJECTION -  FULVESTRANT|157.91|157.91||
125|J9390|J9390 - VINORELBINE TARTRATE INJ|16.1|16.1||
125|J9371|J9371 - INJ -  VINCRISTINE SUL LIP 1 MG|4403.9|4403.9||
125|J9370|J9370 - VINCRISTINE SULFATE 1 MG INJ|7.77|7.77||
125|J9360|J9360 - VINBLASTINE SULFATE INJ|5.55|5.55||
125|J9357|J9357 - VALRUBICIN INJECTION|1953.26|1953.26||
125|J9355|J9355 - TRASTUZUMAB INJECTION|164.06|164.06||
125|J9354|J9354 - INJ -  ADO-TRASTUZUMAB EMT 1 MG|49.24|49.24||
125|J9352|J9352 - INJECTION TRABECTEDIN 0.1MG|473.74|473.74||
125|J9351|J9351 - TOPOTECAN INJECTION|1.88|1.88||
125|J9340|J9340 - THIOTEPA INJECTION|1075.68|1075.68||
125|J9330|J9330 - TEMSIROLIMUS INJECTION|116.86|116.86||
125|J9328|J9328 - TEMOZOLOMIDE INJECTION|15.58|15.58||
125|J9325|J9325 - INJ TALIMOGENE LAHERPAREPVEC|78.68|78.68||
125|J9320|J9320 - STREPTOZOCIN INJECTION|548.83|548.83||
125|J9315|J9315 - ROMIDEPSIN INJECTION|536.61|536.61||
125|J9310|J9310 - RITUXIMAB INJECTION|1430.87|1430.87||
125|J9308|J9308 - INJECTION -  RAMUCIRUMAB|92.96|92.96||
125|J9307|J9307 - PRALATREXATE INJECTION|419.08|419.08||
125|J9306|J9306 - INJECTION -  PERTUZUMAB -  1 MG|18.64|18.64||
125|J9305|J9305 - PEMETREXED INJECTION|108.08|108.08||
125|J9303|J9303 - PANITUMUMAB INJECTION|181.57|181.57||
125|J9302|J9302 - OFATUMUMAB INJECTION|92.04|92.04||
125|J9301|J9301 - OBINUTUZUMAB INJ|98.84|98.84||
125|J9300|J9300 - GEMTUZUMAB OZOGAMICIN INJ|3092.4|3092.4||
125|J9299|J9299 - INJECTION -  NIVOLUMAB|43.66|43.66||
125|J9295|J9295 - INJECTION -  NECITUMUMAB -  1 MG|8.75|8.75||
125|J9293|J9293 - MITOXANTRONE HYDROCHL / 5 MG|52.23|52.23||
125|J9285|J9285 - INJ -  OLARATUMAB -  10 MG|81.42|81.42||
125|J9280|J9280 - MITOMYCIN INJECTION|229.52|229.52||
125|J9271|J9271 - INJ PEMBROLIZUMAB|78.02|78.02||
125|J9270|J9270 - PLICAMYCIN (MITHRAMYCIN) INJ|98.34|98.34||
125|J9268|J9268 - PENTOSTATIN INJECTION|3224.11|3224.11||
125|J9267|J9267 - PACLITAXEL INJECTION|0.2|0.2||
125|J9266|J9266 - PEGASPARGASE INJECTION|23377.57|23377.57||
125|J9264|J9264 - PACLITAXEL PROTEIN BOUND|17.99|17.99||
125|J9263|J9263 - OXALIPLATIN|0.32|0.32||
125|J9262|J9262 - INJ -  OMACETAXINE MEP -  0.01 MG|3.26|3.26||
125|J9261|J9261 - NELARABINE INJECTION|247.62|247.62||
125|J9260|J9260 - METHOTREXATE SODIUM INJ|4.75|4.75||
125|J9250|J9250 - METHOTREXATE SODIUM INJ|0.47|0.47||
125|J9245|J9245 - INJ MELPHALAN HYDROCHL 50 MG|1944.59|1944.59||
125|J9230|J9230 - MECHLORETHAMINE HCL INJ|476.74|476.74||
125|J9228|J9228 - IPILIMUMAB INJECTION|239.1|239.1||
125|J9226|J9226 - SUPPRELIN LA IMPLANT|47231.99|47231.99||
125|J9225|J9225 - VANTAS IMPLANT|5356.23|5356.23||
125|J9219|J9219 - LEUPROLIDE ACETATE IMPLANT|4800.54|4800.54||
125|J9218|J9218 - LEUPROLIDE ACETATE INJECITON|43.41|43.41||
125|J9217|J9217 - LEUPROLIDE ACETATE SUSPNSION|344.26|344.26||
125|J9216|J9216 - INTERFERON GAMMA 1-B INJ|7112.72|7112.72||
125|J9215|J9215 - INTERFERON ALFA-N3 INJ|36|36||
125|J9214|J9214 - INTERFERON ALFA-2B INJ|51.32|51.32||
125|J9213|J9213 - INTERFERON ALFA-2A INJ|50.74|50.74||
125|J9212|J9212 - INTERFERON ALFACON-1 INJ|11.54|11.54||
125|J9211|J9211 - IDARUBICIN HCL INJECTION|70.74|70.74||
125|J9209|J9209 - MESNA INJECTION|3.73|3.73||
125|J9208|J9208 - IFOSFAMIDE INJECTION|43.14|43.14||
125|J9207|J9207 - IXABEPILONE INJECTION|118.99|118.99||
125|J9206|J9206 - IRINOTECAN INJECTION|5.29|5.29||
125|J9205|J9205 - INJ IRINOTECAN LIPOSOME 1 MG|69.96|69.96||
125|J9203|J9203 - GEMTUZUMAB OZOGAMICIN 0.1 MG|314.84|314.84||
125|J9202|J9202 - GOSERELIN ACETATE IMPLANT|612.38|612.38||
125|J9201|J9201 - GEMCITABINE HCL INJECTION|9.62|9.62||
125|J9200|J9200 - FLOXURIDINE INJECTION|102.44|102.44||
125|J9190|J9190 - FLUOROURACIL INJECTION|2.47|2.47||
125|J9185|J9185 - FLUDARABINE PHOSPHATE INJ|138.05|138.05||
125|J9181|J9181 - ETOPOSIDE INJECTION|0.99|0.99||
125|J9179|J9179 - ERIBULIN MESYLATE INJECTION|180.23|180.23||
125|J9178|J9178 - INJ -  EPIRUBICIN HCL -  2 MG|2.24|2.24||
125|J9176|J9176 - INJECTION -  ELOTUZUMAB -  1 MG|10.34|10.34||
125|J9175|J9175 - ELLIOTTS B SOLUTION PER ML|10.16|10.16||
125|J9171|J9171 - DOCETAXEL INJECTION|2.84|2.84||
125|J9165|J9165 - DIETHYLSTILBESTROL INJECTION|15.11|15.11||
125|J9160|J9160 - DENILEUKIN DIFTITOX INJ|1856.15|1856.15||
125|J9155|J9155 - DEGARELIX INJECTION|5.93|5.93||
125|J9151|J9151 - DAUNORUBICIN CITRATE INJ|274.9|274.9||
125|J9150|J9150 - DAUNORUBICIN INJECTION|71.02|71.02||
125|J9145|J9145 - INJECTION -  DARATUMUMAB 10 MG|80.69|80.69||
125|J9130|J9130 - DACARBAZINE 100 MG INJ|6.21|6.21||
125|J9120|J9120 - DACTINOMYCIN INJECTION|2288.54|2288.54||
125|J9100|J9100 - CYTARABINE HCL 100 MG INJ|1.28|1.28||
125|J9098|J9098 - CYTARABINE LIPOSOME INJ|1025.11|1025.11||
125|J9070|J9070 - CYCLOPHOSPHAMIDE 100 MG INJ|68.91|68.91||
125|J9065|J9065 - INJ CLADRIBINE PER 1 MG|34.52|34.52||
125|J9060|J9060 - CISPLATIN 10 MG INJECTION|3.11|3.11||
125|J9055|J9055 - CETUXIMAB INJECTION|96.53|96.53||
125|J9050|J9050 - CARMUSTINE INJECTION|6280.04|6280.04||
125|J9047|J9047 - INJECTION -  CARFILZOMIB -  1 MG|54.09|54.09||
125|J9045|J9045 - CARBOPLATIN INJECTION|5.22|5.22||
125|J9043|J9043 - CABAZITAXEL INJECTION|259.4|259.4||
125|J9042|J9042 - BRENTUXIMAB VEDOTIN INJ|236.28|236.28||
125|J9041|J9041 - INJ. -  VELCADE 0.1 MG|76.53|76.53||
125|J9040|J9040 - BLEOMYCIN SULFATE INJECTION|43.99|43.99||
125|J9039|J9039 - INJECTION -  BLINATUMOMAB|175.62|175.62||
125|J9035|J9035 - BEVACIZUMAB INJECTION|124.96|124.96||
125|J9034|J9034 - INJ. -  BENDEKA 1 MG|38.57|38.57||
125|J9033|J9033 - INJ. -  TREANDA 1 MG|49.12|49.12||
125|J9032|J9032 - INJECTION -  BELINOSTAT -  10MG|58.85|58.85||
125|J9031|J9031 - BCG LIVE INTRAVESICAL VAC|216.44|216.44||
125|J9027|J9027 - CLOFARABINE INJECTION|237.09|237.09||
125|J9025|J9025 - AZACITIDINE INJECTION|2.57|2.57||
125|J9023|J9023 - INJECTION -  AVELUMAB -  10 MG|129.38|129.38||
125|J9022|J9022 - INJ -  ATEZOLIZUMAB - 10 MG|123.54|123.54||
125|J9020|J9020 - ASPARAGINASE -  NOS|72.79|72.79||
125|J9019|J9019 - ERWINAZE INJECTION|656.47|656.47||
125|J9017|J9017 - ARSENIC TRIOXIDE INJECTION|115.82|115.82||
125|J9015|J9015 - ALDESLEUKIN INJECTION|4057.34|4057.34||
125|J9000|J9000 - DOXORUBICIN HCL INJECTION|5.11|5.11||
125|J8705|J8705 - TOPOTECAN ORAL|168.99|168.99||
125|J8700|J8700 - TEMOZOLOMIDE|1.67|1.67||
125|J8670|J8670 - ROLAPITANT -  ORAL -  1 MG|3.7|3.7||
125|J8655|J8655 - ORAL NETUPITANT -  PALONOSETRO|650.09|650.09||
125|J8650|J8650 - NABILONE ORAL|44.86|44.86||
125|J8610|J8610 - METHOTREXATE ORAL 2.5 MG|0.55|0.55||
125|J8600|J8600 - MELPHALAN ORAL 2 MG|19.11|19.11||
125|J8565|J8565 - GEFITINIB ORAL|302.7|302.7||
125|J8562|J8562 - ORAL FLUDARABINE PHOSPHATE|92.2|92.2||
125|J8560|J8560 - ETOPOSIDE ORAL 50 MG|120.26|120.26||
125|J8540|J8540 - ORAL DEXAMETHASONE|0.13|0.13||
125|J8530|J8530 - CYCLOPHOSPHAMIDE ORAL 25 MG|5.59|5.59||
125|J8521|J8521 - CAPECITABINE -  ORAL -  500 MG|9.36|9.36||
125|J8520|J8520 - CAPECITABINE -  ORAL -  150 MG|2.73|2.73||
125|J8515|J8515 - CABERGOLINE -  ORAL 0.25MG|18.25|18.25||
125|J8510|J8510 - ORAL BUSULFAN|39.32|39.32||
125|J8501|J8501 - ORAL APREPITANT|10.89|10.89||
125|J7686|J7686 - TREPROSTINIL -  NON-COMP UNIT|908.04|908.04||
125|J7685|J7685 - TOBRAMYCIN COMP UNIT|57.52|57.52||
125|J7684|J7684 - TRIAMCINOLONE COMP UNIT|0.55|0.55||
125|J7683|J7683 - TRIAMCINOLONE COMP CON|0.55|0.55||
125|J7682|J7682 - TOBRAMYCIN NON-COMP UNIT|64.71|64.71||
125|J7681|J7681 - TERBUTALINE SULF COMP UNIT|0.02|0.02||
125|J7680|J7680 - TERBUTALINE SULF COMP CON|0.02|0.02||
125|J7674|J7674 - METHACHOLINE CHLORIDE -  NEB|0.86|0.86||
125|J7669|J7669 - METAPROTERENOL NON-COMP UNIT|0.43|0.43||
125|J7668|J7668 - METAPROTERENOL NON-COMP CON|0.31|0.31||
125|J7665|J7665 - MANNITOL FOR INHALER|5.04|5.04||
125|J7659|J7659 - ISOPROTERENOL NON-COMP UNIT|2.06|2.06||
125|J7658|J7658 - ISOPROTERENOL NON-COMP CON|2.06|2.06||
125|J7649|J7649 - ISOETHARINE NON-COMP UNIT|0.2|0.2||
125|J7648|J7648 - ISOETHARINE NON-COMP CON|0.18|0.18||
125|J7645|J7645 - IPRATROPIUM BROMIDE COMP|0.06|0.06||
125|J7644|J7644 - IPRATROPIUM BROMIDE NON-COMP|0.36|0.36||
125|J7643|J7643 - GLYCOPYRROLATE COMP UNIT|0.89|0.89||
125|J7642|J7642 - GLYCOPYRROLATE COMP CON|1.19|1.19||
125|J7641|J7641 - FLUNISOLIDE COMP UNIT|0.2|0.2||
125|J7640|J7640 - FORMOTEROL COMP UNIT|2.94|2.94||
125|J7639|J7639 - DORNASE ALFA NON-COMP UNIT|74.1|74.1||
125|J7638|J7638 - DEXAMETHASONE COMP UNIT|0.12|0.12||
125|J7637|J7637 - DEXAMETHASONE COMP CON|0.06|0.06||
125|J7636|J7636 - ATROPINE COMP UNIT|0.67|0.67||
125|J7635|J7635 - ATROPINE COMP CON|0.12|0.12||
125|J7633|J7633 - BUDESONIDE NON-COMP CON|7.78|7.78||
125|J7632|J7632 - CROMOLYN SODIUM COMP UNIT|0.32|0.32||
125|J7631|J7631 - CROMOLYN SODIUM NONCOMP UNIT|1.2|1.2||
125|J7629|J7629 - BITOLTEROL MESYLATE COMP UNT|0.28|0.28||
125|J7628|J7628 - BITOLTEROL MESYLATE COMP CON|0.26|0.26||
125|J7627|J7627 - BUDESONIDE COMP UNIT|0.36|0.36||
125|J7626|J7626 - BUDESONIDE NON-COMP UNIT|5.16|5.16||
125|J7624|J7624 - BETAMETHASONE COMP UNIT|1.2|1.2||
125|J7622|J7622 - BECLOMETHASONE COMP UNIT|0.02|0.02||
125|J7620|J7620 - ALBUTEROL IPRATROP NON-COMP|0.19|0.19||
125|J7615|J7615 - LEVALBUTEROL COMP UNIT|1.68|1.68||
125|J7614|J7614 - LEVALBUTEROL NON-COMP UNIT|0.09|0.09||
125|J7613|J7613 - ALBUTEROL NON-COMP UNIT|0.08|0.08||
125|J7612|J7612 - LEVALBUTEROL NON-COMP CON|0.31|0.31||
125|J7611|J7611 - ALBUTEROL NON-COMP CON|0.23|0.23||
125|J7610|J7610 - ALBUTEROL COMP CON|1.44|1.44||
125|J7609|J7609 - ALBUTEROL COMP UNIT|0.4|0.4||
125|J7608|J7608 - ACETYLCYSTEINE NON-COMP UNIT|8.92|8.92||
125|J7606|J7606 - FORMOTEROL FUMARATE -  INH|16.82|16.82||
125|J7605|J7605 - ARFORMOTEROL NON-COMP UNIT|15.42|15.42||
125|J7527|J7527 - ORAL EVEROLIMUS|13.61|13.61||
125|J7525|J7525 - TACROLIMUS INJECTION|306.16|306.16||
125|J7520|J7520 - SIROLIMUS -  ORAL|12.16|12.16||
125|J7518|J7518 - MYCOPHENOLIC ACID|4.36|4.36||
125|J7517|J7517 - MYCOPHENOLATE MOFETIL ORAL|1.45|1.45||
125|J7516|J7516 - CYCLOSPORIN PARENTERAL 250MG|68.95|68.95||
125|J7515|J7515 - CYCLOSPORINE ORAL 25 MG|1.22|1.22||
125|J7513|J7513 - DACLIZUMAB -  PARENTERAL|593.47|593.47||
125|J7512|J7512 - PREDNISONE IR OR DR ORAL 1 MG|0.02|0.02||
125|J7511|J7511 - ANTITHYMOCYTE GLOBULN RABBIT|1160.89|1160.89||
125|J7510|J7510 - PREDNISOLONE ORAL PER 5 MG|0.14|0.14||
125|J7509|J7509 - METHYLPREDNISOLONE ORAL|0.62|0.62||
125|J7508|J7508 - TACROL ASTAGRAF EX REL ORAL|0.71|0.71||
125|J7507|J7507 - TACROLIMUS IMME REL ORAL 1MG|0.96|0.96||
125|J7505|J7505 - MONOCLONAL ANTIBODIES|1303.54|1303.54||
125|J7504|J7504 - LYMPHOCYTE IMMUNE GLOBULIN|3166.73|3166.73||
125|J7503|J7503 - TACROL ENVARSUS EX REL ORAL|2.01|2.01||
125|J7502|J7502 - CYCLOSPORINE ORAL 100 MG|4.35|4.35||
125|J7501|J7501 - AZATHIOPRINE PARENTERAL|298.8|298.8||
125|J7500|J7500 - AZATHIOPRINE ORAL 50MG|0.54|0.54||
125|J7345|J7345 - AMINOLEVULINIC ACID -  10% GEL -  10 MG|1.61|1.61||
125|J7342|J7342 - CIPROFLOXACIN OTIC SUSP 6 MG|33.84|33.84||
125|J7340|J7340 - CARBIDOPA LEVODOPA ENT 100ML|241.24|241.24||
125|J7336|J7336 - CAPSAICIN 8% PATCH|5.14|5.14||
125|J7330|J7330 - CULTURED CHONDROCYTES IMPLNT|45631.54|45631.54||
125|J7328|J7328 - GELSYN-3 INJECTION 0.1 MG|2.46|2.46||
125|J7327|J7327 - MONOVISC INJ PER DOSE|1380.22|1380.22||
125|J7326|J7326 - GEL-ONE|850.16|850.16||
125|J7325|J7325 - SYNVISC OR SYNVISC-ONE|19.99|19.99||
125|J7324|J7324 - ORTHOVISC INJ PER DOSE|228.37|228.37||
125|J7323|J7323 - EUFLEXXA INJ PER DOSE|253.02|253.02||
125|J7322|J7322 - HYMOVIS INJECTION 1 MG|21.71|21.71||
125|J7321|J7321 - HYALGAN SUPARTZ VISCO-3 DOSE|138.89|138.89||
125|J7320|J7320 - GENVISC 850 -  INJ -  1 MG|10.47|10.47||
125|J7316|J7316 - INJ -  OCRIPLASMIN -  0.125 MG|1706.29|1706.29||
125|J7315|J7315 - OPHTHALMIC MITOMYCIN|429.07|429.07||
125|J7313|J7313 - FLUOCINOL ACET INTRAVIT IMP|799.48|799.48||
125|J7312|J7312 - DEXAMETHASONE INTRA IMPLANT|326.9|326.9||
125|J7311|J7311 - FLUOCINOLONE ACETONIDE IMPLT|32763.28|32763.28||
125|J7310|J7310 - GANCICLOVIR LONG ACT IMPLANT|19123.2|19123.2||
125|J7309|J7309 - METHYL AMINOLEVULINATE -  TOP|94.36|94.36||
125|J7308|J7308 - AMINOLEVULINIC ACID HCL TOP|659.48|659.48||
125|J7307|J7307 - ETONOGESTREL IMPLANT SYSTEM|1017.48|1017.48||
125|J7306|J7306 - LEVONORGESTREL IMPLANT SYS|505.48|505.48||
125|J7304|J7304 - CONTRACEPTIVE HORMONE PATCH|47.92|47.92||
125|J7303|J7303 - CONTRACEPTIVE VAGINAL RING|168.44|168.44||
125|J7301|J7301 - SKYLA -  13.5 MG|908.24|908.24||
125|J7300|J7300 - INTRAUT COPPER CONTRACEPTIVE|970.2|970.2||
125|J7298|J7298 - MIRENA -  52 MG|1090.76|1090.76||
125|J7297|J7297 - LILETTA -  52 MG|750|750||
125|J7296|J7296 - KYLEENA -  19.5 MG|1090.76|1090.76||
125|J7211|J7211 - INJ -  KOVALTRY -  1 I.U.|2.03|2.03||
125|J7210|J7210 - INJ -  AFSTYLA -  1 I.U.|1.97|1.97||
125|J7209|J7209 - FACTOR VIII NUWIQ RECOMB 1IU|2.02|2.02||
125|J7207|J7207 - FACTOR VIII PEGYLATED RECOMB|2.38|2.38||
125|J7205|J7205 - FACTOR VIII FC FUSION RECOMB|3.29|3.29||
125|J7202|J7202 - FACTOR IX IDELVION INJ|5.26|5.26||
125|J7201|J7201 - FACTOR IX ALPROLIX RECOMB|4.88|4.88||
125|J7200|J7200 - FACTOR IX RECOMBINAN RIXUBIS|2.25|2.25||
125|J7198|J7198 - ANTI-INHIBITOR|3.27|3.27||
125|J7197|J7197 - ANTITHROMBIN III INJECTION|6.08|6.08||
125|J7196|J7196 - ANTITHROMBIN RECOMBINANT|167.93|167.93||
125|J7195|J7195 - FACTOR IX RECOMBINANT NOS|2.46|2.46||
125|J7194|J7194 - FACTOR IX COMPLEX|2.29|2.29||
125|J7193|J7193 - FACTOR IX NON-RECOMBINANT|1.87|1.87||
125|J7192|J7192 - FACTOR VIII RECOMBINANT NOS|2.08|2.08||
125|J7191|J7191 - FACTOR VIII (PORCINE)|2.2|2.2||
125|J7190|J7190 - FACTOR VIII|1.76|1.76||
125|J7189|J7189 - FACTOR VIIA|3.24|3.24||
125|J7188|J7188 - FACTOR VIII RECOMB OBIZUR|6.17|6.17||
125|J7187|J7187 - HUMATE-P -  INJ|1.79|1.79||
125|J7186|J7186 - ANTIHEMOPHILIC VIII/VWF COMP|1.59|1.59||
125|J7185|J7185 - XYNTHA INJ|2.08|2.08||
125|J7183|J7183 - WILATE INJECTION|1.67|1.67||
125|J7182|J7182 - FACTOR VIII RECOMB NOVOEIGHT|2.05|2.05||
125|J7181|J7181 - FACTOR XIII RECOMB A-SUBUNIT|17.29|17.29||
125|J7180|J7180 - FACTOR XIII ANTI-HEM FACTOR|13.4|13.4||
125|J7179|J7179 - VONVENDI INJ 1 IU VWF:RCO|2.38|2.38||
125|J7178|J7178 - INJ HUMAN FIBRINOGEN CON NOS|1.39|1.39||
125|J7175|J7175 - INJ -  FACTOR X -  (HUMAN) -  1IU|9.72|9.72||
125|J7131|J7131 - HYPERTONIC SALINE SOL|0.04|0.04||
125|J7121|J7121 - 5% DEXTROSE IN LAC RINGERS|1.18|1.18||
125|J7120|J7120 - RINGERS LACTATE INFUSION|4.41|4.41||
125|J7110|J7110 - DEXTRAN 75 INFUSION|14.46|14.46||
125|J7100|J7100 - DEXTRAN 40 INFUSION|31.72|31.72||
125|J7070|J7070 - D5W INFUSION|7.27|7.27||
125|J7060|J7060 - 5% DEXTROSE/WATER|3.84|3.84||
125|J7050|J7050 - NORMAL SALINE SOLUTION INFUS|0.89|0.89||
125|J7042|J7042 - 5% DEXTROSE/NORMAL SALINE|1.73|1.73||
125|J7040|J7040 - NORMAL SALINE SOLUTION INFUS|1.8|1.8||
125|J7030|J7030 - NORMAL SALINE SOLUTION INFUS|3.59|3.59||
125|J3520|J3520 - EDETATE DISODIUM PER 150 MG|1.49|1.49||
125|J3489|J3489 - ZOLEDRONIC ACID 1MG|21.22|21.22||
125|J3486|J3486 - ZIPRASIDONE MESYLATE|37.98|37.98||
125|J3485|J3485 - ZIDOVUDINE|2.47|2.47||
125|J3480|J3480 - INJ POTASSIUM CHLORIDE|0.21|0.21||
125|J3475|J3475 - INJ MAGNESIUM SULFATE|0.83|0.83||
125|J3473|J3473 - HYALURONIDASE RECOMBINANT|0.58|0.58||
125|J3472|J3472 - OVINE -  1000 USP UNITS|161.86|161.86||
125|J3471|J3471 - OVINE -  UP TO 999 USP UNITS|0.63|0.63||
125|J3470|J3470 - HYALURONIDASE INJECTION|66.7|66.7||
125|J3465|J3465 - INJECTION -  VORICONAZOLE|3.65|3.65||
125|J3430|J3430 - VITAMIN K PHYTONADIONE INJ|6.74|6.74||
125|J3420|J3420 - VITAMIN B12 INJECTION|3.47|3.47||
125|J3415|J3415 - PYRIDOXINE HCL 100 MG|13.66|13.66||
125|J3411|J3411 - THIAMINE HCL 100 MG|4.85|4.85||
125|J3410|J3410 - HYDROXYZINE HCL INJECTION|10.89|10.89||
125|J3400|J3400 - TRIFLUPROMAZINE HCL INJ|12.95|12.95||
125|J3396|J3396 - VERTEPORFIN INJECTION|17.53|17.53||
125|J3385|J3385 - VELAGLUCERASE ALFA|560.6|560.6||
125|J3380|J3380 - INJECTION -  VEDOLIZUMAB|30.25|30.25||
125|J3370|J3370 - VANCOMYCIN HCL INJECTION|4.76|4.76||
125|J3365|J3365 - UROKINASE 250 - 000 IU INJ|516.11|516.11||
125|J3364|J3364 - UROKINASE 5000 IU INJECTION|10.32|10.32||
125|J3360|J3360 - DIAZEPAM INJECTION|11.41|11.41||
125|J3358|J3358 - USTEKINUMAB -  IV INJECT -  1 MG|20.95|20.95||
125|J3357|J3357 - USTEKINUMAB SUB CU INJ -  1 MG|305|305||
125|J3355|J3355 - UROFOLLITROPIN -  75 IU|149.58|149.58||
125|J3350|J3350 - UREA INJECTION|88.52|88.52||
125|J3320|J3320 - SPECTINOMYCN DI-HCL INJ|35.34|35.34||
125|J3315|J3315 - TRIPTORELIN PAMOATE|677.72|677.72||
125|J3310|J3310 - PERPHENAZINE INJECITON|7.48|7.48||
125|J3305|J3305 - INJ TRIMETREXATE GLUCORONATE|175.85|175.85||
125|J3303|J3303 - TRIAMCINOLONE HEXACETONL INJ|4.25|4.25||
125|J3302|J3302 - TRIAMCINOLONE DIACETATE INJ|0.28|0.28||
125|J3301|J3301 - TRIAMCINOLONE ACET INJ NOS|3.09|3.09||
125|J3300|J3300 - TRIAMCINOLONE A INJ PRS-FREE|6.31|6.31||
125|J3285|J3285 - TREPROSTINIL INJECTION|99.82|99.82||
125|J3280|J3280 - THIETHYLPERAZINE MALEATE INJ|7.39|7.39||
125|J3265|J3265 - INJECTION TORSEMIDE 10 MG/ML|3.55|3.55||
125|J3262|J3262 - TOCILIZUMAB INJECTION|7.38|7.38||
125|J3260|J3260 - TOBRAMYCIN SULFATE INJECTION|4.87|4.87||
125|J3250|J3250 - TRIMETHOBENZAMIDE HCL INJ|49.34|49.34||
125|J3246|J3246 - TIROFIBAN HCL|17.72|17.72||
125|J3243|J3243 - TIGECYCLINE INJECTION|4.6|4.6||
125|J3240|J3240 - THYROTROPIN INJECTION|2612.3|2612.3||
125|J3230|J3230 - CHLORPROMAZINE HCL INJECTION|46.53|46.53||
125|J3145|J3145 - TESTOSTERONE UNDECANOATE 1 MG|1.62|1.62||
125|J3121|J3121 - INJ TESTOSTERO ENANTHATE 1MG|0.06|0.06||
125|J3110|J3110 - TERIPARATIDE INJECTION|59.72|59.72||
125|J3105|J3105 - TERBUTALINE SULFATE INJ|3.13|3.13||
125|J3101|J3101 - TENECTEPLASE INJECTION|181.83|181.83||
125|J3095|J3095 - TELAVANCIN INJECTION|8.76|8.76||
125|J3090|J3090 - INJ TEDIZOLID PHOSPHATE|2.24|2.24||
125|J3070|J3070 - PENTAZOCINE INJECTION|108.18|108.18||
125|J3060|J3060 - INJ -  TALIGLUCERASE ALFA 10 U|65.83|65.83||
125|J3030|J3030 - SUMATRIPTAN SUCCINATE / 6 MG|91.15|91.15||
125|J3010|J3010 - FENTANYL CITRATE INJECTION|0.78|0.78||
125|J3000|J3000 - STREPTOMYCIN INJECTION|39.3|39.3||
125|J2997|J2997 - ALTEPLASE RECOMBINANT|138.47|138.47||
125|J2995|J2995 - INJ STREPTOKINASE /250000 IU|93.37|93.37||
125|J2993|J2993 - RETEPLASE INJECTION|2595.5|2595.5||
125|J2950|J2950 - PROMAZINE HCL INJECTION|1.03|1.03||
125|J2941|J2941 - SOMATROPIN INJECTION|146.42|146.42||
125|J2940|J2940 - SOMATREM INJECTION|52.66|52.66||
125|J2930|J2930 - METHYLPREDNISOLONE INJECTION|9.76|9.76||
125|J2920|J2920 - METHYLPREDNISOLONE INJECTION|7.08|7.08||
125|J2916|J2916 - NA FERRIC GLUCONATE COMPLEX|3.51|3.51||
125|J2910|J2910 - AUROTHIOGLUCOSE INJECITON|29.28|29.28||
125|J2860|J2860 - INJECTION -  SILTUXIMAB|105.62|105.62||
125|J2850|J2850 - INJ SECRETIN SYNTHETIC HUMAN|39.23|39.23||
125|J2840|J2840 - INJ SEBELIPASE ALFA 1 MG|597.6|597.6||
125|J2820|J2820 - SARGRAMOSTIM INJECTION|61.6|61.6||
125|J2810|J2810 - INJ THEOPHYLLINE PER 40 MG|0.5|0.5||
125|J2805|J2805 - SINCALIDE INJECTION|170.79|170.79||
125|J2800|J2800 - METHOCARBAMOL INJECTION|55.3|55.3||
125|J2796|J2796 - ROMIPLOSTIM INJECTION|110.93|110.93||
125|J2795|J2795 - ROPIVACAINE HCL INJECTION|0.12|0.12||
125|J2794|J2794 - RISPERIDONE -  LONG ACTING|14.6|14.6||
125|J2793|J2793 - RILONACEPT INJECTION|27.16|27.16||
125|J2792|J2792 - RHO(D) IMMUNE GLOBULIN H -  SD|41.26|41.26||
125|J2791|J2791 - RHOPHYLAC INJECTION|7.95|7.95||
125|J2790|J2790 - RHO D IMMUNE GLOBULIN INJ|131|131||
125|J2788|J2788 - RHO D IMMUNE GLOBULIN 50 MCG|44.01|44.01||
125|J2786|J2786 - INJECTION -  RESLIZUMAB -  1 MG|10.28|10.28||
125|J2785|J2785 - REGADENOSON INJECTION|92.17|92.17||
125|J2783|J2783 - RASBURICASE|429.52|429.52||
125|J2780|J2780 - RANITIDINE HYDROCHLORIDE INJ|9.92|9.92||
125|J2778|J2778 - RANIBIZUMAB INJECTION|630.08|630.08||
125|J2770|J2770 - QUINUPRISTIN/DALFOPRISTIN|681.66|681.66||
125|J2765|J2765 - METOCLOPRAMIDE HCL INJECTION|1.51|1.51||
125|J2760|J2760 - PHENTOLAINE MESYLATE INJ|507.96|507.96||
125|J2730|J2730 - PRALIDOXIME CHLORIDE INJ|103.62|103.62||
125|J2725|J2725 - INJ PROTIRELIN PER 250 MCG|25.57|25.57||
125|J2724|J2724 - PROTEIN C CONCENTRATE|24.72|24.72||
125|J2720|J2720 - INJ PROTAMINE SULFATE/10 MG|1.44|1.44||
125|J2710|J2710 - NEOSTIGMINE METHYLSLFTE INJ|7.32|7.32||
125|J2704|J2704 - INJ -  PROPOFOL -  10 MG|0.19|0.19||
125|J2700|J2700 - OXACILLIN SODIUM INJECITON|2.43|2.43||
125|J2690|J2690 - PROCAINAMIDE HCL INJECTION|115.51|115.51||
125|J2680|J2680 - FLUPHENAZINE DECANOATE 25 MG|26.63|26.63||
125|J2675|J2675 - INJ PROGESTERONE PER 50 MG|2.12|2.12||
125|J2670|J2670 - TOTAZOLINE HCL INJECTION|4.12|4.12||
125|J2650|J2650 - PREDNISOLONE ACETATE INJ|0.5|0.5||
125|J2597|J2597 - INJ DESMOPRESSIN ACETATE|21.03|21.03||
125|J2590|J2590 - OXYTOCIN INJECTION|1.26|1.26||
125|J2562|J2562 - PLERIXAFOR INJECTION|512.53|512.53||
125|J2560|J2560 - PHENOBARBITAL SODIUM INJ|60.77|60.77||
125|J2550|J2550 - PROMETHAZINE HCL INJECTION|4.02|4.02||
125|J2547|J2547 - INJECTION -  PERAMIVIR|1.9|1.9||
125|J2545|J2545 - PENTAMIDINE NON-COMP UNIT|191.22|191.22||
125|J2543|J2543 - PIPERACILLIN/TAZOBACTAM|4.52|4.52||
125|J2540|J2540 - PENICILLIN G POTASSIUM INJ|1.81|1.81||
125|J2515|J2515 - PENTOBARBITAL SODIUM INJ|83.44|83.44||
125|J2513|J2513 - PENTASTARCH 10% SOLUTION|15.84|15.84||
125|J2510|J2510 - PENICILLIN G PROCAINE INJ|47.75|47.75||
125|J2507|J2507 - PEGLOTICASE INJECTION|3358.58|3358.58||
125|J2505|J2505 - INJECTION -  PEGFILGRASTIM 6MG|7240.96|7240.96||
125|J2504|J2504 - PEGADEMASE BOVINE -  25 IU|585.15|585.15||
125|J2503|J2503 - PEGAPTANIB SODIUM INJECTION|1175.63|1175.63||
125|J2502|J2502 - INJ -  PASIREOTIDE LONG ACTING|334.66|334.66||
125|J2501|J2501 - PARICALCITOL|1.28|1.28||
125|J2469|J2469 - PALONOSETRON HCL|33.09|33.09||
125|J2460|J2460 - OXYTETRACYCLINE INJECTION|1.09|1.09||
125|J2440|J2440 - PAPAVERIN HCL INJECTION|42.76|42.76||
125|J2430|J2430 - PAMIDRONATE DISODIUM /30 MG|16.03|16.03||
125|J2426|J2426 - PALIPERIDONE PALMITATE INJ|16.91|16.91||
125|J2425|J2425 - PALIFERMIN INJECTION|31.12|31.12||
125|J2410|J2410 - OXYMORPHONE HCL INJECTION|3.73|3.73||
125|J2407|J2407 - INJECTION -  ORITAVANCIN|37.88|37.88||
125|J2405|J2405 - ONDANSETRON HCL INJECTION|0.14|0.14||
125|J2400|J2400 - CHLOROPROCAINE HCL INJECTION|36.11|36.11||
125|J2370|J2370 - PHENYLEPHRINE HCL INJECTION|5.48|5.48||
125|J2360|J2360 - ORPHENADRINE INJECTION|12.73|12.73||
125|J2358|J2358 - OLANZAPINE LONG-ACTING INJ|4.75|4.75||
125|J2357|J2357 - OMALIZUMAB INJECTION|56.95|56.95||
125|J2355|J2355 - OPRELVEKIN INJECTION|761.56|761.56||
125|J2354|J2354 - OCTREOTIDE INJ -  NON-DEPOT|1.42|1.42||
125|J2353|J2353 - OCTREOTIDE INJECTION -  DEPOT|310.81|310.81||
125|J2350|J2350 - INJECTION -  OCRELIZUMAB -  1 MG|93.05|93.05||
125|J2326|J2326 - INJ -  NUSINERSEN -  0.1MG|1245|1245||
125|J2325|J2325 - NESIRITIDE INJECTION|84.34|84.34||
125|J2323|J2323 - NATALIZUMAB INJECTION|31.65|31.65||
125|J2320|J2320 - NANDROLONE DECANOATE 50 MG|4.24|4.24||
125|J2315|J2315 - NALTREXONE -  DEPOT FORM|5.3|5.3||
125|J2310|J2310 - INJ NALOXONE HYDROCHLORIDE|44.94|44.94||
125|J2300|J2300 - INJ NALBUPHINE HYDROCHLORIDE|4.26|4.26||
125|J2280|J2280 - INJ -  MOXIFLOXACIN 100 MG|14.51|14.51||
125|J2278|J2278 - ZICONOTIDE INJECTION|12.12|12.12||
125|J2274|J2274 - INJ MORPHINE PF EPID ITHC|18.73|18.73||
125|J2270|J2270 - MORPHINE SULFATE INJECTION|3.32|3.32||
125|J2265|J2265 - MINOCYCLINE HYDROCHLORIDE|1.85|1.85||
125|J2260|J2260 - INJ MILRINONE LACTATE / 5 MG|2.6|2.6||
125|J2250|J2250 - INJ MIDAZOLAM HYDROCHLORIDE|0.2|0.2||
125|J2248|J2248 - MICAFUNGIN SODIUM INJECTION|1.5|1.5||
125|J2212|J2212 - METHYLNALTREXONE INJECTION|1.08|1.08||
125|J2210|J2210 - METHYLERGONOVIN MALEATE INJ|23.73|23.73||
125|J2185|J2185 - MEROPENEM|1.64|1.64||
125|J2182|J2182 - INJECTION -  MEPOLIZUMAB -  1 MG|33.29|33.29||
125|J2180|J2180 - MEPERIDINE/PROMETHAZINE INJ|9.43|9.43||
125|J2175|J2175 - MEPERIDINE HYDROCHL /100 MG|7.22|7.22||
125|J2170|J2170 - MECASERMIN INJECTION|110.41|110.41||
125|J2150|J2150 - MANNITOL INJECTION|3.9|3.9||
125|J2060|J2060 - LORAZEPAM INJECTION|1.17|1.17||
125|J2020|J2020 - LINEZOLID INJECTION|21.2|21.2||
125|J2010|J2010 - LINCOMYCIN INJECTION|21.82|21.82||
125|J2001|J2001 - LIDOCAINE INJECTION|0.03|0.03||
125|J1990|J1990 - CHLORDIAZEPOXIDE INJECTION|26.21|26.21||
125|J1980|J1980 - HYOSCYAMINE SULFATE INJ|45.03|45.03||
125|J1960|J1960 - LEVORPHANOL TARTRATE INJ|0.44|0.44||
125|J1956|J1956 - LEVOFLOXACIN INJECTION|2.96|2.96||
125|J1955|J1955 - INJ LEVOCARNITINE PER 1 GM|40.75|40.75||
125|J1953|J1953 - LEVETIRACETAM INJECTION|0.15|0.15||
125|J1950|J1950 - LEUPROLIDE ACETATE /3.75 MG|1772.55|1772.55||
125|J1945|J1945 - LEPIRUDIN|643.31|643.31||
125|J1942|J1942 - ARIPIPRAZOLE LAUROXIL 1MG|3.96|3.96||
125|J1940|J1940 - FUROSEMIDE INJECTION|1.59|1.59||
125|J1931|J1931 - LARONIDASE INJECTION|49.9|49.9||
125|J1930|J1930 - LANREOTIDE INJECTION|92.41|92.41||
125|J1890|J1890 - CEPHALOTHIN SODIUM INJECTION|10.75|10.75||
125|J1885|J1885 - KETOROLAC TROMETHAMINE INJ|0.98|0.98||
125|J1850|J1850 - KANAMYCIN SULFATE 75 MG INJ|1.36|1.36||
125|J1840|J1840 - KANAMYCIN SULFATE 500 MG INJ|8.99|8.99||
125|J1835|J1835 - ITRACONAZOLE INJECTION|49.66|49.66||
125|J1833|J1833 - INJECTION -  ISAVUCONAZONIUM|0.88|0.88||
125|J1830|J1830 - INTERFERON BETA-1B / .25 MG|473.88|473.88||
125|J1826|J1826 - INTERFERON BETA-1A INJ|1878.55|1878.55||
125|J1817|J1817 - INSULIN FOR INSULIN PUMP USE|16.47|16.47||
125|J1815|J1815 - INSULIN INJECTION|1.4|1.4||
125|J1810|J1810 - DROPERIDOL/FENTANYL INJ|16.86|16.86||
125|J1800|J1800 - PROPRANOLOL INJECTION|2.8|2.8||
125|J1790|J1790 - DROPERIDOL INJECTION|3.48|3.48||
125|J1786|J1786 - IMUGLUCERASE INJECTION|67.97|67.97||
125|J1756|J1756 - IRON SUCROSE INJECTION|0.39|0.39||
125|J1750|J1750 - INJ IRON DEXTRAN|21.25|21.25||
125|J1745|J1745 - INFLIXIMAB NOT BIOSIMIL 10MG|139.87|139.87||
125|J1744|J1744 - ICATIBANT INJECTION|410.65|410.65||
125|J1743|J1743 - IDURSULFASE INJECTION|884.86|884.86||
125|J1742|J1742 - IBUTILIDE FUMARATE INJECTION|326.08|326.08||
125|J1741|J1741 - IBUPROFEN INJECTION|2.24|2.24||
125|J1740|J1740 - IBANDRONATE SODIUM INJECTION|138.36|138.36||
125|J1730|J1730 - DIAZOXIDE INJECTION|128.9|128.9||
125|J1729|J1729 - INJ HYDROXYPROGST CAPOAT NOS|18.42|18.42||
125|J1726|J1726 - INJ -  HYDRO CAPROATE -  MAKENA -  10 MG|36.54|36.54||
125|J1725|J1725 - HYDROXYPROGESTERONE CAPROATE|3.66|3.66||
125|J1720|J1720 - HYDROCORTISONE SODIUM SUCC I|19.45|19.45||
125|J1710|J1710 - HYDROCORTISONE SODIUM PH INJ|5.83|5.83||
125|J1700|J1700 - HYDROCORTISONE ACETATE INJ|1.28|1.28||
125|J1675|J1675 - HISTRELIN ACETATE|0.96|0.96||
125|J1670|J1670 - TETANUS IMMUNE GLOBULIN INJ|791.52|791.52||
125|J1655|J1655 - TINZAPARIN SODIUM INJECTION|5.23|5.23||
125|J1652|J1652 - FONDAPARINUX SODIUM|3.85|3.85||
125|J1650|J1650 - INJ ENOXAPARIN SODIUM|1.35|1.35||
125|J1645|J1645 - DALTEPARIN SODIUM|25.11|25.11||
125|J1644|J1644 - INJ HEPARIN SODIUM PER 1000U|0.32|0.32||
125|J1642|J1642 - INJ HEPARIN SODIUM PER 10 U|0.29|0.29||
125|J1640|J1640 - HEMIN -  1 MG|36.44|36.44||
125|J1631|J1631 - HALOPERIDOL DECANOATE INJ|29.45|29.45||
125|J1630|J1630 - HALOPERIDOL INJECTION|1.77|1.77||
125|J1627|J1627 - INJ -  GRANISETRON -  XR -  0.1 MG|7.5|7.5||
125|J1626|J1626 - GRANISETRON HCL INJECTION|0.52|0.52||
125|J1620|J1620 - GONADORELIN HYDROCH/ 100 MCG|211.76|211.76||
125|J1610|J1610 - GLUCAGON HYDROCHLORIDE/1 MG|357.2|357.2||
125|J1602|J1602 - GOLIMUMAB FOR IV USE 1MG|39.57|39.57||
125|J1600|J1600 - GOLD SODIUM THIOMALEATE INJ|17.44|17.44||
125|J1595|J1595 - INJECTION GLATIRAMER ACETATE|215.54|215.54||
125|J1580|J1580 - GARAMYCIN GENTAMICIN INJ|2.57|2.57||
125|J1575|J1575 - HYQVIA 100MG IMMUNEGLOBULIN|22.92|22.92||
125|J1573|J1573 - HEPAGAM B INTRAVENOUS -  INJ|86.1|86.1||
125|J1572|J1572 - FLEBOGAMMA INJECTION|54.86|54.86||
125|J1571|J1571 - HEPAGAM B IM INJECTION|102.97|102.97||
125|J1570|J1570 - GANCICLOVIR SODIUM INJECTION|109.5|109.5||
125|J1569|J1569 - GAMMAGARD LIQUID INJECTION|66.38|66.38||
125|J1568|J1568 - OCTAGAM INJECTION|58.01|58.01||
125|J1566|J1566 - IMMUNE GLOBULIN -  POWDER|56.1|56.1||
125|J1562|J1562 - VIVAGLOBIN -  INJ|14.34|14.34||
125|J1561|J1561 - GAMUNEX-C/GAMMAKED|66.35|66.35||
125|J1560|J1560 - GAMMA GLOBULIN > 10 CC INJ|537.21|537.21||
125|J1559|J1559 - HIZENTRA INJECTION|16.02|16.02||
125|J1557|J1557 - GAMMAPLEX INJECTION|65.25|65.25||
125|J1556|J1556 - INJ -  IMM GLOB BIVIGAM -  500 MG|114.94|114.94||
125|J1555|J1555 - INJ CUVITRU -  100 MG|22.48|22.48||
125|J1460|J1460 - GAMMA GLOBULIN 1 CC INJ|53.72|53.72||
125|J1459|J1459 - INJ IVIG PRIVIGEN 500 MG|62.73|62.73||
125|J1458|J1458 - GALSULFASE INJECTION|620.17|620.17||
125|J1457|J1457 - GALLIUM NITRATE INJECTION|2.39|2.39||
125|J1455|J1455 - FOSCARNET SODIUM INJECTION|86.05|86.05||
125|J1453|J1453 - FOSAPREPITANT INJECTION|3.34|3.34||
125|J1452|J1452 - INTRAOCULAR FOMIVIRSEN NA|996|996||
125|J1451|J1451 - FOMEPIZOLE -  15 MG|13.21|13.21||
125|J1450|J1450 - FLUCONAZOLE|6.9|6.9||
125|J1447|J1447 - INJ TBO FILGRASTIM 1 MICROG|0.99|0.99||
125|J1443|J1443 - INJ FERRIC PYROPHOSPHATE CIT|0.02|0.02||
125|J1442|J1442 - INJ FILGRASTIM EXCL BIOSIMIL|1.63|1.63||
125|J1439|J1439 - INJ FERRIC CARBOXYMALTOS 1 MG|1.71|1.71||
125|J1438|J1438 - ETANERCEPT INJECTION|663.64|663.64||
125|J1436|J1436 - ETIDRONATE DISODIUM INJ|80.52|80.52||
125|J1435|J1435 - INJECTION ESTRONE PER 1 MG|0.2|0.2||
125|J1430|J1430 - ETHANOLAMINE OLEATE 100 MG|723.88|723.88||
125|J1428|J1428 - INJ -  ETEPLIRSEN -  10 MG|191.23|191.23||
125|J1410|J1410 - INJ ESTROGEN CONJUGATE 25 MG|491.8|491.8||
125|J1380|J1380 - ESTRADIOL VALERATE 10 MG INJ|12.97|12.97||
125|J1364|J1364 - ERYTHRO LACTOBIONATE /500 MG|117.94|117.94||
125|J1335|J1335 - ERTAPENEM INJECTION|90.53|90.53||
125|J1330|J1330 - ERGONOVINE MALEATE INJECTION|5.71|5.71||
125|J1327|J1327 - EPTIFIBATIDE INJECTION|44.94|44.94||
125|J1325|J1325 - EPOPROSTENOL INJECTION|25.37|25.37||
125|J1324|J1324 - ENFUVIRTIDE INJECTION|0.79|0.79||
125|J1322|J1322 - ELOSULFASE ALFA -  INJECTION|265.57|265.57||
125|J1320|J1320 - AMITRIPTYLINE INJECTION|2.63|2.63||
125|J1300|J1300 - ECULIZUMAB INJECTION|372.23|372.23||
125|J1290|J1290 - ECALLANTIDE INJECTION|736.95|736.95||
125|J1270|J1270 - INJECTION -  DOXERCALCIFEROL|0.72|0.72||
125|J1267|J1267 - DORIPENEM INJECTION|1.16|1.16||
125|J1265|J1265 - DOPAMINE INJECTION|1.03|1.03||
125|J1260|J1260 - DOLASETRON MESYLATE|7.01|7.01||
125|J1250|J1250 - INJ DOBUTAMINE HCL/250 MG|10.57|10.57||
125|J1245|J1245 - DIPYRIDAMOLE INJECTION|1.24|1.24||
125|J1240|J1240 - DIMENHYDRINATE INJECTION|13.18|13.18||
125|J1230|J1230 - METHADONE INJECTION|31.6|31.6||
125|J1212|J1212 - DIMETHYL SULFOXIDE 50% 50 ML|903.94|903.94||
125|J1205|J1205 - CHLOROTHIAZIDE SODIUM INJ|100.22|100.22||
125|J1200|J1200 - DIPHENHYDRAMINE HCL INJECTIO|0.96|0.96||
125|J1190|J1190 - DEXRAZOXANE HCL INJECTION|363.85|363.85||
125|J1180|J1180 - DYPHYLLINE INJECTION|9.46|9.46||
125|J1170|J1170 - HYDROMORPHONE INJECTION|2.56|2.56||
125|J1165|J1165 - PHENYTOIN SODIUM INJECTION|0.95|0.95||
125|J1162|J1162 - DIGOXIN IMMUNE FAB (OVINE)|5577.2|5577.2||
125|J1160|J1160 - DIGOXIN INJECTION|18.29|18.29||
125|J1130|J1130 - INJ DICLOFENAC SODIUM 0.5MG|0.25|0.25||
125|J1120|J1120 - ACETAZOLAMID SODIUM INJECTIO|28.36|28.36||
125|J1110|J1110 - INJ DIHYDROERGOTAMINE MESYLT|170.77|170.77||
125|J1100|J1100 - DEXAMETHASONE SODIUM PHOS|0.19|0.19||
125|J1094|J1094 - INJ DEXAMETHASONE ACETATE|0.34|0.34||
125|J1071|J1071 - INJ TESTOSTERONE CYPIONATE|0.04|0.04||
125|J1050|J1050 - MEDROXYPROGESTERONE ACETATE|0.85|0.85||
125|J1040|J1040 - METHYLPREDNISOLONE 80 MG INJ|21.13|21.13||
125|J1030|J1030 - METHYLPREDNISOLONE 40 MG INJ|10.91|10.91||
125|J1020|J1020 - METHYLPREDNISOLONE 20 MG INJ|9.69|9.69||
125|J1000|J1000 - DEPO-ESTRADIOL CYPIONATE INJ|32.89|32.89||
125|J0945|J0945 - BROMPHENIRAMINE MALEATE INJ|0.91|0.91||
125|J0897|J0897 - DENOSUMAB INJECTION|28.93|28.93||
125|J0895|J0895 - DEFEROXAMINE MESYLATE INJ|13.1|13.1||
125|J0894|J0894 - DECITABINE INJECTION|26.3|26.3||
125|J0890|J0890 - PEGINESATIDE INJECTION|12.92|12.92||
125|J0888|J0888 - EPOETIN BETA NON ESRD|2.65|2.65||
125|J0887|J0887 - EPOETIN BETA ESRD USE|2.65|2.65||
125|J0885|J0885 - EPOETIN ALFA -  NON-ESRD|19.77|19.77||
125|J0884|J0884 - ARGATROBAN ESRD DIALYSIS 1MG|5.42|5.42||
125|J0883|J0883 - ARGATROBAN NONESRD USE 1MG|5.42|5.42||
125|J0882|J0882 - DARBEPOETIN ALFA -  ESRD USE|6.36|6.36||
125|J0881|J0881 - DARBEPOETIN ALFA -  NON-ESRD|6.36|6.36||
125|J0878|J0878 - DAPTOMYCIN INJECTION|0.82|0.82||
125|J0875|J0875 - INJECTION -  DALBAVANCIN|24.07|24.07||
125|J0850|J0850 - CYTOMEGALOVIRUS IMM IV /VIAL|1840.47|1840.47||
125|J0840|J0840 - CROTALIDAE POLY IMMUNE FAB|4893.26|4893.26||
125|J0834|J0834 - INJ. -  COSYNTROPIN -  0.25 MG|60.7|60.7||
125|J0833|J0833 - COSYNTROPIN INJECTION NOS|100.62|100.62||
125|J0800|J0800 - CORTICOTROPIN INJECTION|6135.78|6135.78||
125|J0795|J0795 - CORTICORELIN OVINE TRIFLUTAL|14.04|14.04||
125|J0780|J0780 - PROCHLORPERAZINE INJECTION|15.9|15.9||
125|J0775|J0775 - COLLAGENASE -  CLOST HIST INJ|68.19|68.19||
125|J0770|J0770 - COLISTIMETHATE SODIUM INJ|25.19|25.19||
125|J0745|J0745 - INJ CODEINE PHOSPHATE /30 MG|1.51|1.51||
125|J0744|J0744 - CIPROFLOXACIN IV|2.08|2.08||
125|J0743|J0743 - CILASTATIN SODIUM INJECTION|9.85|9.85||
125|J0740|J0740 - CIDOFOVIR INJECTION|759.39|759.39||
125|J0735|J0735 - CLONIDINE HYDROCHLORIDE|22.74|22.74||
125|J0725|J0725 - CHORIONIC GONADOTROPIN/1000U|36.82|36.82||
125|J0720|J0720 - CHLORAMPHENICOL SODIUM INJEC|63.97|63.97||
125|J0717|J0717 - CERTOLIZUMAB PEGOL INJ 1MG|12.93|12.93||
125|J0716|J0716 - CENTRUROIDES IMMUNE F(AB)|5130.36|5130.36||
125|J0715|J0715 - CEFTIZOXIME SODIUM / 500 MG|5.68|5.68||
125|J0714|J0714 - CEFTAZIDIME AND AVIBACTAM|89.42|89.42||
125|J0713|J0713 - INJ CEFTAZIDIME PER 500 MG|3.67|3.67||
125|J0712|J0712 - CEFTAROLINE FOSAMIL INJ|4.25|4.25||
125|J0710|J0710 - CEPHAPIRIN SODIUM INJECTION|1.63|1.63||
125|J0706|J0706 - CAFFEINE CITRATE INJECTION|2.6|2.6||
125|J0702|J0702 - BETAMETHASONE ACET&SOD PHOSP|12.45|12.45||
125|J0698|J0698 - CEFOTAXIME SODIUM INJECTION|2.63|2.63||
125|J0697|J0697 - STERILE CEFUROXIME INJECTION|3.38|3.38||
125|J0696|J0696 - CEFTRIAXONE SODIUM INJECTION|1.02|1.02||
125|J0695|J0695 - INJ CEFTOLOZANE TAZOBACTAM|6|6||
125|J0694|J0694 - CEFOXITIN SODIUM INJECTION|7.69|7.69||
125|J0692|J0692 - CEFEPIME HCL FOR INJECTION|4.29|4.29||
125|J0690|J0690 - CEFAZOLIN SODIUM INJECTION|1.43|1.43||
125|J0670|J0670 - INJ MEPIVACAINE HCL/10 ML|4.26|4.26||
125|J0641|J0641 - LEVOLEUCOVORIN INJECTION|0.5|0.5||
125|J0640|J0640 - LEUCOVORIN CALCIUM INJECTION|4.59|4.59||
125|J0638|J0638 - CANAKINUMAB INJECTION|176.09|176.09||
125|J0637|J0637 - CASPOFUNGIN ACETATE|29.55|29.55||
125|J0636|J0636 - INJ CALCITRIOL PER 0.1 MCG|0.86|0.86||
125|J0630|J0630 - CALCITONIN SALMON INJECTION|3695.24|3695.24||
125|J0620|J0620 - CALCIUM GLYCER & LACT/10 ML|15.34|15.34||
125|J0610|J0610 - CALCIUM GLUCONATE INJECTION|5.17|5.17||
125|J0606|J0606 - INJ -  ETELCALCETIDE -  0.1 MG|3.9|3.9||
125|J0604|J0604 - CINACALCET -  ESRD ON DIALYSIS|1.08|1.08||
125|J0600|J0600 - EDETATE CALCIUM DISODIUM INJ|9108.98|9108.98||
125|J0598|J0598 - C-1 ESTERASE -  CINRYZE|93.18|93.18||
125|J0597|J0597 - C-1 ESTERASE -  BERINERT|79.72|79.72||
125|J0596|J0596 - INJECTION -  RUCONEST|45.6|45.6||
125|J0595|J0595 - BUTORPHANOL TARTRATE 1 MG|4.34|4.34||
125|J0594|J0594 - BUSULFAN INJECTION|51.18|51.18||
125|J0592|J0592 - BUPRENORPHINE HYDROCHLORIDE|5.48|5.48||
125|J0588|J0588 - INCOBOTULINUMTOXIN A|8.27|8.27||
125|J0587|J0587 - INJ -  RIMABOTULINUMTOXINB|19.54|19.54||
125|J0586|J0586 - ABOBOTULINUMTOXINA|13.43|13.43||
125|J0585|J0585 - INJECTION - ONABOTULINUMTOXINA|9.98|9.98||
125|J0583|J0583 - BIVALIRUDIN|1.86|1.86||
125|J0575|J0575 - BUPREN/NAL OVER 10MG BUPRENO|18.54|18.54||
125|J0574|J0574 - BUPREN/NAL 6.1 TO 10MG BUPRE|9.28|9.28||
125|J0573|J0573 - BUPREN/NAL 3.1 TO 6MG BUPREN|9.28|9.28||
125|J0572|J0572 - BUPREN/NAL UP TO 3MG BUPRENO|4.68|4.68||
125|J0571|J0571 - BUPRENORPHINE ORAL 1MG|2.24|2.24||
125|J0570|J0570 - BUPRENORPHINE IMPLANT 74.2MG|2049.08|2049.08||
125|J0565|J0565 - INJ -  BEZLOTOXUMAB -  10 MG|45.42|45.42||
125|J0561|J0561 - PENICILLIN G BENZATHINE INJ|20.87|20.87||
125|J0558|J0558 - PENG BENZATHINE/PROCAINE INJ|16.34|16.34||
125|J0520|J0520 - BETHANECHOL CHLORIDE INJECT|5.59|5.59||
125|J0515|J0515 - INJ BENZTROPINE MESYLATE|32.41|32.41||
125|J0500|J0500 - DICYCLOMINE INJECTION|122.6|122.6||
125|J0490|J0490 - BELIMUMAB INJECTION|69.97|69.97||
125|J0485|J0485 - BELATACEPT INJECTION|6.37|6.37||
125|J0480|J0480 - BASILIXIMAB|5781.35|5781.35||
125|J0476|J0476 - BACLOFEN INTRATHECAL TRIAL|69.9|69.9||
125|J0475|J0475 - BACLOFEN 10 MG INJECTION|289.9|289.9||
125|J0470|J0470 - DIMECAPROL INJECTION|83.5|83.5||
125|J0461|J0461 - ATROPINE SULFATE INJECTION|0.07|0.07||
125|J0456|J0456 - AZITHROMYCIN|5.64|5.64||
125|J0401|J0401 - INJ ARIPIPRAZOLE EXT REL 1MG|8.19|8.19||
125|J0400|J0400 - ARIPIPRAZOLE INJECTION|0.85|0.85||
125|J0395|J0395 - ARBUTAMINE HCL INJECTION|191.23|191.23||
125|J0390|J0390 - CHLOROQUINE INJECTION|20.64|20.64||
125|J0380|J0380 - INJ METARAMINOL BITARTRATE|1.33|1.33||
125|J0365|J0365 - APROTONIN -  10 - 000 KIU|2.64|2.64||
125|J0364|J0364 - APOMORPHINE HYDROCHLORIDE|40.16|40.16||
125|J0360|J0360 - HYDRALAZINE HCL INJECTION|5.17|5.17||
125|J0350|J0350 - INJECTION ANISTREPLASE 30 U|2824.24|2824.24||
125|J0348|J0348 - ANIDULAFUNGIN INJECTION|0.89|0.89||
125|J0330|J0330 - SUCCINYCHOLINE CHLORIDE INJ|2.29|2.29||
125|J0300|J0300 - AMOBARBITAL 125 MG INJ|219.04|219.04||
125|J0295|J0295 - AMPICILLIN SULBACTAM 1.5 GM|4.31|4.31||
125|J0290|J0290 - AMPICILLIN 500 MG INJ|2.13|2.13||
125|J0289|J0289 - AMPHOTERICIN B LIPOSOME INJ|33.75|33.75||
125|J0288|J0288 - AMPHO B CHOLESTERYL SULFATE|15.94|15.94||
125|J0287|J0287 - AMPHOTERICIN B LIPID COMPLEX|24.32|24.32||
125|J0285|J0285 - AMPHOTERICIN B|53.77|53.77||
125|J0282|J0282 - AMIODARONE HCL|0.5|0.5||
125|J0280|J0280 - AMINOPHYLLIN 250 MG INJ|11.74|11.74||
125|J0278|J0278 - AMIKACIN SULFATE INJECTION|2.41|2.41||
125|J0275|J0275 - ALPROSTADIL URETHRAL SUPPOS|49.01|49.01||
125|J0270|J0270 - ALPROSTADIL FOR INJECTION|10.51|10.51||
125|J0257|J0257 - GLASSIA INJECTION|7.62|7.62||
125|J0256|J0256 - ALPHA 1 PROTEINASE INHIBITOR|7.4|7.4||
125|J0221|J0221 - LUMIZYME INJECTION|260.4|260.4||
125|J0220|J0220 - ALGLUCOSIDASE ALFA INJECTION|233.06|233.06||
125|J0215|J0215 - ALEFACEPT|46.96|46.96||
125|J0210|J0210 - METHYLDOPATE HCL INJECTION|47.81|47.81||
125|J0207|J0207 - AMIFOSTINE|1587.68|1587.68||
125|J0205|J0205 - ALGLUCERASE INJECTION|47.39|47.39||
125|J0202|J0202 - INJECTION -  ALEMTUZUMAB|2954.81|2954.81||
125|J0200|J0200 - ALATROFLOXACIN MESYLATE|19.96|19.96||
125|J0190|J0190 - INJ BIPERIDEN LACTATE/5 MG|3.23|3.23||
125|J0180|J0180 - AGALSIDASE BETA INJECTION|279.39|279.39||
125|J0178|J0178 - AFLIBERCEPT INJECTION|1584.27|1584.27||
125|J0171|J0171 - ADRENALIN EPINEPHRINE INJECT|0.97|0.97||
125|J0153|J0153 - ADENOSINE INJ 1MG|1.12|1.12||
125|J0135|J0135 - ADALIMUMAB INJECTION|1327.04|1327.04||
125|J0133|J0133 - ACYCLOVIR INJECTION|0.11|0.11||
125|J0132|J0132 - ACETYLCYSTEINE INJECTION|1.99|1.99||
125|J0131|J0131 - ACETAMINOPHEN INJECTION|0.44|0.44||
125|J0130|J0130 - ABCIXIMAB INJECTION|1967.13|1967.13||
125|J0129|J0129 - ABATACEPT INJECTION|79.13|79.13||
125|J0120|J0120 - TETRACYCLIN INJECTION|16.57|16.57||
125|H2037|H2037 - DEV DELAY PREV DP CH -  15 MIN|18.01|18.01||
125|H2036|H2036 - A/D TX PROGRAM -  PER DIEM|323.68|323.68||
125|H2035|H2035 - A/D TX PROGRAM -  PER HOUR|76.62|76.62||
125|H2034|H2034 - A/D HALFWAY HOUSE -  PER DIEM|22.22|22.22||
125|H2033|H2033 - MULTISYS THER/JUVENILE 15MIN|15.19|15.19||
125|H2032|H2032 - ACTIVITY THERAPY -  PER 15 MIN|2.88|2.88||
125|H2031|H2031 - MH CLUBHOUSE SVC -  PER DIEM|7.68|7.68||
125|H2030|H2030 - MH CLUBHOUSE SVC -  PER 15 MIN|2.9|2.9||
125|H2029|H2029 - SEX OFFEND TX SVC -  PER DIEM|59.95|59.95||
125|H2027|H2027 - PSYCHOED SVC -  PER 15 MIN|15.44|15.44||
125|H2026|H2026 - SUPP MAINT EMPLOY -  PER DIEM|53.44|53.44||
125|H2025|H2025 - SUPP MAINT EMPLOY -  15 MIN|137.03|137.03||
125|H2024|H2024 - SUPPORTED EMPLOY -  PER DIEM|77.76|77.76||
125|H2023|H2023 - SUPPORTED EMPLOY -  PER 15 MIN|77.76|77.76||
125|H2022|H2022 - COM WRAP-AROUND SV -  PER DIEM|99.07|99.07||
125|H2021|H2021 - COM WRAP-AROUND SV -  15 MIN|6.94|6.94||
125|H2020|H2020 - THER BEHAV SVC -  PER DIEM|29.88|29.88||
125|H2019|H2019 - THER BEHAV SVC -  PER 15 MIN|14.05|14.05||
125|H2018|H2018 - PSYSOC REHAB SVC -  PER DIEM|58.51|58.51||
125|H2017|H2017 - PSYSOC REHAB SVC -  PER 15 MIN|5.47|5.47||
125|H2016|H2016 - COMP COMM SUPP SVC -  PER DIEM|9.19|9.19||
125|H2015|H2015 - COMP COMM SUPP SVC -  15 MIN|18.26|18.26||
125|H2014|H2014 - SKILLS TRAIN AND DEV -  15 MIN|13.58|13.58||
125|H2013|H2013 - PSYCH HLTH FAC SVC -  PER DIEM|173.59|173.59||
125|H2012|H2012 - BEHAV HLTH DAY TREAT -  PER HR|51.92|51.92||
125|H2011|H2011 - CRISIS INTERVEN SVC -  15 MIN|23.32|23.32||
125|H2010|H2010 - COMPREHENSIVE MED SVC 15 MIN|45.42|45.42||
125|H2001|H2001 - REHABILITATION PROGRAM 1/2 D|48.79|48.79||
125|H2000|H2000 - COMP MULTIDISIPLN EVALUATION|51.2|51.2||
125|H1011|H1011 - FAMILY ASSESSMENT|129.58|129.58||
125|H1010|H1010 - NONMED FAMILY PLANNING ED|109.14|109.14||
125|H1005|H1005 - PRENATALCARE ENHANCED SRV PK|68.76|68.76||
125|H1004|H1004 - FOLLOW UP HOME VISIT/PRENTAL|37.22|37.22||
125|H1003|H1003 - PRENATAL AT RISK EDUCATION|11.8|11.8||
125|H1002|H1002 - CARECOORDINATION PRENATAL|15.95|15.95||
125|H1001|H1001 - ANTEPARTUM MANAGEMENT|12.61|12.61||
125|H1000|H1000 - PRENATAL CARE ATRISK ASSESSM|32.68|32.68||
125|H0050|H0050 - ALCOHOL/DRUG SERVICE 15 MIN|37.44|37.44||
125|H0049|H0049 - ALCOHOL/DRUG SCREENING|0.01|0.01||
125|H0048|H0048 - SPEC COLL NON-BLOOD:A/D TEST|0.01|0.01||
125|H0045|H0045 - RESPITE NOT-IN-HOME PER DIEM|102.74|102.74||
125|H0044|H0044 - SUPPORTED HOUSING -  PER MONTH|369.89|369.89||
125|H0043|H0043 - SUPPORTED HOUSING -  PER DIEM|132.31|132.31||
125|H0041|H0041 - FOS C CHLD NON-THER PER DIEM|53.83|53.83||
125|H0040|H0040 - ASSERT COMM TX PGM PER DIEM|300.79|300.79||
125|H0039|H0039 - ASSER COM TX FACE-FACE/15MIN|20.54|20.54||
125|H0038|H0038 - SELF-HELP/PEER SVC PER 15MIN|2.75|2.75||
125|H0037|H0037 - COMM PSY SUP TX PGM PER DIEM|102.11|102.11||
125|H0036|H0036 - COMM PSY FACE-FACE PER 15MIN|14.53|14.53||
125|H0035|H0035 - MH PARTIAL HOSP TX UNDER 24H|152.21|152.21||
125|H0034|H0034 - MED TRNG & SUPPORT PER 15MIN|21.28|21.28||
125|H0033|H0033 - ORAL MED ADM DIRECT OBSERVE|33.85|33.85||
125|H0032|H0032 - MH SVC PLAN DEV BY NON-MD|13.48|13.48||
125|H0031|H0031 - MH HEALTH ASSESS BY NON-MD|38.92|38.92||
125|H0030|H0030 - ALCOHOL AND/OR DRUG HOTLINE|5.71|5.71||
125|H0029|H0029 - ALCOHOL AND/OR DRUG PREVENTI|173.26|173.26||
125|H0026|H0026 - ALCOHOL AND/OR DRUG PREVENTI|33.06|33.06||
125|H0025|H0025 - ALCOHOL AND/OR DRUG PREVENTI|9.48|9.48||
125|H0024|H0024 - ALCOHOL AND/OR DRUG PREVENTI|13.62|13.62||
125|H0023|H0023 - ALCOHOL AND/OR DRUG OUTREACH|292.74|292.74||
125|H0022|H0022 - ALCOHOL AND/OR DRUG INTERVEN|59.93|59.93||
125|H0021|H0021 - ALCOHOL AND/OR DRUG TRAINING|5.59|5.59||
125|H0020|H0020 - ALCOHOL AND/OR DRUG SERVICES|29.57|29.57||
125|H0019|H0019 - ALCOHOL AND/OR DRUG SERVICES|132.36|132.36||
125|H0018|H0018 - ALCOHOL AND/OR DRUG SERVICES|292.01|292.01||
125|H0017|H0017 - ALCOHOL AND/OR DRUG SERVICES|1003.27|1003.27||
125|H0016|H0016 - ALCOHOL AND/OR DRUG SERVICES|36.12|36.12||
125|H0015|H0015 - ALCOHOL AND/OR DRUG SERVICES|145.27|145.27||
125|H0014|H0014 - ALCOHOL AND/OR DRUG SERVICES|226.49|226.49||
125|H0013|H0013 - ALCOHOL AND/OR DRUG SERVICES|261.95|261.95||
125|H0012|H0012 - ALCOHOL AND/OR DRUG SERVICES|48|48||
125|H0011|H0011 - ALCOHOL AND/OR DRUG SERVICES|291.02|291.02||
125|H0010|H0010 - ALCOHOL AND/OR DRUG SERVICES|133.03|133.03||
125|H0009|H0009 - ALCOHOL AND/OR DRUG SERVICES|305.05|305.05||
125|H0008|H0008 - ALCOHOL AND/OR DRUG SERVICES|134.4|134.4||
125|H0007|H0007 - ALCOHOL AND/OR DRUG SERVICES|13.68|13.68||
125|H0006|H0006 - ALCOHOL AND/OR DRUG SERVICES|18.16|18.16||
125|H0005|H0005 - ALCOHOL AND/OR DRUG SERVICES|24.89|24.89||
125|H0004|H0004 - ALCOHOL AND/OR DRUG SERVICES|18.13|18.13||
125|H0003|H0003 - ALCOHOL AND/OR DRUG SCREENIN|0.01|0.01||
125|H0002|H0002 - ALCOHOL AND/OR DRUG SCREENIN|62.96|62.96||
125|H0001|H0001 - ALCOHOL AND/OR DRUG ASSESS|50.38|50.38||
125|G9990||0.01|0.01||
125|G9989||0.01|0.01||
125|G9977|G9977 - DILATED MAC EXAM NOT PERF RSN NOS|0.01|0.01||
125|G9976|G9976 - DOC PT RSN NO DIL MAC EXAM PERF|0.01|0.01||
125|G9975|G9975 - DOC MED RSN NO DIL MAC EXAM PERF|0.01|0.01||
125|G9974|G9974 - DILATED MAC EXAM PERFORMED|0.01|0.01||
125|G9970|G9970 - PVDR RFRD PT NO RPRT RCVD|0.01|0.01||
125|G9969|G9969 - PVDR RFRD PT RPRT RCVD|0.01|0.01||
125|G9968|G9968 - PT REFRD 2 PVDR/SPCLST IN PP|0.01|0.01||
125|G9967|G9967 - NO SCRN -  INTER -  REPRT CHILD|0.01|0.01||
125|G9966|G9966 - SCRN -  INTER -  REPORT CHILD|0.01|0.01||
125|G9965|G9965 - NO WELL-CHLD VIST RECV BY PT|0.01|0.01||
125|G9964|G9964 - PT RECV >=1 WELL-CHLD VISIT|0.01|0.01||
125|G9963|G9963 - EMBOLIZATION NOT DOC SEPARATELY|0.01|0.01||
125|G9962|G9962 - EMBOLIZATION DOC SEPARATLY|0.01|0.01||
125|G9961|G9961 - SYSTEMIC ANTIMICRO PRESC|0.01|0.01||
125|G9960|G9960 - MED RSN SYS ANTIMI NT RX|0.01|0.01||
125|G9959|G9959 - SYSTEMIC ANTIMICRO NOT PRESC|0.01|0.01||
125|G9958|G9958 - NO COMBO PROHPYL THRP FOR PT|0.01|0.01||
125|G9957|G9957 - DOC MED RSN NO COMBO THRPY|0.01|0.01||
125|G9956|G9956 - COMBO THRPY OF >= 2 PROPHLY PRE/INT|0.01|0.01||
125|G9955|G9955 - INHLNT ANESTH ONLY FOR INDUC|0.01|0.01||
125|G9954|G9954 - PT >2 RSK FAC POST-OP VOMIT|0.01|0.01||
125|G9949|G9949 - LG PN NT MSR VAS SCL PRE/PST|0.01|0.01||
125|G9948|G9948 - ADTL SPINE PROC ON SAME DATE|0.01|0.01||
125|G9947|G9947 - PRE AND POST VAS WTHN 3 MOS|0.01|0.01||
125|G9946|G9946 - BK PN NT MSR VAS PRE-PST 1Y|0.01|0.01||
125|G9945|G9945 - PT W/CANCER  SCOLIOSIS|0.01|0.01||
125|G9944|G9944 - VAS 3 MON PRE AND 1 YR POST|0.01|0.01||
125|G9943|G9943 - BK PN NT MSR VAS SCL PRE/PST|0.01|0.01||
125|G9942|G9942 - ADTL SPINE PROC ON SAME DATE|0.01|0.01||
125|G9941|G9941 - PRE AND POST VAS WTHN 3 MOS|0.01|0.01||
125|G9940|G9940 - DOC REAS NO STATIN THERAPY|0.01|0.01||
125|G9939|G9939 - SAME PATH/DERM PERF BIOPSY|0.01|0.01||
125|G9938|G9938 - SNP/LG TRM CRE PT W/POS CDE|0.01|0.01||
125|G9937|G9937 - DIG OR SURV COLSCO|0.01|0.01||
125|G9936|G9936 - PMH PLYP/NEO CO/RECT/JUN/ANS|0.01|0.01||
125|G9935|G9935 - CANC NOT DETECTD DURING SRCN|0.01|0.01||
125|G9934|G9934 - DOC RSN NOT DETECTING CANCER|0.01|0.01||
125|G9933|G9933 - CANC DETECTD DURING COL SCRN|0.01|0.01||
125|G9932|G9932 - DOC PT RSN NO TB SCRN RECRDS|0.01|0.01||
125|G9931|G9931 - NO CHAD OR CHAD SCR 0 OR 1|0.01|0.01||
125|G9930|G9930 - COM CARE|0.01|0.01||
125|G9929|G9929 - TRS/REV AF|0.01|0.01||
125|G9928|G9928 - NO WARF OR FDA DRUG PRESC|0.01|0.01||
125|G9927|G9927 - DOC NO WARF /FDA  PT TRIAL|0.01|0.01||
125|G9926|G9926 - SFTY CNCRNS SCRN BUT NO RECS|0.01|0.01||
125|G9925|G9925 - NO SCRN PROV RSN NOS|0.01|0.01||
125|G9924|G9924 - DOC MED RSN NO SCRN OR RECS|0.01|0.01||
125|G9923|G9923 - SAFTY CNCRNS SCRN AND NEG|0.01|0.01||
125|G9922|G9922 - SFTY CNCRNS SCRN ND MIT RECS|0.01|0.01||
125|G9921|G9921 - NO OR PART SCRN ND RNG OR OS|0.01|0.01||
125|G9920|G9920 - SCRNING PERF AND NEGATIVE|0.01|0.01||
125|G9919|G9919 - SCRN ND POS ND PROV OF REC|0.01|0.01||
125|G9918|G9918 - NO FUNCT STAT PERF -  RSN NOS|0.01|0.01||
125|G9917|G9917 - DOC MED RSN NO FUNCT STATUS|0.01|0.01||
125|G9916|G9916 - FUNCT STATUS PAST 12 MONTHS|0.01|0.01||
125|G9915|G9915 - NO DOCUMNTD HBV RESULTS RCD|0.01|0.01||
125|G9914|G9914 - PT RECEIVING ANTI-TNF AGENT|0.01|0.01||
125|G9913|G9913 - NO HBV STATUS ASSESD AND INT|0.01|0.01||
125|G9912|G9912 - HBV STATUS ASSESED AND INT|0.01|0.01||
125|G9911|G9911 - NODE NEG PRE/POST SYST THER|0.01|0.01||
125|G9910|G9910 - SNP/LG TRM CRE PT W/POS CDE|0.01|0.01||
125|G9909|G9909 - DOC MED RSN NO TBCO INTERV|0.01|0.01||
125|G9908|G9908 - NO PT TBCO CESS INTERV RNG|0.01|0.01||
125|G9907|G9907 - DOC MED RSN NO TBCO INTERVENTION|0.01|0.01||
125|G9906|G9906 - PT RECV TBCO CESS INTERVENTION|0.01|0.01||
125|G9905|G9905 - NO PT TBCO SCRN RNG|0.01|0.01||
125|G9904|G9904 - DOC MED RSN NO TBCO SCRN|0.01|0.01||
125|G9903|G9903 - PT SCRN TBCO ID AS NON USER|0.01|0.01||
125|G9902|G9902 - PT SCRN TBCO AND ID AS USER|0.01|0.01||
125|G9901|G9901 - SNP/LG TRM CRE PT W/POS CDE|0.01|0.01||
125|G9900|G9900 - SCRN MAM PERF RSLTS NOT DOC REV|0.01|0.01||
125|G9899|G9899 - SCRN MAM PERF RSLTS DOC REV|0.01|0.01||
125|G9898|G9898 - SNP/LG TRM CRE PT W/POS CDE|0.01|0.01||
125|G9897|G9897 - PT NT PRSC ADR DEP THRPY RNG|0.01|0.01||
125|G9896|G9896 - DOC PT RSN NO ADR DEP THRPY|0.01|0.01||
125|G9895|G9895 - DOC MED RSN NO ADR DEP THRPY|0.01|0.01||
125|G9894|G9894 - ADR DEP THRPY PRESCRIBED|0.01|0.01||
125|G9893|G9893 - NO MAC EXAM|0.01|0.01||
125|G9892|G9892 - DOC PT RSN NO DIL MAC EXAM|0.01|0.01||
125|G9891|G9891 - EM SESSION REPORTING|0|0||
125|G9890|G9890 - EM BRIDGE PAYMENT|40.75|40.75||
125|G9885|G9885 - 2 EM ONGOING MS MO 22-24 WL|81.5|81.5||
125|G9884|G9884 - 2 EM ONGOING MS MO 19-21 WL|81.5|81.5||
125|G9883|G9883 - 2 EM ONGOING MS MO 16-18 WL|81.5|81.5||
125|G9882|G9882 - 2 EM ONGOING MS MO 13-15 WL|81.5|81.5||
125|G9881|G9881 - EM 9 PERCENT WL|40.75|40.75||
125|G9880|G9880 - EM 5 PERCENT WL|260.8|260.8||
125|G9879|G9879 - 2 EM CORE MS MO 10-12 WL|97.8|97.8||
125|G9878|G9878 - 2 EM CORE MS MO 7-9  WL|97.8|97.8||
125|G9877|G9877 - 2 EM CORE MS MO 10-12 NO WL|24.45|24.45||
125|G9876|G9876 - 2 EM CORE MS MO 7-9 NO WL|24.45|24.45||
125|G9875|G9875 - 9 EM CORE SESSIONS|146.7|146.7||
125|G9874|G9874 - 4 EM CORE SESSIONS|81.5|81.5||
125|G9873|G9873 - 1 EM CORE SESSION|40.75|40.75||
125|G9870|G9870 - NEXT GEN ACO MODEL > 20 MINUTES|78.63|78.63||
125|G9869|G9869 - NEXT GEN ACO MODEL 10-20 MINUTES|62.79|62.79||
125|G9868|G9868 - NEXT GEN ACO MODEL < 10 MINUTES|46.94|46.94||
125|G9862|G9862 - DOC RSN NO 10 YR FOLLOW|0.01|0.01||
125|G9861|G9861 - PT MORE THAN 3D HOSPICE|0.01|0.01||
125|G9860|G9860 - PT LESS 3D HOSPICE|0.01|0.01||
125|G9859|G9859 - PT DIED FROM CANCER|0.01|0.01||
125|G9858|G9858 - PT ENROLL HOSPICE|0.01|0.01||
125|G9857|G9857 - PT ADMIT HOSPICE|0.01|0.01||
125|G9856|G9856 - PT NO HOSPICE|0.01|0.01||
125|G9855|G9855 - PT DIED FROM CANCER|0.01|0.01||
125|G9854|G9854 - NO ICU STAY LAST 30D LIFE|0.01|0.01||
125|G9853|G9853 - ICU STAY LAST 30D LIFE|0.01|0.01||
125|G9852|G9852 - PT DIED FROM CANCER|0.01|0.01||
125|G9851|G9851 - 1/NO ED VISIT LAST 30D LIFE|0.01|0.01||
125|G9850|G9850 - 1/MORE ED LAST 30D LIFE|0.01|0.01||
125|G9849|G9849 - PT DIED FROM CANCER|0.01|0.01||
125|G9848|G9848 - PT NO CHEMO LAST 14D LIFE|0.01|0.01||
125|G9847|G9847 - PT RECD CHEMO LAST 14D LIFE|0.01|0.01||
125|G9846|G9846 - PT DIED FROM CANCER|0.01|0.01||
125|G9845|G9845 - PT RECD ANTI-EGFR THER|0.01|0.01||
125|G9844|G9844 - PT NO RECD ANTI-EGFR THER|0.01|0.01||
125|G9843|G9843 - KRAS OR NRAS GENE MUTATION|0.01|0.01||
125|G9842|G9842 - PT MET DIS AT DX|0.01|0.01||
125|G9841|G9841 - GENE TESTING NOT PERFORMED|0.01|0.01||
125|G9840|G9840 - GENE TESTING PERFORMED|0.01|0.01||
125|G9839|G9839 - ANTI-EGFR MON ANTI THER|0.01|0.01||
125|G9838|G9838 - PT MET DIS AT DX|0.01|0.01||
125|G9837|G9837 - TRASTUZ NOT IN 12 MOS DX|0.01|0.01||
125|G9836|G9836 - RSN NO TRAST GIVEN DOC|0.01|0.01||
125|G9835|G9835 - TRASTUZ GIVEN W/IN 12 MOS DX|0.01|0.01||
125|G9834|G9834 - PT MET DIS AT DX|0.01|0.01||
125|G9833|G9833 - TRANSF PRACT AFT INIT CHEMO|0.01|0.01||
125|G9832|G9832 - BRT CA DX I -  NO T1/T1A/T1B|0.01|0.01||
125|G9831|G9831 - AJCC STG BRT CA DX II OR III|0.01|0.01||
125|G9830|G9830 - HER-2 POS|0.01|0.01||
125|G9829|G9829 - BREAST ADJ CHEMO ADMIN|0.01|0.01||
125|G9828|G9828 - HER-2 TARG THER DUR INIT TX|0.01|0.01||
125|G9827|G9827 - HER-2 TARG THER NO INIT TX|0.01|0.01||
125|G9826|G9826 - TRANSF PRACT AFT INIT CHEMO|0.01|0.01||
125|G9825|G9825 - HER-2 NEG - UNDOC/UNKN|0.01|0.01||
125|G9824|G9824 - ENDO SMPL/HYST BX RES NO DOC|0.01|0.01||
125|G9823|G9823 - ENDO SMPL/HYST BX RES DOC|0.01|0.01||
125|G9822|G9822 - ENDO ABL PROC YR PREV IND DT|0.01|0.01||
125|G9821|G9821 - NO DOC CHLAM SCR TS W/FOLLOW|0.01|0.01||
125|G9820|G9820 - DOC CHLAM SCR TEST W/FOLLOW|0.01|0.01||
125|G9819|G9819 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9818|G9818 - DOC SEX ACTIVITY|0.01|0.01||
125|G9817|G9817 - NO DEATH 30-DAYS POST-DISCH|0.01|0.01||
125|G9816|G9816 - DEATH <30 DAY POST DISCHARGE|0.01|0.01||
125|G9815|G9815 - DEATH NOT DURING INDEX HOSP|0.01|0.01||
125|G9814|G9814 - DEATH DURING INDEX HOSP|0.01|0.01||
125|G9813|G9813 - PT NOT DIED W/IN 30D OF PROC|0.01|0.01||
125|G9812|G9812 - PT DIED DURING INPT/30D AFT|0.01|0.01||
125|G9811|G9811 - NO PDC 75% W/ASTH CONT MED|0.01|0.01||
125|G9810|G9810 - PDC 75% W/ASTH CONT MED|0.01|0.01||
125|G9809|G9809 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9808|G9808 - PT NO ASTHM CONT MED MST PER|0.01|0.01||
125|G9807|G9807 - PT NO RECD CERV CYTO/HPV|0.01|0.01||
125|G9806|G9806 - PT RECD CERV CYTO/HPV|0.01|0.01||
125|G9805|G9805 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9804|G9804 - PT NOT PRESC 135 DAY TRMT|0.01|0.01||
125|G9803|G9803 - PT PRESC 135 DAY TRMT|0.01|0.01||
125|G9802|G9802 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9801|G9801 - NONACUT TRANSF FROM INPT|0.01|0.01||
125|G9800|G9800 - PT ID INTOL/ALLEG BETA-BLOCK|0.01|0.01||
125|G9799|G9799 - MED DISP EVT INDIC HX ASTH|0.01|0.01||
125|G9798|G9798 - D/C AMI BTW 7/1-6/30 MST PER|0.01|0.01||
125|G9797|G9797 - PT CURRENTLY ON STATIN|0.01|0.01||
125|G9796|G9796 - PT NOT CURRENTLY ON STATIN|0.01|0.01||
125|G9795|G9795 - PT NO DAILY ASA/ANTIPLAT|0.01|0.01||
125|G9794|G9794 - DOC MED RSN NO DAILY ASPIRIN|0.01|0.01||
125|G9793|G9793 - PT ON DAILY ASA/ANTIPLAT|0.01|0.01||
125|G9792|G9792 - MOST RCT TOB STAT NOT FREE|0.01|0.01||
125|G9791|G9791 - MOST RCT TOB STAT FREE|0.01|0.01||
125|G9790|G9790 - MOST RCT BP >/= 140/90|0.01|0.01||
125|G9789|G9789 - RECORD BP IP -  ER -  URG/SELF|0.01|0.01||
125|G9788|G9788 - MOST RCT BP </= 140/90|0.01|0.01||
125|G9787|G9787 - PT ALIVE LST DAY MSMT YR|0.01|0.01||
125|G9786|G9786 - PATHOLOGY REPORT NOT SENT|0.01|0.01||
125|G9785|G9785 - PATHOLOGY REPORT SENT|0.01|0.01||
125|G9784|G9784 - PATH/DERM PROV 2ND BIOP OPIN|0.01|0.01||
125|G9783|G9783 - DOC DX DM -  FAST <70 -  NO STAT|0.01|0.01||
125|G9782|G9782 - HX DX FAM/PURE HYPERCHOLES|0.01|0.01||
125|G9781|G9781 - DOC RSN NO STATIN|0.01|0.01||
125|G9780|G9780 - PTS DX W/RHABDOMYOLYSIS|0.01|0.01||
125|G9779|G9779 - PTS BREASTFEEDING|0.01|0.01||
125|G9778|G9778 - PTS DX W/PREGN|0.01|0.01||
125|G9777|G9777 - PT NO ANTIEMET PRE/INTRAOP|0.01|0.01||
125|G9776|G9776 - DOC MED RSN NO PROPH ANTIEM|0.01|0.01||
125|G9775|G9775 - RECD 2 ANTI-EMET PRE/INTRAOP|0.01|0.01||
125|G9774|G9774 - PT HAD HYST|0.01|0.01||
125|G9773|G9773 - 1 BOD TEMP >=35.5|0.01|0.01||
125|G9772|G9772 - DOC MED RSN NO TEMP >= 35.5|0.01|0.01||
125|G9771|G9771 - ANES END -  1 TEMP >35.5(95.9)|0.01|0.01||
125|G9770|G9770 - PERIP NERVE BLOCK|0.01|0.01||
125|G9769|G9769 - BN DEN 2YR/GOT OST MED/THER|0.01|0.01||
125|G9768|G9768 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9767|G9767 - HOSP NEW DX CVA CONSID EVST|0.01|0.01||
125|G9766|G9766 - CVA STROKE DX TX TRANSF FAC|0.01|0.01||
125|G9765|G9765 - DOC PAT DECLINED THERAPY|0.01|0.01||
125|G9764|G9764 - PT TREATD W/ORAL SYST OR BIO|0.01|0.01||
125|G9763|G9763 - PT NOT HAVE 2-3 HPV VACCINES|0.01|0.01||
125|G9762|G9762 - PT HAD >= 2-3 HPV VACCINES|0.01|0.01||
125|G9761|G9761 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9760|G9760 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9759|G9759 - HX PREOP POST CAP RUP|0.01|0.01||
125|G9758|G9758 - PT IN HOS|0.01|0.01||
125|G9757|G9757 - SURG PROC W/SILICONE OIL|0.01|0.01||
125|G9756|G9756 - SURG PROC W/SILICONE OIL|0.01|0.01||
125|G9755|G9755 - DOC MED RSN NO FLLW UP|0.01|0.01||
125|G9754|G9754 - INCID PULM NODULE|0.01|0.01||
125|G9753|G9753 - DOC NO DICOM -  CT OTHER FAC|0.01|0.01||
125|G9752|G9752 - URGENT SURGERY|0.01|0.01||
125|G9751|G9751 - PT DIED W/IN 24 MOS RPT TIME|0.01|0.01||
125|G9750|G9750 - APP TRANSPL LVG KIDNEY DONOR|0.01|0.01||
125|G9749|G9749 - PALL DIALYSIS WITH CATHETER|0.01|0.01||
125|G9748|G9748 - APP TRANSPL LVG KIDNEY DONOR|0.01|0.01||
125|G9747|G9747 - PALL DIALYSIS WITH CATHETER|0.01|0.01||
125|G9746|G9746 - MIT STEN -  VALVE OR TRANS AF|0.01|0.01||
125|G9745|G9745 - DOC RSN NO HBP SCRN OR F/U|0.01|0.01||
125|G9744|G9744 - PT NOT ELI D/T ACT DIG HTN|0.01|0.01||
125|G9743|G9743 - PSYCH SYMP NOT ASSESSED -  RNS|0.01|0.01||
125|G9742|G9742 - PSYCH SYMPT ASSESSED|0.01|0.01||
125|G9741|G9741 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9740|G9740 - HOSP SRV TO PT DUR MSMT PER|0.01|0.01||
125|G9739|G9739 - PT UNBL CMPLT GO FS PROM|0.01|0.01||
125|G9738|G9738 - REFUSED TO PARTICIPATE|0.01|0.01||
125|G9737|G9737 - PT UNBL CMPLT EWH FS PROM|0.01|0.01||
125|G9736|G9736 - REFUSED TO PARTICIPATE|0.01|0.01||
125|G9735|G9735 - PT UNBL CMPLT SHLD FS PROM|0.01|0.01||
125|G9734|G9734 - REFUSED TO PARTICIPATE|0.01|0.01||
125|G9733|G9733 - PT UNBL CMPLT LB FS PROM|0.01|0.01||
125|G9732|G9732 - REFUSED TO PARTICIPATE|0.01|0.01||
125|G9731|G9731 - PT UNBL CMPLT FT/ANK FS PROM|0.01|0.01||
125|G9730|G9730 - REFUSED TO PARTICIPATE|0.01|0.01||
125|G9729|G9729 - PT UNBL CMPLT HIP FS PROM|0.01|0.01||
125|G9728|G9728 - REFUSED TO PARTICIPATE|0.01|0.01||
125|G9727|G9727 - PT UNABLE CMPLT KNEE FS PROM|0.01|0.01||
125|G9726|G9726 - REFUSED TO PARTICIPATE|0.01|0.01||
125|G9725|G9725 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9724|G9724 - PT W/DOC USE ANTICOAG MST YR|0.01|0.01||
125|G9723|G9723 - HOSP RECD BY PT DUR MSMT PER|0.01|0.01||
125|G9722|G9722 - DOC HX RENAL FAIL OR CR+ >4|0.01|0.01||
125|G9721|G9721 - PT NOT AMBUL/IMMOB/WC|0.01|0.01||
125|G9720|G9720 - HOSPICE ANYTIME MSMT PER|0.01|0.01||
125|G9719|G9719 - PT NOT AMBUL/IMMOB/WC|0.01|0.01||
125|G9718|G9718 - HOSPICE ANYTIME MSMT PER|0.01|0.01||
125|G9717|G9717 - DOC PT DX DEP/BP F/U NT REQ|0.01|0.01||
125|G9716|G9716 - BMI DOC ONL FUP NOT CMPLTD|0.01|0.01||
125|G9715|G9715 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9714|G9714 - PT IS W/HOSP DURING MSMT PER|0.01|0.01||
125|G9713|G9713 - PT USE HOSP DURING MSMT PER|0.01|0.01||
125|G9712|G9712 - DOC MED RSN PRESC ANBX|0.01|0.01||
125|G9711|G9711 - PT HX TOT COL OR COLON CA|0.01|0.01||
125|G9710|G9710 - PT PROV HOSP SRV MSMT PER|0.01|0.01||
125|G9709|G9709 - HOSP SRV USED PT IN MSMT PER|0.01|0.01||
125|G9708|G9708 - BILAT MAST/HX BI /UNILAT MAS|0.01|0.01||
125|G9707|G9707 - PT HAD HOSP DUR MSMT PER|0.01|0.01||
125|G9706|G9706 - LOW RECUR PROST CA|0.01|0.01||
125|G9705|G9705 - AJCC BR CA STG IB|0.01|0.01||
125|G9704|G9704 - AJCC BR CA STG I: T1 MIC/T1A|0.01|0.01||
125|G9703|G9703 - CHILD ANBX 30 PRIOR DX PHARY|0.01|0.01||
125|G9702|G9702 - PT USE HOSP DURING MSMT PER|0.01|0.01||
125|G9701|G9701 - CHILD ANBX 30 PRIOR DX ESTAB|0.01|0.01||
125|G9700|G9700 - PT IS W/HOSP DURING MSMT PER|0.01|0.01||
125|G9699|G9699 - LONG INHAL BRONCHDIL NO PRES|0.01|0.01||
125|G9698|G9698 - SYS RSN NO PRESC BRONCHDIL|0.01|0.01||
125|G9697|G9697 - PT RSN NO PRESC BRONCHDIL|0.01|0.01||
125|G9696|G9696 - MED RSN NO PRESC BRONCHDIL|0.01|0.01||
125|G9695|G9695 - LONG ACT INHAL BRONCHDIL PRE|0.01|0.01||
125|G9694|G9694 - HOSP SRV USED PT IN MSMT PER|0.01|0.01||
125|G9693|G9693 - PT USE HOSP DURING MSMT PER|0.01|0.01||
125|G9692|G9692 - HOSP RECD BY PT DUR MSMT PER|0.01|0.01||
125|G9691|G9691 - PT HOSP DUR MSMT PERIOD|0.01|0.01||
125|G9690|G9690 - PT IN HOS|0.01|0.01||
125|G9689|G9689 - INPT ELECT CAROTID INTERVENT|0.01|0.01||
125|G9688|G9688 - PT W/HOSP ANYTIME MSMT PER|0.01|0.01||
125|G9687|G9687 - HOSPICE ANYTIME MSMT PER|0.01|0.01||
125|G9686|G9686 - NURSING FACILITY CONFERENCE|127.03|127.03||
125|G9685|G9685 - ACUTE NURSING FACILITY CARE|328.64|328.64||
125|G9676|G9676 - 40-75Y W/TYPE 1/2 W/LDL-C RS|0.01|0.01||
125|G9675|G9675 - PT W/FAST/DIR LAB LDL-C >190|0.01|0.01||
125|G9674|G9674 - PT W/CLIN ASCVD DX|0.01|0.01||
125|G9666|G9666 - FAS/DIR LDL 70-189MG/DL MST|0.01|0.01||
125|G9665|G9665 - NO STATIN/NO ORDER STATIN|0.01|0.01||
125|G9664|G9664 - TAKING STATIN OR REC'D ORDER|0.01|0.01||
125|G9663|G9663 - FAST/DIR LDL = 190 MG/DL|0.01|0.01||
125|G9662|G9662 - PRIOR DX/ACTIVE CLIN ASCVD|0.01|0.01||
125|G9661|G9661 - >85Y SCOPE OTHR RSN|0.01|0.01||
125|G9660|G9660 - DOC MED RSN SCOPE PT >85Y|0.01|0.01||
125|G9659|G9659 - >85Y NO HX COLO CA/RSN SCOPE|0.01|0.01||
125|G9658|G9658 - TOC TOOL INCL ELEM NOT USED|0.01|0.01||
125|G9656|G9656 - PT TRANS FROM ANEST TO PACU|0.01|0.01||
125|G9655|G9655 - TOC TOOL INCL KEY ELEM|0.01|0.01||
125|G9654|G9654 - MON ANESTH CARE|0.01|0.01||
125|G9649|G9649 - PSOR AS DOC SPC BM|0.01|0.01||
125|G9648|G9648 - PT W/90D MRS >2|0.01|0.01||
125|G9647|G9647 - NO MRS SCORE IN 90D FOLLOWUP|0.01|0.01||
125|G9646|G9646 - PT W/90D MRS 0-2|0.01|0.01||
125|G9645|G9645 - HAD SMOKE B/4 ANES DAY SURG|0.01|0.01||
125|G9644|G9644 - NO SMOK B/4 ANES DAY OF SURG|0.01|0.01||
125|G9643|G9643 - ELECTIVE SURGERY|0.01|0.01||
125|G9642|G9642 - CURRENT SMOKER|0.01|0.01||
125|G9641|G9641 - AMP REQD W/IN 48H IELER PROC|0.01|0.01||
125|G9640|G9640 - DOC PLAN HYBRID/STAGE PROC|0.01|0.01||
125|G9639|G9639 - AMP NO REQD IN48H IELER PROC|0.01|0.01||
125|G9638|G9638 - NO DOC >1 DOSE REDUC TECH|0.01|0.01||
125|G9637|G9637 - DOC >1 DOSE REDUC TECH|0.01|0.01||
125|G9636|G9636 - NO LIFE ASST 2X SAME/DECR|0.01|0.01||
125|G9635|G9635 - NO DOC RSN DO QUAL LIFE ASSM|0.01|0.01||
125|G9634|G9634 - QUAL LIFE TOOL 2X SAME/IMPR|0.01|0.01||
125|G9633|G9633 - PT NO UI SRG 30 DAY PST SRG|0.01|0.01||
125|G9632|G9632 - MED RSN FOR NO RPT URET INJ|0.01|0.01||
125|G9631|G9631 - PT UI SRG 30 DAY PST SRG|0.01|0.01||
125|G9630|G9630 - PT NO BWLI SRG 30 DAY SRG|0.01|0.01||
125|G9629|G9629 - MED RSN NO RPT BOWEL INJ|0.01|0.01||
125|G9628|G9628 - PT BWLI SRG 30 DAY PST SRG|0.01|0.01||
125|G9627|G9627 - PT NO BL SRG 30 DAY PST SRG|0.01|0.01||
125|G9626|G9626 - MED RSN NO RPT BALDDER INJ|0.01|0.01||
125|G9625|G9625 - PT BL SRG 30 DAY PST SRG|0.01|0.01||
125|G9624|G9624 - PT NOT SCRN OR NO COUNSELING|0.01|0.01||
125|G9623|G9623 - DOC MED RSN NO SCR ETOH USE|0.01|0.01||
125|G9622|G9622 - NO UNHEAL ETOH USER|0.01|0.01||
125|G9621|G9621 - SCR UNHEAL ETOH W/COUNSEL|0.01|0.01||
125|G9620|G9620 - NO SCR UTR MALIG/US/SAMP RNG|0.01|0.01||
125|G9618|G9618 - DOC SCR UTER MAL OR US/SAMP|0.01|0.01||
125|G9617|G9617 - PRE-OP ASST NOT DOC -  RNG|0.01|0.01||
125|G9616|G9616 - DOC RSN NO PREOP ASSMT|0.01|0.01||
125|G9615|G9615 - PRE-OP ASST DOC|0.01|0.01||
125|G9614|G9614 - PHOTODOC < 2 CEC LNDMK|0.01|0.01||
125|G9613|G9613 - DOC POST SURG ANATOMY|0.01|0.01||
125|G9612|G9612 - PHODOC 2 MR CEC LNDMK|0.01|0.01||
125|G9611|G9611 - NO DOC ORDER ANTI-PLAT RNG|0.01|0.01||
125|G9610|G9610 - DOC MD RSN NO ANTIPLA|0.01|0.01||
125|G9609|G9609 - DOC ORDER ANTI-PLAT|0.01|0.01||
125|G9608|G9608 - INTRAOP CYST EVAL NOT DONE|0.01|0.01||
125|G9607|G9607 - DOC MED RSN NOT PERF CYSTOSC|0.01|0.01||
125|G9606|G9606 - INTRAOP CYST EVAL TRAC INJ|0.01|0.01||
125|G9605|G9605 - SURV SCORE NO IMPROV W/TX|0.01|0.01||
125|G9604|G9604 - PT SURV RESULTS NOT AVAIL|0.01|0.01||
125|G9603|G9603 - PT SURV IMPROV BSLINE TX|0.01|0.01||
125|G9602|G9602 - PT NO DCHG HOME POSTOP DAY 7|0.01|0.01||
125|G9601|G9601 - PT DCHG HOME POST OP DAY 7|0.01|0.01||
125|G9600|G9600 - SYMP AAA URGENT REPAIR|0.01|0.01||
125|G9599|G9599 - AOR ANE >=6.0 CM MAX DIAM|0.01|0.01||
125|G9598|G9598 - AOR ANE 5.5-5.9 CM MAX DIAM|0.01|0.01||
125|G9597|G9597 - NO LOW PECARN PED HEAD TRAUM|0.01|0.01||
125|G9596|G9596 - PED PT HD CT ORD|0.01|0.01||
125|G9595|G9595 - DOC SHNT/TUM/COAG/THROMBOCYT|0.01|0.01||
125|G9594|G9594 - PT MBHT HD CT ORD EC PROV|0.01|0.01||
125|G9593|G9593 - LOW PECARN PED HEAD TRAUMA|0.01|0.01||
125|G9585|G9585 - NO EVAL OPI USE INSTR/INTV|0.01|0.01||
125|G9584|G9584 - EVAL OPIOID USE INSTR/PT INT|0.01|0.01||
125|G9583|G9583 - PRESC OPIATES >6 WKS|0.01|0.01||
125|G9582|G9582 - DOOR TO PUNC TIME >2HR -  NRG|0.01|0.01||
125|G9580|G9580 - DOOR TO PUNC TIME <2HRS|0.01|0.01||
125|G9579|G9579 - NO DOC OPIOID TX 1X AT THER|0.01|0.01||
125|G9578|G9578 - DOC OPIOID TX 1X DURING THER|0.01|0.01||
125|G9577|G9577 - PRESC OPIATES >6 WKS|0.01|0.01||
125|G9574|G9574 - ADL PT MD DYS NO REM 6 MON|0.01|0.01||
125|G9573|G9573 - ADL PT MD OR DYS REM 6 MON|0.01|0.01||
125|G9563|G9563 - NO F/U EVAL Q3MO OPIOD TX|0.01|0.01||
125|G9562|G9562 - FOLL-UP EVAL Q3MO OPIOD TX|0.01|0.01||
125|G9561|G9561 - PRESC OPIATES >6 WKS|0.01|0.01||
125|G9560|G9560 - NO BETA-LACTAM ABX THER -  RNG|0.01|0.01||
125|G9559|G9559 - DOC MED REAS NO ABX THERAPY|0.01|0.01||
125|G9558|G9558 - TX BETA-LACTAM ABX THERAPY|0.01|0.01||
125|G9557|G9557 - CT/CTA/MRI/A NO THYR <1.0CM|0.01|0.01||
125|G9556|G9556 - CT/CTA/MRI/A NO FOLLUP IMAG|0.01|0.01||
125|G9555|G9555 - DOC MED RSN FOR FOLLUP IMAGE|0.01|0.01||
125|G9554|G9554 - CT/CTA/MRI/A CHST FOLL REC|0.01|0.01||
125|G9553|G9553 - PRIOR THYROID DISE DX|0.01|0.01||
125|G9552|G9552 - INC THYR NODE <1.0 IN RPT|0.01|0.01||
125|G9551|G9551 - ABD IMAG NO LES - KID/LIVR/ADR|0.01|0.01||
125|G9550|G9550 - ABD IMAG AND FOLLOWUP NO REC|0.01|0.01||
125|G9549|G9549 - DOC MED RSN FOR FOLLOW IMAG|0.01|0.01||
125|G9548|G9548 - ABD IMAG AND FOLLOWUP REC|0.01|0.01||
125|G9547|G9547 - INCID FINDING LIVER/KID/ADRE|0.01|0.01||
125|G9544|G9544 - NO FILT REMOV W/IN 3MOS PLCM|0.01|0.01||
125|G9543|G9543 - DOC 2X RE-ASSESS FILT REMOV|0.01|0.01||
125|G9542|G9542 - DOC REASS APPR REMO FILT 3MS|0.01|0.01||
125|G9541|G9541 - FILTER REM 3 MON PLMT|0.01|0.01||
125|G9540|G9540 - PT ALIVE 3 MOS POST PROC|0.01|0.01||
125|G9539|G9539 - INTENT POT REMV TIME PLACEMT|0.01|0.01||
125|G9538|G9538 - ADV BRAIN IMAGE ORDERED|0.01|0.01||
125|G9537|G9537 - DOC SYSM RSN IMG HD|0.01|0.01||
125|G9536|G9536 - DOC MED REAS ADV BRAIN IMAGE|0.01|0.01||
125|G9535|G9535 - NORMAL NEURO EXAM|0.01|0.01||
125|G9534|G9534 - ADV BRAIN IMAGE NOT ORDERED|0.01|0.01||
125|G9533|G9533 - INDIC FOR HEAD CT NOT VALID|0.01|0.01||
125|G9532|G9532 - PT HD CT ORD|0.01|0.01||
125|G9531|G9531 - PT DOC|0.01|0.01||
125|G9530|G9530 - PT MBHT HD CT ORD EC PROV|0.01|0.01||
125|G9529|G9529 - MINOR BLUNT TRAUMA W/HEAD CT|0.01|0.01||
125|G9526|G9526 - NO REASON -  NO REFER HOSPICE|0.01|0.01||
125|G9525|G9525 - DOC PT REAS NO HOSPICE REFER|0.01|0.01||
125|G9524|G9524 - REFER TO HOSPICE|0.01|0.01||
125|G9523|G9523 - D/C HEMO OR PERIT DIALYSIS|0.01|0.01||
125|G9522|G9522 - ER/IP HOSP =/>2 IN 12 MOS|0.01|0.01||
125|G9521|G9521 - ER AND IP HOSP <2 IN 12 MOS|0.01|0.01||
125|G9520|G9520 - REFRACT NOT +/- 0.5 W/IN 90D|0.01|0.01||
125|G9519|G9519 - FINAL REF +/- 0.5 W/IN 90D|0.01|0.01||
125|G9518|G9518 - DOC ACTIVE INJ DRUG USE|0.01|0.01||
125|G9517|G9517 - NO IMPR VIS ACUIT W/IN 90D|0.01|0.01||
125|G9516|G9516 - IMPR VIS ACUIT W/IN 90D|0.01|0.01||
125|G9515|G9515 - NO REAS -  NO RET OR W/IN 90D|0.01|0.01||
125|G9514|G9514 - REQ RET OR W/IN 90D OF SURG|0.01|0.01||
125|G9513|G9513 - INDIV PDC NOT > 0.8|0.01|0.01||
125|G9512|G9512 - INDIV PDC > 0.8|0.01|0.01||
125|G9511|G9511 - IDX EVT DTE PHQ>9 DOC 12 MO|0.01|0.01||
125|G9510|G9510 - REMIS 12M NOT PHQ-9 SCORE <5|0.01|0.01||
125|G9509|G9509 - ADIT MDD DYS REM 12 MNTHS|0.01|0.01||
125|G9508|G9508 - DOC PT NOT ON STATIN|0.01|0.01||
125|G9507|G9507 - DOC REAS ON STATIN OR CONTRA|0.01|0.01||
125|G9506|G9506 - BIO IMM RESP MOD PRESC|0.01|0.01||
125|G9505|G9505 - ABX PRES W/IN 10 DYS OF SYMP|0.01|0.01||
125|G9504|G9504 - DOC RSN HEP B STAT NOT ASSES|0.01|0.01||
125|G9503|G9503 - PT TK TAMS HCL|0.01|0.01||
125|G9502|G9502 - MED REAS NO PERF FOOT EXAM|0.01|0.01||
125|G9501|G9501 - RAD EXPOS IND/EXP TM NO DOC|0.01|0.01||
125|G9500|G9500 - RAD EXPOS IND/EXP TM DOC|0.01|0.01||
125|G9498|G9498 - ABX REG PRESCRIBED|0.01|0.01||
125|G9497|G9497 - REC INST NO SMOKE DAY SURG|0.01|0.01||
125|G9496|G9496 - DOC RSN NO ADENO/NEOPL DETEC|0.01|0.01||
125|G9490|G9490 - CMMI MOD HOME VISIT|68.36|68.36||
125|G9489|G9489 - REMOTE E/M EST. PT 40MINS|133.25|133.25||
125|G9488|G9488 - REMOTE E/M EST. PT 25MINS|94.31|94.31||
125|G9487|G9487 - REMOTE E/M EST. PT 15MINS|61.32|61.32||
125|G9486|G9486 - REMOTE E/M EST. PT 10MINS|30.68|30.68||
125|G9485|G9485 - REMOTE E/M NEW PT 60MINS|204.27|204.27||
125|G9484|G9484 - REMOTE E/M NEW PT 45MINS|156.45|156.45||
125|G9483|G9483 - REMOTE E/M NEW PT 30MINS|92.76|92.76||
125|G9482|G9482 - REMOTE E/M NEW PT 20MINS|59.61|59.61||
125|G9481|G9481 - REMOTE E/M NEW PT 10MINS|31.31|31.31||
125|G9480|G9480 - ADMISSION TO MCCM|0.01|0.01||
125|G9472|G9472 - NO DXA NO MED HX NO RV SX|0.01|0.01||
125|G9471|G9471 - W/IN 2YR DXA NOT ORDER|0.01|0.01||
125|G9470|G9470 - NO REC CORTICO>60D 1RX 600MG|0.01|0.01||
125|G9469|G9469 - REC CORTICO>60D OR 1RX 600MG|0.01|0.01||
125|G9468|G9468 - NO RECD CORTICO>=10MG/D >60D|0.01|0.01||
125|G9460|G9460 - NO TOB ASSESS OR CESS INTER|0.01|0.01||
125|G9459|G9459 - TOB NON-USER|0.01|0.01||
125|G9458|G9458 - TOB USER RECD CESS INTERV|0.01|0.01||
125|G9457|G9457 - PT NO ABD IMG NO DOC RSN|0.01|0.01||
125|G9456|G9456 - DOC MED PT REAS NO HCC SCRN|0.01|0.01||
125|G9455|G9455 - ABD IMAG W/US -  CT OR MRI|0.01|0.01||
125|G9454|G9454 - NO SCR HCV INF 12 MTH RP|0.01|0.01||
125|G9453|G9453 - PT REAS NO HCV INFECT|0.01|0.01||
125|G9452|G9452 - DOC MED REAS NO SCRN HCV|0.01|0.01||
125|G9451|G9451 - 1X SCRN HCV INFECT|0.01|0.01||
125|G9450|G9450 - HX INJEC DRUG USE|0.01|0.01||
125|G9449|G9449 - HX BLD TRANSF B/F 1992|0.01|0.01||
125|G9448|G9448 - BORN 1945-1965|0.01|0.01||
125|G9434|G9434 - ASTH NOT CONTROLLED|0.01|0.01||
125|G9432|G9432 - ASTH CONTROLLED|0.01|0.01||
125|G9431|G9431 - PATHO RPT NO PT CTG|0.01|0.01||
125|G9430|G9430 - SPEC SITE NO CUTANEOUS|0.01|0.01||
125|G9429|G9429 - DOC MED RSN NO PT CAT|0.01|0.01||
125|G9428|G9428 - PATHO RPT INCL PT CTG|0.01|0.01||
125|G9427|G9427 - NO IMPRO MED TIME PAIN MED|0.01|0.01||
125|G9426|G9426 - IMPR MED TIME EDARR PAIN MED|0.01|0.01||
125|G9425|G9425 - SPEC RPT NO DOC CLASS HISTO|0.01|0.01||
125|G9424|G9424 - SITE NO LUNG OR LUNG CX|0.01|0.01||
125|G9423|G9423 - MED REAS RPT NO HISTO TYPE|0.01|0.01||
125|G9422|G9422 - RPT DOC CLASS HISTO TYPE|0.01|0.01||
125|G9421|G9421 - LUNG CX BX RPT NO DOC CLASS|0.01|0.01||
125|G9420|G9420 - SPEC SITE NO LUNG|0.01|0.01||
125|G9419|G9419 - MED REAS NOT INCL HISTO TYPE|0.01|0.01||
125|G9418|G9418 - LUNGCX BX RPT DOCS CLASS|0.01|0.01||
125|G9417|G9417 - PT NOT 1 TDAP BETW 10-13 YRS|0.01|0.01||
125|G9416|G9416 - PT 1 TDAP BETW 10-13 YRS|0.01|0.01||
125|G9415|G9415 - NO 1DOSE MENI VAC BTWN 11&13|0.01|0.01||
125|G9414|G9414 - 1DOSE MENIG VAC BTWN 11 & 13|0.01|0.01||
125|G9413|G9413 - NO ADMIT REQ SURG REV|0.01|0.01||
125|G9412|G9412 - ADMIT W/IN 180D REQ SURG REV|0.01|0.01||
125|G9411|G9411 - NO ADMIT W/IN 180D REQ REMOV|0.01|0.01||
125|G9410|G9410 - ADMIT W/IN 180D REQ REMOV|0.01|0.01||
125|G9409|G9409 - NO CARD TAMP E/IN 30D|0.01|0.01||
125|G9408|G9408 - CARD TAMP W/IN 30D|0.01|0.01||
125|G9407|G9407 - NO 7D F/U|0.01|0.01||
125|G9406|G9406 - DOC REAS NO 7D F/U|0.01|0.01||
125|G9405|G9405 - RECD F/U W/IN 7D DISCH|0.01|0.01||
125|G9404|G9404 - NO 30 DAY F/U|0.01|0.01||
125|G9403|G9403 - DOC REAS NO 30 DAY F/U|0.01|0.01||
125|G9402|G9402 - RECD F/U W/IN 30D DISCH|0.01|0.01||
125|G9401|G9401 - NO DISC TX CHOICES|0.01|0.01||
125|G9400|G9400 - DOC REAS NO DISC TX OPT|0.01|0.01||
125|G9399|G9399 - DOC DISC TX CHOICES|0.01|0.01||
125|G9396|G9396 - INI PHQ9 >9 NOT ASSESS|0.01|0.01||
125|G9395|G9395 - INI PHQ9 >9 NO REMISS >=5|0.01|0.01||
125|G9394|G9394 - DX BIPOL -  DEATH -  NHRES -  HOSP|0.01|0.01||
125|G9393|G9393 - INI PHQ9 >9 REMISS <5|0.01|0.01||
125|G9390|G9390 - NO UNPLN RUP POST CAP|0.01|0.01||
125|G9389|G9389 - UNPLN RUP POST CAP|0.01|0.01||
125|G9386|G9386 - SCRN HCV INFEC NOT RECD|0.01|0.01||
125|G9385|G9385 - DOC PT REAS NOT REC HCV SRN|0.01|0.01||
125|G9384|G9384 - DOC MED RSN NO HCV SCRN|0.01|0.01||
125|G9383|G9383 - RECD SCRN HCV INFEC|0.01|0.01||
125|G9382|G9382 - NO OFF ASSIS EOL|0.01|0.01||
125|G9381|G9381 - DOC MED REAS NO OFFER EOL|0.01|0.01||
125|G9380|G9380 - OFF ASSIS EOL ISS|0.01|0.01||
125|G9368|G9368 - >= 2 SAME HI-RSK MED NOT ORD|0.01|0.01||
125|G9367|G9367 - >= 2 SAME HI-RSK MED ORD|0.01|0.01||
125|G9366|G9366 - 1 HIGH RISK NO ORD|0.01|0.01||
125|G9365|G9365 - 1 HIGH RISK MED ORD|0.01|0.01||
125|G9364|G9364 - SINUS CAUS BAC INX|0.01|0.01||
125|G9361|G9361 - DOC RSN ELECT C-SEC/INDUCT|0.01|0.01||
125|G9360|G9360 - NO DOC OF NEG OR MAN POS TB|0.01|0.01||
125|G9359|G9359 - DOC OF NEG OR MAN POS TB SCN|0.01|0.01||
125|G9358|G9358 - PP EVAL/EDU NOT PERF|0.01|0.01||
125|G9357|G9357 - PP EVAL/EDU PERF|0.01|0.01||
125|G9356|G9356 - EARLY IND/DELIVERY|0.01|0.01||
125|G9355|G9355 - NO EARLY IND/DELIVERY|0.01|0.01||
125|G9354|G9354 - 1 OR NO CT SINUS W/IN 90D DX|0.01|0.01||
125|G9353|G9353 - MEDRSN >1 SINUS CT W 90D DX|0.01|0.01||
125|G9352|G9352 - NOT >1 SINUS CT W 90D DX|0.01|0.01||
125|G9351|G9351 - DOC >1 SINUS CT W 90D DX|0.01|0.01||
125|G9350|G9350 - NO DOC SINUS CT 28D OR DX|0.01|0.01||
125|G9349|G9349 - DOC SINUS CT 28D|0.01|0.01||
125|G9348|G9348 - DOC RSN FOR ORD CT SCAN|0.01|0.01||
125|G9347|G9347 - NO FOLLOW UP PULM NOD NORSN|0.01|0.01||
125|G9345|G9345 - FOLLOW UP PULM NOD|0.01|0.01||
125|G9344|G9344 - SYSRSN NO DICOM SRCH|0.01|0.01||
125|G9342|G9342 - NO SRCH FOR CT IN 12MO NORSN|0.01|0.01||
125|G9341|G9341 - SRCH FOR CT W IN 12 MOS|0.01|0.01||
125|G9340|G9340 - DICOM FORMAT DOC ON RPT|0.01|0.01||
125|G9329|G9329 - NORSN NO DICOM FORMAT DOC|0.01|0.01||
125|G9327|G9327 - CT DONE RAD DS INDEX|0.01|0.01||
125|G9326|G9326 - CT DONE NO RAD DS INDEX -  NRG|0.01|0.01||
125|G9322|G9322 - NO DOC COUNT OF CT IN 12MO|0.01|0.01||
125|G9321|G9321 - DOC COUNT OF CT IN 12MO|0.01|0.01||
125|G9319|G9319 - IMAGE NOT STD NOMENCLATURE|0.01|0.01||
125|G9318|G9318 - IMAGE STD NOMENCLATURE|0.01|0.01||
125|G9317|G9317 - NO DOC COMM RISK CALC|0.01|0.01||
125|G9316|G9316 - DOC COMM RISK CALC|0.01|0.01||
125|G9315|G9315 - DOC FIRST LINE AMOX|0.01|0.01||
125|G9314|G9314 - NORSN NOT FIRST LINE AMOX|0.01|0.01||
125|G9313|G9313 - AMOXIC NOT PRESC AS 1ST LINE|0.01|0.01||
125|G9312|G9312 - SURGICAL SITE INFECTION|0.01|0.01||
125|G9311|G9311 - NO SURG SITE INFECTION|0.01|0.01||
125|G9310|G9310 - UNPLND HOSP READM IN 30D|0.01|0.01||
125|G9309|G9309 - NO UNPLND HOSP READM IN 30D|0.01|0.01||
125|G9308|G9308 - UNPL RET OR W/COMPL W/IN 30D|0.01|0.01||
125|G9307|G9307 - NO RET FOR SURG W IN 30D|0.01|0.01||
125|G9306|G9306 - INTERV REQ FOR LEAK|0.01|0.01||
125|G9305|G9305 - NO INTERV REQ FOR LEAK|0.01|0.01||
125|G9304|G9304 - PROS INFO OP RPT|0.01|0.01||
125|G9303|G9303 - NORSN NO PROS INFO OP RPT|0.01|0.01||
125|G9302|G9302 - NORSN INCOMP INF ANTIBIO|0.01|0.01||
125|G9301|G9301 - DOC COMPL INF ANTIBIO|0.01|0.01||
125|G9300|G9300 - DOC MEDRSN NO COMPL ANTIBIO|0.01|0.01||
125|G9299|G9299 - NO EVAL RISKK VTE CARD PRIOR|0.01|0.01||
125|G9298|G9298 - EVAL RISK VTE CARD 30D PRIOR|0.01|0.01||
125|G9297|G9297 - NO DOC SHARE DEC PRIOR PROC|0.01|0.01||
125|G9296|G9296 - DOC SHARE DEC PRIOR PROC|0.01|0.01||
125|G9295|G9295 - NON CUTANEOUS LOC|0.01|0.01||
125|G9294|G9294 - PT CAT AND THCK ON REPORT|0.01|0.01||
125|G9293|G9293 - NO PT CATEGORY ON REPORT|0.01|0.01||
125|G9292|G9292 - MEDRSN NO PT CATEGORY|0.01|0.01||
125|G9291|G9291 - NOT NSM LUNG CA|0.01|0.01||
125|G9290|G9290 - NO DOC TYPE NSM LUNG CA|0.01|0.01||
125|G9289|G9289 - DOC TYPE NSM LUNG CA|0.01|0.01||
125|G9288|G9288 - DOC MEDRSN NO HIST TYPE RPT|0.01|0.01||
125|G9287|G9287 - NO ANTIBIO W IN 10D OF SYMPT|0.01|0.01||
125|G9286|G9286 - ANTIBIO RX W IN 10D OF SYMPT|0.01|0.01||
125|G9285|G9285 - SITE NOT SMALL CELL LUNG CA|0.01|0.01||
125|G9284|G9284 - NO HIST TYPE DOC ON REPORT|0.01|0.01||
125|G9283|G9283 - HIST TYPE DOC ON REPORT|0.01|0.01||
125|G9282|G9282 - DOC MEDRSN NO HISTO TYPE|0.01|0.01||
125|G9281|G9281 - PNE SCRN DONE DOC NOT IND|0.01|0.01||
125|G9280|G9280 - PNE NOT GIVEN NORSN|0.01|0.01||
125|G9279|G9279 - PNE SCRN DONE DOC VAC DONE|0.01|0.01||
125|G9278|G9278 - DOC NO DAILY ASPIRIN|0.01|0.01||
125|G9277|G9277 - DOC DAILY ASPIRIN OR CONTRA|0.01|0.01||
125|G9276|G9276 - DOC OF TOBACCO USER|0.01|0.01||
125|G9275|G9275 - DOC OF NON TOBACCO USER|0.01|0.01||
125|G9274|G9274 - BP OUT OF NRML LIMITS|0.01|0.01||
125|G9273|G9273 - SYS<140 AND DIA<90|0.01|0.01||
125|G9270|G9270 - DOC NO COMP OR MORT W IN 90D|0.01|0.01||
125|G9269|G9269 - DOC NO COMP OR MORT W IN 30D|0.01|0.01||
125|G9268|G9268 - DOC COMP OR MORT W IN 90D|0.01|0.01||
125|G9267|G9267 - DOC COMP OR MORT W IN 30D|0.01|0.01||
125|G9266|G9266 - NORSN PT CATH >=90D|0.01|0.01||
125|G9265|G9265 - DOC CATH >90D FOR MAINT DIA|0.01|0.01||
125|G9264|G9264 - DOC RSN HEMOD W/CATH >=90D|0.01|0.01||
125|G9263|G9263 - DOC OF DISCH POST-AAA REPAIR|0.01|0.01||
125|G9262|G9262 - DOC OF DEATH POST-AAA REPAIR|0.01|0.01||
125|G9261|G9261 - SURVIVE/NO STROKE POST CEA|0.01|0.01||
125|G9260|G9260 - DOC OF PAT DEATH AFTER CEA|0.01|0.01||
125|G9259|G9259 - SURVIVE/NO STROKE POST CAS|0.01|0.01||
125|G9258|G9258 - DOC OF PAT STROKE AFTER CEA|0.01|0.01||
125|G9257|G9257 - DOC OF PAT STROKE AFTER CAS|0.01|0.01||
125|G9256|G9256 - DOC OF PAT DEATH AFTER CAS|0.01|0.01||
125|G9255|G9255 - DOC PT DISCHG <=2D|0.01|0.01||
125|G9254|G9254 - DOC PT DISCHG >2D|0.01|0.01||
125|G9251|G9251 - DOC NO PAIN COMFORT 48HR|0.01|0.01||
125|G9250|G9250 - DOC OF PAIN COMFORT 48HR|0.01|0.01||
125|G9247|G9247 - 1 MED VISIT IN 24MO|0.01|0.01||
125|G9246|G9246 - NO MED VISIT IN 24MO|0.01|0.01||
125|G9243|G9243 - DOC VIRAL LOAD <200|0.01|0.01||
125|G9242|G9242 - DOC VIRAL LOAD >=200|0.01|0.01||
125|G9241|G9241 - DOC PT W OUT CATH MAINT DIA|0.01|0.01||
125|G9240|G9240 - DOC PT W CATH MAINT DIA|0.01|0.01||
125|G9239|G9239 - DOC RSN HEMOD & CATH ACC|0.01|0.01||
125|G9232|G9232 - PTRSN NO COMM COMORBID|0.01|0.01||
125|G9231|G9231 - DOC ESRD DIA TRANS PREG|0.01|0.01||
125|G9230|G9230 - NORSN FOR GC CHL SYP TEST|0.01|0.01||
125|G9229|G9229 - PTRSN NO GC CHL SYP TEST|0.01|0.01||
125|G9228|G9228 - GC CHL SYP DOCUMENTED|0.01|0.01||
125|G9227|G9227 - FOA DOC -  CARE PLAN NOT DOC|0.01|0.01||
125|G9226|G9226 - 3 COMP FOOT EXAM COMPLETED|0.01|0.01||
125|G9225|G9225 - NORSN NO FOOT EXAM|0.01|0.01||
125|G9223|G9223 - PJP PROPH ORDERED CD4 LOW|0.01|0.01||
125|G9213|G9213 - NO DOC OF DSM-IV|0.01|0.01||
125|G9212|G9212 - DOC OF DSM-IV INIT EVAL|0.01|0.01||
125|G9198|G9198 - NO ORDER FOR CEPH NO REASON|0.01|0.01||
125|G9197|G9197 - ORDER FOR CEPH|0.01|0.01||
125|G9196|G9196 - MED REASON FOR NO CEPH|0.01|0.01||
125|G9192|G9192 - SYSTEM REASON FOR NO BETA|0.01|0.01||
125|G9191|G9191 - PT REASON FOR NO BETA|0.01|0.01||
125|G9190|G9190 - MEDICAL REASON FOR NO BETA|0.01|0.01||
125|G9189|G9189 - BETA PRES OR ALREADY TAKING|0.01|0.01||
125|G9188|G9188 - BETA NOT GIVEN NO REASON|0.01|0.01||
125|G9187|G9187 - BPCI HOME VISIT|68.36|68.36||
125|G9186|G9186 - MOTOR SPEECH GOAL STATUS|0.01|0.01||
125|G9176|G9176 - SPEECH LANG D/C STATUS|0.01|0.01||
125|G9175|G9175 - SPEECH LANG GOAL STATUS|0.01|0.01||
125|G9174|G9174 - SPEECH LANG CURRENT STATUS|0.01|0.01||
125|G9173|G9173 - VOICE D/C STATUS|0.01|0.01||
125|G9172|G9172 - VOICE GOAL STATUS|0.01|0.01||
125|G9171|G9171 - VOICE CURRENT STATUS|0.01|0.01||
125|G9170|G9170 - MEMORY D/C STATUS|0.01|0.01||
125|G9169|G9169 - MEMORY GOAL STATUS|0.01|0.01||
125|G9168|G9168 - MEMORY CURRENT STATUS|0.01|0.01||
125|G9167|G9167 - ATTEN D/C STATUS|0.01|0.01||
125|G9166|G9166 - ATTEN GOAL STATUS|0.01|0.01||
125|G9165|G9165 - ATTEN CURRENT STATUS|0.01|0.01||
125|G9164|G9164 - LANG EXPRESS D/C STATUS|0.01|0.01||
125|G9163|G9163 - LANG EXPRESS GOAL STATUS|0.01|0.01||
125|G9162|G9162 - LANG EXPRESS CURRENT STATUS|0.01|0.01||
125|G9161|G9161 - LANG COMP D/C STATUS|0.01|0.01||
125|G9160|G9160 - LANG COMP GOAL STATUS|0.01|0.01||
125|G9159|G9159 - LANG COMP CURRENT STATUS|0.01|0.01||
125|G9158|G9158 - MOTOR SPEECH D/C STATUS|0.01|0.01||
125|G9157|G9157 - TRANSESOPH DOPPL CARDIAC MON|159.84|159.84||
125|G9156|G9156 - EVALUATION FOR WHEELCHAIR|0.01|0.01||
125|G9153|G9153 - MAPCP DEMO PHYSICIAN|0.01|0.01||
125|G9152|G9152 - MAPCP DEMO COMMUNITY|0.01|0.01||
125|G9151|G9151 - MAPCP DEMO STATE|0.01|0.01||
125|G9150|G9150 - MEDICAL HOME LEVEL III|0.01|0.01||
125|G9149|G9149 - MEDICAL HOME LEVEL II|0.01|0.01||
125|G9148|G9148 - MEDICAL HOME LEVEL 1|0.01|0.01||
125|G9147|G9147 - OUTPT IV INSULIN TX ANY MEA|0.01|0.01||
125|G9143|G9143 - WARFARIN RESPON GENETIC TEST|242.92|242.92||59.82
125|G9140|G9140 - FRONTIER EXTENDED STAY DEMO|0.01|0.01||
125|G9139|G9139 - ONC DX CML DX STATUS UNKNOWN|0.01|0.01||
125|G9138|G9138 - ONC DX NHL STG UNKNOWN|0.01|0.01||
125|G9137|G9137 - ONC DX NHL RELAPSE/REFRACTOR|0.01|0.01||
125|G9136|G9136 - ONC DX NHL TRANS TO LG BCELL|0.01|0.01||
125|G9135|G9135 - ONC DX NHL STG 3-4 NOT RELAP|0.01|0.01||
125|G9134|G9134 - ONC NHLSTG 1-2 NO RELAP NO|0.01|0.01||
125|G9133|G9133 - ONC DX PROSTATE CLINICAL MET|0.01|0.01||
125|G9132|G9132 - ONC DX PROSTATE METS NO CAST|0.01|0.01||
125|G9131|G9131 - ONC DX BRST UNKNOWN NOS|0.01|0.01||
125|G9130|G9130 - ONC DX MULTI MYELOMA UNKNOWN|0.01|0.01||
125|G9129|G9129 - ONC DX MULT MYELOMA STG2 HIG|0.01|0.01||
125|G9128|G9128 - ONC DX MULTI MYELOMA STAGE I|0.01|0.01||
125|G9126|G9126 - ONC DX CML REMISSION|0.01|0.01||
125|G9125|G9125 - ONC DX CML BLAST PHASE|0.01|0.01||
125|G9124|G9124 - ONC DX CML ACCELER PHASE|0.01|0.01||
125|G9123|G9123 - ONC DX CML CHRONIC PHASE|0.01|0.01||
125|G9117|G9117 - ONC DX OVARIAN UNKNOWN NOS|0.01|0.01||
125|G9116|G9116 - ONC DX OVARIAN RECURRENCE|0.01|0.01||
125|G9115|G9115 - ONC DX OVARIAN STG3/4 NOPROG|0.01|0.01||
125|G9114|G9114 - ONC DX OVARIAN STG1A-B OR 2|0.01|0.01||
125|G9113|G9113 - ONC DX OVARIAN STG1A-B NO PR|0.01|0.01||
125|G9112|G9112 - ONC DX HEAD/NECK EXT UNKNOWN|0.01|0.01||
125|G9111|G9111 - ONC DX HEAD/NECK M1 METS REC|0.01|0.01||
125|G9110|G9110 - ONC DX HEAD/NECK T3-4 NOPROG|0.01|0.01||
125|G9109|G9109 - ONC DX HEAD/NECK T1-T2NO PRG|0.01|0.01||
125|G9108|G9108 - ONC DX PANCREATIC UNKNWN NOS|0.01|0.01||
125|G9107|G9107 - ONC DX PANCREATIC UNRESECTAB|0.01|0.01||
125|G9106|G9106 - ONC DX PANCREATC P R1/R2 NO|0.01|0.01||
125|G9105|G9105 - ONC DX PANCREATC P R0 RES NO|0.01|0.01||
125|G9104|G9104 - ONC DX GASTRIC UNKNOWN NOS|0.01|0.01||
125|G9103|G9103 - ONC DX GASTRIC RECURRENT|0.01|0.01||
125|G9102|G9102 - ONC DX GASTRIC UNRESECTABLE|0.01|0.01||
125|G9101|G9101 - ONC DX GASTRIC P R1-R2NOPROG|0.01|0.01||
125|G9100|G9100 - ONC DX GASTRIC NO RECURRENCE|0.01|0.01||
125|G9099|G9099 - ONC DX ESOPHAGEAL UNKNOWN|0.01|0.01||
125|G9098|G9098 - ONC DX ESOPHAGEAL METS RECUR|0.01|0.01||
125|G9097|G9097 - ONC DX ESOPHAGEAL T4 NO PROG|0.01|0.01||
125|G9096|G9096 - ONC DX ESOPHAG T1-T3 NOPROG|0.01|0.01||
125|G9095|G9095 - ONC DX RECTAL EXTENT UNKNWN|0.01|0.01||
125|G9094|G9094 - ONC DX RECTAL M1 W/METS PROG|0.01|0.01||
125|G9093|G9093 - ONC DX RECTAL T4 - N - M0 NO PRG|0.01|0.01||
125|G9092|G9092 - ONC DX RECTAL T1-3 - N1-2NOPRG|0.01|0.01||
125|G9091|G9091 - ONC DX RECTAL T3 N0 NO PROG|0.01|0.01||
125|G9090|G9090 - ONC DX RECTAL T1-2 NO PROGR|0.01|0.01||
125|G9089|G9089 - ONC DX COLON EXTENT UNKNOWN|0.01|0.01||
125|G9088|G9088 - ONC DX COLON METAS NOEVID DX|0.01|0.01||
125|G9087|G9087 - ONC DX COLON METAS EVID DX|0.01|0.01||
125|G9086|G9086 - ONC DX COLON T1-4 NO DX PROG|0.01|0.01||
125|G9085|G9085 - ONC DX COLON T4 -  N0 W/O PROG|0.01|0.01||
125|G9084|G9084 - ONC DX COLON T1-3 - N1-2 - NO PR|0.01|0.01||
125|G9083|G9083 - ONC DX PROSTATE UNKNWN NOS|0.01|0.01||
125|G9080|G9080 - ONC DX PROSTATE W/RISE PSA|0.01|0.01||
125|G9079|G9079 - ONC DX PROSTATE T3B-T4NOPROG|0.01|0.01||
125|G9078|G9078 - ONC DX PROSTATE T2NO PROGRES|0.01|0.01||
125|G9077|G9077 - ONC DX PROSTATE T1NO PROGRES|0.01|0.01||
125|G9075|G9075 - ONC DX BRST METASTIC/ RECUR|0.01|0.01||
125|G9074|G9074 - ONC DX BRST STG3-NOPROGRESS|0.01|0.01||
125|G9073|G9073 - ONC DX BRST STG3-HR -  NO PRO|0.01|0.01||
125|G9072|G9072 - ONC DX BRST STG1-2 NOPROGRES|0.01|0.01||
125|G9071|G9071 - ONC DX BRST STG1-2B HR - NOPRO|0.01|0.01||
125|G9070|G9070 - ONC DX SCLC/NSCLC EXT UNKNWN|0.01|0.01||
125|G9069|G9069 - ONC DX SCLC/NSCLC EXT AT DX|0.01|0.01||
125|G9068|G9068 - ONC DX SCLC/NSCLC LIMITED|0.01|0.01||
125|G9067|G9067 - ONC DX NSCLC DX UNKNOWN NOS|0.01|0.01||
125|G9066|G9066 - ONC DX NSCLC STG3B-4 METASTA|0.01|0.01||
125|G9065|G9065 - ONC DX NSCLC STG3A NO PROGRE|0.01|0.01||
125|G9064|G9064 - ONC DX NSCLC STG2 NO PROGRES|0.01|0.01||
125|G9063|G9063 - ONC DX NSCLC STGI NO PROGRES|0.01|0.01||
125|G9062|G9062 - ONC PRAC GUIDE DIFFERS NOS|0.01|0.01||
125|G9061|G9061 - ONC PRAC COND NOADD BY GUIDE|0.01|0.01||
125|G9060|G9060 - ONC PRAC MGMT DIF PT COMORB|0.01|0.01||
125|G9059|G9059 - ONC PRAC MGMT PT OPT ALTERNA|0.01|0.01||
125|G9058|G9058 - ONC PRAC MGMT DISAGREE W/GUI|0.01|0.01||
125|G9057|G9057 - ONC PRACT MGMT DIFFERS TRIAL|0.01|0.01||
125|G9056|G9056 - ONC PRAC MGMT ADHERES GUIDE|0.01|0.01||
125|G9055|G9055 - ONC VISIT UNSPECIFIED NOS|0.01|0.01||
125|G9054|G9054 - ONC SUPERVISION PALLIATIVE|0.01|0.01||
125|G9053|G9053 - ONC EXPECTANT MANAGEMENT PT|0.01|0.01||
125|G9052|G9052 - ONC SURVEILLANCE FOR DISEASE|0.01|0.01||
125|G9051|G9051 - ONCOLOGY TX DECISION-MGMT|0.01|0.01||
125|G9050|G9050 - ONCOLOGY WORK-UP EVALUATION|0.01|0.01||
125|G9036|G9036 - RIMANTADINE HCL -  BRAND|2.6|2.6||
125|G9035|G9035 - OSELTAMIVIR PHOSP -  BRAND|18.16|18.16||
125|G9034|G9034 - ZANAMIVIR -  INH PWDR -  BRAND|7.06|7.06||
125|G9033|G9033 - AMANTADINE HCL ORAL BRAND|0.01|0.01||
125|G9020|G9020 - RIMANTADINE HCL 100MG ORAL|2.6|2.6||
125|G9019|G9019 - OSELTAMIVIR PHOSPHATE 75MG|15.4|15.4||
125|G9018|G9018 - ZANAMIVIR - INHALATION PWD 10M|7.06|7.06||
125|G9017|G9017 - AMANTADINE HCL 100MG ORAL|2.02|2.02||
125|G9016|G9016 - DEMO-SMOKING CESSATION COUN|0.01|0.01||
125|G9014|G9014 - ESRD DEMO BUNDLE-LEVEL II|0.01|0.01||
125|G9013|G9013 - ESRD DEMO BUNDLE LEVEL I|0.01|0.01||
125|G9012|G9012 - OTHER SPECIFIED CASE MGMT|0.01|0.01||
125|G9011|G9011 - MCCD -  RISK ADJ -  LEVEL 5|0.01|0.01||
125|G9010|G9010 - MCCD -  RISK ADJ -  LEVEL 4|0.01|0.01||
125|G9009|G9009 - MCCD -  RISK ADJ -  LEVEL 3|0.01|0.01||
125|G9008|G9008 - MCCD - PHYS COOR-CARE OVRSGHT|0.01|0.01||
125|G9007|G9007 - MCCD -  SCH TEAM CONF|0.01|0.01||
125|G9006|G9006 - MCCD -  HOME MONITORING|0.01|0.01||
125|G9005|G9005 - MCCD -  RISK ADJ -  MAINTENANCE|0.01|0.01||
125|G9004|G9004 - MCCD -  RISK ADJ LO -  INITIAL|0.01|0.01||
125|G9003|G9003 - MCCD -  RISK ADJ HI -  INITIAL|0.01|0.01||
125|G9002|G9002 - MCCD - MAINTENANCE RATE|0.01|0.01||
125|G9001|G9001 - MCCD -  INITIAL RATE|0.01|0.01||
125|G8999|G8999 - MOTOR SPEECH CURRENT STATUS|0.01|0.01||
125|G8998|G8998 - SWALLOW D/C STATUS|0.01|0.01||
125|G8997|G8997 - SWALLOW GOAL STATUS|0.01|0.01||
125|G8996|G8996 - SWALLOW CURRENT STATUS|0.01|0.01||
125|G8995|G8995 - SUB PT/OT D/C STATUS|0.01|0.01||
125|G8994|G8994 - SUB PT/OT GOAL STATUS|0.01|0.01||
125|G8993|G8993 - SUB PT/OT CURRENT STATUS|0.01|0.01||
125|G8992|G8992 - OTHER PT/OT  D/C STATUS|0.01|0.01||
125|G8991|G8991 - OTHER PT/OT GOAL STATUS|0.01|0.01||
125|G8990|G8990 - OTHER PT/OT CURRENT STATUS|0.01|0.01||
125|G8989|G8989 - SELF CARE D/C STATUS|0.01|0.01||
125|G8988|G8988 - SELF CARE GOAL STATUS|0.01|0.01||
125|G8987|G8987 - SELF CARE CURRENT STATUS|0.01|0.01||
125|G8986|G8986 - CARRY D/C STATUS|0.01|0.01||
125|G8985|G8985 - CARRY GOAL STATUS|0.01|0.01||
125|G8984|G8984 - CARRY CURRENT STATUS|0.01|0.01||
125|G8983|G8983 - BODY POS D/C STATUS|0.01|0.01||
125|G8982|G8982 - BODY POS GOAL STATUS|0.01|0.01||
125|G8981|G8981 - BODY POS CURRENT STATUS|0.01|0.01||
125|G8980|G8980 - MOBILITY D/C STATUS|0.01|0.01||
125|G8979|G8979 - MOBILITY GOAL STATUS|0.01|0.01||
125|G8978|G8978 - MOBILITY CURRENT STATUS|0.01|0.01||
125|G8976|G8976 - HGB >= 10 G/DL|0.01|0.01||
125|G8975|G8975 - HGB <10G/DL -  MED RSN|0.01|0.01||
125|G8974|G8974 - HGB NOT DOC RNS NOT GVN|0.01|0.01||
125|G8973|G8973 - MST RCNT HBB < 10G/DL|0.01|0.01||
125|G8972|G8972 - 1>=RISK OR>= MOD RISK FOR TE|0.01|0.01||
125|G8971|G8971 - WARFRN OR OTHR ANTCOG NO RX|0.01|0.01||
125|G8970|G8970 - NO RSK FAC OR 1 MOD RISK TE|0.01|0.01||
125|G8969|G8969 - DOC PT RSN NO PRESC WARF/FDA|0.01|0.01||
125|G8968|G8968 - DOC MED NOT PRESB|0.01|0.01||
125|G8967|G8967 - WARF OR OTHER FDA DRUG PRESC|0.01|0.01||
125|G8966|G8966 - CSIT PERF SX OR HIGH CHD RSK|0.01|0.01||
125|G8965|G8965 - CSIT PERF ON LOW CHD RSK|0.01|0.01||
125|G8964|G8964 - CSI ANY OTHER THAN PCI 2 YR|0.01|0.01||
125|G8963|G8963 - CSI PER ASX PT W/PCI 2 YRS|0.01|0.01||
125|G8962|G8962 - CSIT ON PT ANY REAS 30 DAYS|0.01|0.01||
125|G8961|G8961 - CSIT LOWRISK SURG PTS PREOP|0.01|0.01||
125|G8960|G8960 - CLIN TX MDD NOT COMM|0.01|0.01||
125|G8959|G8959 - CLIN TX MDD COMM TO TX CLIN|0.01|0.01||
125|G8958|G8958 - ASSESS VOL MGMT NOT DOC|0.01|0.01||
125|G8956|G8956 - PT RCV HEDIA OUTPT DYLS FAC|0.01|0.01||
125|G8955|G8955 - MOST RECENT ASSESS VOL MGMT|0.01|0.01||
125|G8952|G8952 - PRE-HTN/HTN -  NO F/U -  NOT GVN|0.01|0.01||
125|G8950|G8950 - PRE-HTN OR HTN DOC -  F/U INDC|0.01|0.01||
125|G8947|G8947 - 1 OR MORE NEUROPSYCH|0.01|0.01||
125|G8946|G8946 - MIBM BUT NO DX OF BREAST CA|0.01|0.01||
125|G8944|G8944 - AJCC MEL CNR STG 0 - IIC|0.01|0.01||
125|G8942|G8942 - DOC FCN/CARE PLAN W/30 DAYS|0.01|0.01||
125|G8941|G8941 - ELD MALTREATMENT DOC AS POS|0.01|0.01||
125|G8939|G8939 - PAIN AS DOC POSITIVE -  NO F/U|0.01|0.01||
125|G8938|G8938 - BMI DOC ONL FUP NT DOC|0.01|0.01||
125|G8937|G8937 - NO RX ACE/ARB THERAPY|0.01|0.01||
125|G8936|G8936 - PT NOT ELIGIBLE ACE/ARB|0.01|0.01||
125|G8935|G8935 - RX ACE OR ARB THERAPY|0.01|0.01||
125|G8934|G8934 - LVEF <40% OR DEP LV SYS FCN|0.01|0.01||
125|G8926|G8926 - SPIRO NO PERF OR DOC|0.01|0.01||
125|G8925|G8925 - SPIR FEV1/FVC>=60% & NO COPD|0.01|0.01||
125|G8924|G8924 - SPIR FEV1/FVC<70% - FEV<60%|0.01|0.01||
125|G8923|G8923 - LVEF < 40% OR LVSD|0.01|0.01||
125|G8918|G8918 - PT W/O PREOP ORDER IV AB PRO|0.01|0.01||
125|G8917|G8917 - PT W IV AB NOT GIVEN ON TIME|0.01|0.01||
125|G8916|G8916 - PT W IV AB GIVEN ON TIME|0.01|0.01||
125|G8915|G8915 - PT NOT TRANS TO HOSP AT D/C|0.01|0.01||
125|G8914|G8914 - PT TRANS TO HOSP POST D/C|0.01|0.01||
125|G8913|G8913 - PT DOC NO WRONG EVENT|0.01|0.01||
125|G8912|G8912 - PT DOC WITH WRONG EVENT|0.01|0.01||
125|G8911|G8911 - PT DOC NO FALL IN ASC|0.01|0.01||
125|G8910|G8910 - PT DOC TO HAVE FALL IN ASC|0.01|0.01||
125|G8909|G8909 - PT DOC NO BURN PRIOR TO D/C|0.01|0.01||
125|G8908|G8908 - PT DOC W BURN PRIOR TO D/C|0.01|0.01||
125|G8907|G8907 - PT DOC NO EVENTS ON DISCHARG|0.01|0.01||
125|G8885|G8885 - NO REV -  COMM -  TRACK BIOPSY|0.01|0.01||
125|G8884|G8884 - DOC REAS BIOPSY NOT REVIEW|0.01|0.01||
125|G8883|G8883 - REV -  COMM -  TRACK -  DOC BIOPSY|0.01|0.01||
125|G8882|G8882 - NO SENT LYMPH NODE BIOPSY|0.01|0.01||
125|G8881|G8881 - BRST CNCR STAGE > T1N0M0|0.01|0.01||
125|G8880|G8880 - SEN LYM P NODE BIOP NOT PERF|0.01|0.01||
125|G8879|G8879 - NODE NEG INV BRST CNCR|0.01|0.01||
125|G8878|G8878 - SENT LYMPH NODE BIOPSY|0.01|0.01||
125|G8877|G8877 - NO BRST CNCR DX MIN INVASIVE|0.01|0.01||
125|G8876|G8876 - DOC REAS NO MIN INV DX|0.01|0.01||
125|G8875|G8875 - BREAST CANCER DX MIN INVSIVE|0.01|0.01||
125|G8874|G8874 - TISSUE NOT IMAGE INTRAOP|0.01|0.01||
125|G8873|G8873 - SPECIMEN NOT INTRAOP IMAGE|0.01|0.01||
125|G8872|G8872 - INTRAOP IMAGE CONFIRM EXCISE|0.01|0.01||
125|G8869|G8869 - DOC IMMUNE HEP B ANTITNF|0.01|0.01||
125|G8867|G8867 - NO PNEUMOCOCCAL ADMIN|0.01|0.01||
125|G8866|G8866 - DOC PT REAS NO PNEUMOCOCCAL|0.01|0.01||
125|G8865|G8865 - DOC MED REAS NO PNEUMOCOCCAL|0.01|0.01||
125|G8864|G8864 - PNEUMOCOCCAL VACCINE ADMIN|0.01|0.01||
125|G8863|G8863 - NO ASSESS BONE LOSS|0.01|0.01||
125|G8861|G8861 - DXA ORDERED FOR OSTEO|0.01|0.01||
125|G8858|G8858 - NOT REF FOR OTO EVAL|0.01|0.01||
125|G8857|G8857 - NO ELIG REF FOR OTO EVAL|0.01|0.01||
125|G8856|G8856 - REF FOR OTO EVAL|0.01|0.01||
125|G8855|G8855 - POS AIR PRESS ADHERE NO PERF|0.01|0.01||
125|G8854|G8854 - REAS NO ADHERE POS AIR PRES|0.01|0.01||
125|G8852|G8852 - POS AIR PRESS PRESCRIBE|0.01|0.01||
125|G8851|G8851 - ADHERE POS AIR PRESS THERAPY|0.01|0.01||
125|G8850|G8850 - NO PAP PRESCRIBED|0.01|0.01||
125|G8849|G8849 - DOC REAS NO POS AIR PRESS|0.01|0.01||
125|G8846|G8846 - MOD OR SEVERE OSA|0.01|0.01||
125|G8845|G8845 - POS AIRWAY PRESS PRESCRIBED|0.01|0.01||
125|G8844|G8844 - NO AHI OR RDI INITIAL DX|0.01|0.01||
125|G8843|G8843 - DOC REAS NO AHI OR RDI|0.01|0.01||
125|G8842|G8842 - AHI OR RDI INITIAL DX|0.01|0.01||
125|G8841|G8841 - NO SLEEP APNEA ASSESS|0.01|0.01||
125|G8840|G8840 - DOC REAS NO SLEEP APNEA|0.01|0.01||
125|G8839|G8839 - SLEEP APNEA ASSESS|0.01|0.01||
125|G8838|G8838 - NOT DISCH HOME BY DAY #2|0.01|0.01||
125|G8834|G8834 - PT DISCH HOME DAY #2 CEA|0.01|0.01||
125|G8833|G8833 - PT NOT DISCH HOME DAY#2 EVAR|0.01|0.01||
125|G8826|G8826 - PT DISCH HOME DAY #2 EVAR|0.01|0.01||
125|G8825|G8825 - PT NOT DISCH TO HOME DAY#7|0.01|0.01||
125|G8818|G8818 - PT DISCH TO HOME BY DAY#7|0.01|0.01||
125|G8817|G8817 - DOC REAS NO STATIN MED DISCH|0.01|0.01||
125|G8816|G8816 - STATIN MED PRES AT DISCH|0.01|0.01||
125|G8815|G8815 - DOC REAS NO STATIN THERAPY|0.01|0.01||
125|G8811|G8811 - NO RH-IMMUNOGLOBULIN ORDER|0.01|0.01||
125|G8810|G8810 - DOC REAS NO RH-IMMUNO|0.01|0.01||
125|G8809|G8809 - RH-IMMUNOGLOBULIN ORDER|0.01|0.01||
125|G8808|G8808 - ULTRASOUND NOT PERF -  RNG|0.01|0.01||
125|G8807|G8807 - NO TA TV ULTRASND|0.01|0.01||
125|G8806|G8806 - PERF ULTRSND TO LCT PREG DOC|0.01|0.01||
125|G8798|G8798 - SPECIMEN SITE NOT PROSTATE|0.01|0.01||
125|G8797|G8797 - SPECIMEN SITE NOT ESOPHAGUS|0.01|0.01||
125|G8785|G8785 - BP SCRN NO PERF AT INTERVAL|0.01|0.01||
125|G8783|G8783 - BP SCRN PERF REC INTERVAL|0.01|0.01||
125|G8756|G8756 - NO BP MEASURE DOC|0.01|0.01||
125|G8755|G8755 - DIAS BP > OR = 90|0.01|0.01||
125|G8754|G8754 - DIAS BP LESS 90|0.01|0.01||
125|G8753|G8753 - SYS BP > OR = 140|0.01|0.01||
125|G8752|G8752 - SYS BP LESS 140|0.01|0.01||
125|G8749|G8749 - NO SIGNS MELANOMA|0.01|0.01||
125|G8735|G8735 - ELD MAL SCRN POS NO PLAN|0.01|0.01||
125|G8734|G8734 - DOC NEG ELDER MAL NO PLAN|0.01|0.01||
125|G8733|G8733 - DOC POS ELDER MAL SCRN PLAN|0.01|0.01||
125|G8732|G8732 - NO DOC OF PAIN|0.01|0.01||
125|G8731|G8731 - PAIN NEG NO PLAN|0.01|0.01||
125|G8730|G8730 - PAIN DOC POS AND PLAN|0.01|0.01||
125|G8724|G8724 - PT -  PN -  HIST GRADE NOT DOC|0.01|0.01||
125|G8723|G8723 - SPEC SIT NOT PRIM TUMOR|0.01|0.01||
125|G8722|G8722 - MED REAS PT -  PN -  NOT DOC|0.01|0.01||
125|G8721|G8721 - PT -  PN -  HIST GRADE DOC|0.01|0.01||
125|G8712|G8712 - NOT PRES ANTIBIOTIC|0.01|0.01||
125|G8711|G8711 - PRES ANTIBIOTIC|0.01|0.01||
125|G8710|G8710 - PT PRES ANTIBIOTIC|0.01|0.01||
125|G8709|G8709 - PT PRESC DOC MED RSN ID URI|0.01|0.01||
125|G8708|G8708 - ANTIBIOTIC NOT PRES|0.01|0.01||
125|G8698|G8698 - ANTITHROMB NO PRESC NO REAS|0.01|0.01||
125|G8697|G8697 - ANTITHROMB NO PRESC DOC REAS|0.01|0.01||
125|G8696|G8696 - ANTITHROMB THX PRESC|0.01|0.01||
125|G8694|G8694 - LVEF <40%|0.01|0.01||
125|G8674|G8674 - RAFSCRS NECK -  NO MSR/NO FOTO|0.01|0.01||
125|G8673|G8673 - RAFSCRS GOI NO SCOR|0.01|0.01||
125|G8672|G8672 - RAFSCRS GOI SCOR < 0|0.01|0.01||
125|G8671|G8671 - RAFSCRS GOI SCOR >= 0|0.01|0.01||
125|G8670|G8670 - RAFSCRS EWH NO SCOR NO SURV|0.01|0.01||
125|G8669|G8669 - RAFSCRS HAND -  NO MSR/SURV|0.01|0.01||
125|G8668|G8668 - RAFSCRS EWH SCOR < 0|0.01|0.01||
125|G8667|G8667 - RAFSCRS EWH SCOR >= 0|0.01|0.01||
125|G8666|G8666 - RAFSCRS SI NO SCOR NO SURV|0.01|0.01||
125|G8665|G8665 - RAFSCRS SI NO SCOR|0.01|0.01||
125|G8664|G8664 - RAFSCRS SI SCOR < 0|0.01|0.01||
125|G8663|G8663 - RAFSCRS SI SCOR >= 0|0.01|0.01||
125|G8662|G8662 - RAFSCRS LBI NO SCOR NO SURV|0.01|0.01||
125|G8661|G8661 - RAFSCRS LBI NO SCOR|0.01|0.01||
125|G8660|G8660 - RAFSCRS LBI SCOR < 0|0.01|0.01||
125|G8659|G8659 - RAFSCRS LBI SCOR >= 0|0.01|0.01||
125|G8658|G8658 - RAFSCRS LLFAI NO SCOR + SURV|0.01|0.01||
125|G8657|G8657 - RAFSCRS LLFAI NO SCOR|0.01|0.01||
125|G8656|G8656 - RAFSCRS LLFAI SCOR < 0|0.01|0.01||
125|G8655|G8655 - RAFSCRS LLFAI SCOR >= 0|0.01|0.01||
125|G8654|G8654 - RAFSCRS HI NO SCOR NO SURV|0.01|0.01||
125|G8653|G8653 - RAFSCRS HI NO SCOR|0.01|0.01||
125|G8652|G8652 - RAFSCRS HI SCOR < 0|0.01|0.01||
125|G8651|G8651 - RAFSCRS HI SCOR >=0|0.01|0.01||
125|G8650|G8650 - RAFSCRS KI NO SCOR NO SURV|0.01|0.01||
125|G8649|G8649 - RAFSCRS KI NO SCOR|0.01|0.01||
125|G8648|G8648 - RAFSCRS KI SCOR < 0|0.01|0.01||
125|G8647|G8647 - RAFSCRS KI SCOR >= 0|0.01|0.01||
125|G8635|G8635 - NO PHARM THER OSTEO RX|0.01|0.01||
125|G8633|G8633 - PHARM THER OSTEO RX|0.01|0.01||
125|G8628|G8628 - NO SURG PROC W/IN 30 DAYS|0.01|0.01||
125|G8627|G8627 - SURG PROC W/IN 30 DAYS|0.01|0.01||
125|G8602|G8602 - NO TPA INIT W/IN 3 HRS|0.01|0.01||
125|G8601|G8601 - NO ELIG TPA INIT W/IN 3 HRS|0.01|0.01||
125|G8600|G8600 - TPA INITI W/IN 3 HRS|0.01|0.01||
125|G8599|G8599 - NO ASA/ANTIPLAT THER USE RNG|0.01|0.01||
125|G8598|G8598 - ASA/ANTIPLAT THER USED|0.01|0.01||
125|G8578|G8578 - NO REOP REQ BLD GRFT OTH|0.01|0.01||
125|G8577|G8577 - REOP REQ BLD GRFT OTH|0.01|0.01||
125|G8576|G8576 - NO POSTOP REN FAIL|0.01|0.01||
125|G8575|G8575 - POSTOP REN FAIL|0.01|0.01||
125|G8574|G8574 - NO STRK CABG|0.01|0.01||
125|G8573|G8573 - STK CABG|0.01|0.01||
125|G8572|G8572 - NO STER WD IFX|0.01|0.01||
125|G8571|G8571 - STER WD IFX 30 D POSTOP|0.01|0.01||
125|G8570|G8570 - NO PROL INTUB REQ|0.01|0.01||
125|G8569|G8569 - PROL INTUBATION REQ|0.01|0.01||
125|G8568|G8568 - PT NO REF OTOLO NO SPEC|0.01|0.01||
125|G8567|G8567 - PT NO DOC HEAR LOSS|0.01|0.01||
125|G8566|G8566 - PT INELIG REF OTO EVAL|0.01|0.01||
125|G8565|G8565 - VER DOC HEAR LOSS|0.01|0.01||
125|G8564|G8564 - PT REF OTO EVAL|0.01|0.01||
125|G8563|G8563 - PT NO REF OTO REAS NO SPEC|0.01|0.01||
125|G8562|G8562 - PT NO HX ACT DRAIN 90 D|0.01|0.01||
125|G8561|G8561 - PT INELIG FOR REF OTO EVAL|0.01|0.01||
125|G8560|G8560 - PT HX ACT DRAIN PREV 90 DAYS|0.01|0.01||
125|G8559|G8559 - PT REF DOC OTO EVAL|0.01|0.01||
125|G8543|G8543 - CUR FUNCT ASSES; NO CARE PLN|0.01|0.01||
125|G8542|G8542 - DOC FUNCT NO DEFICIENCIES|0.01|0.01||
125|G8541|G8541 - NO DOC CUR FUNCT ASSESS|0.01|0.01||
125|G8540|G8540 - FOA NOT DOC AS BEING PERF|0.01|0.01||
125|G8539|G8539 - DOC FUNCT AND CARE PLAN|0.01|0.01||
125|G8536|G8536 - NO DOC ELDER MAL SCRN|0.01|0.01||
125|G8535|G8535 - ELD MALTREATMENT NOT DOC|0.01|0.01||
125|G8511|G8511 - SCR DEP POS -  NO PLAN DOC RNG|0.01|0.01||
125|G8510|G8510 - SCR DEP NEG -  NO PLAN REQD|0.01|0.01||
125|G8509|G8509 - POS PAIN ASSESS NO F/U DOC|0.01|0.01||
125|G8506|G8506 - PT REC ACE/ARB|0.01|0.01||
125|G8484|G8484 - FLU IMMUNIZE NO ADMIN|0.01|0.01||
125|G8483|G8483 - FLU IMM NO ADMIN DOC REA|0.01|0.01||
125|G8482|G8482 - FLU IMMUNIZE ORDER/ADMIN|0.01|0.01||
125|G8478|G8478 - BP NOT PERFORMED/DOC|0.01|0.01||
125|G8477|G8477 - BP SYS>=140 AND/OR DIAS >=90|0.01|0.01||
125|G8476|G8476 - BP SYS <140 AND DIAS <90|0.01|0.01||
125|G8475|G8475 - ACE/ARB THXPY NOT RX'D|0.01|0.01||
125|G8474|G8474 - ACE/ARB NOT RX'D; DOC REAS|0.01|0.01||
125|G8473|G8473 - ACE/ARB THXPY RX'D|0.01|0.01||
125|G8465|G8465 - HIGH RISK RECURRENCE PRO CA|0.01|0.01||
125|G8452|G8452 - PT W/ABN LVEF B-BLOC NO RX|0.01|0.01||
125|G8451|G8451 - PT W/ABN LVEF INELIG B-BLOC|0.01|0.01||
125|G8450|G8450 - BETA-BLOC RX PT W/ABN LVEF|0.01|0.01||
125|G8442|G8442 - DOC PAIN AS NT PERF -  NOT ELG|0.01|0.01||
125|G8433|G8433 - SCR FOR DEP NOT CPT DOC RSN|0.01|0.01||
125|G8432|G8432 - DEP SCR NOT DOC -  RNG|0.01|0.01||
125|G8431|G8431 - POS CLIN DEPRES SCRN F/U DOC|0.01|0.01||
125|G8430|G8430 - EC AT DOC MEDREC PT NOT ELIG|0.01|0.01||
125|G8428|G8428 - CUR MEDS NOT DOCUMENT|0.01|0.01||
125|G8427|G8427 - DOCREV CUR MEDS BY ELIG CLIN|0.01|0.01||
125|G8422|G8422 - PT INELIG BMI CALCULATION|0.01|0.01||
125|G8421|G8421 - BMI NOT CALCULATED|0.01|0.01||
125|G8420|G8420 - CALC BMI NORM PARAMETERS|0.01|0.01||
125|G8419|G8419 - CALC BMI OUT NRM PARAM NOF/U|0.01|0.01||
125|G8418|G8418 - CALC BMI BLW LOW PARAM F/U|0.01|0.01||
125|G8417|G8417 - CALC BMI ABV UP PARAM F/U|0.01|0.01||
125|G8416|G8416 - PT INELIG FOOTWEAR EVALUATIO|0.01|0.01||
125|G8415|G8415 - EVAL ON FOOT NOT PERFORMED|0.01|0.01||
125|G8410|G8410 - EVAL ON FOOT DOCUMENTED|0.01|0.01||
125|G8405|G8405 - LOW EXTEMITY NEUR NOT PERFOR|0.01|0.01||
125|G8404|G8404 - LOW EXTEMITY NEUR EXAM DOCUM|0.01|0.01||
125|G8400|G8400 - PT W/DXA NO RESULTS DOC|0.01|0.01||
125|G8399|G8399 - PT W/DXA RESULTS DOCUMENT|0.01|0.01||
125|G8398|G8398 - DIL MACULAR/FUNDUS NOT PERFO|0.01|0.01||
125|G8397|G8397 - DIL MACULA/FUNDUS EXAM/W DOC|0.01|0.01||
125|G8396|G8396 - LVEF NOT PERFORMED|0.01|0.01||
125|G8395|G8395 - LVEF>=40% DOC NORMAL OR MILD|0.01|0.01||
125|G6017|G6017 - INTRAFRACTION TRACK MOTION|79.99|79.99||
125|G6016|G6016 - DELIVERY COMP IMRT|523.93|523.93||
125|G6015|G6015 - RADIATION TX DELIVERY IMRT|525.82|525.82||
125|G6014|G6014 - RADIATION TREATMENT DELIVERY|403.23|403.23||
125|G6013|G6013 - RADIATION TREATMENT DELIVERY|402.71|402.71||
125|G6012|G6012 - RADIATION TREATMENT DELIVERY|402.71|402.71||
125|G6011|G6011 - RADIATION TREATMENT DELIVERY|423.18|423.18||
125|G6010|G6010 - RADIATION TREATMENT DELIVERY|301.32|301.32||
125|G6009|G6009 - RADIATION TREATMENT DELIVERY|303.42|303.42||
125|G6008|G6008 - RADIATION TREATMENT DELIVERY|304.48|304.48||
125|G6007|G6007 - RADIATION TREATMENT DELIVERY|445.33|445.33||
125|G6006|G6006 - RADIATION TREATMENT DELIVERY|220.08|220.08||
125|G6005|G6005 - RADIATION TREATMENT DELIVERY|219.56|219.56||
125|G6004|G6004 - RADIATION TREATMENT DELIVERY|220.08|220.08||
125|G6003|G6003 - RADIATION TREATMENT DELIVERY|296.58|296.58||
125|G6002|G6002 - STEREOSCOPIC X-RAY GUIDANCE|117.62|117.62||33.11
125|G6001|G6001 - ECHO GUIDANCE RADIOTHERAPY|83.93|83.93||49.01
125|G0918|G0918 - NO SATISFY WITH CARE|0.01|0.01||
125|G0917|G0917 - SATISFY SURVEY NOT COMPLETE|0.01|0.01||
125|G0916|G0916 - SATISFY WITH CARE|0.01|0.01||
125|G0915|G0915 - NO IMPROVE VISUAL FUNCT|0.01|0.01||
125|G0914|G0914 - SURVEY NOT COMPLETE|0.01|0.01||
125|G0913|G0913 - IMPROVE VISUAL FUNCT|0.01|0.01||
125|G0659|G0659 - DRUG TEST DEF SIMPLE ALL CL|117.08|117.08||
125|G0518|G0518 - REMOVE W INSERT DRUG IMPLANT -  4 <|691.58|691.58||
125|G0517|G0517 - REMOVE DRUG IMPLANT -  4 OR MORE|400.72|400.72||
125|G0516|G0516 - INSERT DRUG DEL IMPLANT -  >=4|364.14|364.14||
125|G0515|G0515 - COGNITIVE SKILLS DEVELOPMENT EA 15|45.54|45.54||
125|G0514|G0514 - PROLONG PREV SVCS -  ADDL 30 MIN|104.92|104.92||
125|G0513|G0513 - PROLONG PREV SVCS -  FIRST 30 MIN|104.92|104.92||
125|G0512|G0512 - COCM BY RHC/FQHC 60 MIN MO|151.19|151.19||
125|G0511|G0511 - CCM/BHI BY RHC/FQHC 20MIN MO|65.12|65.12||
125|G0509|G0509 - CRIT CARE TELEHEA CONSULT 50|314.62|314.62||
125|G0508|G0508 - CRIT CARE TELEHEA CONSULT 60|325.46|325.46||
125|G0507|G0507 - CARE MANAGE SERV MINIMUM 20|49.96|49.96||
125|G0506|G0506 - COMP ASSES CARE PLAN CCM SVC|100.2|100.2||
125|G0505|G0505 - COG/FUNC ASSESSMENT  OUTPT|250.99|250.99||
125|G0504|G0504 - INIT/SUB PSYCH CARE ADD 30 M|69|69||
125|G0503|G0503 - SUBSEQ  PSYCH CARE MAN - 60MI|131.86|131.86||
125|G0502|G0502 - INIT PSYCH CARE MANAG -  70MIN|148.96|148.96||
125|G0500|G0500 - MOD SEDAT ENDO SERVICE >5YRS|88.36|88.36||
125|G0499|G0499 - HEP B SCREEN HIGH RISK INDIV|56.89|56.89||
125|G0498|G0498 - CHEMO EXTEND IV INFUS W/PUMP|188.96|188.96||
125|G0494|G0494 - LPN CARE EA 15MIN HH/HOSPICE|10.8|10.8||
125|G0493|G0493 - RN CARE EA 15 MIN HH/HOSPICE|10.8|10.8||
125|G0483|G0483 - DRUG TEST DEF 22+ CLASSES|402.48|402.48||
125|G0482|G0482 - DRUG TEST DEF 15-21 CLASSES|323.95|323.95||
125|G0481|G0481 - DRUG TEST DEF 8-14 CLASSES|255.24|255.24||
125|G0480|G0480 - DRUG TEST DEF 1-7 CLASSES|186.52|186.52||
125|G0476|G0476 - HPV COMBO ASSAY CA SCREEN|70.63|70.63||0.01
125|G0475|G0475 - HIV COMBINATION ASSAY|48.46|48.46||0.01
125|G0473|G0473 - GROUP BEHAVE COUNS 2-10|20.46|20.46||
125|G0472|G0472 - HEP C SCREEN HIGH RISK/OTHER|75.55|75.55||
125|G0471|G0471 - VEN BLOOD COLL SNF/HHA|8.15|8.15||
125|G0470|G0470 - FQHC VISIT -  MH ESTAB PT|99.6|99.6||
125|G0469|G0469 - FQHC VISIT -  MH NEW PT|132.18|132.18||
125|G0468|G0468 - FQHC VISIT -  IPPE OR AWV|131.69|131.69||
125|G0467|G0467 - FQHC VISIT -  ESTAB PT|85.92|85.92||
125|G0466|G0466 - FQHC VISIT NEW PATIENT|123.05|123.05||
125|G0463|G0463 - HOSPITAL OUTPT CLINIC VISIT|89.69|89.69||
125|G0459|G0459 - TELEHEALTH INPT PHARM MGMT|67.24|67.24||
125|G0458|G0458 - LDR PROSTATE BRACHY COMP RAT|36|36||
125|G0455|G0455 - FECAL MICROBIOTA PREP INSTIL|202.12|202.12||
125|G0454|G0454 - MD DOCUMENT VISIT BY NPP|14.88|14.88||
125|G0453|G0453 - CONT INTRAOP NEURO MONITOR|53.12|53.12||
125|G0452|G0452 - MOLECULAR PATHOLOGY INTERPR|20.04|20.04||29.73
125|G0451|G0451 - DEVLOPMENT TEST INTERPT&REP|15.4|15.4||
125|G0448|G0448 - PLACE PERM PACING CARDIOVERT|3263.82|3263.82||
125|G0447|G0447 - BEHAVIOR COUNSEL OBESITY 15M|41.48|41.48||
125|G0446|G0446 - INTENS BEHAVE THER CARDIO DX|41.48|41.48||
125|G0445|G0445 - HIGH INTEN BEH COUNS STD 30M|43.59|43.59||
125|G0444|G0444 - DEPRESSION SCREEN ANNUAL|28.07|28.07||
125|G0443|G0443 - BRIEF ALCOHOL MISUSE COUNSEL|41.48|41.48||
125|G0442|G0442 - ANNUAL ALCOHOL SCREEN 15 MIN|28.61|28.61||
125|G0439|G0439 - PPPS -  SUBSEQ VISIT|184.52|184.52||
125|G0438|G0438 - PPPS -  INITIAL VISIT|272.94|272.94||
125|G0435|G0435 - ORAL HIV-1/HIV-2 SCREEN|24.12|24.12||16.76
125|G0433|G0433 - ELISA HIV-1/HIV-2 SCREEN|29.81|29.81||19.18
125|G0432|G0432 - EIA HIV-1/HIV-2 SCREEN|31.9|31.9||19.18
125|G0429|G0429 - DERMAL FILLER INJECTION(S)|155.76|155.76||
125|G0427|G0427 - INPT/ED TELECONSULT70|326.11|326.11||
125|G0426|G0426 - INPT/ED TELECONSULT50|218.62|218.62||
125|G0425|G0425 - INPT/ED TELECONSULT30|161.57|161.57||
125|G0424|G0424 - PULMONARY REHAB W EXER|46.7|46.7||
125|G0423|G0423 - INTENS CARDIAC REHAB NO EXER|182.32|182.32||
125|G0422|G0422 - INTENS CARDIAC REHAB W/EXERC|182.32|182.32||
125|G0421|G0421 - ED SVC CKD GRP PER SESSION|40.72|40.72||
125|G0420|G0420 - ED SVC CKD IND PER SESSION|176.37|176.37||
125|G0416|G0416 - PROSTATE BIOPSY -  ANY MTHD|659.19|659.19||295.94
125|G0415|G0415 - OPEN TX POST PELVIC FXCTURE|2253.41|2253.41||
125|G0414|G0414 - PELVIC RING FX TREAT INT FIX|1637.32|1637.32||
125|G0413|G0413 - PELVIC RING FRACTURE UNI/BIL|1745.65|1745.65||
125|G0412|G0412 - OPEN TX ILIAC SPINE UNI/BIL|1174.66|1174.66||
125|G0411|G0411 - INTER ACTIVE GRP PSYCH PARTI|536.69|536.69||
125|G0410|G0410 - GRP PSYCH PARTIAL HOSP 45-50|14.95|14.95||
125|G0409|G0409 - CORF RELATED SERV 15 MINS EA|30.17|30.17||
125|G0408|G0408 - INPT/TELE FOLLOW UP 35|167.65|167.65||
125|G0407|G0407 - INPT/TELE FOLLOW UP 25|116.68|116.68||
125|G0406|G0406 - INPT/TELE FOLLOW UP 15|62.41|62.41||
125|G0405|G0405 - EKG INTERPRET & REPORT PREVE|13.77|13.77||
125|G0404|G0404 - EKG TRACING FOR INITIAL PREV|12.76|12.76||
125|G0403|G0403 - EKG FOR INITIAL PREVENT EXAM|26.54|26.54||
125|G0402|G0402 - INITIAL PREVENTIVE EXAM|264.92|264.92||
125|G0400|G0400 - HOME SLEEP TEST/TYPE 4 PORTA|180|180||63
125|G0399|G0399 - HOME SLEEP TEST/TYPE 3 PORTA|216|216||75.6
125|G0398|G0398 - HOME SLEEP TEST/TYPE 2 PORTA|288|288||100.8
125|G0397|G0397 - ALCOHOL/SUBS INTERV >30 MIN|110.86|110.86||
125|G0396|G0396 - ALCOHOL/SUBS INTERV 15-30MN|57.64|57.64||
125|G0390|G0390 - TRAUMA RESPONS W/HOSP CRITI|533.77|533.77||
125|G0384|G0384 - LEV 5 HOSP TYPE B ED VISIT|559.08|559.08||
125|G0383|G0383 - LEV 4 HOSP TYPE B ED VISIT|360.42|360.42||
125|G0382|G0382 - LEV 3 HOSP TYPE B ED VISIT|276.64|276.64||
125|G0381|G0381 - LEV 2 HOSP TYPE B ED VISIT|137|137||
125|G0380|G0380 - LEV 1 HOSP TYPE B ED VISIT|131.47|131.47||
125|G0379|G0379 - DIRECT REFER HOSPITAL OBSERV|53.51|53.51||
125|G0378|G0378 - HOSPITAL OBSERVATION PER HR|141.91|141.91||
125|G0372|G0372 - MD SERVICE REQUIRED FOR PMD|14.83|14.83||
125|G0365|G0365 - VESSEL MAPPING HEMO ACCESS|188.1|188.1||20.24
125|G0364|G0364 - BONE MARROW ASPIRATE &BIOPSY|13.14|13.14||
125|G0343|G0343 - LAPAROTOMY ISLET CELL TRANSP|1905.26|1905.26||
125|G0342|G0342 - LAPAROSCOPY ISLET CELL TRANS|1154.81|1154.81||
125|G0341|G0341 - PERCUTANEOUS ISLET CELLTRANS|3183.94|3183.94||
125|G0340|G0340 - ROBT LIN-RADSURG FRACTX 2-5|2080.74|2080.74||
125|G0339|G0339 - ROBOT LIN-RADSURG COM -  FIRST|2615.41|2615.41||
125|G0337|G0337 - HOSPICE EVALUATION PREELECTI|117.38|117.38||
125|G0333|G0333 - DISPENSE FEE INITIAL 30 DAY|17.99|17.99||
125|G0329|G0329 - ELECTROMAGNTIC TX FOR ULCERS|16.81|16.81||
125|G0328|G0328 - FECAL BLOOD SCRN IMMUNOASSAY|32.01|32.01||22.26
125|G0307|G0307 - CBC WITHOUT PLATELET|13.01|13.01||9.05
125|G0306|G0306 - CBC/DIFFWBC W/O PLATELET|15.63|15.63||10.87
125|G0305|G0305 - POST OP SERVICE LVRS MIN 6|0.01|0.01||
125|G0303|G0303 - PRE-OP SERVICE LVRS 10-15DOS|56.86|56.86||
125|G0300|G0300 - HHS/HOSPICE OF LPN EA 15 MIN|10.8|10.8||
125|G0299|G0299 - HHS/HOSPICE OF RN EA 15 MIN|10.8|10.8||
125|G0297|G0297 - LDCT FOR LUNG CA SCREEN|361.78|361.78||83.68
125|G0296|G0296 - VISIT TO DETERM LDCT ELIG|46.11|46.11||
125|G0295|G0295 - ELECTROMAGNETIC THERAPY ONC|11.45|11.45||
125|G0294|G0294 - NON-COV PROC -  CLINICAL TRIAL|0.01|0.01||
125|G0293|G0293 - NON-COV SURG PROC - CLIN TRIAL|3.2|3.2||
125|G0289|G0289 - ARTHRO -  LOOSE BODY + CHONDRO|144.14|144.14||
125|G0288|G0288 - RECON -  CTA FOR SURG PLAN|55.35|55.35||
125|G0283|G0283 - ELEC STIM OTHER THAN WOUND|23.33|23.33||
125|G0282|G0282 - ELECT STIM WOUND CARE NOT PD|11.45|11.45||
125|G0281|G0281 - ELEC STIM UNATTEND FOR PRESS|23.33|23.33||
125|G0279|G0279 - TOMOSYNTHESIS -  MAMMO|86.16|86.16||48.7
125|G0278|G0278 - ILIAC ART ANGIO - CARDIAC CATH|23.19|23.19||
125|G0277|G0277 - HBOT -  FULL BODY CHAMBER -  30M|126.28|126.28||
125|G0276|G0276 - PILD/PLACEBO CONTROL CLIN TR|656.76|656.76||
125|G0271|G0271 - GROUP MNT 2 OR MORE 30 MINS|25.33|25.33||
125|G0270|G0270 - MNT SUBS TX FOR CHANGE DX|47.71|47.71||
125|G0269|G0269 - OCCLUSIVE DEVICE IN VEIN ART|332.77|332.77||
125|G0268|G0268 - REMOVAL OF IMPACTED WAX MD|82.61|82.61||
125|G0260|G0260 - INJ FOR SACROILIAC JT ANESTH|152.51|152.51||
125|G0259|G0259 - INJECT FOR SACROILIAC JOINT|152.51|152.51||
125|G0257|G0257 - UNSCHED DIALYSIS ESRD PT HOS|6.97|6.97||
125|G0255|G0255 - CURRENT PERCEP THRESHOLD TST|480|480||144
125|G0252|G0252 - PET IMAGING INITIAL DX|1800|1800||121.14
125|G0250|G0250 - MD INR TEST REVIE INTER MGMT|14.88|14.88||
125|G0249|G0249 - PROVIDE INR TEST MATER/EQUIP|132.52|132.52||
125|G0248|G0248 - DEMONSTRATE USE HOME INR MON|132.08|132.08||
125|G0247|G0247 - ROUTINE FOOTCARE PT W LOPS|111.41|111.41||
125|G0246|G0246 - FOLLOWUP EVAL OF FOOT PT LOP|60.47|60.47||
125|G0245|G0245 - INITIAL FOOT EXAM PT LOPS|103.95|103.95||
125|G0239|G0239 - OTH RESP PROC -  GROUP|19.63|19.63||
125|G0238|G0238 - OTH RESP PROC -  INDIV|15.4|15.4||
125|G0237|G0237 - THERAPEUTIC PROCD STRG ENDUR|14.87|14.87||
125|G0235|G0235 - PET NOT OTHERWISE SPECIFIED|1800|1800||450
125|G0219|G0219 - PET IMG WHOLBOD MELANO NONCO|1800|1800||450
125|G0206|G0206 - DX MAMMO INCL CAD UNI|134.4|134.4||42.02
125|G0204|G0204 - DX MAMMO INCL CAD BI|170.36|170.36||52.21
125|G0202|G0202 - SCR MAMMO BI INCL CAD|137.3|137.3||39.71
125|G0186|G0186 - DSTRY EYE LESN - FDR VSSL TECH|623.8|623.8||
125|G0182|G0182 - HOSPICE CARE SUPERVISION|173.33|173.33||
125|G0181|G0181 - HOME HEALTH CARE SUPERVISION|172.89|172.89||
125|G0180|G0180 - MD CERTIFICATION HHA PATIENT|84.66|84.66||
125|G0179|G0179 - MD RECERTIFICATION HHA PT|65.22|65.22||
125|G0177|G0177 - OPPS/PHP; TRAIN & EDUC SERV|77.76|77.76||
125|G0176|G0176 - OPPS/PHP;ACTIVITY THERAPY|83.15|83.15||
125|G0175|G0175 - OPPS SERVICE - SCHED TEAM CONF|79.09|79.09||
125|G0168|G0168 - WOUND CLOSURE BY ADHESIVE|158.37|158.37||
125|G0166|G0166 - EXTRNL COUNTERPULSE -  PER TX|210.25|210.25||
125|G0162|G0162 - HHC RN E&M PLAN SVS -  15 MIN|10.8|10.8||
125|G0161|G0161 - HHC SLP EA 15 MIN|7.45|7.45||
125|G0160|G0160 - HHC OCCUP THERAPY EA 15|9.6|9.6||
125|G0159|G0159 - HHC PT MAINT EA 15 MIN|9.6|9.6||
125|G0158|G0158 - HHC OT ASSISTANT EA 15|6|6||
125|G0157|G0157 - HHC PT ASSISTANT EA 15|6|6||
125|G0156|G0156 - HHCP-SVS OF AIDE - EA 15 MIN|9.6|9.6||
125|G0155|G0155 - HHCP-SVS OF CSW - EA 15 MIN|9.6|9.6||
125|G0153|G0153 - HHCP-SVS OF S/L PATH - EA 15MN|9.6|9.6||
125|G0152|G0152 - HHCP-SERV OF OT - EA 15 MIN|9.6|9.6||
125|G0151|G0151 - HHCP-SERV OF PT - EA 15 MIN|9.6|9.6||
125|G0148|G0148 - SCR C/V CYTO -  AUTOSYS -  RESCR|52.06|52.06||14.78
125|G0147|G0147 - SCR C/V CYTO -  AUTOMATED SYS|23.88|23.88||14.78
125|G0145|G0145 - SCR C/V CYTO - THINLAYER - RESCR|53.32|53.32||37.03
125|G0144|G0144 - SCR C/V CYTO - THINLAYER - RESCR|71.67|71.67||29.89
125|G0143|G0143 - SCR C/V CYTO - THINLAYER - RESCR|44.09|44.09||28.34
125|G0141|G0141 - SCR C/V CYTO - AUTOSYS AND MD|51.23|51.23||
125|G0130|G0130 - SINGLE ENERGY X-RAY STUDY|53.74|53.74||18.29
125|G0129|G0129 - PARTIAL HOSP PROG SERVICE|25|25||
125|G0128|G0128 - CORF SKILLED NURSING SERVICE|11.7|11.7||
125|G0127|G0127 - TRIM NAIL(S)|37.51|37.51||
125|G0124|G0124 - SCREEN C/V THIN LAYER BY MD|51.23|51.23||
125|G0123|G0123 - SCREEN CERV/VAG THIN LAYER|40.77|40.77||28.34
125|G0122|G0122 - COLON CA SCRN; BARIUM ENEMA|409.93|409.93||80.55
125|G0121|G0121 - COLON CA SCRN NOT HI RSK IND|499.95|499.95||
125|G0120|G0120 - COLON CA SCRN; BARIUM ENEMA|327.92|327.92||84.65
125|G0118|G0118 - GLAUCOMA SCRN HGH RISK DIREC|65.46|65.46||
125|G0117|G0117 - GLAUCOMA SCRN HGH RISK DIREC|83.59|83.59||
125|G0109|G0109 - DIAB MANAGE TRN IND/GROUP|23.21|23.21||
125|G0108|G0108 - DIAB MANAGE TRN  PER INDIV|85.4|85.4||
125|G0106|G0106 - COLON CA SCREEN;BARIUM ENEMA|323.52|323.52||80.23
125|G0105|G0105 - COLORECTAL SCRN; HI RISK IND|499.32|499.32||
125|G0104|G0104 - CA SCREEN;FLEXI SIGMOIDSCOPE|259.94|259.94||
125|G0103|G0103 - PSA SCREENING|37.02|37.02||25.74
125|G0102|G0102 - PROSTATE CA SCREENING; DRE|32.76|32.76||
125|G0101|G0101 - CA SCREEN;PELVIC/BREAST EXAM|60.15|60.15||
125|G0027|G0027 - SEMEN ANALYSIS|13.09|13.09||9.1
125|G0010|G0010 - ADMIN HEPATITIS B VACCINE|31.51|31.51||
125|G0009|G0009 - ADMIN PNEUMOCOCCAL VACCINE|31.51|31.51||
125|G0008|G0008 - ADMIN INFLUENZA VIRUS VAC|31.51|31.51||
125|E8002|E8002 - ANTERIOR GAIT TRAINER|2034.46|2034.46||203.45
125|E8001|E8001 - UPRIGHT GAIT TRAINER|1812.41|1812.41||181.24
125|E8000|E8000 - POSTERIOR GAIT TRAINER|1300.86|1300.86||130.09
125|E2633|E2633 - MOBILE ARM SUPPORT SUPINATOR|118.1|118.1||11.81
125|E2632|E2632 - OFFSET/LAT ROCKER ARM W/ELA|145.79|145.79||14.58
125|E2631|E2631 - ELEVAT PROXIMAL ARM SUPPORT|242.41|242.41||24.24
125|E2630|E2630 - MONOSUSPENSION ARM/HAND SUPP|555.78|555.78||55.57
125|E2629|E2629 - FRICTION DAMPENING ARM SUPP|824.41|824.41||82.44
125|E2628|E2628 - MOBILE ARM SUPPORTS RECLININ|653.11|653.11||65.32
125|E2627|E2627 - ARM SUPP ATT TO WC RANCHO TY|835.9|835.9||83.59
125|E2626|E2626 - SEO MOBILE ARM SUP ATT TO WC|540.24|540.24||54.02
125|E2625|E2625 - ADJ SKIN PRO/POS WC CUS>=22|328.67|328.67||32.87
125|E2624|E2624 - ADJ SKIN PRO/POS CUS<22IN|265.56|265.56||26.56
125|E2623|E2623 - ADJ SKIN PRO WC CUS WD>=22IN|330.48|330.48||33.05
125|E2622|E2622 - ADJ SKIN PRO W/C CUS WD<22IN|261.34|261.34||26.14
125|E2621|E2621 - WC PLANAR BACK CUSH WD>=22IN|392.44|392.44||39.25
125|E2620|E2620 - WC PLANAR BACK CUSH WD <22IN|335.95|335.95||33.6
125|E2619|E2619 - REPLACE COVER W/C SEAT CUSH|41.21|41.21||4.13
125|E2617|E2617 - CUSTOM FAB W/C BACK CUSHION|986.09|986.09||
125|E2616|E2616 - POS BACK POST/LAT WDTH>=22IN|408.85|408.85||40.88
125|E2615|E2615 - POS BACK POST/LAT WDTH <22IN|304.24|304.24||30.43
125|E2614|E2614 - POSITION BACK CUSH WD>=22IN|386.74|386.74||38.68
125|E2613|E2613 - POSITION BACK CUSH WD <22IN|269.02|269.02||26.9
125|E2612|E2612 - GEN USE BACK CUSH WDTH>=22IN|273.06|273.06||27.31
125|E2611|E2611 - GEN USE BACK CUSH WDTH <22IN|143.11|143.11||14.32
125|E2610|E2610 - POWERED W/C CUSHION|37.08|37.08||3.71
125|E2609|E2609 - CUSTOM FABRICATE W/C CUSHION|983.03|983.03||
125|E2608|E2608 - SKIN PRO/POS WC CUS WD>=22IN|224.87|224.87||22.49
125|E2607|E2607 - SKIN PRO/POS WC CUS WD <22IN|181.7|181.7||18.17
125|E2606|E2606 - POSITION WC CUSH WDTH>=22 IN|290.12|290.12||29.02
125|E2605|E2605 - POSITION WC CUSH WDTH <22 IN|180.52|180.52||18.06
125|E2604|E2604 - SKIN PROTECT WC CUS WD>=22IN|126.76|126.76||12.67
125|E2603|E2603 - SKIN PROTECT WC CUS WD <22IN|92.6|92.6||9.26
125|E2602|E2602 - GEN W/C CUSHION WDTH >=22 IN|74.34|74.34||7.44
125|E2601|E2601 - GEN W/C CUSHION WDTH < 22 IN|34.61|34.61||3.47
125|E2512|E2512 - SGD ACCESSORY -  MOUNTING SYS|32.36|32.36||3.94
125|E2511|E2511 - SGD SFTWRE PRGRM FOR PC/PDA|158.23|158.23||15.83
125|E2510|E2510 - SGD W MULTI METHODS MSG/ACCS|6781.26|6781.26||678.13
125|E2508|E2508 - SGD SPELLING PHYS CONTACT|3583.48|3583.48||358.34
125|E2506|E2506 - SGD PREREC MSG > 40 MIN|2317.42|2317.42||231.72
125|E2504|E2504 - SGD PREREC MSG>20MIN <=40MIN|1580.45|1580.45||158.06
125|E2502|E2502 - SGD PREREC MSG >8MIN <=20MIN|1198.09|1198.09||119.82
125|E2500|E2500 - SGD DIGITIZED PRE-REC <=8MIN|391.8|391.8||39.19
125|E2402|E2402 - NEG PRESS WOUND THERAPY PUMP|6198.48|6198.48||619.85
125|E2397|E2397 - PWC ACC -  LITH-BASED BATTERY|371.54|371.54||37.15
125|E2396|E2396 - CASTER FORK|45.18|45.18||4.52
125|E2395|E2395 - CASTER WHEEL EXCLUDES TIRE|37.57|37.57||3.77
125|E2394|E2394 - DRIVE WHEEL EXCLUDES TIRE|49.93|49.93||4.99
125|E2392|E2392 - SOLID CASTER TIRE -  INTEGRATE|36|36||3.6
125|E2391|E2391 - SOLID CASTER TIRE|14.92|14.92||1.5
125|E2390|E2390 - SOLID DRIVE WHEEL TIRE|34.62|34.62||3.47
125|E2389|E2389 - FOAM CASTER TIRE|22.37|22.37||2.23
125|E2388|E2388 - FOAM DRIVE WHEEL TIRE|40.02|40.02||4.01
125|E2387|E2387 - FOAM FILLED CASTER TIRE|43.34|43.34||4.34
125|E2386|E2386 - FOAM FILLED DRIVE WHEEL TIRE|92.87|92.87||9.29
125|E2385|E2385 - TUBE -  PNEUMATIC CASTER TIRE|36.77|36.77||3.68
125|E2384|E2384 - PNEUMATIC CASTER TIRE|53.38|53.38||5.34
125|E2383|E2383 - INSERT -  PNEUM WHEEL DRIVE|105.47|105.47||10.55
125|E2382|E2382 - TUBE -  PNEUM WHEEL DRIVE TIRE|15.32|15.32||1.54
125|E2381|E2381 - PNEUM DRIVE WHEEL TIRE|51.7|51.7||5.17
125|E2378|E2378 - PW ACTUATOR REPLACEMENT|493.02|493.02||49.31
125|E2377|E2377 - EXPANDABLE CONTROLLER -  INITL|386.92|386.92||38.69
125|E2376|E2376 - EXPANDABLE CONTROLLER -  REPL|1044.36|1044.36||104.44
125|E2375|E2375 - NON-EXPANDABLE CONTROLLER|590.76|590.76||59.08
125|E2374|E2374 - HAND/CHIN CTRL STD JOYSTICK|420.4|420.4||42.04
125|E2373|E2373 - HAND/CHIN CTRL SPEC JOYSTICK|664.56|664.56||66.46
125|E2371|E2371 - GR27 SEALED LEADACID BATTERY|118.99|118.99||11.9
125|E2370|E2370 - PWR WC DR WH MOTOR/GEAR COMB|465.94|465.94||46.6
125|E2369|E2369 - PWR WC DRIVEWHEEL GEAR REPL|328.32|328.32||32.83
125|E2368|E2368 - PWR WC DRIVEWHEEL MOTOR REPL|351.46|351.46||35.15
125|E2367|E2367 - BATTERY CHARGER -  DUAL MODE|267.85|267.85||26.78
125|E2366|E2366 - BATTERY CHARGER -  SINGLE MODE|143.21|143.21||14.32
125|E2365|E2365 - U1 SEALED LEADACID BATTERY|67.08|67.08||6.71
125|E2364|E2364 - U1NONSEALED LEADACID BATTERY|83.63|83.63||8.36
125|E2363|E2363 - GR24 SEALED LEADACID BATTERY|126.71|126.71||12.67
125|E2362|E2362 - GR24 NONSEALED LEADACID|79.3|79.3||7.93
125|E2361|E2361 - 22NF SEALED LEADACID BATTERY|97.99|97.99||9.8
125|E2360|E2360 - 22NF NONSEALED LEADACID|86.64|86.64||8.66
125|E2359|E2359 - GR34 SEALED LEADACID BATTERY|143.84|143.84||14.39
125|E2351|E2351 - ELECTRONIC SGD INTERFACE|593.52|593.52||59.35
125|E2343|E2343 - W/C DPTH 22-25 IN SEAT FRAME|718.16|718.16||71.81
125|E2342|E2342 - W/C DPTH 20-21 IN SEAT FRAME|448.85|448.85||44.88
125|E2341|E2341 - W/C WDTH 24-27 IN SEAT FRAME|538.62|538.62||53.86
125|E2340|E2340 - W/C WDTH 20-23 IN SEAT FRAME|359.05|359.05||35.92
125|E2331|E2331 - ATTENDANT CONTROL|884.24|884.24||88.43
125|E2330|E2330 - HEAD CONTROL PROXIMITY SWITC|2865.16|2865.16||286.51
125|E2329|E2329 - HEAD CONTROL NONPROPORTIONAL|1492.3|1492.3||149.23
125|E2328|E2328 - HEAD/EXTREMITY CONTROL INTER|4132.36|4132.36||413.23
125|E2327|E2327 - HEAD CONTROL INTERFACE MECH|2189.34|2189.34||218.94
125|E2326|E2326 - BREATH TUBE KIT|293.58|293.58||29.36
125|E2325|E2325 - SIP AND PUFF INTERFACE|1119.24|1119.24||111.92
125|E2324|E2324 - CHIN CUP INTERFACE|37.69|37.69||3.77
125|E2323|E2323 - SPECIAL JOYSTICK HANDLE|57.08|57.08||5.71
125|E2322|E2322 - MULT MECH SWITCHES|1171.08|1171.08||117.11
125|E2321|E2321 - HAND INTERFACE JOYSTICK|1239.48|1239.48||123.95
125|E2313|E2313 - PWC HARNESS -  EXPAND CONTROL|321.12|321.12||32.11
125|E2312|E2312 - MINI-PROP REMOTE JOYSTICK|2020.5|2020.5||202.06
125|E2311|E2311 - ELECTRO CONNECT BTW 2 SYS|1840.86|1840.86||184.09
125|E2310|E2310 - ELECTRO CONNECT BTW CONTROL|912.24|912.24||91.22
125|E2301|E2301 - PWR STANDING|151.8|151.8||15.18
125|E2300|E2300 - PWR SEAT ELEVATION SYS|154.82|154.82||15.49
125|E2295|E2295 - PED DYNAMIC SEATING FRAME|88.92|88.92||8.89
125|E2294|E2294 - CONTOUR SEAT FOR PED SIZE WC|346|346||34.6
125|E2293|E2293 - CONTOUR BACK FOR PED SIZE WC|447.66|447.66||44.77
125|E2292|E2292 - PLANAR SEAT FOR PED SIZE WC|318.48|318.48||31.85
125|E2291|E2291 - PLANAR BACK FOR PED SIZE WC|290.06|290.06||29
125|E2231|E2231 - SOLID SEAT SUPPORT BASE|122.57|122.57||12.26
125|E2228|E2228 - MWC ACC -  WHEELCHAIR BRAKE|809.38|809.38||80.94
125|E2227|E2227 - GEAR REDUCTION DRIVE WHEEL|1874.44|1874.44||187.44
125|E2226|E2226 - CASTER FORK REPLACEMENT ONLY|33.41|33.41||3.34
125|E2225|E2225 - CASTER WHEEL EXCLUDES TIRE|15.68|15.68||1.57
125|E2224|E2224 - PROPULSION WHL EXCL TIRE REP|81.1|81.1||8.11
125|E2222|E2222 - SOLID CASTER INTEG WHL -  REPL|19.13|19.13||1.92
125|E2221|E2221 - SOLID CASTER TIRE REPL -  EACH|22.61|22.61||2.26
125|E2220|E2220 - SOLID PROPULS TIRE -  REPL -  EA|25.45|25.45||2.54
125|E2219|E2219 - FOAM CASTER TIRE ANY SIZE EA|34.26|34.26||3.43
125|E2218|E2218 - FOAM PROPULSION TIRE EACH|29.59|29.59||2.96
125|E2217|E2217 - FOAM FILLED CASTER TIRE EACH|47.66|47.66||4.76
125|E2216|E2216 - FOAM FILLED PROPULSION TIRE|27.43|27.43||2.75
125|E2215|E2215 - PNEUMATIC CASTER TIRE TUBE|8.68|8.68||0.86
125|E2214|E2214 - PNEUMATIC CASTER TIRE EACH|26.77|26.77||2.69
125|E2213|E2213 - PNEUMATIC PROP TIRE INSERT|25.14|25.14||2.51
125|E2212|E2212 - PNEUMATIC PROP TIRE TUBE|5.28|5.28||0.53
125|E2211|E2211 - PNEUMATIC PROPULSION TIRE|29.58|29.58||2.96
125|E2210|E2210 - WHEELCHAIR BEARINGS|4.55|4.55||0.46
125|E2209|E2209 - ARM TROUGH EACH|70.81|70.81||7.08
125|E2208|E2208 - CYLINDER TANK CARRIER|69.53|69.53||6.96
125|E2207|E2207 - CRUTCH AND CANE HOLDER|38.1|38.1||3.8
125|E2206|E2206 - MAN WC WHL LOCK COMP REPL EA|32.96|32.96||3.3
125|E2205|E2205 - MANUAL WC ACCESSORY -  HANDRIM|30.07|30.07||3.01
125|E2204|E2204 - FRAME DEPTH 22 TO 25 IN|647.53|647.53||64.75
125|E2203|E2203 - FRAME DEPTH LESS THAN 22 IN|375.07|375.07||37.51
125|E2202|E2202 - SEAT WIDTH 24-27 IN|388.3|388.3||38.83
125|E2201|E2201 - MAN W/CH ACC SEAT W>=20''<24''|276.28|276.28||27.64
125|E2120|E2120 - PULSE GEN SYS TX ENDOLYMP FL|2840.68|2840.68||284.06
125|E2101|E2101 - BLD GLUCOSE MONITOR W LANCE|188.92|188.92||18.89
125|E2100|E2100 - BLD GLUCOSE MONITOR W VOICE|547.76|547.76||54.78
125|E2000|E2000 - GASTRIC SUCTION PUMP HME MDL|503.56|503.56||50.35
125|E1902|E1902 - AAC NON-ELECTRONIC BOARD|165.98|165.98||16.6
125|E1841|E1841 - STATIC STR SHLDR DEV ROM ADJ|4538.62|4538.62||453.86
125|E1840|E1840 - ADJ SHOULDER EXT/FLEX DEVICE|3707.64|3707.64||370.76
125|E1831|E1831 - STATIC STR TOE DEV EXT/FLEX|662.04|662.04||66.2
125|E1830|E1830 - ADJUST TOE EXT/FLEX DEVICE|1076.04|1076.04||107.6
125|E1825|E1825 - ADJUST FINGER EXT/FLEX DEVC|1076.04|1076.04||107.6
125|E1821|E1821 - REPLACEMENT INTERFACE SPSD|105.44|105.44||10.52
125|E1820|E1820 - SOFT INTERFACE MATERIAL|81.9|81.9||8.18
125|E1818|E1818 - SPS FOREARM DEVICE|1351.44|1351.44||135.14
125|E1816|E1816 - SPS ANKLE DEVICE|1323.9|1323.9||132.4
125|E1815|E1815 - ADJUST ANKLE EXT/FLEX DEVICE|1076.04|1076.04||107.6
125|E1812|E1812 - KNEE EXT/FLEX W ACT RES CTRL|861.58|861.58||86.16
125|E1811|E1811 - SPS KNEE DEVICE|1303.66|1303.66||130.37
125|E1810|E1810 - ADJUST KNEE EXT/FLEX DEVICE|1061.02|1061.02||106.1
125|E1806|E1806 - SPS WRIST DEVICE|1029.24|1029.24||102.92
125|E1805|E1805 - ADJUST WRIST EXT/FLEX DEVICE|1076.04|1076.04||107.6
125|E1802|E1802 - ADJST FOREARM PRO/SUP DEVICE|3274.38|3274.38||327.44
125|E1801|E1801 - SPS ELBOW DEVICE|1253.88|1253.88||125.39
125|E1800|E1800 - ADJUST ELBOW EXT/FLEX DEVICE|1043.28|1043.28||104.33
125|E1702|E1702 - REPL MEASR SCALES JAW MOTION|20.27|10.36|10.36|10.36
125|E1701|E1701 - REPL CUSHIONS FOR JAW MOTION|10.1|4.87|4.87|4.87
125|E1700|E1700 - JAW MOTION REHAB SYSTEM|345.6|345.6||34.56
125|E1639|E1639 - SCALE -  EACH|24.17|24.17||2.41
125|E1637|E1637 - HEMOSTATS FOR DIALYSIS -  EACH|28.5|28.5||2.86
125|E1634|E1634 - PERITONEAL DIALYSIS CLAMP|12.02|12.02||1.2
125|E1625|E1625 - WATER SOFTENING SYSTEM|228|228||22.8
125|E1620|E1620 - REPLACEMENT BLOOD PUMP|41.9|41.9||4.19
125|E1615|E1615 - DEIONIZER H2O PURI SYSTEM|411.84|411.84||41.18
125|E1610|E1610 - REVERSE OSMOSIS H2O PURI SYS|314.16|314.16||31.42
125|E1600|E1600 - DELI/INSTALL CHRG HEMO EQUIP|1041.22|1041.22||104.12
125|E1594|E1594 - CYCLER DIALYSIS MACHINE|443.62|443.62||44.36
125|E1575|E1575 - TRANSDUCER PROTECT/FLD BAR|7.03|7.03||0.71
125|E1570|E1570 - ADJUSTABLE CHAIR FOR ESRD PT|224.4|224.4||22.44
125|E1560|E1560 - REPLACE BLOOD LEAK DETECTOR|1128.6|1128.6||112.86
125|E1550|E1550 - BATH CONDUCTIVITY METER|47.94|47.94||4.8
125|E1540|E1540 - REPLACEMENT PRESSURE ALARM|615.6|615.6||61.56
125|E1530|E1530 - REPLACEMENT AIR BUBBLE DETEC|991.8|991.8||99.18
125|E1520|E1520 - HEPARIN INFUSION PUMP|684|684||68.4
125|E1510|E1510 - KIDNEY DIALYSATE DELIVRY SYS|842.64|842.64||84.26
125|E1500|E1500 - CENTRIFUGE|62.96|62.96||6.3
125|E1406|E1406 - O2/WATER VAPOR ENRICH W/O HE|690.3|690.3||69.04
125|E1405|E1405 - O2/WATER VAPOR ENRICH W/HEAT|900.9|900.9||90.1
125|E1392|E1392 - PORTABLE OXYGEN CONCENTRATOR|336.96|336.96||33.7
125|E1391|E1391 - OXYGEN CONCENTRATOR -  DUAL|639.46|639.46||63.95
125|E1390|E1390 - OXYGEN CONCENTRATOR|639.46|639.46||63.95
125|E1372|E1372 - OXY SUPPL HEATER FOR NEBULIZ|114.86|114.86||11.48
125|E1358|E1358 - DC POWER ADAPTER -  PORT CONC|5.59|5.59||
125|E1357|E1357 - BATTERY CHARGER -  PORT CONC|4.32|4.32||0.43
125|E1356|E1356 - BATT PACK/CART -  PORT CONC|54.92|54.92||5.5
125|E1355|E1355 - OXYGEN SUPPLIES STAND/RACK|21.38|16.26|16.26|1.74
125|E1354|E1354 - WHEELED CART -  PORT CYL/CONC|12.52|12.52||1.25
125|E1353|E1353 - OXYGEN SUPPLIES REGULATOR|28.38|21.78|21.78|2.03
125|E1310|E1310 - WHIRLPOOL NON-PORTABLE|2151.53|2151.53||184.02
125|E1300|E1300 - WHIRLPOOL PORTABLE|741|741||74.1
125|E1298|E1298 - WHEELCHAIR SPEC SEAT DEPTH/W|424.48|424.48||43.44
125|E1297|E1297 - WHEELCHAIR SPECIAL SEAT DEPT|104.82|104.82||11.65
125|E1296|E1296 - WHEELCHAIR SPECIAL SEAT HEIG|492.6|492.6||50.05
125|E1295|E1295 - WHEELCHAIR HEAVY DUTY FIXED|1216.98|1216.98||121.7
125|E1290|E1290 - WHEELCHAIR HVY DUTY DETACH A|899|899||90.01
125|E1285|E1285 - WHEELCHAIR HEAVY DUTY FIXED|869.09|869.09||86.82
125|E1280|E1280 - WHCHR H-DUTY DET ARM LEG RES|1145.44|1145.44||114.54
125|E1270|E1270 - WHEELCHAIR LIGHTWEIGHT LEG R|790.92|790.92||79.09
125|E1260|E1260 - WHEELCHAIR LIGHTWT FOOT REST|674.26|674.26||67.37
125|E1250|E1250 - WHEELCHAIR LIGHTWT FIXED ARM|576.97|576.97||52.56
125|E1240|E1240 - WHCHR LITWT DET ARM LEG REST|1032.22|1032.22||103.22
125|E1239|E1239 - PED POWER WHEELCHAIR NOS|1955.29|1955.29||195.53
125|E1238|E1238 - FLD PED WC ADJSTABL W/O SEAT|1641.88|1641.88||164.18
125|E1237|E1237 - RGD PED WC ADJSTABL W/O SEAT|1656.28|1656.28||165.62
125|E1236|E1236 - FOLDING PED WC ADJUSTABLE|1641.88|1641.88||164.18
125|E1235|E1235 - RIGID PED WC ADJUSTABLE|1861.2|1861.2||186.12
125|E1234|E1234 - FLD PED WC TLTNSPC W/O SEAT|1932.76|1932.76||193.27
125|E1233|E1233 - RIG PED WC TLTNSPC W/O SEAT|2219.94|2219.94||222
125|E1232|E1232 - FOLDING PED WC TILT-IN-SPACE|2142.64|2142.64||214.26
125|E1231|E1231 - RIGID PED W/C TILT-IN-SPACE|2893.46|2893.46||289.34
125|E1230|E1230 - POWER OPERATED VEHICLE|2266.15|2266.15||222.88
125|E1229|E1229 - PEDIATRIC WHEELCHAIR NOS|758.4|758.4||75.6
125|E1228|E1228 - WHEELCHAIR SPEC SZ SPEC HT B|238.68|238.68||23.87
125|E1227|E1227 - WHEELCHAIR SPEC SZ SPEC HT A|278.04|278.04||27.82
125|E1226|E1226 - MANUAL FULLY RECLINING BACK|347.21|347.21||34.73
125|E1225|E1225 - MANUAL SEMI-RECLINING BACK|329.04|329.04||32.9
125|E1224|E1224 - WHEELCHAIR SPEC SIZE W/ LEG|813.06|813.06||81.31
125|E1223|E1223 - WHEELCHAIR SPEC SIZE W FOOT|741.52|741.52||74.15
125|E1222|E1222 - WHEELCHAIR SPEC SIZE W/ LEG|673.3|673.3||67.33
125|E1221|E1221 - WHEELCHAIR SPEC SIZE W FOOT|476.1|476.1||47.62
125|E1220|E1220 - WHLCHR SPECIAL SIZE/CONSTRC|4541.28|4541.28||454.13
125|E1200|E1200 - WHEELCHAIR AMPUTEE FIXED ARM|740.98|740.98||74.1
125|E1195|E1195 - WHEELCHAIR AMPUTEE HEAVY DUT|1069.84|1069.84||106.98
125|E1190|E1190 - WHEELCHAIR AMPUTEE W/ LEG RE|997.12|997.12||99.71
125|E1180|E1180 - WHEELCHAIR AMPUTEE W/ FOOT R|863.02|863.02||86.3
125|E1172|E1172 - WHEELCHAIR AMPUTEE DETACH AR|981.54|981.54||98.16
125|E1171|E1171 - WHEELCHAIR AMPUTEE W/O LEG R|710.28|710.28||71.03
125|E1170|E1170 - WHLCHR AMPU FXD ARM LEG REST|760.68|760.68||76.07
125|E1161|E1161 - MANUAL ADULT WC W TILTINSPAC|2370.6|2370.6||237.06
125|E1160|E1160 - WHEELCHAIR FIXED ARMS|532.26|532.26||53.23
125|E1150|E1150 - WHEELCHAIR STANDARD W/ LEG R|749.7|749.7||74.98
125|E1140|E1140 - WHEELCHAIR STANDARD DETACH A|539.52|539.52||54.01
125|E1130|E1130 - WHLCHR STAND FXD ARM FT REST|374.58|374.58||37.46
125|E1110|E1110 - WHEELCHAIR SEMI-RECL DETACH|865.72|865.72||86.57
125|E1100|E1100 - WHCHR S-RECL FXD ARM LEG RES|883.98|883.98||88.4
125|E1093|E1093 - WHEELCHAIR WIDE W/ FOOT REST|941.22|941.22||94.13
125|E1092|E1092 - WHEELCHAIR WIDE W/ LEG RESTS|1287.64|1287.64||128.76
125|E1090|E1090 - WHEELCHAIR LIGHTWEIGHT DET A|973.92|973.92||94.37
125|E1089|E1089 - WHEELCHAIR LIGHTWT FIXED ARM|944.59|944.59||94.37
125|E1088|E1088 - WHEELCHAIR LIGHTWEIGHT DET A|1379.44|1379.44||137.94
125|E1087|E1087 - WHEELCHAIR LIGHTWT FIXED ARM|1077.58|1077.58||107.76
125|E1086|E1086 - HEMI-WHEELCHAIR DETACHABLE A|711.71|711.71||64.75
125|E1085|E1085 - HEMI-WHEELCHAIR FIXED ARMS|584.23|584.23||58.37
125|E1084|E1084 - HEMI-WHEELCHAIR DETACHABLE A|982.9|982.9||98.29
125|E1083|E1083 - HEMI-WHEELCHAIR FIXED ARMS|670.6|670.6||67.06
125|E1070|E1070 - WHEELCHAIR DETACHABLE FOOT R|932.86|932.86||93.29
125|E1060|E1060 - WHEELCHAIR DETACHABLE ARMS|1073.62|1073.62||107.36
125|E1050|E1050 - WHELCHR FXD FULL LENGTH ARMS|867.24|867.24||86.72
125|E1039|E1039 - TRANSPORT CHAIR PT WT >300LB|284.4|284.4||28.44
125|E1038|E1038 - TRANSPORT CHAIR PT WT<=300LB|133.84|133.84||13.38
125|E1037|E1037 - TRANSPORT CHAIR -  PED SIZE|911.34|911.34||91.14
125|E1036|E1036 - PATIENT TRANSFER SYSTEM >300|7337.7|7337.7||733.78
125|E1035|E1035 - PATIENT TRANSFER SYSTEM <300|5154.58|5154.58||515.46
125|E1031|E1031 - ROLLABOUT CHAIR WITH CASTERS|370|370||37
125|E1030|E1030 - W/C VENT TRAY GIMBALED|984.34|984.34||98.44
125|E1029|E1029 - W/C VENT TRAY FIXED|315.18|315.18||31.52
125|E1028|E1028 - W/C MANUAL SWINGAWAY|120.78|120.78||12.08
125|E1020|E1020 - RESIDUAL LIMB SUPPORT SYSTEM|157.6|157.6||15.76
125|E1018|E1018 - HD SHCK ABSRBER FOR HD POWWC|143.64|143.64||14.36
125|E1016|E1016 - SHOCK ABSORBER FOR POWER W/C|93.84|93.84||9.38
125|E1015|E1015 - SHOCK ABSORBER FOR MAN W/C|102.86|102.86||10.28
125|E1014|E1014 - RECLINING BACK ADD PED W/C|365.94|365.94||36.6
125|E1012|E1012 - CTR MOUNT PWR ELEV LEG REST|935.38|935.38||93.54
125|E1011|E1011 - PED WC MODIFY WIDTH ADJUSTM|688.8|688.8||68.88
125|E1010|E1010 - ADD PWR LEG ELEVATION|935.38|935.38||93.54
125|E1009|E1009 - ADD MECH LEG ELEVATION|59.89|59.89||6.74
125|E1008|E1008 - PWR SEAT COMBO PWR SHEAR|6883.12|6883.12||688.31
125|E1007|E1007 - PWR SEAT COMBO W/SHEAR|6710.5|6710.5||671.05
125|E1006|E1006 - PWR SEAT COMBO W/O SHEAR|5406.04|5406.04||540.6
125|E1005|E1005 - PWR SEAT RECLINE PWR|4384.54|4384.54||438.46
125|E1004|E1004 - PWR SEAT RECLINE MECH|4008.06|4008.06||400.81
125|E1003|E1003 - PWR SEAT RECLINE|3646.54|3646.54||364.66
125|E1002|E1002 - PWR SEAT TILT|3115.44|3115.44||311.54
125|E0995|E0995 - WC CALF REST -  PAD REPLACEMNT|22.45|22.45||2.24
125|E0994|E0994 - WHEELCHAIR ARM REST|15.01|15.01||1.51
125|E0992|E0992 - WHEELCHAIR SOLID SEAT INSERT|70.72|70.72||7.08
125|E0990|E0990 - WHEELCHAIR ELEVATING LEG RES|65.45|65.45||6.54
125|E0988|E0988 - LEVER-ACTIVATED WHEEL DRIVE|2999.26|2999.26||299.93
125|E0986|E0986 - MAN W/C PUSH-RIM POWR SYSTEM|4873.68|4873.68||487.37
125|E0985|E0985 - W/C SEAT LIFT MECHANISM|182.44|182.44||18.24
125|E0984|E0984 - ADD PWR TILLER|1914.12|1914.12||191.41
125|E0983|E0983 - ADD PWR JOYSTICK|2433.78|2433.78||243.38
125|E0982|E0982 - BACK UPHOLSTERY -  REPLACEMENT|38.69|38.69||3.88
125|E0981|E0981 - SEAT UPHOLSTERY -  REPLACEMENT|34.94|34.94||3.49
125|E0980|E0980 - WHEELCHAIR SAFETY VEST|28.15|28.15||2.83
125|E0978|E0978 - W/C ACC - SAF BELT PELV STRAP|21.76|21.76||2.18
125|E0974|E0974 - W/CH ACCESS ANTI-ROLLBACK|62.98|62.98||6.3
125|E0973|E0973 - W/CH ACCESS DET ADJ ARMREST|49.61|49.61||4.96
125|E0971|E0971 - WHEELCHAIR ANTI-TIPPING DEVI|26.95|26.95||2.7
125|E0970|E0970 - WHEELCHAIR NO. 2 FOOTPLATES|37.75|37.75||3.48
125|E0969|E0969 - WHEELCHAIR NARROWING DEVICE|156.94|156.94||15.54
125|E0968|E0968 - WHEELCHAIR COMMODE SEAT|172.62|172.62||17.27
125|E0967|E0967 - MAN WC RIM/PROJECTION REP EA|62.28|62.28||6.23
125|E0966|E0966 - WHEELCHAIR HEAD REST EXTENSI|59.7|59.7||5.96
125|E0961|E0961 - WHEELCHAIR BRAKE EXTENSION|17.3|17.3||1.73
125|E0960|E0960 - W/C SHOULDER HARNESS/STRAPS|63.06|63.06||6.31
125|E0959|E0959 - AMPUTEE ADAPTER|37.19|37.19||3.72
125|E0958|E0958 - WHLCHR ATT- CONV 1 ARM DRIVE|355.14|355.14||35.52
125|E0957|E0957 - W/C MEDIAL THIGH SUPPORT|104.1|104.1||10.42
125|E0956|E0956 - W/C LATERAL TRUNK/HIP SUPPOR|65.62|65.62||6.56
125|E0955|E0955 - CUSHIONED HEADREST|124.48|124.48||12.44
125|E0954|E0954 - FOOT BOX -  ANY TYPE EACH FOOT|45.61|45.61||4.58
125|E0953|E0953 - W/C LATERAL THIGH/KNEE SUP EACH|65.62|65.62||6.56
125|E0952|E0952 - TOE LOOP/HOLDER -  EACH|13.84|13.84||1.39
125|E0951|E0951 - LOOP HEEL|11.5|11.5||1.15
125|E0950|E0950 - TRAY|66.42|66.42||6.65
125|E0948|E0948 - FRACTURE FRAME ATTACHMNTS CE|538.3|538.3||53.84
125|E0947|E0947 - FRACTURE FRAME ATTACHMNTS PE|538.3|538.3||54.49
125|E0946|E0946 - FRACTURE FRAME DUAL W CROSS|503.92|503.92||50.39
125|E0945|E0945 - BELT/HARNESS EXTREMITY|37.75|37.75||3.78
125|E0944|E0944 - PELVIC BELT/HARNESS/BOOT|44.92|44.92||4.49
125|E0942|E0942 - CERVICAL HEAD HARNESS/HALTER|17.23|17.23||2
125|E0941|E0941 - GRAVITY ASSISTED TRACTION DE|434.88|434.88||43.49
125|E0940|E0940 - TRAPEZE BAR FREE STANDING|185.04|185.04||18.5
125|E0936|E0936 - CPM DEVICE -  OTHER THAN KNEE|25.84|25.84||
125|E0935|E0935 - CONT PAS MOTION EXERCISE DEV|193.68|193.68||19.37
125|E0930|E0930 - FRACTURE FRAME FREE STANDING|388.98|388.98||38.9
125|E0920|E0920 - FRACTURE FRAME ATTACHED TO B|410.86|410.86||41.09
125|E0912|E0912 - HD TRAPEZE BAR FREE STANDING|747.9|747.9||74.8
125|E0911|E0911 - HD TRAPEZE BAR ATTACH TO BED|372.6|372.6||37.26
125|E0910|E0910 - TRAPEZE BAR ATTACHED TO BED|98.1|98.1||9.82
125|E0900|E0900 - TRAC STAND FREE STAND PELVIC|109.12|109.12||23.53
125|E0890|E0890 - TRACTION FRAME ATTACH PELVIC|102.54|102.54||32.71
125|E0880|E0880 - TRAC STAND FREE STAND EXTREM|106.92|106.92||16.79
125|E0870|E0870 - TRACT FRAME ATTACH FOOTBOARD|99.06|99.06||11.42
125|E0860|E0860 - TRACT EQUIP CERVICAL TRACT|36.25|36.25||5.54
125|E0856|E0856 - CERVIC COLLAR W AIR BLADDERS|154.18|154.18||15.42
125|E0855|E0855 - CERVICAL TRACTION EQUIPMENT|503.56|503.56||50.35
125|E0850|E0850 - TRACTION STAND FREE STANDING|89.46|89.46||12.29
125|E0849|E0849 - CERVICAL PNEUM TRAC EQUIP|516.42|516.42||51.65
125|E0840|E0840 - TRACT FRAME ATTACH HEADBOARD|71.2|71.2||16.37
125|E0830|E0830 - AMBULATORY TRACTION DEVICE|42.28|42.28||4.22
125|E0791|E0791 - PARENTERAL INFUSION PUMP STA|2480.04|2480.04||248
125|E0786|E0786 - IMPLANTABLE PUMP REPLACEMENT|8001.17|8001.17||800.1
125|E0785|E0785 - REPLACEMENT IMPL PUMP CATHET|361.81|167.04|167.04|167.04
125|E0784|E0784 - EXT AMB INFUSN PUMP INSULIN|3764.08|3764.08||376.4
125|E0783|E0783 - PROGRAMMABLE INFUSION PUMP|8202.64|8202.64||820.28
125|E0782|E0782 - NON-PROGRAMBLE INFUSION PUMP|4301.66|4301.66||430.19
125|E0781|E0781 - EXTERNAL AMBULATORY INFUS PU|2087.56|2087.56||208.75
125|E0780|E0780 - MECH AMB INFUSION PUMP <8HRS|10.22|10.22||0.48
125|E0779|E0779 - AMB INFUSION PUMP MECHANICAL|160.84|160.84||16.08
125|E0776|E0776 - IV POLE|121.92|121.92||12.41
125|E0770|E0770 - FUNCTIONAL ELECTRIC STIM NOS|1595.18|1595.18||159.52
125|E0769|E0769 - ELECTRIC WOUND TREATMENT DEV|169.2|169.2||16.92
125|E0766|E0766 - ELEC STIM CANCER TREATMENT|3900|3900||390
125|E0765|E0765 - NERVE STIMULATOR FOR TX N&V|84.3|84.3||8.45
125|E0764|E0764 - FUNCTIONAL NEUROMUSCULARSTIM|11087.92|11087.92||1108.79
125|E0762|E0762 - TRANS ELEC JT STIM DEV SYS|1101.6|1101.6||110.16
125|E0761|E0761 - NONTHERM ELECTROMGNTC DEVICE|1440|1440||144
125|E0760|E0760 - OSTEOGEN ULTRASOUND STIMLTOR|3239.33|3239.33||323.94
125|E0755|E0755 - ELECTRONIC SALIVARY REFLEX S|11.4|11.4||1.14
125|E0749|E0749 - ELEC OSTEOGEN STIM IMPLANTED|2421.72|2421.72||242.17
125|E0748|E0748 - ELEC OSTEOGEN STIM SPINAL|3898.19|3898.19||389.8
125|E0747|E0747 - ELEC OSTEOGEN STIM NOT SPINE|3923.59|3923.59||389.89
125|E0746|E0746 - ELECTROMYOGRAPH BIOFEEDBACK|58.66|58.66||5.87
125|E0745|E0745 - NEUROMUSCULAR STIM FOR SHOCK|896.86|896.86||89.69
125|E0744|E0744 - NEUROMUSCULAR STIM FOR SCOLI|917.46|917.46||91.75
125|E0740|E0740 - NON-IMPLANT PELV FLR E-STIM|523.98|523.98||52.4
125|E0731|E0731 - CONDUCTIVE GARMENT FOR TENS/|80.45|80.45||16.37
125|E0730|E0730 - TENS FOUR LEAD|64.9|64.9||24.68
125|E0720|E0720 - TENS TWO LEAD|64.22|64.22||24.68
125|E0710|E0710 - RESTRAINTS ANY TYPE|20.16|20.16||
125|E0705|E0705 - TRANSFER DEVICE|43.2|43.2||4.32
125|E0700|E0700 - SAFETY EQUIPMENT|18|18||1.8
125|E0694|E0694 - UVL MD CABINET SYS 6 FT|4435.85|4435.85||443.58
125|E0693|E0693 - UVL SYS PANEL 6 FT|1393.66|1393.66||139.38
125|E0692|E0692 - UVL SYS PANEL 4 FT|1130.56|1130.56||113.04
125|E0691|E0691 - UVL PNL 2 SQ FT OR LESS|900.31|900.31||90.02
125|E0676|E0676 - INTER LIMB COMPRESS DEV NOS|540|540||54
125|E0675|E0675 - PNEUMATIC COMPRESSION DEVICE|3852.9|3852.9||385.3
125|E0673|E0673 - PRESSURE PNEUM APPL HALF LEG|268.69|268.69||26.88
125|E0672|E0672 - PRESSURE PNEUM APPL FULL ARM|323.34|323.34||32.35
125|E0671|E0671 - PRESSURE PNEUM APPL FULL LEG|416.15|416.15||41.64
125|E0670|E0670 - SEG PNEUM INT LEGS/TRUNK|1259.47|1259.47||134.83
125|E0669|E0669 - SEG PNEUMATIC APPLI HALF LEG|181.38|181.38||18.16
125|E0668|E0668 - SEG PNEUMATIC APPL FULL ARM|442.73|442.73||43.69
125|E0667|E0667 - SEG PNEUMATIC APPL FULL LEG|324.4|324.4||36.64
125|E0666|E0666 - PNEUMATIC APPLIANCE HALF LEG|138.37|138.37||14.26
125|E0665|E0665 - PNEUMATIC APPLIANCE FULL ARM|134.3|134.3||13.44
125|E0660|E0660 - PNEUMATIC APPLIANCE FULL LEG|160.06|160.06||16.33
125|E0657|E0657 - SEGMENTAL PNEUMATIC CHEST|543.88|543.88||54.38
125|E0656|E0656 - SEGMENTAL PNEUMATIC TRUNK|578.98|578.98||57.9
125|E0655|E0655 - PNEUMATIC APPLIANCE HALF ARM|94.58|94.58||10.8
125|E0652|E0652 - PNEUM COMPRES W/CAL PRESSURE|5311.64|5311.64||524.94
125|E0651|E0651 - PNEUM COMPRESSOR SEGMENTAL|920.18|920.18||94.01
125|E0650|E0650 - PNEUMA COMPRESOR NON-SEGMENT|613.36|613.36||80.02
125|E0642|E0642 - DYNAMIC STANDING FRAME|2496.58|2496.58||249.66
125|E0641|E0641 - MULTI-POSITION STND FRAM SYS|2354.66|2354.66||235.46
125|E0640|E0640 - FIXED PATIENT LIFT SYSTEM|1100.62|1100.62||110.06
125|E0639|E0639 - MOVEABLE PATIENT LIFT SYSTEM|1100.62|1100.62||110.06
125|E0638|E0638 - STANDING FRAME SYS|512.15|512.15||51.22
125|E0637|E0637 - COMBINATION SIT TO STAND SYS|1340.38|1340.38||134.15
125|E0636|E0636 - PT SUPPORT & POSITIONING SYS|8606.16|8606.16||860.62
125|E0635|E0635 - PATIENT LIFT ELECTRIC|1018.44|1018.44||101.84
125|E0630|E0630 - PATIENT LIFT HYDRAULIC|520.56|520.56||52.06
125|E0629|E0629 - SEAT LIFT MECH -  NON-ELECTRIC|226.79|226.79||22.68
125|E0627|E0627 - SEAT LIFT MECH -  ELECTRIC ANY|227.82|227.82||22.78
125|E0625|E0625 - PATIENT LIFT BATHROOM OR TOI|565.44|565.44||56.54
125|E0621|E0621 - PATIENT LIFT SLING OR SEAT|70.12|70.12||7.01
125|E0620|E0620 - CAP BLD SKIN PIERCING LASER|875.98|875.98||87.6
125|E0619|E0619 - APNEA MONITOR W RECORDER|1429.8|1429.8||72
125|E0618|E0618 - APNEA MONITOR|2809.08|2809.08||280.91
125|E0617|E0617 - AUTOMATIC EXT DEFIBRILLATOR|3046.24|3046.24||304.62
125|E0616|E0616 - CARDIAC EVENT RECORDER|109.18|109.18||11.52
125|E0615|E0615 - PACEMAKER MONITR DIGITAL/VIS|479.72|479.72||58.61
125|E0610|E0610 - PACEMAKER MONITR AUDIBLE/VIS|210.82|210.82||21.36
125|E0607|E0607 - BLOOD GLUCOSE MONITOR HOME|66.95|66.95||6.68
125|E0606|E0606 - DRAINAGE BOARD POSTURAL|230.04|230.04||23
125|E0605|E0605 - VAPORIZER ROOM TYPE|22.51|22.51||2.62
125|E0604|E0604 - HOSP GRADE ELEC BREAST PUMP|161.74|161.74||62.14
125|E0603|E0603 - ELECTRIC BREAST PUMP|204|204||20.4
125|E0602|E0602 - MANUAL BREAST PUMP|29.58|29.58||2.98
125|E0601|E0601 - CONT AIRWAY PRESSURE DEVICE|365.04|365.04||36.5
125|E0600|E0600 - SUCTION PUMP PORTAB HOM MODL|408.06|408.06||40.81
125|E0585|E0585 - NEBULIZER W/ COMPRESSOR & HE|261.46|261.46||26.15
125|E0580|E0580 - NEBULIZER FOR USE W/ REGULAT|115.76|115.76||11.58
125|E0575|E0575 - NEBULIZER ULTRASONIC|1009.72|1009.72||100.97
125|E0574|E0574 - ULTRASONIC GENERATOR W SVNEB|393.58|393.58||39.36
125|E0572|E0572 - AEROSOL COMPRESSOR ADJUST PR|276.22|276.22||27.62
125|E0570|E0570 - NEBULIZER WITH COMPRESSION|50.86|50.86||5.09
125|E0565|E0565 - COMPRESSOR AIR POWER SOURCE|365.22|365.22||36.53
125|E0562|E0562 - HUMIDIFIER HEATED USED W PAP|122.17|122.17||12.22
125|E0561|E0561 - HUMIDIFIER NONHEATED W PAP|64.82|64.82||6.48
125|E0560|E0560 - HUMIDIFIER SUPPLEMENTAL W/ I|125.89|125.89||15.9
125|E0555|E0555 - HUMIDIFIER FOR USE W/ REGULA|5.23|5.23||3.78
125|E0550|E0550 - HUMIDIF EXTENS SUPPLE W IPPB|502.3|502.3||50.23
125|E0500|E0500 - IPPB ALL TYPES|934.74|934.74||93.48
125|E0487|E0487 - ELECTRONIC SPIROMETER|127.68|127.68||12.77
125|E0486|E0486 - ORAL DEVICE/APPLIANCE CUSFAB|1895.22|1895.22||189.53
125|E0485|E0485 - ORAL DEVICE/APPLIANCE PREFAB|248.39|248.39||24.84
125|E0484|E0484 - NON-ELEC OSCILLATORY PEP DVC|37.01|37.01||3.7
125|E0483|E0483 - HI FREQ CHEST WALL OSCIL SYS|10651.78|10651.78||1065.18
125|E0482|E0482 - COUGH STIMULATING DEVICE|4179.16|4179.16||417.91
125|E0481|E0481 - INTRPULMNRY PERCUSS VENT SYS|602.4|602.4||
125|E0480|E0480 - PERCUSSOR ELECT/PNEUM HOME M|432.82|432.82||43.28
125|E0472|E0472 - RAD W BACKUP INVASIVE INTRFC|3504.78|3504.78||350.48
125|E0471|E0471 - RAD W/BACKUP NON INV INTRFC|2318.4|2318.4||231.84
125|E0470|E0470 - RAD W/O BACKUP NON-INV INTFC|941.4|941.4||94.14
125|E0466|E0466 - HOME VENT NON-INVASIVE INTER|9563.58|9563.58||956.36
125|E0465|E0465 - HOME VENT INVASIVE INTERFACE|9563.58|9563.58||956.36
125|E0462|E0462 - ROCKING BED W/ OR W/O SIDE R|2919.7|2919.7||291.97
125|E0459|E0459 - CHEST WRAP|340.32|340.32||33.97
125|E0457|E0457 - CHEST SHELL|410.88|410.88||40.94
125|E0455|E0455 - OXYGEN TENT EXCL CROUP/PED T|120.38|120.38||12.04
125|E0446|E0446 - TOPICAL OX DELIVER SYS -  NOS|32.83|32.83||3.29
125|E0445|E0445 - OXIMETER NON-INVASIVE|720|720||72
125|E0444|E0444 - PORTABLE 02 CONTENTS -  LIQUID|43.48|41.82|41.82|41.82
125|E0443|E0443 - PORTABLE 02 CONTENTS -  GAS|43.48|41.82|41.82|41.82
125|E0442|E0442 - STATIONARY O2 CONTENTS -  LIQ|47.99|41.82|41.82|41.82
125|E0441|E0441 - STATIONARY O2 CONTENTS -  GAS|47.99|41.82|41.82|41.82
125|E0440|E0440 - OXYGEN SYSTEM LIQUID STATION|1505.89|1505.89||88.01
125|E0439|E0439 - STATIONARY LIQUID 02|639.46|639.46||63.95
125|E0435|E0435 - OXYGEN SYSTEM LIQUID PORTABL|741.62|741.62||78
125|E0434|E0434 - PORTABLE LIQUID 02|155.62|155.62||15.56
125|E0433|E0433 - PORTABLE LIQUID OXYGEN SYS|336.96|336.96||33.7
125|E0431|E0431 - PORTABLE GASEOUS 02|155.62|155.62||15.56
125|E0430|E0430 - OXYGEN SYSTEM GAS PORTABLE|1078.74|1078.74||63.05
125|E0425|E0425 - GAS SYSTEM STATIONARY COMPRE|2382.24|2382.24||139.22
125|E0424|E0424 - STATIONARY COMPRESSED GAS 02|639.46|639.46||63.95
125|E0373|E0373 - NONPOWERED PRESSURE MATTRESS|1767.96|1767.96||176.8
125|E0372|E0372 - POWERED AIR MATTRESS OVERLAY|1767.96|1767.96||176.8
125|E0371|E0371 - NONPOWER MATTRESS OVERLAY|1767.96|1767.96||176.8
125|E0370|E0370 - AIR ELEVATOR FOR HEEL|9.6|9.6||0.9
125|E0352|E0352 - DISPOSABLE PACK W/BOWEL SYST|4.8|4.8||
125|E0350|E0350 - CONTROL UNIT BOWEL SYSTEM|391.5|391.5||39.16
125|E0329|E0329 - PED HOSPITAL BED SEMI/ELECT|4577.1|4577.1||457.72
125|E0328|E0328 - PED HOSPITAL BED -  MANUAL|2788.1|2788.1||278.81
125|E0326|E0326 - URINAL FEMALE JUG-TYPE|8.29|8.29||0.83
125|E0325|E0325 - URINAL MALE JUG-TYPE|7.74|7.74||0.78
125|E0316|E0316 - BED SAFETY ENCLOSURE|1543.14|1543.14||154.32
125|E0315|E0315 - BED ACCESSORY BRD/TBL/SUPPRT|38.12|38.12||
125|E0310|E0310 - RAILS BED SIDE FULL LENGTH|102.08|102.08||10.21
125|E0305|E0305 - RAILS BED SIDE HALF LENGTH|96.58|96.58||9.66
125|E0304|E0304 - HOSP BED XTRA HVY DTY X WIDE|4407.4|4407.4||440.74
125|E0303|E0303 - HOSP BED HVY DTY XTRA WIDE|1503.46|1503.46||150.35
125|E0302|E0302 - EX HD HOSP BED > 600 LBS|4242.88|4242.88||424.28
125|E0301|E0301 - HD HOSP BED -  350-600 LBS|1475.38|1475.38||147.54
125|E0300|E0300 - ENCLOSED PED CRIB HOSP GRADE|2150.64|2150.64||215.06
125|E0297|E0297 - HOSP BED TOTAL ELECT W/O MAT|851.68|851.68||85.16
125|E0296|E0296 - HOSP BED TOTAL ELECT W/ MATT|965.16|965.16||96.52
125|E0295|E0295 - HOSP BED SEMI-ELECT W/O MATT|547.2|547.2||54.72
125|E0294|E0294 - HOSP BED SEMI-ELECT W/ MATTR|548.38|548.38||54.84
125|E0293|E0293 - HOSP BED VAR HT NO SR NO MAT|479.26|479.26||47.93
125|E0292|E0292 - HOSP BED VAR HT NO SR W/MATT|525.7|525.7||52.57
125|E0291|E0291 - HOSP BED FX HT W/O RAIL W/O|377.74|377.74||37.78
125|E0290|E0290 - HOSP BED FX HT W/O RAILS W/M|496.18|496.18||49.62
125|E0280|E0280 - BED CRADLE|26.83|26.83||2.69
125|E0277|E0277 - POWERED PRES-REDU AIR MATTRS|1767.96|1767.96||176.8
125|E0276|E0276 - BED PAN FRACTURE|10|10||1
125|E0275|E0275 - BED PAN STANDARD|11.98|11.98||1.2
125|E0274|E0274 - OVER-BED TABLE|30.78|30.78||13.36
125|E0273|E0273 - BED BOARD|19.16|19.16||7.55
125|E0272|E0272 - MATTRESS FOAM RUBBER|125.22|125.22||12.52
125|E0271|E0271 - MATTRESS INNERSPRING|111.5|111.5||11.15
125|E0270|E0270 - HOSPITAL BED INSTITUTIONAL T|240|240||24
125|E0266|E0266 - HOSP BED TOTAL ELEC W/O MATT|1076.32|1076.32||107.63
125|E0265|E0265 - HOSP BED TOTAL ELECTR W/ MAT|1237.06|1237.06||123.71
125|E0261|E0261 - HOSP BED SEMI-ELECTR W/O MAT|547.2|547.2||54.72
125|E0260|E0260 - HOSP BED SEMI-ELECTR W/ MATT|549.36|549.36||54.94
125|E0256|E0256 - HOSPITAL BED VAR HT W/O MATT|521.28|521.28||52.13
125|E0255|E0255 - HOSPITAL BED VAR HT W/ MATTR|547.74|547.74||54.78
125|E0251|E0251 - HOSP BED FIXD HT W/O MATTRES|499.86|499.86||49.99
125|E0250|E0250 - HOSP BED FIXED HT W/ MATTRES|540.82|540.82||54.08
125|E0249|E0249 - PAD WATER CIRCULATING HEAT U|99.8|99.8||10.97
125|E0248|E0248 - HDTRANS BENCH W/WO COMM OPEN|25.3|25.3||2.58
125|E0247|E0247 - TRANS BENCH W/WO COMM OPEN|38.92|38.92||3.78
125|E0246|E0246 - TRANSFER TUB RAIL ATTACHMENT|54.01|54.01||
125|E0245|E0245 - TUB STOOL OR BENCH|39.49|39.49||
125|E0244|E0244 - TOILET SEAT RAISED|24.1|24.1||
125|E0243|E0243 - TOILET RAIL|31.66|31.66||
125|E0242|E0242 - BATH TUB RAIL FLOOR|39.78|39.78||
125|E0241|E0241 - BATH TUB WALL RAIL|17.71|17.71||
125|E0240|E0240 - BATH/SHOWER CHAIR|18|18||
125|E0239|E0239 - HYDROCOLLATOR UNIT PORTABLE|450.7|450.7||45.08
125|E0236|E0236 - PUMP FOR WATER CIRCULATING P|394.74|394.74||39.48
125|E0235|E0235 - PARAFFIN BATH UNIT PORTABLE|172.8|172.8||17.28
125|E0232|E0232 - WARMING CARD FOR NWT|39.9|39.9||
125|E0231|E0231 - WOUND WARMING DEVICE|1.8|1.8||
125|E0225|E0225 - HYDROCOLLATOR UNIT|389.4|389.4||38.39
125|E0221|E0221 - INFRARED HEATING PAD SYSTEM|118.56|14.98|14.98|1.4
125|E0218|E0218 - FLUID CIRC COLD PAD W PUMP|252.91|252.91||29.33
125|E0217|E0217 - WATER CIRC HEAT PAD W PUMP|494.71|494.71||49.45
125|E0215|E0215 - ELECTRIC HEAT PAD MOIST|60.34|60.34||6.31
125|E0210|E0210 - ELECTRIC HEAT PAD STANDARD|29.2|29.2||2.9
125|E0205|E0205 - HEAT LAMP WITH STAND|194.44|194.44||21.4
125|E0203|E0203 - THERAPEUTIC LIGHTBOX TABLETP|240|240||24
125|E0202|E0202 - PHOTOTHERAPY LIGHT W/ PHOTOM|533.26|533.26||53.33
125|E0200|E0200 - HEAT LAMP WITHOUT STAND|79.44|79.44||10.79
125|E0199|E0199 - DRY PRESSURE PAD FOR MATTRES|25.97|25.97||2.6
125|E0198|E0198 - WATER PRESSURE PAD FOR MATTR|188.74|188.74||18.88
125|E0197|E0197 - AIR PRESSURE PAD FOR MATTRES|148.42|148.42||14.84
125|E0196|E0196 - GEL PRESSURE MATTRESS|265.06|265.06||26.51
125|E0194|E0194 - AIR FLUIDIZED BED|27715.06|27715.06||2771.51
125|E0193|E0193 - POWERED AIR FLOTATION BED|6078.16|6078.16||607.81
125|E0191|E0191 - PROTECTOR HEEL OR ELBOW|8.52|8.52||0.89
125|E0190|E0190 - POSITIONING CUSHION|42.73|42.73||4.27
125|E0189|E0189 - LAMBSWOOL SHEEPSKIN PAD|43.87|43.87||4.38
125|E0188|E0188 - SYNTHETIC SHEEPSKIN PAD|21.12|21.12||2.11
125|E0187|E0187 - WATER PRESSURE MATTRESS|172.62|172.62||17.27
125|E0186|E0186 - AIR PRESSURE MATTRESS|158.32|158.32||15.83
125|E0185|E0185 - GEL PRESSURE MATTRESS PAD|151.7|151.7||15.18
125|E0184|E0184 - DRY PRESSURE MATTRESS|142.08|142.08||14.21
125|E0182|E0182 - REPLACE PUMP -  ALT PRESS PAD|172.36|172.36||17.23
125|E0181|E0181 - PRESS PAD ALTERNATING W/ PUM|138.96|138.96||13.9
125|E0175|E0175 - COMMODE CHAIR FOOT REST|66.37|66.37||6.64
125|E0172|E0172 - SEAT LIFT MECHANISM TOILET|834.72|834.72||83.47
125|E0171|E0171 - COMMODE CHAIR NON-ELECTRIC|260.92|260.92||26.09
125|E0170|E0170 - COMMODE CHAIR ELECTRIC|1419.66|1419.66||141.97
125|E0168|E0168 - HEAVYDUTY/WIDE COMMODE CHAIR|105.78|105.78||10.57
125|E0167|E0167 - COMMODE CHAIR PAIL OR PAN|8.88|8.88||0.89
125|E0165|E0165 - COMMODE CHAIR WITH DETACHARM|110.44|110.44||11.04
125|E0163|E0163 - COMMODE CHAIR WITH FIXED ARM|47.96|47.96||4.8
125|E0162|E0162 - SITZ BATH CHAIR|124.09|124.09||13.02
125|E0161|E0161 - SITZ BATH/EQUIPMENT W/FAUCET|21.98|21.98||2.2
125|E0160|E0160 - SITZ TYPE BATH OR EQUIPMENT|23.47|23.47||2.35
125|E0159|E0159 - BRAKE FOR WHEELED WALKER|13.15|13.15||1.32
125|E0158|E0158 - WALKER LEG EXTENDERS SET OF4|18.94|18.94||1.9
125|E0157|E0157 - WALKER CRUTCH ATTACHMENT|50.47|50.47||5.05
125|E0156|E0156 - WALKER SEAT ATTACHMENT|14.11|14.11||1.42
125|E0155|E0155 - WALKER WHEEL ATTACHMENT - PAIR|17.84|17.84||1.79
125|E0154|E0154 - WALKER PLATFORM ATTACHMENT|41.83|41.83||4.19
125|E0153|E0153 - FOREARM CRUTCH PLATFORM ATTA|60.49|60.49||6.68
125|E0149|E0149 - HEAVY DUTY WHEELED WALKER|110.26|110.26||11.03
125|E0148|E0148 - HEAVYDUTY WALKER NO WHEELS|74|74||7.4
125|E0147|E0147 - WALKER VARIABLE WHEEL RESIST|336.54|336.54||33.65
125|E0144|E0144 - ENCLOSED WALKER W REAR SEAT|230.94|230.94||23.1
125|E0143|E0143 - WALKER FOLDING WHEELED W/O S|42.79|42.79||4.28
125|E0141|E0141 - RIGID WHEELED WALKER ADJ/FIX|42.79|42.79||4.28
125|E0140|E0140 - WALKER W TRUNK SUPPORT|253.18|253.18||25.32
125|E0135|E0135 - WALKER FOLDING ADJUST/FIXED|40.5|40.5||4.06
125|E0130|E0130 - WALKER RIGID ADJUST/FIXED HT|40.32|40.32||4.03
125|E0118|E0118 - CRUTCH SUBSTITUTE|30|30||3
125|E0117|E0117 - UNDERARM SPRINGASSIST CRUTCH|192.96|192.96||19.3
125|E0116|E0116 - CRUTCH UNDERARM EACH NO WOOD|23.64|23.64||4.61
125|E0114|E0114 - CRUTCH UNDERARM PAIR NO WOOD|40.2|40.2||7.3
125|E0113|E0113 - CRUTCH UNDERARM EACH WOOD|18|18||4.38
125|E0112|E0112 - CRUTCH UNDERARM PAIR WOOD|31.52|31.52||8.47
125|E0111|E0111 - CRUTCH FOREARM EACH|49.28|49.28||7.18
125|E0110|E0110 - CRUTCH FOREARM PAIR|66.08|66.08||13.61
125|E0105|E0105 - CANE ADJUST/FIXED QUAD/3 PRO|49.21|49.21||7.55
125|E0100|E0100 - CANE ADJUST/FIXED WITH TIP|21.12|21.12||5.06
125|D9975|D9975 - EXTERNAL BLEACHING - PER ARCH (HOME)|36.34|36.34||
125|D9974|D9974 - INTERNAL BLEACHING - PER TOOTH|103.88|103.88||
125|D9973|D9973 - EXTERNAL BLEACHING - PER TOOTH|19.74|19.74||
125|D9972|D9972 - EXTERNAL BLEACHING - PER ARCH|118.76|118.76||
125|D9971|D9971 - ODONTOPLASTY 1-2 TEETH; INCL REMOVAL ENAMEL PROJ|34.62|34.62||
125|D9970|D9970 - ENAMEL MICROABRASION|26.58|26.58||
125|D9952|D9952 - OCCLUSAL ADJUSTMENT - COMPLETE|237.58|237.58||
125|D9951|D9951 - OCCLUSAL ADJUSTMENT - LIMITED|50.33|50.33||
125|D9950|D9950 - OCCLUSION ANALYSIS - MOUNTED CASE|112.74|112.74||
125|D9943|D9943 - OCCLUSAL GUARD ADJUSTMENT|78.65|78.65||
125|D9942|D9942 - REPAIR AND/OR RELINE OF OCCLUSAL GUARD|70.85|70.85||
125|D9941|D9941 - FABRICATION OF ATHLETIC MOUTHGUARD|59.2|59.2||
125|D9940|D9940 - OCCLUSAL GUARD BY REPORT|172.32|172.32||
125|D9935|D9935 - CLEAN INSPECT REMVBL PARTIAL MANDIBULAR DENTURE|15.64|15.64||
125|D9934|D9934 - CLEAN/ INSPECT REMVBL PARTIAL MAXILLARY DENTURE|63.2|63.2||
125|D9933|D9933 - CLEAN INSPECT REMVBL COMPLETE MANDIBULAR DENTURE|32.46|32.46||
125|D9932|D9932 - CLEAN/INSPECT REMOVBL COMPLETE MAXILLARY DENTURE|24.32|24.32||
125|D9930|D9930 - TX COMPLICATIONS - UNUSUAL CIRCUMSTANCES REPORT|64.37|64.37||
125|D9920|D9920 - BEHAVIOR MANAGEMENT BY REPORT|51.95|51.95||
125|D9911|D9911 - APPLIC DESENZT RSN CERV &OR ROOT SURF-TOOTH|28.99|28.99||
125|D9910|D9910 - APPLICATION OF DESENSITIZING MEDICAMENT|20.95|20.95||
125|D9630|D9630 - DRUGS AND/OR MEDICAMENTS BY REPORT -  HOME USE|27.26|27.26||
125|D9612|D9612 - TX PARENTERAL DRUGS 2/> ADMINISTRATIONS DIFF MED|17.36|17.36||
125|D9610|D9610 - THERAPEUTIC PARENTERAL DRUG SINGL ADMINISTRATION|17.36|17.36||
125|D9450|D9450 - CASE PRESENTATION DTL&EXT  TREATMENT PLANNING|29.81|29.81||
125|D9440|D9440 - OFFICE VISIT - AFTER REGULARLY SCHEDULED HOURS|59.2|59.2||
125|D9430|D9430 - OFFICE VISIT OBSERVATION NO OTHER SRVC PERFORMED|20.32|20.32||
125|D9420|D9420 - HOSPITAL OR AMBULATORY SURGICAL CENTER CALL|175.55|175.55||
125|D9410|D9410 - HOUSE/EXTENDED CARE FACILITY CALL|108.71|108.71||
125|D9310|D9310 - CONSULT DX SERV DENT/PHY NOT REQUESTING DENT/PHY|95.02|95.02||
125|D9248|D9248 - NON-INTRAVENOUS CONSCIOUS SEDATION|41.47|41.47||
125|D9243|D9243 - IV MOD (CONSCIOUS) SEDATION EACH 15 MIN INCRMENT|84|84||
125|D9239|D9239 - IV MOD (CONSCIOUS) SEDTION/ANALGSIA FIRST 15 MIN|84|84||
125|D9230|D9230 - INHALATION OF NITROUS OXIDE/ANXIOLYSIS ANALGESIA|28.61|28.61||
125|D9223|D9223 - DEEP SEDATION/ GEN ANESTH EACH 15 MIN INCREMENT|84|84||
125|D9222|D9222 - DEEP SEDATION / GENERAL ANESTHESIA FIRST 15 MIN|84|84||
125|D9219|D9219 - EVALUATION FOR MOD OR DEEP SEDATION / GA|32.45|32.45||
125|D9215|D9215 - LOCAL ANESTHESIA CONJUCTION OPERATIVE/SURG PROC|13.68|13.68||
125|D9212|D9212 - TRIGEMINAL DIVISION BLOCK ANESTHESIA|29.81|29.81||
125|D9211|D9211 - REGIONAL BLOCK ANESTHESIA|18.92|18.92||
125|D9210|D9210 - LOCAL ANES-NOT CONJUNCTION W/OP/SURGICAL PROC|17.34|17.34||
125|D9120|D9120 - FIXED PARTIAL DENTURE SECTIONING|51.54|51.54||
125|D9110|D9110 - PALLIATIVE EMERGENCY TX DENTAL PAIN MINOR PROC|45.9|45.9||
125|D8694|D8694 - REPAIR OF FIXED RETAINERS INCLUDES REATTACHMENT|127.45|127.45||
125|D8693|D8693 - RE-CEMENT OR RE-BOND FIXED RETAINER|98.32|98.32||
125|D8692|D8692 - REPLACEMENT OF LOST OR BROKEN RETAINER|167.78|167.78||
125|D8691|D8691 - REPAIR OF ORTHODONTIC APPLIANCE|84.1|84.1||
125|D8690|D8690 - ORTHODONTIC TREATMENT|159.73|159.73||
125|D8681|D8681 - REMOVABLE ORTHODONTIC RETAINER ADJUSTMENT|148.67|148.67||
125|D8680|D8680 - ORTHODONTIC RETENTION|339.37|339.37||
125|D8670|D8670 - PERIODIC ORTHODONTIC TREATMENT VISIT|154.61|154.61||
125|D8660|D8660 - PREORTHODONTIC TREATMENT VISIT|31.86|31.86||
125|D8220|D8220 - FIXED APPLIANCE THERAPY|311.59|311.59||
125|D8210|D8210 - REMOVABLE APPLIANCE THERAPY|452.33|452.33||
125|D8090|D8090 - COMPREHENSIVE ORTHODONTIC TX ADULT DENTITION|1218.79|1218.79||
125|D8080|D8080 - COMPREHENSIVE ORTHODONTIC TX ADOLES DENTITION|2187.02|2187.02||
125|D8070|D8070 - COMP ORTHODONTIC TX TRANSITIONAL DENTITION|851.88|851.88||
125|D8060|D8060 - INTRCPTV ORTHODONTIC TX TRANSITIONAL DENTITION|1421.74|1421.74||
125|D8050|D8050 - INTERCEPTIVE ORTHODONTIC TX PRIMARY DENTITION|1618.46|1618.46||
125|D8040|D8040 - LIMITED ORTHODONTIC TREATMENT ADULT DENTITION|1496.89|1496.89||
125|D8030|D8030 - LTD ORTHODONTIC TREATMENT ADOLESCENT DENTITION|1490.71|1490.71||
125|D8020|D8020 - LTD ORTHODONTIC TREATMENT TRANSITIONAL DENTITION|1460.89|1460.89||
125|D8010|D8010 - LIMITED ORTHODONTIC TREATMENT PRIMARY DENTITION|1131.66|1131.66||
125|D7998|D7998 - INTRAORAL PLCMT FIX DEVICE NOT CONJUNCTION W/FX|607.27|607.27||
125|D7997|D7997 - APPLIANCE REMOVAL INCLUDES REMOVAL OF ARCHBAR|139.67|139.67||
125|D7996|D7996 - IMPLANT-MANDIBLE AUGMENTATION PURPOSES BY REPORT|1022.96|1022.96||
125|D7991|D7991 - CORONOIDECTOMY|1822.68|1822.68||
125|D7990|D7990 - EMERGENCY TRACHEOTOMY|746.93|746.93||
125|D7983|D7983 - CLOSURE OF SALIVARY FISTULA|868.49|868.49||
125|D7982|D7982 - SIALODOCHOPLASTY|905.17|905.17||
125|D7981|D7981 - EXCISION OF SALIVARY GLAND BY REPORT|345.92|345.92||
125|D7980|D7980 - SURGICAL SIALOLITHOTOMY|383.16|383.16||
125|D7972|D7972 - SURGICAL REDUCTION OF FIBROUS TUBEROSITY|340.72|340.72||
125|D7971|D7971 - EXCISION OF PERICORONAL GINGIVA|91.07|91.07||
125|D7970|D7970 - EXCISION OF HYPERPLASTIC TISSUE - PER ARCH|243.07|243.07||
125|D7963|D7963 - FRENULOPLASTY|272.75|272.75||
125|D7960|D7960 - FRENULECTOMY SEP PROC NOT INCIDENTL ANOTHER PROC|166.88|166.88||
125|D7955|D7955 - REPAIR MAXLOFACIAL SOFT &/ HARD TISSUE DEFECT|892.87|892.87||
125|D7953|D7953 - BONE REPLCMT GRAFT RIDGE PRESERVATION  PER SITE|103.42|103.42||
125|D7952|D7952 - SINUS AUGMENTATION VIA A VERTICAL APPROACH|608.8|608.8||
125|D7951|D7951 - SINUS AUG WITH BONE OR BONE SUBSTITUTES-LAT APP|1162.73|1162.73||
125|D7950|D7950 - OSSEOUS OSTEOPERIOSTEAL/CARTILAGE GRAFT MAND/MAX|1288.22|1288.22||
125|D7949|D7949 - LEFORT II OR LEFORT III - WITH BONE GRAFT|7167.52|7167.52||
125|D7948|D7948 - LEFORT II/LEFORT III - W/O BONE GRAFT|5503.03|5503.03||
125|D7947|D7947 - LEFORT I (MAXILLA - SEGMENTED)|4240.28|4240.28||
125|D7946|D7946 - LEFORT I (MAXILLA - TOTAL)|5041.61|5041.61||
125|D7945|D7945 - OSTEOTOMY - BODY OF MANDIBLE|4069.72|4069.72||
125|D7944|D7944 - OSTEOTOMY - SEGMENTED OR SUBAPICAL|3058.68|3058.68||
125|D7943|D7943 - OSTEOT-MANDIB RAMI W/BONE GRFT;INCL OBTAIN GRAFT|3431.95|3431.95||
125|D7941|D7941 - OSTEOTOMY - MANDIBULAR RAMI|3735.56|3735.56||
125|D7940|D7940 - OSTEOPLASTY - FOR ORTHOGNATHIC DEFORMITIES|402.24|402.24||
125|D7921|D7921 - COLL APPL AUTOLOGOUS BLD CNCNTRT PRODUCT|282.35|282.35||
125|D7920|D7920 - SKIN GRAFT|1466.69|1466.69||
125|D7912|D7912 - COMPLICATED SUTURE - GREATER THAN 5 CM|894.85|894.85||
125|D7911|D7911 - COMPLICATED SUTURE - UP TO 5 CM|497.28|497.28||
125|D7910|D7910 - SUTURE OF RECENT SMALL WOUNDS UP TO 5 CM|199.81|199.81||
125|D7880|D7880 - OCCLUSAL ORTHOTIC DEVICE BY REPORT|335.35|335.35||
125|D7877|D7877 - ARTHROSCOPY: DEBRIDEMENT|2684.59|2684.59||
125|D7876|D7876 - ARTHROSCOPY: DISCECTOMY|3041.78|3041.78||
125|D7875|D7875 - ARTHROSCOPY: SYNOVECTOMY|2821.37|2821.37||
125|D7874|D7874 - ARTHROSCOPY: DISC REPSTN & STABILIZATION|2575.42|2575.42||
125|D7873|D7873 - ARTHROSCOPY:  LAVAGE & LYSIS ADHESIONS|1795.07|1795.07||
125|D7872|D7872 - ARTHROSCOPY - DIAGNOSIS WITH OR WITHOUT BIOPSY|1491.02|1491.02||
125|D7871|D7871 - NON-ARTHROSCOPIC LYSIS AND LAVAGE|279.32|279.32||
125|D7870|D7870 - ARTHROCENTESIS|139.67|139.67||
125|D7865|D7865 - ARTHROPLASTY|4227.52|4227.52||
125|D7860|D7860 - ARTHROTOMY|2623.62|2623.62||
125|D7858|D7858 - JOINT RECONSTRUCTION|6154.43|6154.43||
125|D7856|D7856 - MYOTOMY|2159.27|2159.27||
125|D7854|D7854 - SYNOVECTOMY|3043.03|3043.03||
125|D7852|D7852 - DISC REPAIR|2949.07|2949.07||
125|D7850|D7850 - SURGICAL DISCECTOMY WITH/WITHOUT IMPLANT|2575.42|2575.42||
125|D7840|D7840 - CONDYLECTOMY|2982.44|2982.44||
125|D7830|D7830 - MANIPULATION UNDER ANESTHESIA|204.76|204.76||
125|D7820|D7820 - CLOSED REDUCTION OF DISLOCATION|358.44|358.44||
125|D7810|D7810 - OPEN REDUCTION OF DISLOCATION|2187.7|2187.7||
125|D7780|D7780 - FACIAL BONES-COMP RDUC FIX & MULT APPROACHES|4974.06|4974.06||
125|D7771|D7771 - ALVEOLUS CLOSED REDUCTION STABILIZATION OF TEETH|892.79|892.79||
125|D7770|D7770 - ALVEOLUS - OPEN REDUCTION STABILIZATION OF TEETH|1156.88|1156.88||
125|D7760|D7760 - MALAR AND/OR ZYGOMATIC ARCH - CLOSED REDUCTION|854.09|854.09||
125|D7750|D7750 - MALAR AND/OR ZYGOMATIC ARCH - OPEN REDUCTION|2128.4|2128.4||
125|D7740|D7740 - MANDIBLE - CLOSED REDUCTION|1673.94|1673.94||
125|D7730|D7730 - MANDIBLE - OPEN REDUCTION|3382.08|3382.08||
125|D7720|D7720 - MAXILLA - CLOSED REDUCTION|1641.4|1641.4||
125|D7710|D7710 - MAXILLA - OPEN REDUCTION|2337.67|2337.67||
125|D7680|D7680 - FACE BONES-COMP RDUC W/FIX&MX SURG APPRCHES CPT|3730.24|3730.24||
125|D7671|D7671 - ALVEOLUS-OPEN REDUCTION W/STABILIZATION TEETH|1078.2|1078.2||
125|D7670|D7670 - ALVEOLUS-CLOSED REDUCTION W/STABILIZATION TEETH|572.27|572.27||
125|D7660|D7660 - MALAR AND/OR ZYGOMATIC ARCH - CLOSED REDUCTION|732.96|732.96||
125|D7650|D7650 - MALAR AND/OR ZYGOMATIC ARCH - OPEN REDUCTION|1243.39|1243.39||
125|D7640|D7640 - MANDIBLE-CLOSED REDUCTION|1641.4|1641.4||
125|D7630|D7630 - MANDIBLE-OPEN REDUCTION|2586.94|2586.94||
125|D7620|D7620 - MAXILLA-CLOSED REDUCTION|1491.85|1491.85||
125|D7610|D7610 - MAXILLA-OPEN REDUCTION|1989.12|1989.12||
125|D7560|D7560 - MAXILLARY SINUSOTOMY REMOVAL TOOTH FRAGMENT/FB|1229.81|1229.81||
125|D7550|D7550 - PART OSTEC/SEQUESTRECTOMY REMOVAL NON-VITAL BONE|154.92|154.92||
125|D7540|D7540 - REMV REACT-PRODUC FOREIGN BODIES-MUSCULOSKEL SYS|248.45|248.45||
125|D7530|D7530 - REMOVAL FB FROM MUCOSA SKIN/SUBCUT ALVEOL TISSUE|224.54|224.54||
125|D7521|D7521 - I & D ABSCESS EXTRAORAL SOFT TISSUE COMPLICATED|683.51|683.51||
125|D7520|D7520 - INCISION & DRAINAGE ABSCESS-EXTRAORAL SOFT TISS|622.1|622.1||
125|D7511|D7511 - I & D ABSCESS INTRAORAL SOFT TISSUE  COMPLICATED|196.93|196.93||
125|D7510|D7510 - INCISION & DRAINAGE ABSCESS-INTRAORAL SOFT TISS|130.58|130.58||
125|D7490|D7490 - RADICAL RESECTION OF MAXILLA OR MANDIBLE|3644.54|3644.54||
125|D7485|D7485 - REDUCTION OF OSSEOUS TUBEROSITY|451.14|451.14||
125|D7473|D7473 - REMOVAL OF TORUS MANDIBULARIS|505.92|505.92||
125|D7472|D7472 - REMOVAL OF TORUS PALATINUS|536.84|536.84||
125|D7471|D7471 - REMOVAL OF LATERAL EXOSTOSIS|451.14|451.14||
125|D7465|D7465 - DESTRUCTION LESION PHYSICAL/CHEM METHOD BY REPRT|196.93|196.93||
125|D7461|D7461 - REMOVAL BEN NONODONTOGENIC CYST/TUMOR > 1.25 CM|498.1|498.1||
125|D7460|D7460 - REMOVAL BEN NONODONTOGENIC CYST/TUMR- UP 1.25 CM|364.2|364.2||
125|D7451|D7451 - REMOVAL BENIGN ODONTOGENIC CYST/TUMOR- > 1.25 CM|498.1|498.1||
125|D7450|D7450 - REMOVL BENIGN ODONTOGENC CYST/TUMR-UP T0 1.25 CM|364.2|364.2||
125|D7441|D7441 - EXC MALIG TUMOR-LESION DIAM GREATER THAN 1.25 CM|850.78|850.78||
125|D7440|D7440 - EXC MALIG TUMOR-LESION DIAMETER UP TO 1.25 CM|577.21|577.21||
125|D7415|D7415 - EXCISION OF MALIGNANT LESION COMPLICATED|713.57|713.57||
125|D7414|D7414 - EXCISION OF MALIGNANT LESION > 1.25 CM|638.18|638.18||
125|D7413|D7413 - EXCISION OF MALIGNANT LESION UP TO 1.25 CM|425.17|425.17||
125|D7412|D7412 - EXCISION OF BENIGN LESION COMPLICATED|638.18|638.18||
125|D7411|D7411 - EXCISION OF BENIGN LESION GREATER THAN 1.25 CM|577.21|577.21||
125|D7410|D7410 - EXCISION OF BENIGN LESION UP TO 1.25 CM|364.2|364.2||
125|D7350|D7350 - VESTIBULOPLASTY RIDGE EXT W/SOFT TISS GRAFTS|2429.57|2429.57||
125|D7340|D7340 - VESTIBULOPLASTY RIDGE EXT SEC EPITHELIALIZATION|835.13|835.13||
125|D7321|D7321 - ALVEOLOPLSTY NOT CNJNC XTRCT 1-3 TEETH/SPCE QUAD|166.88|166.88||
125|D7320|D7320 - ALVEOLOPLASTY NOT W/EXTRACTIONS 4/> TEETH/SPACE|196.93|196.93||
125|D7311|D7311 - ALVEOLOPLSTY CONJNC XTRACT 1-3 TEETH/SPACES QUAD|106.3|106.3||
125|D7310|D7310 - ALVEOLOPLASTY W/EXTRACTION 4/> TEETH/SPACE QUAD|121.13|121.13||
125|D7295|D7295 - HARVEST BONE FOR USE AUTOGENOUS GRAFTING PROC|237.78|237.78||
125|D7294|D7294 - PLACEMENT TEMP ANCHORAGE DEVICE W/O SURG FLAP|151.62|151.62||
125|D7293|D7293 - PLACEMENT TEMP ANCHORAGE DEVICE RQR SURG FLAP|182.1|182.1||
125|D7292|D7292 - PLACEMENT TEMP ANCHORAGE SCREW RET PLATE FLAP|291.71|291.71||
125|D7291|D7291 - TRANSSEPTAL FIBEROT/SUPRA CRESTAL FIBEROT BR|67.52|67.52||
125|D7290|D7290 - SURGICAL REPOSITIONING OF TEETH|182.1|182.1||
125|D7288|D7288 - BRUSH BIOPSY - TRANSEPITHELIAL SAMPLE COLLECTION|72.49|72.49||
125|D7287|D7287 - EXFOLIATIVE CYTOLOGICAL SAMPLE COLLECTION|72.49|72.49||
125|D7286|D7286 - BIOPSY OF ORAL TISSUE  SOFT|182.1|182.1||
125|D7285|D7285 - BIOPSY OF ORAL TISSUE HARD|425.17|425.17||
125|D7283|D7283 - PLCMT DEVICE FACILITATE ERUPTION IMPACTED TOOTH|91.07|91.07||
125|D7282|D7282 - MOBILIZ ERUPTED/MALPOSITIONED TOOTH AID ERUPTION|106.3|106.3||
125|D7280|D7280 - EXPOSURE OF AN UNERUPTED TOOTH|212.58|212.58||
125|D7272|D7272 - TOOTH TRANSPLANTATION|303.66|303.66||
125|D7270|D7270 - TOOTH REIMPL &/OR STBL ACC EVULSED/DISPLCD TOOTH|227.84|227.84||
125|D7261|D7261 - PRIMARY CLOSURE OF A SINUS PERFORATION|303.66|303.66||
125|D7260|D7260 - OROANTRAL FISTULA CLOSURE|728.83|728.83||
125|D7251|D7251 - CORONECTOMY  INTENTIONAL PARTIAL TOOTH REMOVAL|243.07|243.07||
125|D7250|D7250 - SURGICAL REMOVAL OF RESIDUAL TOOTH ROOTS|124.01|124.01||
125|D7241|D7241 - REMV IMP TOOTH - CMPL BONY W/UNUSUAL SURG COMPS|288.4|288.4||
125|D7240|D7240 - REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY|229.49|229.49||
125|D7230|D7230 - REMOVAL OF IMPACTED TOOTH - PARTIALLY BONY|195.68|195.68||
125|D7220|D7220 - REMOVAL OF IMPACTED TOOTH - SOFT TISSUE|146.66|146.66||
125|D7210|D7210 - EXTRACTION ERUPTED TOOTH REMV BONE ELEV FLAP|117.43|117.43||
125|D7140|D7140 - EXTRACTION ERUPTED TOOTH OR EXPOSED ROOT|66.35|66.35||
125|D7111|D7111 - EXTRACTION CORONAL REMNANTS - PRIMARY TOOTH|49.84|49.84||
125|D6985|D6985 - PEDIATRIC PARTIAL DENTURE FIXED|243.07|243.07||
125|D6980|D6980 - FIXED PARTIAL DENTURE REPAIR MATERIAL FAILURE|226.69|226.69||
125|D6950|D6950 - PRECISION ATTACHMENT|279.32|279.32||
125|D6940|D6940 - STRESS BREAKER|144.6|144.6||
125|D6930|D6930 - RECEMENT / REBOND FIXED PARTIAL DENTURE|63.85|63.85||
125|D6920|D6920 - CONNECTOR BAR|109.18|109.18||
125|D6794|D6794 - RETAINER CROWN - TITANIUM|516.24|516.24||
125|D6793|D6793 - PROVISIONAL RETAINER CROWN|215.89|215.89||
125|D6792|D6792 - RETAINER CROWN - FULL CAST NOBLE METAL|516.24|516.24||
125|D6791|D6791 - RETAINER CROWN FULL CAST PREDOM BASE METAL|498.1|498.1||
125|D6790|D6790 - RETAINER CROWN - FULL CAST HIGH NOBLE METAL|525.31|525.31||
125|D6783|D6783 - RETAINER CROWN - 3/4 PORCELAIN/CERAMIC|529.01|529.01||
125|D6782|D6782 - RETAINER CROWN - 3/4 CAST NOBLE METAL|476.69|476.69||
125|D6781|D6781 - RETAINER CROWN 3/4 CAST PREDOMINANTLY BASE METAL|513.36|513.36||
125|D6780|D6780 - RETAINER CROWN - 3/4 CAST HIGH NOBLE METAL|513.36|513.36||
125|D6752|D6752 - RETAINER CROWN - PORCELAIN FUSED TO NOBLE METAL|519.94|519.94||
125|D6751|D6751 - RETNR CROWN PORCELAIN FUSED PREDOM BASE METAL|507.98|507.98||
125|D6750|D6750 - RETNR CROWN PORCELAIN FUSED TO HIGH NOBLE METAL|544.24|544.24||
125|D6740|D6740 - RETAINER CROWN - PORCELAIN/CERAMIC|558.68|558.68||
125|D6722|D6722 - RETAINER CROWN - RESIN WITH NOBLE METAL|513.36|513.36||
125|D6721|D6721 - RETAINER CROWN - RESIN WITH PREDOM BASE METAL|504.29|504.29||
125|D6720|D6720 - RETAINER CROWN - RESIN WITH HIGH NOBLE METAL|531.47|531.47||
125|D6710|D6710 - RETAINER CROWN - INDIRECT RESIN BASED COMPOSITE|455.66|455.66||
125|D6634|D6634 - RETAINER ONLAY - TITANIUM|446.58|446.58||
125|D6624|D6624 - RETAINER INLAY - TITANIUM|425.17|425.17||
125|D6615|D6615 - RETNR ONLAY CAST NOBLE METAL 3 OR MORE SURFACES|463.92|463.92||
125|D6614|D6614 - RETAINER ONLAY - CAST NOBLE METAL TWO SURFACES|446.58|446.58||
125|D6613|D6613 - RETNR ONLAY CAST PREDOM BASE METAL 3/MORE SURFS|476.69|476.69||
125|D6612|D6612 - RETAINER ONLAY CAST PREDOM BASE METAL 2 SURFACES|456.08|456.08||
125|D6611|D6611 - RETAINER ONLAY HIGH NOBLE METAL 3/MORE SURFACES|501.79|501.79||
125|D6610|D6610 - RETAINER ONLAY - HIGH NOBLE METAL TWO SURFACES|458.54|458.54||
125|D6609|D6609 - RETAINER ONLAY PORCELAIN/CERAMIC 3/MORE SURFACES|451.14|451.14||
125|D6608|D6608 - RETAINER ONLAY - PORCELAIN/CERAMIC TWO SURFACES|432.61|432.61||
125|D6607|D6607 - RETNR INLAY CAST NOBLE METAL 3 OR MORE SURFACES|454.84|454.84||
125|D6606|D6606 - RETAINER INLAY - CAST NOBLE METAL TWO SURFACES|409.52|409.52||
125|D6605|D6605 - RTAINR INLAY - CAST PREDOM BASE MTL 3/MORE SURFS|442.07|442.07||
125|D6604|D6604 - RETAINER INLAY - CAST PREDOM BASE METAL 2 SURFS|416.53|416.53||
125|D6603|D6603 - RETAINR INLAY - CAST HI NOBLE METAL 3/MORE SURFS|467.62|467.62||
125|D6602|D6602 - RETAINER INLAY CAST HIGH NOBLE METAL 2 SURFACES|425.17|425.17||
125|D6601|D6601 - RETAINER INLAY - PORC/CERAMIC 3 OR MORE SURFACES|417.35|417.35||
125|D6600|D6600 - RETAINER INLAY - PORCELAIN/CERAMIC TWO SURFACES|397.57|397.57||
125|D6549|D6549 - RESIN RETAINER FOR RESIN BONDED FIXED PROSTHESIS|241.84|241.84||
125|D6548|D6548 - RETAINER - PORCELN/CERAMIC RSN BONDED FIX PROSTH|220.42|220.42||
125|D6545|D6545 - RETAINER - CAST METAL RESIN BONDED FIX PROSTH|200.63|200.63||
125|D6253|D6253 - PROVISIONAL PONTIC|203.12|203.12||
125|D6252|D6252 - PONTIC - RESIN WITH NOBLE METAL|447.84|447.84||
125|D6251|D6251 - PONTIC - RESIN WITH PREDOMINANTLY BASE METAL|434.24|434.24||
125|D6250|D6250 - PONTIC - RESIN WITH HIGH NOBLE METAL|470.93|470.93||
125|D6245|D6245 - PONTIC - PORCELAIN/CERAMIC|492.34|492.34||
125|D6242|D6242 - PONTIC - PORCELAIN FUSED TO NOBLE METAL|464.74|464.74||
125|D6241|D6241 - PONTIC - PORCELN FUSED PREDOMINANTLY BASE METAL|440.44|440.44||
125|D6240|D6240 - PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL|476.69|476.69||
125|D6214|D6214 - PONTIC - TITANIUM|485.33|485.33||
125|D6212|D6212 - PONTIC - CAST NOBLE METAL|470.93|470.93||
125|D6211|D6211 - PONTIC - CAST PREDOMINANTLY BASE METAL|451.97|451.97||
125|D6210|D6210 - PONTIC - CAST HIGH NOBLE METAL|482.88|482.88||
125|D6205|D6205 - PONTIC - INDIRECT RESIN BASED COMPOSITE|316|316||
125|D6194|D6194 - ABUTMENT SUPPORTED RETAINER CROWN FOR FPD-TITANM|516.24|516.24||
125|D6190|D6190 - RADIOGRAPHIC/SURGICAL IMPLANT INDEX BY REPORT|112.49|112.49||
125|D6117|D6117 - IMPL/ABUT SUPPORTED FD - MANDIBULAR - PARTIAL|1695.94|1695.94||
125|D6116|D6116 - IMPL/ABUTMENT SUPPORTED FD - MAXILLARY - PARTIAL|1129.92|1129.92||
125|D6115|D6115 - IMPLANT/ABUTMENT SUPPORTED FD - MANDIBULAR FULL|1490.03|1490.03||
125|D6114|D6114 - IMPLANT / ABUTMENT SUPPORTED FD - MAXILLARY FULL|2222.63|2222.63||
125|D6113|D6113 - IMPLANT / ABUTMENT SUPPORTED RPD - MANDIBULAR|1022.68|1022.68||
125|D6112|D6112 - IMPL/ABUTMENT SUPPORTED RPD - MAXILLARY|1498.1|1498.1||
125|D6111|D6111 - IMPL/ABUTMENT SUPPORTED RD - MANDIBULAR|1251.96|1251.96||
125|D6110|D6110 - IMPL/ABUTMENT SUPPORTED RD - MAXILLARY|1089.55|1089.55||
125|D6104|D6104 - BONE GRAFT AT TIME OF IMPLANT PLACEMENT|240.22|240.22||
125|D6103|D6103 - BONE GRFT RPR PERIIMPLNT DFCT W/O FLAP ENTR/CLSE|325.13|325.13||
125|D6102|D6102 - DBRDMNT AND OSSEOUS CNTUR OF PERI-IMPLANT DEFECT|326.02|326.02||
125|D6101|D6101 - DBRDMNT OF SNGL PERI-IMPLANT DEFECT/S|561.78|561.78||
125|D6100|D6100 - IMPLANT REMOVAL BY REPORT|189.24|189.24||
125|D6095|D6095 - REPAIR IMPLANT ABUTMENT BY REPORT|257.72|257.72||
125|D6094|D6094 - ABUTMENT SUPPORTED CROWN  TITANIUM|500.98|500.98||
125|D6093|D6093 - RECMNT/REBOND IMPL/ABUTMNT SUPP FIX PART DENTURE|76.62|76.62||
125|D6092|D6092 - RECEMENT / REBOND  IMPLANT/ABUTMENT SUPP CROWN|49.02|49.02||
125|D6091|D6091 - REPL ATTACHMNT IMPL/ABUT SUPP PROS PER ATTACHMNT|252.14|252.14||
125|D6090|D6090 - REPAIR IMPLANT SUPPORTED PROSTHESIS BY REPORT|153.41|153.41||
125|D6080|D6080 - IMPL MAINT PROC REMV CLEAN PROSTH & ABUT REINSRT|52.33|52.33||
125|D6077|D6077 - IMPL SUPP RTNR CST METL FPD TITNM/HIGH NOBLE|595.75|595.75||
125|D6076|D6076 - IMPL SUPP RTNR PORCLN FUSED METL FPD TITNM/HIGH|613.46|613.46||
125|D6075|D6075 - IMPLANT SUPPORTED RETAINER FOR CERAMIC FPD|629.93|629.93||
125|D6074|D6074 - ABUTMENT RTNR CAST METAL FPD NOBLE METAL|598.2|598.2||
125|D6073|D6073 - ABUT RTNR CAST METL FPD PREDOM BASE METL|563.2|563.2||
125|D6072|D6072 - ABUT SUPP RETN CAST METL FPD HIGH NOBLE METL|616.34|616.34||
125|D6071|D6071 - ABUT SUPP RETN PORCELN FUSD METAL FPD NOBLE METL|609.34|609.34||
125|D6070|D6070 - ABUT RETN PORCELN TO METL FPD PREDOM BASE METL|597|597||
125|D6069|D6069 - ABUT RETAINR PORCELN TO METL FPD HI NOBL METL|631.18|631.18||
125|D6068|D6068 - ABUT SUPP RETAINER PORCELAIN/CERAMIC FPD|634.88|634.88||
125|D6067|D6067 - IMPL SUPP METAL CROWN TITIANM/HIGH NOBLE METL|595.75|595.75||
125|D6066|D6066 - IMPL SUPP PORCLN FUSED METL CRWN TITNM/HIGH NOBL|613.46|613.46||
125|D6065|D6065 - IMPL SUPP PORCELAIN/CERAMIC CROWN|629.93|629.93||
125|D6064|D6064 - ABUTMENT SUPP CAST METAL CROWN NOBLE METAL|552.49|552.49||
125|D6063|D6063 - ABUTMENT SUPP CAST METAL CROWN PREDOM BASE METAL|529.01|529.01||
125|D6062|D6062 - ABUTMENT SUPP CAST METAL CROWN HIGH NOBLE METAL|606.46|606.46||
125|D6061|D6061 - ABUT SUPP PORCELAIN TO METAL CROWN NOBLE METAL|609.34|609.34||
125|D6060|D6060 - ABUT SUPP PORCELAIN TO MTL CROWN PREDOM BASE MTL|597|597||
125|D6059|D6059 - ABUT SUPP PORCELAIN TO METL CROWN HI NOBLE METL|631.18|631.18||
125|D6058|D6058 - ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN|639.83|639.83||
125|D6057|D6057 - CUSTOM FABRICATED ABUTMENT  INCLUDES PLACEMENT|285.52|285.52||
125|D6056|D6056 - PREFABRICATED ABUTMENT INCLUDES PLACEMENT|230.3|230.3||
125|D6055|D6055 - CONNECTING BAR IMPLANT OR ABUTMENT SUPPORTED|334.14|334.14||
125|D6052|D6052 - SEMI-PRECISION ATTACHMENT ABUTMENT|451.52|451.52||
125|D6051|D6051 - INTERIM ABUTMENT|248.46|248.46||
125|D6050|D6050 - SURGICAL PLACEMENT: TRANSOSTEAL IMPLANT|2854.74|2854.74||
125|D6040|D6040 - SURGICAL PLACEMENT: EPOSTEAL IMPLANT|3826.63|3826.63||
125|D6013|D6013 - SURGICAL PLACEMENT OF MINI IMPLANT|704.53|704.53||
125|D6012|D6012 - SURG PLCMT INTERIM IMPL TRNSITIONL PROS: ENDOS|1051.02|1051.02||
125|D6011|D6011 - SECOND STAGE IMPLANT SURGERY|93.25|93.25||
125|D6010|D6010 - SURG PLACEMENT IMPLANT BODY: ENDOSTEAL IMPLANT|1111.56|1111.56||
125|D5993|D5993 - MAINT / CLEAN MAXILLOFACIAL PROSTH BY REPORT|38.02|38.02||
125|D5992|D5992 - ADJUST MAXILLOFACIAL PROSTH APPLIANCE BY REPORT|54.86|54.86||
125|D5991|D5991 - VESICULOBULLOUS DISEASE MEDICAMENT CARRIER|70.04|70.04||
125|D5988|D5988 - SURGICAL SPLINT|182.1|182.1||
125|D5987|D5987 - COMMISSURE SPLINT|910.93|910.93||
125|D5986|D5986 - FLUORIDE GEL CARRIER|60.97|60.97||
125|D5985|D5985 - RADIATION CONE LOCATOR|607.27|607.27||
125|D5984|D5984 - RADIATION SHIELD|607.27|607.27||
125|D5983|D5983 - RADIATION CARRIER|607.27|607.27||
125|D5982|D5982 - SURGICAL STENT|270.29|270.29||
125|D5960|D5960 - SPEECH AID PROSTHESIS MODIFICATION|1364.77|1364.77||
125|D5959|D5959 - PALATAL LIFT PROSTHESIS MODIFICATION|1202.86|1202.86||
125|D5958|D5958 - PALATAL LIFT PROSTHESIS INTERIM|1202.86|1202.86||
125|D5955|D5955 - PALATAL LIFT PROSTHESIS DEFINITIVE|2754.64|2754.64||
125|D5954|D5954 - PALATAL AUGMENTATION PROSTHESIS|2977.5|2977.5||
125|D5953|D5953 - SPEECH AID PROSTHESIS ADULT|3214|3214||
125|D5952|D5952 - SPEECH AID PROSTHESIS PEDIATRIC|1691.66|1691.66||
125|D5951|D5951 - FEEDING AID|521.18|521.18||
125|D5937|D5937 - TRISMUS APPLIANCE (NOT FOR TMD TREATMENT)|400.88|400.88||
125|D5936|D5936 - OBTURATOR PROSTHESIS INTERIM|3189.7|3189.7||
125|D5935|D5935 - MANDIBULAR RESECTION PROSTHESIS W/O GUIDE FLANGE|2839.48|2839.48||
125|D5934|D5934 - MANDIBULAR RESECTION PROSTHESIS W/GUIDE FLANGE|3263.44|3263.44||
125|D5933|D5933 - OBTURATOR PROSTHESIS MODIFICATION|1514.04|1514.04||
125|D5932|D5932 - OBTURATOR PROSTHESIS DEFINITIVE|3580.68|3580.68||
125|D5931|D5931 - OBTURATOR PROSTHESIS SURGICAL|1914.56|1914.56||
125|D5928|D5928 - ORBITAL PROSTHESIS REPLACEMENT|701.89|701.89||
125|D5927|D5927 - AURICULAR PROSTHESIS REPLACEMENT|1445.24|1445.24||
125|D5926|D5926 - NASAL PROSTHESIS REPLACEMENT|1431.24|1431.24||
125|D5925|D5925 - FACIAL AUGMENTATION IMPLANT PROSTHESIS|1241.39|1241.39||
125|D5924|D5924 - CRANIAL PROSTHESIS|795.24|795.24||
125|D5923|D5923 - OCULAR PROSTHESIS INTERIM|91.45|91.45||
125|D5922|D5922 - NASAL SEPTAL PROSTHESIS|208.42|208.42||
125|D5916|D5916 - OCULAR PROSTHESIS|1282.96|1282.96||
125|D5915|D5915 - ORBITAL PROSTHESIS|4811.74|4811.74||
125|D5914|D5914 - AURICULAR PROSTHESIS|3555.96|3555.96||
125|D5913|D5913 - NASAL PROSTHESIS|3555.96|3555.96||
125|D5912|D5912 - FACIAL MOULAGE (COMPLETE)|168.9|168.9||
125|D5911|D5911 - FACIAL MOULAGE (SECTIONAL)|168.9|168.9||
125|D5875|D5875 - MODIFICATION REMV PROSTH AFTER IMPLANT SURGERY|195.86|195.86||
125|D5867|D5867 - REPLACEMENT REPL PART SEMI-PRCISN/PRCISN ATTCH|87.68|87.68||
125|D5866|D5866 - OVERDENTURE  PARTIAL MIBULAR|923.78|923.78||
125|D5865|D5865 - OVERDENTURE  COMPLETE MIBULAR|1107.05|1107.05||
125|D5864|D5864 - OVERDENTURE  PARTIAL MAXILLARY|1203.22|1203.22||
125|D5863|D5863 - OVERDENTURE  COMPLETE MAXILLARY|1197.42|1197.42||
125|D5862|D5862 - PRECISION ATTACHMENT BY REPORT|271.38|271.38||
125|D5851|D5851 - TISSUE CONDITIONING MANDIBULAR|63.85|63.85||
125|D5850|D5850 - TISSUE CONDITIONING MAXILLARY|63.85|63.85||
125|D5821|D5821 - INTERIM PARTIAL DENTURE (MANDIBULAR)|264.1|264.1||
125|D5820|D5820 - INTERIM PARTIAL DENTURE (MAXILLARY)|249.26|249.26||
125|D5811|D5811 - INTERIM COMPLETE DENTURE (MANDIBULAR)|346.09|346.09||
125|D5810|D5810 - INTERIM COMPLETE DENTURE (MAXILLARY)|321.76|321.76||
125|D5761|D5761 - RELINE MANDIBULAR PARTIAL DENTURE (LABORATORY)|200.63|200.63||
125|D5760|D5760 - RELINE MAXILLARY PARTIAL DENTURE (LABORATORY)|200.63|200.63||
125|D5751|D5751 - RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY)|203.94|203.94||
125|D5750|D5750 - RELINE COMPLETE MAXILLARY DENTURE (LABORATORY)|203.94|203.94||
125|D5741|D5741 - RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE)|139.67|139.67||
125|D5740|D5740 - RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE)|139.67|139.67||
125|D5731|D5731 - RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE)|152.86|152.86||
125|D5730|D5730 - RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE)|152.86|152.86||
125|D5721|D5721 - REBASE MANDIBULAR PARTIAL DENTURE|255.02|255.02||
125|D5720|D5720 - REBASE MAXILLARY PARTIAL DENTURE|255.02|255.02||
125|D5711|D5711 - REBASE COMPLETE MANDIBULAR DENTURE|258.34|258.34||
125|D5710|D5710 - REBASE COMPLETE MAXILLARY DENTURE|270.29|270.29||
125|D5671|D5671 - REPLACE ALL TEETH&ACRYLIC CAST METL FRMEWRK MAND|267.37|267.37||
125|D5670|D5670 - REPLACE ALL TEETH&ACRYLIC CAST METAL FRMEWRK MAX|267.37|267.37||
125|D5660|D5660 - ADD CLASP TO EXISTING PARTIAL DENTURE PER TOOTH|109.18|109.18||
125|D5650|D5650 - ADD TOOTH TO EXISTING PARTIAL DENTURE|91.07|91.07||
125|D5640|D5640 - REPLACE BROKEN TEETH - PER TOOTH|66.73|66.73||
125|D5630|D5630 - REPAIR OR REPLACE BROKEN CLASP PER TOOTH|103.42|103.42||
125|D5520|D5520 - REPLACE MISSING/BROKEN TEETH - COMPLETE DENTURE|60.97|60.97||
125|D5422|D5422 - ADJUST PARTIAL DENTURE - MANDIBULAR|36.25|36.25||
125|D5421|D5421 - ADJUST PARTIAL DENTURE - MAXILLARY|36.25|36.25||
125|D5411|D5411 - ADJUST COMPLETE DENTURE - MANDIBULAR|36.25|36.25||
125|D5410|D5410 - ADJUST COMPLETE DENTURE - MAXILLARY|36.25|36.25||
125|D5281|D5281 - REMV UNILAT PART DENTUR - 1 PIECE CAST METAL|429.3|429.3||
125|D5226|D5226 - MANDIBULAR PARTIAL DENTURE FLEXIBLE BASE|652.6|652.6||
125|D5225|D5225 - MAXILLARY PARTIAL DENTRUE FLEXIBLE BASE|562.38|562.38||
125|D5222|D5222 - IMMED MANDIBULAR PARTIAL DENTURE RESIN BASE|593.71|593.71||
125|D5221|D5221 - IMMED MAXILLARY PARTIAL DENTURE RESIN BASE|590.87|590.87||
125|D5214|D5214 - MAND PART DENTUR- CAST METL FRMEWRK W/RSN BASE|735.41|735.41||
125|D5213|D5213 - MAX PART DENTUR-CAST METL FRMEWRK W/RSN BASE|735.41|735.41||
125|D5212|D5212 - MANDIBULAR PARTIAL DENTURE - RESIN BASE|652.6|652.6||
125|D5211|D5211 - MAXILLARY PARTIAL DENTURE - RESIN BASE|562.38|562.38||
125|D5140|D5140 - IMMEDIATE DENTURE - MANDIBULAR|725.95|725.95||
125|D5130|D5130 - IMMEDIATE DENTURE - MAXILLARY|725.95|725.95||
125|D5120|D5120 - COMPLETE DENTURE - MANDIBULAR|665.36|665.36||
125|D5110|D5110 - COMPLETE DENTURE - MAXILLARY|665.36|665.36||
125|D4921|D4921 - GINGIVAL IRRIGATION PER QUADRANT|41.06|41.06||
125|D4920|D4920 - UNSCHEDULED DRESSING CHANGE|51.08|51.08||
125|D4910|D4910 - PERIODONTAL MAINTENANCE|70.86|70.86||
125|D4381|D4381 - LOC DEL ANTIMICROBL AGTS CREVICULR TISS TOOTH BR|73.92|73.92||
125|D4355|D4355 - FULL MOUTH DEBRID ENABLE COMP EVALUATION&DX|79.12|79.12||
125|D4342|D4342 - PRDONTAL SCALING&ROOT PLANING 1-3 TEETH-QUAD|66.73|66.73||
125|D4341|D4341 - PRDONTAL SCALING&ROOT PLANING 4/MORE TEETH-QUAD|115.37|115.37||
125|D4321|D4321 - PROVISIONAL SPLINTING - EXTRACORONAL|182.1|182.1||
125|D4320|D4320 - PROVISIONAL SPLINTING - INTRACORONAL|200.63|200.63||
125|D4285|D4285 - NON-AUTO CNNCTV TSSUE GRFT PROC E/A TOOTH/IMPLNT|264.74|264.74||
125|D4283|D4283 - AUTO CNNCTV TISSUE GRFT PROC E/A TOOTH -  IMPLANT|437.45|437.45||
125|D4278|D4278 - FREE SOFT TISSUE GRAFT -  E/ADNL TOOTH -  IMPLNT|310.5|310.5||
125|D4277|D4277 - FREE SOFT TISSUE GRAFT -  1ST TOOTH/ IMPLANT|547.37|547.37||
125|D4276|D4276 - COMB CNCTIVE TISSUE&DBL PEDICLE GRAFT PER TOOTH|562.38|562.38||
125|D4275|D4275 - NONAUTGNS CONECTV TISSUE GRFT 1ST TOOTH/IMPLANT|376.15|376.15||
125|D4274|D4274 - MESIAL OR DISTAL WEDGE PROCEDURE|284.27|284.27||
125|D4273|D4273 - AUTOGNS CONECTIVE TISSUE GRFT 1ST TOOTH/IMPLANT|500.98|500.98||
125|D4270|D4270 - PEDICLE SOFT TISSUE GRAFT PROCEDURE|409.52|409.52||
125|D4268|D4268 - SURGICAL REVISION PROCEDURE PER TOOTH|270.48|270.48||
125|D4267|D4267 - GUID TISSUE REGEN - NONRESORB BARRIER PER SITE|272.75|272.75||
125|D4266|D4266 - GUID TISSUE REGEN - RESORBABLE BARRIER PER SITE|212.58|212.58||
125|D4265|D4265 - BIOLOGIC MATERIALS AID SOFT&OSSEOUS TISSUE REGEN|269.93|269.93||
125|D4264|D4264 - BONE REPLACEMENT GRAFT - EA ADD SITE QUADRANT|176.34|176.34||
125|D4263|D4263 - BONE REPLACEMENT GRAFT - FIRST SITE IN QUADRANT|206.4|206.4||
125|D4261|D4261 - OSSEOUS SURG 1-3 CNTIG TEETH QUAD|309.8|309.8||
125|D4260|D4260 - OSSEOUS SURG 4/> CNTIG TEETH QUAD|577.21|577.21||
125|D4249|D4249 - CLINICAL CROWN LENGTHENING - HARD TISSUE|379.46|379.46||
125|D4245|D4245 - APICALLY POSITIONED FLAP|255.02|255.02||
125|D4241|D4241 - GINGL FLP PROC 1-3 CONTIG/TOOTH BOUND SPACE-QUAD|200.63|200.63||
125|D4240|D4240 - GINGL FLP PROC 4/> CONTIG/TOOTH BOUND SPACE-QUAD|346.09|346.09||
125|D4231|D4231 - ANATOMICAL CROWN EXPOSURE 1-3 TEETH PER QUADRANT|182.1|182.1||
125|D4230|D4230 - ANAT CROWN EXP 4/> CONTIGUOUS TEETH PER QUAD|383.16|383.16||
125|D4212|D4212 - GINGIVECT/PLSTY FOR ACCESS RESTORATION PER TOOTH|57.84|57.84||
125|D4211|D4211 - GINGIVECT/PLSTY 1-3 CNTIG/TOOTH BOUND SPACE-QUAD|121.13|121.13||
125|D4210|D4210 - GINGIVECT/PLSTY 4/>CNTIG/TOOTH BOUND SPACES-QUAD|272.75|272.75||
125|D3950|D3950 - CANAL PREPARATION&FITTING PREFORMED DOWEL/POST|79.12|79.12||
125|D3920|D3920 - HEMISECTION NOT INCLUDING ROOT CANAL THERAPY|173.03|173.03||
125|D3910|D3910 - SURGICAL PROCEDURE ISOLATION TOOTH W/RUBBER DAM|60.97|60.97||
125|D3470|D3470 - INTENTIONAL REIMPLANTATION W/NECESSARY SPLINTING|434.24|434.24||
125|D3460|D3460 - ENDODONTIC ENDOSSEOUS IMPLANT|850.78|850.78||
125|D3450|D3450 - ROOT AMPUTATION - PER ROOT|227.84|227.84||
125|D3432|D3432 - GTR RESORB BRRER PER SITE IN CONJ PERIRAD SURG|298.8|298.8||
125|D3431|D3431 - BIO MAT SFT OSS REGE CONJ PERIR SUR|302.4|302.4||
125|D3430|D3430 - RETROGRADE FILLING - PER ROOT|109.18|109.18||
125|D3429|D3429 - BG IN CONJ PERIRADICUL SURG EACH CONTIG TH SSS|166.56|166.56||
125|D3428|D3428 - BG IN CONJ PERIRADICULAR SURG/TOOTH SINGLE SITE|294.98|294.98||
125|D3427|D3427 - PERIRADICULAR SURGERY WITHOUT APICOECTOMY|629.76|629.76||
125|D3426|D3426 - APICOECTOMY (EACH ADDITIONAL ROOT)|148.73|148.73||
125|D3425|D3425 - APICOECTOMY - MOLAR (FIRST ROOT)|440.44|440.44||
125|D3421|D3421 - APICOECTOMY - PREMOLAR (FIRST ROOT)|388.92|388.92||
125|D3410|D3410 - APICOECTOMY - ANTERIOR|349.37|349.37||
125|D3357|D3357 - PULPAL REGENERATION - COMPLETION OF TREATMENT|304.66|304.66||
125|D3356|D3356 - PULPAL REGEN - INTERIM MED RPLCMNT|46.31|46.31||
125|D3355|D3355 - PULPAL REGENERATION - INITIAL VISIT|232.27|232.27||
125|D3353|D3353 - APEXIFICATION/RECALCIFICATION - FINAL VISIT|243.07|243.07||
125|D3352|D3352 - APEXIFICAT/RECALCIFICAT INT MED REPL|79.12|79.12||
125|D3351|D3351 - APEXIFICATION/RECALCIFICAT INIT VST|176.34|176.34||
125|D3348|D3348 - RETREATMENT PREVIOUS ROOT CANAL THERAPY - MOLAR|601.51|601.51||
125|D3347|D3347 - RETREATMENT PREVIOUS RC THERAPY - PREMOLAR|485.33|485.33||
125|D3346|D3346 - RETREATMENT PREVIOUS RC THERAPY - ANTERIOR|413.22|413.22||
125|D3333|D3333 - INTERNAL ROOT REPAIR OF PERFORATION DEFECTS|106.3|106.3||
125|D3332|D3332 - INCOMPLETE ENDO TX; INOP UNRESTORABLE/FX TOOTH|230.3|230.3||
125|D3331|D3331 - TREATMENT RC OBSTRUCTION; NON-SURGICAL ACCESS|121.13|121.13||
125|D3330|D3330 - ENODODONTIC THERAPY MOLAR|470.93|470.93||
125|D3320|D3320 - ENDODONTIC THERAPY PREMOLAR TOOTH|379.46|379.46||
125|D3310|D3310 - ENDODONTIC THERAPY ANTERIOR TOOTH|309.8|309.8||
125|D3240|D3240 - PULPAL THERAPY - POSTERIOR PRIMARY TOOTH|97.22|97.22||
125|D3230|D3230 - PULPAL THERAPY - ANTERIOR PRIMARY TOOTH|79.12|79.12||
125|D3222|D3222 - PART PULPOTOMY FOR APEXOGENEIS PERM TOOTH|75.8|75.8||
125|D3221|D3221 - PULPAL DEBRIDEMENT PRIMARY AND PERMANENT TEETH|82|82||
125|D3220|D3220 - TX PULP-REMV PULP CORONAL DENTINOCEMENTL JUNC|74.56|74.56||
125|D3120|D3120 - PULP CAP - INDIRECT(EXCLUDING FINAL RESTORATION)|29.24|29.24||
125|D3110|D3110 - PULP CAP - DIRECT (EXCLUDING FINAL RESTORATION)|36.25|36.25||
125|D2990|D2990 - RESIN INFILT OF INCIPIENT LESIONS|27.04|27.04||
125|D2983|D2983 - VENEER REPAIR BY REPORT|124.4|124.4||
125|D2982|D2982 - ONLAY REPAIR BY REPORT|128.82|128.82||
125|D2981|D2981 - INLAY REPAIR BY REPORT|108.17|108.17||
125|D2980|D2980 - CROWN REPAIR MATERIAL FAILURE|156.24|156.24||
125|D2975|D2975 - COPING|212.58|212.58||
125|D2971|D2971 - ADD PROC NEW CRWN UND XSTING PART DENTUR FRMEWRK|70.04|70.04||
125|D2962|D2962 - LABIAL VENEER (PORCELAIN LAMINATE) - LABORATORY|434.24|434.24||
125|D2961|D2961 - LABIAL VENEER (RESIN LAMINATE) - LABORATORY|399.62|399.62||
125|D2960|D2960 - LABIAL VENEER (RESIN LAMINATE) - CHAIRSIDE|352.25|352.25||
125|D2957|D2957 - EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH|72.49|72.49||
125|D2955|D2955 - POST REMOVAL|112.49|112.49||
125|D2954|D2954 - PREFABRICATED POST AND CORE IN ADDITION TO CROWN|145.85|145.85||
125|D2953|D2953 - EACH ADDITIONAL INDIRECTLY FAB POST SAME TOOTH|91.07|91.07||
125|D2952|D2952 - POST AND CORE ADDITION TO CROWN INDIRECTLY FAB|182.1|182.1||
125|D2951|D2951 - PIN RETENTION - PER TOOTH ADDITION RESTORATION|25.54|25.54||
125|D2950|D2950 - CORE BUILDUP INCLUDING ANY PINS WHEN REQUIRED|115.37|115.37||
125|D2941|D2941 - INTERIM THERAPEUTIC RESTORATION  PRIM DENTITION|53.99|53.99||
125|D2940|D2940 - PROTECTIVE RESTORATION|46.14|46.14||
125|D2934|D2934 - PREFAB ESTHETIC COAT STNLESS STEEL CROWN  PRIM|166.88|166.88||
125|D2933|D2933 - PREFABR STAINLESS STEEL CROWN W/RESIN WINDOW|166.88|166.88||
125|D2932|D2932 - PREFABRICATED RESIN CROWN|145.85|145.85||
125|D2931|D2931 - PREFABR STAINLESS STEEL CROWN - PERMANENT TOOTH|136.78|136.78||
125|D2930|D2930 - PREFABR STAINLESS STEEL CROWN - PRIMARY TOOTH|120.7|120.7||
125|D2929|D2929 - PREFABR  PORC CROWN - PRIMARY TOOTH|203.3|203.3||
125|D2921|D2921 - REATTACHMENT OF TOOTH FRAG INCISAL EDGE/CUSP|110.46|110.46||
125|D2920|D2920 - RE-CEMENT OR RE-BOND CROWN|44.51|44.51||
125|D2915|D2915 - RECMNT/REBND INDRCT OR PREFAB POST AND CORE|43.26|43.26||
125|D2910|D2910 - RECMNT/REBND INLAY/ONLAY/VNR/PART CVRGE RESTRATN|43.26|43.26||
125|D2799|D2799 - PROVISIONAL CROWN|215.89|215.89||
125|D2794|D2794 - CROWN - TITANIUM|531.47|531.47||
125|D2792|D2792 - CROWN - FULL CAST NOBLE METAL|500.98|500.98||
125|D2791|D2791 - CROWN - FULL CAST PREDOMINANTLY BASE METAL|492.34|492.34||
125|D2790|D2790 - CROWN - FULL CAST HIGH NOBLE METAL|519.52|519.52||
125|D2783|D2783 - CROWN - 3/4 PORCELAIN/CERAMIC|530.65|530.65||
125|D2782|D2782 - CROWN - 3/4 CAST NOBLE METAL|501.79|501.79||
125|D2781|D2781 - CROWN - 3/4 CAST PREDOMINANTLY BASE METAL|485.33|485.33||
125|D2780|D2780 - CROWN - 3/4 CAST HIGH NOBLE METAL|516.24|516.24||
125|D2752|D2752 - CROWN - PORCELAIN FUSED TO NOBLE METAL|513.36|513.36||
125|D2751|D2751 - CROWN - PORCELAIN FUSED PREDOMINANTLY BASE METAL|500.98|500.98||
125|D2750|D2750 - CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL|538.09|538.09||
125|D2740|D2740 - CROWN - PORCELAIN/CERAMIC|545.48|545.48||
125|D2722|D2722 - CROWN - RESIN WITH NOBLE METAL|508.8|508.8||
125|D2721|D2721 - CROWN - RESIN WITH PREDOMINANTLY BASE METAL|498.1|498.1||
125|D2720|D2720 - CROWN - RESIN WITH HIGH NOBLE METAL|531.47|531.47||
125|D2712|D2712 - CROWN 3/4 RESIN-BASED COMPOSITE (INDIRECT)|215.89|215.89||
125|D2710|D2710 - CROWN - RESIN-BASED COMPOSITE (INDIRECT)|215.89|215.89||
125|D2664|D2664 - ONLAY RESIN BASED COMPOSIT FOUR OR MORE SURFACES|383.16|383.16||
125|D2663|D2663 - ONLAY - RESIN-BASED COMPOSITE - THREE SURFACES|357.62|357.62||
125|D2662|D2662 - ONLAY - RESIN-BASED COMPOSITE - TWO SURFACES|303.66|303.66||
125|D2652|D2652 - INLAY RESIN BASED COMPOSITE 3 OR MORE SURFACES|349.8|349.8||
125|D2651|D2651 - INLAY - RESIN-BASED COMPOSITE - TWO SURFACES|332.89|332.89||
125|D2650|D2650 - INLAY - RESIN-BASED COMPOSITE - ONE SURFACE|279.32|279.32||
125|D2644|D2644 - ONLAY - PORCELAIN/CERAMIC - 4 OR MORE SURFACES|531.47|531.47||
125|D2643|D2643 - ONLAY - PORCELAIN/CERAMIC - THREE SURFACES|500.98|500.98||
125|D2642|D2642 - ONLAY - PORCELAIN/CERAMIC - TWO SURFACES|464.74|464.74||
125|D2630|D2630 - INLAY - PORCELAIN/CERAMIC - THREE/MORE SURFACES|477.5|477.5||
125|D2620|D2620 - INLAY - PORCELAIN/CERAMIC - TWO SURFACES|449.08|449.08||
125|D2610|D2610 - INLAY - PORCELAIN/CERAMIC - ONE SURFACE|425.17|425.17||
125|D2544|D2544 - ONLAY - METALLIC - FOUR OR MORE SURFACES|504.29|504.29||
125|D2543|D2543 - ONLAY - METALLIC - THREE SURFACES|484.51|484.51||
125|D2542|D2542 - ONLAY - METALLIC - TWO SURFACES|463.49|463.49||
125|D2530|D2530 - INLAY - METALLIC - THREE OR MORE SURFACES|472.56|472.56||
125|D2520|D2520 - INLAY - METALLIC - TWO SURFACES|409.52|409.52||
125|D2510|D2510 - INLAY - METALLIC - ONE SURFACE|361.75|361.75||
125|D2430|D2430 - GOLD FOIL - THREE SURFACES|395.11|395.11||
125|D2420|D2420 - GOLD FOIL - TWO SURFACES|227.84|227.84||
125|D2410|D2410 - GOLD FOIL - ONE SURFACE|136.78|136.78||
125|D2394|D2394 - RESIN COMPOS - FOUR OR MORE SURFACES POSTERIOR|148.73|148.73||
125|D2393|D2393 - RESIN-BASED COMPOSITE - THREE SURFACES POSTERIOR|121.13|121.13||
125|D2392|D2392 - RESIN-BASED COMPOSITE - TWO SURFACES POSTERIOR|97.22|97.22||
125|D2391|D2391 - RESIN-BASED COMPOSITE - ONE SURFACE POSTERIOR|74.56|74.56||
125|D2390|D2390 - RESIN-BASED COMPOSITE CROWN ANTERIOR|130.58|130.58||
125|D2335|D2335 - RESIN-BASED COMPOSITE 4/> SURFACES INCISAL ANGLE|117.82|117.82||
125|D2332|D2332 - RESIN-BASED COMPOSITE - THREE SURFACES ANTERIOR|99.71|99.71||
125|D2331|D2331 - RESIN-BASED COMPOSITE - TWO SURFACES ANTERIOR|82|82||
125|D2330|D2330 - RESIN-BASED COMPOSITE - ONE SURFACE ANTERIOR|63.85|63.85||
125|D2161|D2161 - AMALGAM-FOUR/MORE SURFACES PRIMARY/PERMANENT|98.46|98.46||
125|D2160|D2160 - AMALGAM - THREE SURFACES PRIMARY OR PERMANENT|80.75|80.75||
125|D2150|D2150 - AMALGAM - TWO SURFACES PRIMARY OR PERMANENT|66.73|66.73||
125|D2140|D2140 - AMALGAM - ONE SURFACE PRIMARY OR PERMANENT|51.08|51.08||
125|D1555|D1555 - REMOVAL OF FIXED SPACE MAINTAINER|31.02|31.02||
125|D1550|D1550 - RECMNT/REBND OF SPACE MAINTAINER|32.22|32.22||
125|D1525|D1525 - SPACE MAINTAINER - REMOVABLE - BILATERAL|252.46|252.46||
125|D1520|D1520 - SPACE MAINTAINER - REMOVABLE - UNILATERAL|163.07|163.07||
125|D1515|D1515 - SPACE MAINTAINER - FIXED - BILATERAL|208.2|208.2||
125|D1510|D1510 - SPACE MAINTAINER - FIXED - UNILATERAL|148.58|148.58||
125|D1354|D1354 - INTERIM CARIES ARRESTING MEDICATION APPLICATION|41.69|41.69||
125|D1353|D1353 - SEALANT REPAIR PER TOOTH|17.18|17.18||
125|D1352|D1352 - PREV RSN REST MOD HIGH CARIES RISK PT-PERM TOOTH|29.81|29.81||
125|D1351|D1351 - SEALANT - PER TOOTH|22.54|22.54||
125|D1330|D1330 - ORAL HYGIENE INSTRUCTIONS|28.61|28.61||
125|D1320|D1320 - TOBACCO CNSL CONTROL&PREVENTION ORAL DISEASE|22.54|22.54||
125|D1310|D1310 - NUTRITIONAL COUNSELING CONTROL OF DENTAL DISEASE|20.95|20.95||
125|D1208|D1208 - TOPICAL APPLICATION OF FLUORIDE EXCL VARNISH|11.62|11.62||
125|D1206|D1206 - TOPICAL APPLICATION OF FLUORIDE VARNISH|26.58|26.58||
125|D1120|D1120 - PROPHYLAXIS - CHILD|28.99|28.99||
125|D1110|D1110 - PROPHYLAXIS - ADULT|41.86|41.86||
125|D0502|D0502 - OTHER ORAL PATHOLOGY PROCEDURES BY REPORT|21.02|21.02||
125|D0486|D0486 - ACCESSION TRANSEPITHELIAL CYTOLOG SAMPL MIC EXAM|54.97|54.97||
125|D0485|D0485 - CONSULT INCL PREP SLIDES BX MATL SPL REF SRC|118.09|118.09||
125|D0484|D0484 - CONSULTATION ON SLIDES PREPARED ELSEWHERE|85.56|85.56||
125|D0483|D0483 - INDIRECT IMMUNOFLUORESCENCE|56.92|56.92||
125|D0482|D0482 - DIRECT IMMUNOFLUORESCENCE|56.92|56.92||
125|D0481|D0481 - ELECTRON MICROSCOPY|171.13|171.13||
125|D0480|D0480 - ACESS EXFOLIATIVE CYTOL SMEAR MIC EXAM PREP/REPT|45.68|45.68||
125|D0479|D0479 - TISSUE INSITU HYBRIDIZATION INCL INTERPRETATION|74.34|74.34||
125|D0478|D0478 - IMMUNOHISTOCHEMICAL STAINS|48.4|48.4||
125|D0477|D0477 - SPECIAL STAINS NOT FOR MICROORGANISMS|53.04|53.04||
125|D0476|D0476 - SPECIAL STAINS FOR MICROORGANISMS|38.71|38.71||
125|D0475|D0475 - DECALCIFICATION PROCEDURE|39.88|39.88||
125|D0474|D0474 - ACCESS TISS GR&MIC EX ASSESS SURG MARG PREP/RPT|74.34|74.34||
125|D0473|D0473 - ACCESS TISSUE GR&MIC EXAMINATION PREP/REPRT|66.2|66.2||
125|D0472|D0472 - ACCESSION OF TISSUE GROSS EXAMINATION PREP/REPRT|31.36|31.36||
125|D0470|D0470 - DIAGNOSTIC CASTS|49.94|49.94||
125|D0460|D0460 - PULP VITALITY TESTS|22.85|22.85||
125|D0431|D0431 - ADJUNCTIVE PREDX TST NOT INCL CYTOLOGY/BX PROC|22.85|22.85||
125|D0425|D0425 - CARIES SUSCEPTIBILITY TESTS|14.33|14.33||
125|D0418|D0418 - ANALYSIS OF SALIVA SAMPLE|22.85|22.85||
125|D0417|D0417 - CLCT & PREP SALIVA SAMPLE FOR LAB DX TESTING|22.07|22.07||
125|D0416|D0416 - VIRAL CULTURE|24.4|24.4||
125|D0415|D0415 - COLLECTION MICROORGANISMS CULTURE & SENSITIVITY|16.64|16.64||
125|D0394|D0394 - DIGITAL SUBTR OF 2 > IMAGES OF THE SAME MODALITY|9.6|9.6||
125|D0393|D0393 - TREATMENT SIMULATION USING 3D IMAGE VOLUME|210.61|210.61||
125|D0391|D0391 - INTERPRETATION OF DIAGNOSTIC IMAGE|37.75|37.75||
125|D0386|D0386 - MAXILLOFACIAL ULTRASOUND IMAGE CAPTURE|146.45|146.45||
125|D0385|D0385 - MAXILLOFACIAL MRI IMAGE CAPTURE|510|510||102
125|D0384|D0384 - CNE BEAM CAPTR  FR TMJ 2 OR MORE|330|330||66
125|D0383|D0383 - CNE BEAM CAPTR  W FLD VIEW BTH JAWS|258.79|258.79||51.76
125|D0382|D0382 - CNE BEAM CAPTR  W FLD VIEW 1 ARCH MAXL|211.44|211.44||42.29
125|D0381|D0381 - CNE BEAM CAPTR  W FLD VIEW 1 ARCH MNDBL|240|240||48
125|D0380|D0380 - CNE BEAM CAPTR LMTD FLD <1 WHL JAW|147.16|147.16||29.44
125|D0371|D0371 - SIALOENDOSCOPY CAPTURE AND INTERPRETATION|19.01|19.01||
125|D0370|D0370 - MAXLFCL US IMAGE CAPTR AND INTRP|107.93|107.93||
125|D0369|D0369 - MAXILLOFACIAL MRI CAPTURE AND INTERPRETATION|510|510||151.2
125|D0368|D0368 - CNE BEAM CAPTR INTERP  FR TMJ 2 OR MORE|330|330||66
125|D0367|D0367 - CNE BEAM CAPTR INTERP W FLD VIEW BTH JAWS|248.36|248.36||49.67
125|D0366|D0366 - CNE BEAM CAPTR INTERP W FLD VIEW 1 ARCH MAXL|276.4|276.4||55.28
125|D0365|D0365 - CNE BEAM CAPTR INTERP W FLD VIEW 1 ARCH MNDBL|196.85|196.85||
125|D0364|D0364 - CNE BEAM  CAPTR & INTREP LESS THAN WHL JAW|149.5|149.5||
125|D0351|D0351 - 3D PHOTOGRAPHIC IMAGE|31.68|31.68||
125|D0350|D0350 - 2D ORAL/FACIAL PHOTOGRAPHIC IMAGES|29.3|29.3||
125|D0340|D0340 - 2D CEPHLOMTRIC RAD IMG - ACQSTN MEASRE& ANALYSIS|61.39|61.39||
125|D0330|D0330 - PANORAMIC RADIOGRAPHIC IMAGE|54.25|54.25||
125|D0322|D0322 - TOMOGRAPHIC SURVEY|250.73|250.73||
125|D0321|D0321 - OTHER TEMPOROMANDIBULAR JOINT IMAGES BY REPORT|76.38|76.38||
125|D0320|D0320 - TEMPOROMANDIBULAR JOINT ARTHROGRAM INCL INJ|309.37|309.37||
125|D0310|D0310 - SIALOGRAPHY|175.09|175.09||
125|D0277|D0277 - VERTICAL BITEWINGS - 7 TO 8 RADIOGRAPHIC IMAGES|39.19|39.19||
125|D0274|D0274 - BITEWINGS - FOUR RADIOGRAPHIC IMAGES|26.16|26.16||
125|D0273|D0273 - BITEWINGS - THREE RADIOGRAPHIC IMAGES|22.58|22.58||
125|D0272|D0272 - BITEWINGS - TWO RADIOGRAPHIC IMAGES|18.62|18.62||
125|D0270|D0270 - BITEWING - SINGLE RADIOGRAPHIC IMAGE|11.48|11.48||
125|D0251|D0251 - EXTRAORAL POSTERIOR DENTAL RAD IMAGE|24.47|24.47||
125|D0250|D0250 - EXTRAORAL 2D PRJECTN RAD IMG BY RAD SRCE/ DTECTR|22.2|22.2||
125|D0240|D0240 - INTRAORAL - OCCLUSAL RADIOGRAPHIC IMAGE|18.24|18.24||
125|D0230|D0230 - INTRAORAL-PERIAPICAL-EACH ADDITIONAL IMAGE|10.28|10.28||
125|D0220|D0220 - INTRAORAL - PERIAPICAL FIRST RADIOGRAPHIC IMAGE|11.48|11.48||
125|D0210|D0210 - INTRAORAL-COMPLETE SERIES OF RADIOGRAPHIC IMAGES|57.82|57.82||
125|D0191|D0191 - ASSESSMENT OF A PATIENT|4.8|4.8||
125|D0190|D0190 - SCREENING OF A PATIENT|9.72|9.72||
125|D0180|D0180 - COMP PERIODONTAL EVALUATION - NEW OR EST PATIENT|39.94|39.94||
125|D0171|D0171 - RE-EVALUATION POST-OPERATIVE OFFICE VISIT|31.01|31.01||
125|D0170|D0170 - RE-EVALUATION - LIMITED PROBLEM FOCUSED|24.56|24.56||
125|D0160|D0160 - DTL&EXT ORAL EVALUATION - PROBLEM FOCUSED REPORT|73.67|73.67||
125|D0150|D0150 - COMP ORAL EVALUATION - NEW OR EST PATIENT|36.62|36.62||
125|D0145|D0145 - ORAL EVAL PT UND 3 YR AGE CNSL W/PRIM CAREGIVER|32.45|32.45||
125|D0140|D0140 - LIMITED ORAL EVALUATION - PROBLEM FOCUSED|35.36|35.36||
125|D0120|D0120 - PERIODIC ORAL EVALUATION - EST PATIENT|20.4|20.4||
125|C9740|C9740 - CYSTO IMPL 4 OR MORE|4815.36|4815.36||
125|C9739|C9739 - CYSTOSCOPY PROSTATIC IMP 1-3|1927.03|1927.03||
125|C9733|C9733 - NON-OPHTHALMIC FVA|143.48|143.48||
125|C9728|C9728 - PLACE DEVICE/MARKER -  NON PRO|580.99|580.99||
125|C9727|C9727 - INSERT PALATE IMPLANTS|786.73|786.73||
125|C9726|C9726 - RXT BREAST APPL PLACE/REMOV|1442.14|1442.14||
125|C9725|C9725 - PLACE ENDORECTAL APP|345.07|345.07||
125|C9607|C9607 - PERC D-E COR REVASC CHRO SIN|1375.92|1375.92||
125|C9606|C9606 - PERC D-E COR REVASC W AMI S|825.6|825.6||
125|C9600|C9600 - PERC DRUG-EL COR STENT SING|7777.33|7777.33||
125|C9497|C9497 - LOXAPINE -  INHALATION POWDER|173.3|173.3||
125|C9494|C9494 - INJECTION -  OCRELIZUMAB|64.74|64.74||
125|C9493|C9493 - INJECTION -  EDARAVONE|21.64|21.64||
125|C9492|C9492 - INJECTION -  DURVALUMAB|83.16|83.16||
125|C9491|C9491 - INJECTION -  AVELUMAB|91.22|91.22||
125|C9490|C9490 - INJECTION -  BEZLOTOXUMAB|45.42|45.42||
125|C9489|C9489 - INJECTION -  NUSINERSEN|1245|1245||
125|C9488|C9488 - CONIVAPTAN HCL|37.36|37.36||
125|C9486|C9486 - INJ -  GRANISETRON EXT|5.92|5.92||
125|C9485|C9485 - INJECTION -  OLARATUMAB|56.41|56.41||
125|C9484|C9484 - INJECTION -  ETEPLIRSEN|191.23|191.23||
125|C9483|C9483 - INJECTION -  ATEZOLIZUMAB|85.86|85.86||
125|C9482|C9482 - SOTALOL HYDROCHLORIDE IV|11.26|11.26||
125|C9460|C9460 - INJECTION -  CANGRELOR|17.9|17.9||
125|C9447|C9447 - INJ -  PHENYLEPHRINE KETOROLAC|555.77|555.77||
125|C9364|C9364 - PORCINE IMPLANT -  PERMACOL|21.54|21.54||
125|C9363|C9363 - INTEGRA MESHED BIL WOUND MAT|46.45|46.45||
125|C9362|C9362 - IMPLNT - BON VOID FILLER-STRIP|122.68|122.68||
125|C9361|C9361 - NEUROMEND NERVE WRAP|207.71|207.71||
125|C9360|C9360 - SURGIMEND -  NEONATAL|18.66|18.66||
125|C9359|C9359 - IMPLNT - BON VOID FILLER-PUTTY|144.42|144.42||
125|C9358|C9358 - SURGIMEND -  FETAL|17.44|17.44||
125|C9356|C9356 - TENOGLIDE TENDON PROT -  CM2|80.77|80.77||
125|C9355|C9355 - NEUROMATRIX NERVE CUFF -  CM|213.54|213.54||
125|C9354|C9354 - VERITAS COLLAGEN MATRIX -  CM2|22.7|22.7||
125|C9353|C9353 - NEURAWRAP NERVE PROTECTOR - CM|622.38|622.38||
125|C9352|C9352 - NEURAGEN NERVE GUIDE -  PER CM|546.43|546.43||
125|C9293|C9293 - INJECTION -  GLUCARPIDASE|343.19|343.19||
125|C9290|C9290 - INJ -  BUPIVACAINE LIPOSOME|1.42|1.42||
125|C9285|C9285 - PATCH -  LIDOCAINE/TETRACAINE|18.95|18.95||
125|C9275|C9275 - HEXAMINOLEVULINATE HCL|1165.32|1165.32||
125|C9257|C9257 - BEVACIZUMAB INJECTION|17.14|17.14||
125|C9254|C9254 - INJECTION -  LACOSAMIDE|0.4|0.4||
125|C9250|C9250 - ARTISS FIBRIN SEALANT|191.7|191.7||
125|C9248|C9248 - INJ -  CLEVIDIPINE BUTYRATE|3.32|3.32||
125|C9140|C9140 - AFSTYLA FACTOR VIII RECOMB|1.97|1.97||
125|C9132|C9132 - KCENTRA -  PER I.U.|2.76|2.76||
125|C9113|C9113 - INJ PANTOPRAZOLE SODIUM -  VIA|5.98|5.98||
125|C9029|C9029 - INJECTION -  GUSELKUMAB -  1 MG|115.74|115.74||
125|C9028|C9028 - INJ. INOTUZUMAB OZOGAMICIN -  0.1 MG|2483.35|2483.35||
125|C9024|C9024 - INJ -  DAUNORUBICIN-CYTARABINE|210.52|210.52||
125|C9016|C9016 - INJ -  TRIPTORELIN EXT REL -  3.75 MG|3187.2|3187.2||
125|C9015|C9015 - C-1 ESTERASE -  HAEGARDA -  10 UNITS|11.23|11.23||
125|C9014|C9014 - INJECTION -  CERLIPONASE ALFA -  1 MG|107.57|107.57||
125|C8957|C8957 - PROLONGED IV INF -  REQ PUMP|212.09|212.09||
125|C8936|C8936 - MRA -  W/O&W/DYE -  UPPER EXTR|510|510||102
125|C8935|C8935 - MRA -  W/O DYE -  UPPER EXTR|510|510||102
125|C8934|C8934 - MRA -  W/DYE -  UPPER EXTREMITY|510|510||102
125|C8933|C8933 - MRA -  W/O&W/DYE -  SPINAL CANAL|510|510||102
125|C8932|C8932 - MRA -  W/O DYE -  SPINAL CANAL|510|510||102
125|C8931|C8931 - MRA -  W/DYE -  SPINAL CANAL|510|510||102
125|C8930|C8930 - TTE W OR W/O CONTR -  CONT ECG|1690.86|1690.86||
125|C8929|C8929 - TTE W OR WO FOL WCON - DOPPLER|1142.18|1142.18||
125|C8928|C8928 - TTE W OR W/O FOL W/CON - STRES|1090.46|1090.46||
125|C8927|C8927 - TEE W OR W/O FOL W/CONT -  MON|504.98|504.98||
125|C8926|C8926 - TEE W OR W/O FOL W/CONT - CONG|2072.06|2072.06||
125|C8925|C8925 - 2D TEE W OR W/O FOL W/CON - IN|1026.3|1026.3||
125|C8924|C8924 - 2D TTE W OR W/O FOL W/CON - FU|524.08|524.08||
125|C8923|C8923 - 2D TTE W OR W/O FOL W/CON - CO|901.87|901.87||
125|C8922|C8922 - TTE W OR W/O FOL W/CONT -  F/U|949.69|949.69||
125|C8921|C8921 - TTE W OR W/O FOL W/CONT -  COM|1472.45|1472.45||
125|C8920|C8920 - MRA W/O FOL W/CONT -  PELVIS|510|510||102
125|C8919|C8919 - MRA W/O CONT -  PELVIS|510|510||102
125|C8918|C8918 - MRA W/CONT -  PELVIS|510|510||102
125|C8914|C8914 - MRA W/O FOL W/CONT -  LWR EXT|510|510||102
125|C8913|C8913 - MRA W/O CONT -  LWR EXT|510|510||102
125|C8912|C8912 - MRA W/CONT -  LWR EXT|510|510||102
125|C8911|C8911 - MRA W/O FOL W/CONT -  CHEST|510|510||102
125|C8910|C8910 - MRA W/O CONT -  CHEST|510|510||102
125|C8909|C8909 - MRA W/CONT -  CHEST|510|510||102
125|C8908|C8908 - MRI W/O FOL W/CONT -  BREAST - |510|510||102
125|C8907|C8907 - MRI W/O CONT -  BREAST -  BI|510|510||102
125|C8906|C8906 - MRI W/CONT -  BREAST -   BI|510|510||102
125|C8905|C8905 - MRI W/O FOL W/CONT -  BRST -  UN|510|510||102
125|C8904|C8904 - MRI W/O CONT -  BREAST -  UNI|510|510||102
125|C8903|C8903 - MRI W/CONT -  BREAST -   UNI|510|510||102
125|C8902|C8902 - MRA W/O FOL W/CONT -  ABD|510|510||102
125|C8901|C8901 - MRA W/O CONT -  ABD|510|510||102
125|C8900|C8900 - MRA W/CONT -  ABD|510|510||102
125|C5275|C5275 - LOW COST SKIN SUBSTITUTE APP|42.22|42.22||
125|C5271|C5271 - LOW COST SKIN SUBSTITUTE APP|35.93|35.93||
125|C2643|C2643 - BRACHYTX -  NON-STRANDED - C-131|73.86|73.86||
125|C2642|C2642 - BRACHYTX -  STRANDED -  C-131|101.12|101.12||
125|C2641|C2641 - BRACHYTX -  NON-STRANDED - P-103|4.13|4.13||
125|C2640|C2640 - BRACHYTX -  STRANDED -  P-103|17.78|17.78||
125|C2639|C2639 - BRACHYTX -  NON-STRANDED - I-125|38.46|38.46||
125|C2638|C2638 - BRACHYTX -  STRANDED -  I-125|45.02|45.02||
125|C2636|C2636 - BRACHY LINEAR -  NON-STR - P-103|0.43|0.43||
125|C2635|C2635 - BRACHYTX -  NON-STR -  HA -  P-103|61.34|61.34||
125|C2634|C2634 - BRACHYTX -  NON-STR -  HA -  I-125|125.06|125.06||
125|C2631|C2631 - REP DEV -  URINARY -  W/O SLING|1015.91|1015.91||
125|C2630|C2630 - CATH -  EP -  COOL-TIP|193.07|193.07||
125|C2629|C2629 - INTRO/SHEATH -  LASER|171.56|171.56||
125|C2628|C2628 - CATHETER -  OCCLUSION|244.18|244.18||
125|C2627|C2627 - CATH -  SUPRAPUBIC/CYSTOSCOPIC|87.65|87.65||
125|C2626|C2626 - INFUSION PUMP -  NON-PROG - TEMP|561.7|561.7||
125|C2625|C2625 - STENT -  NON-COR -  TEM W/DEL SY|118.68|118.68||
125|C2622|C2622 - PROSTHESIS -  PENILE -  NON-INF|4522.74|4522.74||
125|C2621|C2621 - PMKR -  OTHER THAN SING/DUAL|4368.56|4368.56||
125|C2620|C2620 - PMKR -  SINGLE -  NON RATE-RESP|699.5|699.5||
125|C2619|C2619 - PMKR -  DUAL -  NON RATE-RESP|3962.6|3962.6||
125|C2618|C2618 - PROBE/NEEDLE -  CRYO|376.61|376.61||
125|C2617|C2617 - STENT -  NON-COR -  TEM W/O DEL|227.48|227.48||
125|C2616|C2616 - BRACHYTX -  NON-STR - YTTRIUM-90|16952.05|16952.05||
125|C2615|C2615 - SEALANT -  PULMONARY -  LIQUID|287.24|287.24||
125|C2614|C2614 - PROBE -  PERC LUMB DISC|1438.42|1438.42||
125|C1900|C1900 - LEAD -  CORONARY VENOUS|118.61|118.61||
125|C1899|C1899 - LEAD -  PMKR/AICD COMBINATION|7155.46|7155.46||
125|C1898|C1898 - LEAD -  PMKR -  OTHER THAN TRANS|1086.64|1086.64||
125|C1897|C1897 - LEAD -  NEUROSTIM TEST KIT|1151.92|1151.92||
125|C1896|C1896 - LEAD -  AICD -  NON SING/DUAL|3766.93|3766.93||
125|C1895|C1895 - LEAD -  AICD -  ENDO DUAL COIL|1557.56|1557.56||
125|C1894|C1894 - INTRO/SHEATH -  NON-LASER|104.81|104.81||
125|C1893|C1893 - INTRO/SHEATH -  FIXED - NON-PEEL|11.17|11.17||
125|C1892|C1892 - INTRO/SHEATH - FIXED - PEEL-AWAY|0.68|0.68||
125|C1891|C1891 - INFUSION PUMP - NON-PROG -  PERM|3284.64|3284.64||328.46
125|C1888|C1888 - ENDOVAS NON-CARDIAC ABL CATH|1143.82|1143.82||
125|C1887|C1887 - CATHETER -  GUIDING|52.63|52.63||
125|C1886|C1886 - CATHETER -  ABLATION|1322.09|1322.09||
125|C1885|C1885 - CATH -  TRANSLUMIN ANGIO LASER|531.76|531.76||
125|C1884|C1884 - EMBOLIZATION PROTECT SYST|161.34|161.34||
125|C1883|C1883 - ADAPT/EXT -  PACING/NEURO LEAD|34.27|34.27||
125|C1882|C1882 - AICD -  OTHER THAN SING/DUAL|14504.72|14504.72||
125|C1881|C1881 - DIALYSIS ACCESS SYSTEM|248.62|248.62||
125|C1880|C1880 - VENA CAVA FILTER|68.5|68.5||
125|C1878|C1878 - MATRL FOR VOCAL CORD|82.56|82.56||
125|C1877|C1877 - STENT -  NON-COAT/COV W/O DEL|788.86|788.86||
125|C1876|C1876 - STENT -  NON-COA/NON-COV W/DEL|1319.48|1319.48||
125|C1875|C1875 - STENT -  COATED/COV W/O DEL SY|322.88|322.88||
125|C1874|C1874 - STENT -  COATED/COV W/DEL SYS|378.2|378.2||
125|C1840|C1840 - TELESCOPIC INTRAOCULAR LENS|778.74|778.74||
125|C1830|C1830 - POWER BONE MARROW BX NEEDLE|142.33|142.33||
125|C1821|C1821 - INTERSPINOUS IMPLANT|1931.12|1931.12||
125|C1820|C1820 - GENERATOR NEURO RECHG BAT SY|1956.22|1956.22||
125|C1819|C1819 - TISSUE LOCALIZATION-EXCISION|182.47|182.47||
125|C1818|C1818 - INTEGRATED KERATOPROSTHESIS|1345.64|1345.64||
125|C1817|C1817 - SEPTAL DEFECT IMP SYS|6814.69|6814.69||
125|C1816|C1816 - RECEIVER/TRANSMITTER -  NEURO|18372.24|18372.24||
125|C1815|C1815 - PROS -  URINARY SPH -  IMP|2944.16|2944.16||
125|C1814|C1814 - RETINAL TAMP -  SILICONE OIL|427.1|427.1||
125|C1813|C1813 - PROSTHESIS -  PENILE -  INFLATAB|4530|4530||
125|C1789|C1789 - PROSTHESIS -  BREAST -  IMP|482.78|482.78||
125|C1788|C1788 - PORT -  INDWELLING -  IMP|892.06|892.06||
125|C1787|C1787 - PATIENT PROGR -  NEUROSTIM|42.35|42.35||
125|C1786|C1786 - PMKR -  SINGLE -  RATE-RESP|1340.03|1340.03||
125|C1785|C1785 - PMKR -  DUAL -  RATE-RESP|330.5|330.5||
125|C1784|C1784 - OCULAR DEV -  INTRAOP -  DET RET|26.15|26.15||
125|C1783|C1783 - OCULAR IMP -  AQUEOUS DRAIN DE|373.93|373.93||
125|C1782|C1782 - MORCELLATOR|131.53|131.53||
125|C1781|C1781 - MESH (IMPLANTABLE)|574.18|574.18||
125|C1780|C1780 - LENS -  INTRAOCULAR (NEW TECH)|276.76|276.76||
125|C1779|C1779 - LEAD -  PMKR -  TRANSVENOUS VDD|258|258||
125|C1778|C1778 - LEAD -  NEUROSTIMULATOR|3724.55|3724.55||
125|C1777|C1777 - LEAD -  AICD -  ENDO SINGLE COIL|1185.82|1185.82||
125|C1776|C1776 - JOINT DEVICE (IMPLANTABLE)|4651.13|4651.13||
125|C1773|C1773 - RET DEV -  INSERTABLE|84|84||
125|C1772|C1772 - INFUSION PUMP -  PROGRAMMABLE|6263.16|6263.16||626.32
125|C1771|C1771 - REP DEV -  URINARY -  W/SLING|105.49|105.49||
125|C1770|C1770 - IMAGING COIL -  MR -  INSERTABLE|195.9|195.9||
125|C1769|C1769 - GUIDE WIRE|185.11|185.11||
125|C1768|C1768 - GRAFT -  VASCULAR|387.32|387.32||
125|C1767|C1767 - GENERATOR -  NEURO NON-RECHARG|11890|11890||
125|C1766|C1766 - INTRO/SHEATH - STRBLE - NON-PEEL|164.96|164.96||
125|C1765|C1765 - ADHESION BARRIER|323.54|323.54||
125|C1764|C1764 - EVENT RECORDER -  CARDIAC|3875.46|3875.46||
125|C1763|C1763 - CONN TISS -  NON-HUMAN|746.78|746.78||
125|C1762|C1762 - CONN TISS -  HUMAN(INC FASCIA)|2569.72|2569.72||
125|C1760|C1760 - CLOSURE DEV -  VASC|137.83|137.83||
125|C1759|C1759 - CATH -  INTRA ECHOCARDIOGRAPHY|84.82|84.82||
125|C1758|C1758 - CATHETER -  URETERAL|31.7|31.7||
125|C1757|C1757 - CATH -  THROMBECTOMY/EMBOLECT|19.6|19.6||
125|C1756|C1756 - CATH -  PACING -  TRANSESOPH|206.95|206.95||
125|C1755|C1755 - CATHETER -  INTRASPINAL|5.94|5.94||
125|C1754|C1754 - CATHETER -  INTRADISCAL|648.3|648.3||
125|C1753|C1753 - CATH -  INTRAVAS ULTRASOUND|103.13|103.13||
125|C1752|C1752 - CATH - HEMODIALYSIS - SHORT-TERM|124.8|124.8||
125|C1751|C1751 - CATH -  INF -  PER/CENT/MIDLINE|82.93|82.93||
125|C1750|C1750 - CATH -  HEMODIALYSIS - LONG-TERM|617.88|617.88||
125|C1749|C1749 - ENDO -  COLON -  RETRO IMAGING|262.4|262.4||
125|C1733|C1733 - CATH -  EP -  OTHR THAN COOL-TIP|1703.14|1703.14||
125|C1732|C1732 - CATH -  EP -  DIAG/ABL -  3D/VECT|299.53|299.53||
125|C1731|C1731 - CATH -  EP -  20 OR MORE ELEC|100.87|100.87||
125|C1730|C1730 - CATH -  EP -  19 OR FEW ELECT|415.94|415.94||
125|C1729|C1729 - CATH -  DRAINAGE|16.64|16.64||
125|C1728|C1728 - CATH -  BRACHYTX SEED ADM|94.49|94.49||
125|C1727|C1727 - CATH -  BAL TIS DIS -  NON-VAS|247.75|247.75||
125|C1726|C1726 - CATH -  BAL DIL -  NON-VASCULAR|163.13|163.13||
125|C1725|C1725 - CATH -  TRANSLUMIN NON-LASER|111.96|111.96||
125|C1724|C1724 - CATH -  TRANS ATHEREC - ROTATION|630.98|630.98||
125|C1722|C1722 - AICD -  SINGLE CHAMBER|4786.56|4786.56||
125|C1721|C1721 - AICD -  DUAL CHAMBER|6000|6000||
125|C1719|C1719 - BRACHYTX -  NS -  NON-HDRIR-192|54.91|54.91||
125|C1717|C1717 - BRACHYTX -  NON-STR - HDR IR-192|357.22|357.22||
125|C1716|C1716 - BRACHYTX -  NON-STR -  GOLD-198|221.26|221.26||
125|C1715|C1715 - BRACHYTHERAPY NEEDLE|2.66|2.66||
125|C1714|C1714 - CATH -  TRANS ATHERECTOMY -  DIR|467.93|467.93||
125|C1713|C1713 - ANCHOR/SCREW BN/BN - TIS/BN|367.69|367.69||
125|B9006|B9006 - PARENTERAL INFUS PUMP STATIO|2310.13|2310.13||365.7
125|B9004|B9004 - PARENTERAL INFUS PUMP PORTAB|2310.13|2310.13||365.7
125|B9002|B9002 - ENTER NUTR INF PUMP ANY TYPE|506.87|506.87||50.69
125|B5200|B5200 - PARENTERAL SOL HEPATIC FREAM|0.14|0.14||
125|B5100|B5100 - PARENTERAL SOLUTION HEPATIC|4.25|4.25||
125|B5000|B5000 - PARENTERAL SOL RENAL-AMIROSY|10.9|10.9||
125|B4224|B4224 - PARENTERAL ADMINISTRATION KI|22.88|22.88||
125|B4222|B4222 - PARENTERAL SUPPLY KIT HOMEMI|9.04|9.04||
125|B4220|B4220 - PARENTERAL SUPPLY KIT PREMIX|7.33|7.33||
125|B4216|B4216 - PARENTERAL NUTRITION ADDITIV|7.07|7.07||
125|B4199|B4199 - PARENTERAL SOL > 100GM PROTE|292.55|292.55||
125|B4197|B4197 - PARENTERAL SOL 74-100 GM PRO|256.02|256.02||
125|B4193|B4193 - PARENTERAL SOL 52-73 GM PROT|210.29|210.29||
125|B4189|B4189 - PARENTERAL SOL AMINO ACID &|162.74|162.74||
125|B4185|B4185 - PARENTERAL SOL 10 GM LIPIDS|10.28|10.28||
125|B4180|B4180 - PARENTERAL SOL CARB > 50%|22.33|22.33||
125|B4178|B4178 - PARENTERAL SOL AMINO ACID >|52.68|52.68||
125|B4176|B4176 - PARENTERAL SOL AMINO ACID 7-|43.9|43.9||
125|B4172|B4172 - PARENTERAL SOL AMINO ACID 5.|32.96|32.96||
125|B4168|B4168 - PARENTERAL SOL AMINO ACID 3.|22.68|22.68||
125|B4164|B4164 - PARENTERAL 50% DEXTROSE SOLU|15.55|15.55||
125|B4162|B4162 - EF PED SPECMETABOLIC INHERIT|4.82|4.82||
125|B4161|B4161 - EF PED HYDROLYZED/AMINO ACID|3.29|3.29||
125|B4160|B4160 - EF PED CALORIC DENSE>/=0.7KC|1.06|1.06||
125|B4159|B4159 - EF PED COMPLETE SOY BASED|1.76|1.76||
125|B4158|B4158 - EF PED COMPLETE INTACT NUT|2.52|2.52||
125|B4157|B4157 - EF SPECIAL METABOLIC INHERIT|7.44|7.44||
125|B4155|B4155 - EF INCOMPLETE/MODULAR|0.56|0.56||
125|B4154|B4154 - EF SPEC METABOLIC NONINHERIT|0.53|0.53||
125|B4153|B4153 - EF HYDROLYZED/AMINO ACIDS|0.96|0.96||
125|B4152|B4152 - EF CALORIE DENSE>/=1.5KCAL|0.24|0.24||
125|B4150|B4150 - EF COMPLET W/INTACT NUTRIENT|0.3|0.3||
125|B4149|B4149 - EF BLENDERIZED FOODS|0.8|0.8||
125|B4104|B4104 - ADDITIVE FOR ENTERAL FORMULA|0.05|0.05||
125|B4103|B4103 - EF PED FLUID AND ELECTROLYTE|3.95|3.95||
125|B4102|B4102 - EF ADULT FLUIDS AND ELECTRO|4.02|4.02||
125|B4100|B4100 - FOOD THICKENER ORAL|0.46|0.46||
125|B4088|B4088 - GASTRO/JEJUNO TUBE -  LOW-PRO|23.52|23.52||
125|B4087|B4087 - GASTRO/JEJUNO TUBE -  STD|20.6|20.6||
125|B4083|B4083 - ENTERAL STOMACH TUBE LEVINE|1.31|1.31||
125|B4082|B4082 - ENTERAL NG TUBING W/O STYLET|8.7|8.7||
125|B4081|B4081 - ENTERAL NG TUBING W/ STYLET|11.89|11.89||
125|B4036|B4036 - ENTERAL FEED SUP KIT GRAV BY|3.37|3.37||
125|B4035|B4035 - ENTERAL FEED SUPP PUMP PER D|4.39|4.39||
125|B4034|B4034 - ENTER FEED SUPKIT SYR BY DAY|2.44|2.44||
125|A9700|A9700 - ECHOCARDIOGRAPHY CONTRAST|123.1|123.1||
125|A9606|A9606 - RADIUM RA223 DICHLORIDE THER|154.06|154.06||
125|A9604|A9604 - SM 153 LEXIDRONAM|15031.74|15031.74||
125|A9600|A9600 - SR89 STRONTIUM|5766.58|5766.58||
125|A9588|A9588 - FLUCICLOVINE F-18|439.24|439.24||
125|A9587|A9587 - GALLIUM GA-68|75.25|75.25||
125|A9586|A9586 - FLORBETAPIR F18|3107.52|3107.52||
125|A9585|A9585 - GADOBUTROL INJECTION|0.62|0.62||
125|A9584|A9584 - IODINE I-123 IOFLUPANE|2839.8|2839.8||
125|A9583|A9583 - GADOFOSVESET TRISODIUM INJ|20.93|20.93||
125|A9582|A9582 - IODINE I-123 IOBENGUANE|7056.67|7056.67||
125|A9581|A9581 - GADOXETATE DISODIUM INJ|24.22|24.22||
125|A9580|A9580 - SODIUM FLUORIDE F-18|255.9|255.9||
125|A9579|A9579 - GAD-BASE MR CONTRAST NOS - 1ML|3.34|3.34||
125|A9578|A9578 - INJ MULTIHANCE MULTIPACK|3.21|3.21||
125|A9577|A9577 - INJ MULTIHANCE|3.33|3.33||
125|A9576|A9576 - INJ PROHANCE MULTIPACK|2.69|2.69||
125|A9575|A9575 - INJ GADOTERATE MEGLUMI 0.1ML|0.36|0.36||
125|A9572|A9572 - INDIUM IN-111 PENTETREOTIDE|6783.96|6783.96||
125|A9571|A9571 - INDIUM IN-111 AUTO PLATELET|4274.34|4274.34||
125|A9570|A9570 - INDIUM IN-111 AUTO WBC|4274.34|4274.34||
125|A9569|A9569 - TECHNETIUM TC-99M AUTO WBC|1740.17|1740.17||
125|A9568|A9568 - TECHNETIUM TC99M ARCITUMOMAB|1294.8|1294.8||
125|A9567|A9567 - TECHNETIUM TC-99M AEROSOL|22.44|22.44||
125|A9566|A9566 - TC99M FANOLESOMAB|248.06|248.06||
125|A9564|A9564 - P32 CHROMIC PHOSPHATE|347.16|347.16||
125|A9563|A9563 - P32 NA PHOSPHATE|364.39|364.39||
125|A9562|A9562 - TC99M MERTIATIDE|926.02|926.02||
125|A9561|A9561 - TC99M OXIDRONATE|52.58|52.58||
125|A9560|A9560 - TC99M LABELED RBC|111.64|111.64||
125|A9559|A9559 - CO57 CYANO|87.56|87.56||
125|A9558|A9558 - XE133 XENON 10MCI|41.44|41.44||
125|A9557|A9557 - TC99M BICISATE|444.72|444.72||
125|A9556|A9556 - GA67 GALLIUM|118.69|118.69||
125|A9555|A9555 - RB82 RUBIDIUM|576.97|576.97||
125|A9554|A9554 - I125 IOTHALAMATE -  DX|41.83|41.83||
125|A9553|A9553 - CR51 CHROMATE|674.09|674.09||
125|A9552|A9552 - F18 FDG|287.63|287.63||
125|A9551|A9551 - TC99M SUCCIMER|716.42|716.42||
125|A9550|A9550 - TC99M GLUCEPTATE|30.49|30.49||
125|A9548|A9548 - IN111 PENTETATE|493.85|493.85||
125|A9547|A9547 - IN111 OXYQUINOLINE|2137.16|2137.16||
125|A9546|A9546 - CO57/58|1.18|1.18||
125|A9543|A9543 - Y90 IBRITUMOMAB -  RX|56421.76|56421.76||
125|A9542|A9542 - IN111 IBRITUMOMAB -  DX|4183.2|4183.2||
125|A9541|A9541 - TC99M SULFUR COLLOID|63.91|63.91||
125|A9540|A9540 - TC99M MAA|23.84|23.84||
125|A9539|A9539 - TC99M PENTETATE|37.45|37.45||
125|A9538|A9538 - TC99M PYROPHOSPHATE|47.81|47.81||
125|A9537|A9537 - TC99M MEBROFENIN|66.12|66.12||
125|A9536|A9536 - TC99M DEPREOTIDE|1394.4|1394.4||
125|A9532|A9532 - I125 SERUM ALBUMIN -  DX|26.15|26.15||
125|A9531|A9531 - I131 MAX 100UCI|4.2|4.2||
125|A9530|A9530 - I131 IODIDE SOL -  RX|11.14|11.14||
125|A9529|A9529 - I131 IODIDE SOL -  DX|1.72|1.72||
125|A9528|A9528 - IODINE I-131 IODIDE CAP -  DX|84.79|84.79||
125|A9527|A9527 - IODINE I-125 SODIUM IODIDE|197.7|197.7||
125|A9526|A9526 - NITROGEN N-13 AMMONIA|175.01|175.01||
125|A9524|A9524 - I131 SERUM ALBUMIN -  DX|94.62|94.62||
125|A9521|A9521 - TC99M EXAMETAZIME|1740.17|1740.17||
125|A9520|A9520 - TC99 TILMANOCEPT DIAG 0.5MCI|560.39|560.39||
125|A9517|A9517 - I131 IODIDE CAP -  RX|42.67|42.67||
125|A9516|A9516 - IODINE I-123 SOD IODIDE MIC|216.16|216.16||
125|A9515|A9515 - CHOLINE C-11|5976|5976||
125|A9512|A9512 - TC99M PERTECHNETATE|13.79|13.79||
125|A9510|A9510 - TC99M DISOFENIN|83.66|83.66||
125|A9509|A9509 - IODINE I-123 SOD IODIDE MIL|2161.52|2161.52||
125|A9508|A9508 - I131 IODOBENGUATE -  DX|883.42|883.42||
125|A9507|A9507 - IN111 CAPROMAB|875.69|875.69||
125|A9505|A9505 - TL201 THALLIUM|34.84|34.84||
125|A9504|A9504 - TC99M APCITIDE|498|498||
125|A9503|A9503 - TC99M MEDRONATE|15.54|15.54||
125|A9502|A9502 - TC99M TETROFOSMIN|116.48|116.48||
125|A9501|A9501 - TECHNETIUM TC-99M TEBOROXIME|116.87|116.87||
125|A9500|A9500 - TC99M SESTAMIBI|127.58|127.58||
125|A9284|A9284 - NON-ELECTRONIC SPIROMETER|11.53|11.53||
125|A9283|A9283 - FOOT PRESS OFF LOAD SUPP DEV|36.01|36.01||
125|A9282|A9282 - WIG ANY TYPE|600|600||
125|A9281|A9281 - REACHING/GRABBING DEVICE|10.68|10.68||
125|A9279|A9279 - MONITORING FEATURE/DEVICENOC|120.35|120.35||12.04
125|A9278|A9278 - EXTERNAL RECEIVER -  CGM SYS|446.47|446.47||
125|A9277|A9277 - EXTERNAL TRANSMITTER -  CGM|434.05|434.05||
125|A9276|A9276 - DISPOSABLE SENSOR -  CGM SYS|11.12|11.12||
125|A9275|A9275 - DISP HOME GLUCOSE MONITOR|6.14|6.14||
125|A9274|A9274 - EXT AMB INSULIN DELIVERY SYS|23.88|23.88||
125|A9273|A9273 - HOT/COLD BOTLE/CAP/COL/WRAP|7.52|7.52||
125|A9272|A9272 - DISP WOUND SUCT -  DRSG/ACCESS|51.74|51.74||
125|A9270|A9270 - NON-COVERED ITEM OR SERVICE|0.01|0.01||
125|A9180|A9180 - LICE TREATMENT -  TOPICAL|4.1|4.1||
125|A9155|A9155 - ARTIFICIAL SALIVA|5.35|5.35||
125|A8003|A8003 - HARD PROTECT HELMET CUSTOM|242.53|242.53||48.5
125|A8002|A8002 - SOFT PROTECT HELMET CUSTOM|221.04|221.04||22.1
125|A8001|A8001 - HARD PROTECT HELMET PREFAB|153.66|153.66||15.36
125|A8000|A8000 - SOFT PROTECT HELMET PREFAB|153.66|153.66||15.36
125|A7527|A7527 - TRACH/LARYN TUBE PLUG/STOP|3.59|3.59||
125|A7526|A7526 - TRACHEOSTOMY TUBE COLLAR|3.4|3.4||
125|A7525|A7525 - TRACHEOSTOMY MASK|2.08|2.08||
125|A7524|A7524 - TRACHEOSTOMA STENT/STUD/BTTN|77.57|77.57||
125|A7523|A7523 - TRACHEOSTOMY SHOWER PROTECT|2.1|2.1||
125|A7522|A7522 - TRACH/LARYN TUBE STAINLESS|45.25|45.25||
125|A7521|A7521 - TRACH/LARYN TUBE CUFFED|47.12|47.12||
125|A7520|A7520 - TRACH/LARYN TUBE NON-CUFFED|47.58|47.58||
125|A7509|A7509 - HEAT & MOISTURE EXCHANGE SYS|1.42|1.42||
125|A7508|A7508 - HOUSING & INTEGRATED ADHESIV|2.87|2.87||
125|A7507|A7507 - INTEGRATED FILTER & HOLDER|2.5|2.5||
125|A7506|A7506 - HMES/TRACHVALVE ADHESIVEDISK|0.34|0.34||
125|A7505|A7505 - HMES OR TRACH VALVE HOUSING|4.7|4.7||
125|A7504|A7504 - TRACHEOSTOMA HMES FILTER|0.68|0.68||
125|A7503|A7503 - HMES FILTER HOLDER OR CAP|11.36|11.36||
125|A7502|A7502 - REPLACEMENT DIAPHRAGM/FPLATE|50.03|50.03||
125|A7501|A7501 - TRACHEOSTOMA VALVE W DIAPHRA|105.22|105.22||
125|A7048|A7048 - VACUUM DRAIN BOTTLE/TUBE KIT|42.62|42.62||
125|A7047|A7047 - RESP SUCTION ORAL INTERFACE|121.14|121.14||9.29
125|A7046|A7046 - REPL WATER CHAMBER -  PAP DEV|11.96|11.96||
125|A7045|A7045 - REPL EXHALATION PORT FOR PAP|10.28|10.28||1.03
125|A7044|A7044 - PAP ORAL INTERFACE|74.65|74.65||
125|A7041|A7041 - WATER SEAL DRAIN CONTAINER|76.57|76.57||
125|A7040|A7040 - ONE WAY CHEST DRAIN VALVE|40.75|40.75||
125|A7039|A7039 - FILTER -  NON DISPOSABLE W PAP|5.32|5.32||
125|A7038|A7038 - POS AIRWAY PRESSURE FILTER|1.81|1.81||
125|A7037|A7037 - POS AIRWAY PRESSURE TUBING|10.39|10.39||
125|A7036|A7036 - POS AIRWAY PRESS CHINSTRAP|9.36|9.36||
125|A7035|A7035 - POS AIRWAY PRESS HEADGEAR|16.09|16.09||
125|A7034|A7034 - NASAL APPLICATION DEVICE|49.02|49.02||
125|A7033|A7033 - REPLACEMENT NASAL PILLOWS|13.61|13.61||
125|A7032|A7032 - REPLACEMENT NASAL CUSHION|16.91|16.91||
125|A7031|A7031 - REPLACEMENT FACEMASK INTERFA|30.13|30.13||
125|A7030|A7030 - CPAP FULL FACE MASK|77.7|77.7||
125|A7029|A7029 - REPL NASAL PILLOW COMB MASK|13.5|13.5||
125|A7028|A7028 - REPL ORAL CUSHION COMBO MASK|30.2|30.2||
125|A7027|A7027 - COMBINATION ORAL/NASAL MASK|108.01|108.01||
125|A7026|A7026 - REPLACE CHST CMPRSS SYS HOSE|28.8|28.8||2.33
125|A7025|A7025 - REPLACE CHEST COMPRESS VEST|435.88|435.88||43.58
125|A7020|A7020 - INTERFACE -  COUGH STIM DEVICE|14.51|14.51||1.16
125|A7018|A7018 - WATER DISTILLED W/NEBULIZER|0.29|0.29||
125|A7017|A7017 - NEBULIZER NOT USED W OXYGEN|110|110||11
125|A7016|A7016 - NEBULIZER DOME & MOUTHPIECE|6.77|6.77||0.58
125|A7015|A7015 - AEROSOL MASK USED W NEBULIZE|1.15|1.15||
125|A7014|A7014 - COMPRESSOR NONDISPOS FILTER|2.87|2.87||
125|A7013|A7013 - DISPOSABLE COMPRESSOR FILTER|0.53|0.53||
125|A7012|A7012 - NEBULIZER WATER COLLEC DEVIC|2.6|2.6||
125|A7010|A7010 - DISPOSABLE CORRUGATED TUBING|14.14|14.14||
125|A7009|A7009 - NEBULIZER RESERVOIR BOTTLE|40.69|40.69||3.19
125|A7008|A7008 - DISPOSABLE NEBULIZER PREFILL|9.37|9.37||0.88
125|A7007|A7007 - LG VOL NEBULIZER DISPOSABLE|2.93|2.93||
125|A7006|A7006 - FILTERED NEBULIZER ADMIN SET|6.68|6.68||
125|A7005|A7005 - NONDISPOSABLE NEBULIZER SET|10.39|10.39||
125|A7004|A7004 - DISPOSABLE NEBULIZER SML VOL|1.13|1.13||
125|A7003|A7003 - NEBULIZER ADMINISTRATION SET|1.32|1.32||
125|A7002|A7002 - TUBING USED W SUCTION PUMP|3.26|3.26||0.29
125|A7001|A7001 - NONDISPOSABLE PUMP CANISTER|28.98|28.98||2.62
125|A7000|A7000 - DISPOSABLE CANISTER FOR PUMP|7.38|7.38||
125|A6550|A6550 - NEG PRES WOUND THER DRSG SET|22.03|22.03||
125|A6549|A6549 - G COMPRESSION STOCKING|84|84||
125|A6545|A6545 - GRAD COMP NON-ELASTIC BK|65.04|65.04||
125|A6544|A6544 - GC STOCKING GARTER BELT|30|30||
125|A6541|A6541 - GC STOCKING WAISTLNGTH 40-50|168|168||
125|A6540|A6540 - GC STOCKING WAISTLNGTH 30-40|144|144||
125|A6539|A6539 - GC STOCKING WAISTLNGTH 18-30|130.8|130.8||
125|A6538|A6538 - GC STOCKING FULL LNGTH 40-50|91.2|91.2||
125|A6537|A6537 - GC STOCKING FULL LNGTH 30-40|75.6|75.6||
125|A6536|A6536 - GC STOCKING FULL LNGTH 18-30|78|78||
125|A6535|A6535 - GC STOCKING THIGHLNGTH 40-50|61.2|61.2||
125|A6534|A6534 - GC STOCKING THIGHLNGTH 30-40|62.4|62.4||
125|A6533|A6533 - GC STOCKING THIGHLNGTH 18-30|50.4|50.4||
125|A6532|A6532 - COMPRESSION STOCKING BK40-50|46.75|46.75||
125|A6531|A6531 - COMPRESSION STOCKING BK30-40|33.11|33.11||
125|A6530|A6530 - COMPRESSION STOCKING BK18-30|36|36||
125|A6513|A6513 - COMPRESS BURN MASK FACE/NECK|44.6|44.6||
125|A6512|A6512 - COMPRES BURN GARMENT -  NOC|1.51|1.51||
125|A6511|A6511 - COMPRES BURN GARMENT PANTY|1.51|1.51||
125|A6510|A6510 - COMPRES BURN GARMENT LEOTARD|1.51|1.51||
125|A6509|A6509 - COMPRES BURN GARMENT JACKET|1.51|1.51||
125|A6508|A6508 - CMPRS BURNGARMENT FOOT-THIGH|3.37|3.37||
125|A6507|A6507 - CMPRS BURNGARMENT FOOT-KNEE|2.44|2.44||
125|A6506|A6506 - CMPRSBURNGRMNT GLOVE-AXILLA|48|48||
125|A6505|A6505 - CMPRSBURNGARMENT GLOVE-ELBOW|90|90||
125|A6504|A6504 - CMPRSBURNGARMENT GLOVE-WRIST|108|108||
125|A6503|A6503 - COMPRES BURNGARMENT FACEHOOD|60|60||
125|A6502|A6502 - COMPRES BURNGARMENT CHINSTRP|120|120||
125|A6501|A6501 - COMPRES BURNGARMENT BODYSUIT|6|6||
125|A6457|A6457 - TUBULAR DRESSING|1.14|1.14||
125|A6456|A6456 - ZINC PASTE BAND W >=3''<5''/YD|1.27|1.27||
125|A6455|A6455 - SELF-ADHER BAND >=5''/YD|1.39|1.39||
125|A6454|A6454 - SELF-ADHER BAND W>=3'' <5''/YD|0.78|0.78||
125|A6453|A6453 - SELF-ADHER BAND W <3''/YD|0.62|0.62||
125|A6452|A6452 - HIGH COMPRES BAND W>=3''<5''YD|5.93|5.93||
125|A6451|A6451 - MOD COMPRES BAND W>=3''<5''/YD|1.75|1.75||
125|A6450|A6450 - LT COMPRES BAND >=5''/YD|1.75|1.75||
125|A6449|A6449 - LT COMPRES BAND >=3'' <5''/YD|1.75|1.75||
125|A6448|A6448 - LT COMPRES BAND <3''/YD|1.16|1.16||
125|A6447|A6447 - CONFORM BAND S W >=5''/YD|0.68|0.68||
125|A6446|A6446 - CONFORM BAND S W>=3'' <5''/YD|0.41|0.41||
125|A6445|A6445 - CONFORM BAND S W <3''/YD|0.32|0.32||
125|A6444|A6444 - CONFORM BAND N/S W>=5''/YD|0.56|0.56||
125|A6443|A6443 - CONFORM BAND N/S W>=3''<5''/YD|0.28|0.28||
125|A6442|A6442 - CONFORM BAND N/S W<3''/YD|0.17|0.17||
125|A6441|A6441 - PAD BAND W>=3'' <5''/YD|0.68|0.68||
125|A6413|A6413 - ADHESIVE BANDAGE -  FIRST-AID|0.4|0.4||
125|A6412|A6412 - OCCLUSIVE EYE PATCH|0.29|0.29||
125|A6411|A6411 - NON-STERILE EYE PAD|0.18|0.18||
125|A6410|A6410 - STERILE EYE PAD|0.38|0.38||
125|A6407|A6407 - PACKING STRIPS -  NON-IMPREG|1.88|1.88||
125|A6404|A6404 - STERILE GAUZE > 48 SQ IN|0.29|0.29||
125|A6403|A6403 - STERILE GAUZE>16 <= 48 SQ IN|0.42|0.42||
125|A6402|A6402 - STERILE GAUZE <= 16 SQ IN|0.12|0.12||
125|A6266|A6266 - IMPREG GAUZE NO H20/SAL/YARD|1.93|1.93||
125|A6262|A6262 - WOUND FILLER DRY FORM / GRAM|0.58|0.58||
125|A6261|A6261 - WOUND FILLER GEL/PASTE /OZ|2.33|2.33||
125|A6260|A6260 - WOUND CLEANSER ANY TYPE/SIZE|0.58|0.58||
125|A6259|A6259 - TRANSPARENT FILM > 48 SQ IN|10.97|10.97||
125|A6258|A6258 - TRANSPARENT FILM >16<=48 IN|4.32|4.32||
125|A6257|A6257 - TRANSPARENT FILM <= 16 SQ IN|1.54|1.54||
125|A6256|A6256 - ABSORPT DRG > 48 SQ IN W/BDR|4.8|4.8||
125|A6255|A6255 - ABSORPT DRG >16<=48 IN W/BDR|3.05|3.05||
125|A6254|A6254 - ABSORPT DRG <=16 SQ IN W/BDR|1.21|1.21||
125|A6253|A6253 - ABSORPT DRG > 48 SQ IN W/O B|6.35|6.35||
125|A6252|A6252 - ABSORPT DRG >16 <=48 W/O BDR|3.26|3.26||
125|A6251|A6251 - ABSORPT DRG <=16 SQ IN W/O B|2|2||
125|A6250|A6250 - SKIN SEAL PROTECT MOISTURIZR|0.04|0.04||
125|A6248|A6248 - HYDROGEL DRSG GEL FILLER|16.28|16.28||
125|A6247|A6247 - HYDROGEL DRG > 48 SQ IN W/B|23.82|23.82||
125|A6246|A6246 - HYDROGEL DRG >16<=48 IN W/B|9.96|9.96||
125|A6245|A6245 - HYDROGEL DRG <= 16 IN W/BDR|7.28|7.28||
125|A6244|A6244 - HYDROGEL DRG >48 IN W/O BDR|39.36|39.36||
125|A6243|A6243 - HYDROGEL DRG >16<=48 W/O BDR|12.35|12.35||
125|A6242|A6242 - HYDROGEL DRG <=16 IN W/O BDR|6.07|6.07||
125|A6241|A6241 - HYDROCOLLOID DRG FILLER DRY|2.58|2.58||
125|A6240|A6240 - HYDROCOLLD DRG FILLER PASTE|12.26|12.26||
125|A6239|A6239 - HYDROCOLLD DRG > 48 IN W/BDR|3.6|3.6||
125|A6238|A6238 - HYDROCOLLD DRG >16<=48 W/BDR|22.85|22.85||
125|A6237|A6237 - HYDROCOLLD DRG <=16 IN W/BDR|7.93|7.93||
125|A6236|A6236 - HYDROCOLLD DRG > 48 IN W/O B|27.31|27.31||
125|A6235|A6235 - HYDROCOLLD DRG >16<=48 W/O B|16.85|16.85||
125|A6234|A6234 - HYDROCOLLD DRG <=16 W/O BDR|6.55|6.55||
125|A6233|A6233 - HYDROGEL DRESSING >48 SQ IN|19.21|19.21||
125|A6232|A6232 - HYDROGEL DSG>16<=48 SQ IN|6.88|6.88||
125|A6231|A6231 - HYDROGEL DSG<=16 SQ IN|4.7|4.7||
125|A6230|A6230 - GAUZE > 48 SQ IN WATER/SALNE|1.74|1.74||
125|A6229|A6229 - GAUZE >16<=48 SQ IN WATR/SAL|3.62|3.62||
125|A6228|A6228 - GAUZE <= 16 SQ IN WATER/SAL|1.16|1.16||
125|A6224|A6224 - GAUZE > 48 IN NO W/SAL W/O B|3.62|3.62||
125|A6223|A6223 - GAUZE >16<=48 NO W/SAL W/O B|2.44|2.44||
125|A6222|A6222 - GAUZE <=16 IN NO W/SAL W/O B|2.14|2.14||
125|A6221|A6221 - GAUZE > 48 SQ IN W/BORDER|2.58|2.58||
125|A6220|A6220 - GAUZE >16 <=48 SQ IN W/BORDR|2.59|2.59||
125|A6219|A6219 - GAUZE <= 16 SQ IN W/BORDER|0.96|0.96||
125|A6218|A6218 - NON-STERILE GAUZE > 48 SQ IN|0.29|0.29||
125|A6217|A6217 - NON-STERILE GAUZE>16<=48 SQ|0.18|0.18||
125|A6216|A6216 - NON-STERILE GAUZE<=16 SQ IN|0.05|0.05||
125|A6215|A6215 - FOAM DRESSING WOUND FILLER|5.59|5.59||
125|A6214|A6214 - FOAM DRG > 48 SQ IN W/BORDER|10.31|10.31||
125|A6213|A6213 - FOAM DRG >16<=48 SQ IN W/BDR|12.49|12.49||
125|A6212|A6212 - FOAM DRG <=16 SQ IN W/BORDER|9.73|9.73||
125|A6211|A6211 - FOAM DRG > 48 SQ IN W/O BRDR|29.44|29.44||
125|A6210|A6210 - FOAM DRG >16<=48 SQ IN W/O B|19.97|19.97||
125|A6209|A6209 - FOAM DRSG <=16 SQ IN W/O BDR|7.49|7.49||
125|A6208|A6208 - CONTACT LAYER > 48 SQ IN|38.4|38.4||
125|A6207|A6207 - CONTACT LAYER >16<= 48 SQ IN|7.36|7.36||
125|A6206|A6206 - CONTACT LAYER <= 16 SQ IN|2.62|2.62||
125|A6205|A6205 - COMPOSITE DRSG > 48 SQ IN|9|9||
125|A6204|A6204 - COMPOSITE DRSG >16<=48 SQ IN|6.24|6.24||
125|A6203|A6203 - COMPOSITE DRSG <= 16 SQ IN|3.37|3.37||
125|A6199|A6199 - ALGINATE DRSG WOUND FILLER|5.3|5.3||
125|A6198|A6198 - ALGINATE DRESSING > 48 SQ IN|24|24||
125|A6197|A6197 - ALGINATE DRSG >16 <=48 SQ IN|16.48|16.48||
125|A6196|A6196 - ALGINATE DRESSING <=16 SQ IN|7.37|7.37||
125|A6154|A6154 - WOUND POUCH EACH|14.41|14.41||
125|A6025|A6025 - SILICONE GEL SHEET -  EACH|14.23|14.23||
125|A6024|A6024 - COLLAGEN DSG WOUND FILLER|6.2|6.2||
125|A6023|A6023 - COLLAGEN DRESSING >48 SQ IN|190.68|190.68||
125|A6022|A6022 - COLLAGEN DRSG>16<=48 SQ IN|21.06|21.06||
125|A6021|A6021 - COLLAGEN DRESSING <=16 SQ IN|21.06|21.06||
125|A6011|A6011 - COLLAGEN GEL/PASTE WOUND FIL|2.29|2.29||
125|A6010|A6010 - COLLAGEN BASED WOUND FILLER|31.03|31.03||
125|A6000|A6000 - WOUND WARMING WOUND COVER|17.1|17.1||
125|A5513|A5513 - MULTI DEN INSERT CUSTOM MOLD|38.78|38.78||
125|A5512|A5512 - MULTI DEN INSERT DIRECT FORM|25.98|25.98||
125|A5510|A5510 - COMPRESSION FORM SHOE INSERT|30|30||
125|A5508|A5508 - DIABETIC DELUXE SHOE|36|36||
125|A5507|A5507 - MODIFICATION DIABETIC SHOE|31.42|31.42||
125|A5506|A5506 - DIABETIC SHOE W/OFF SET HEEL|31.42|31.42||
125|A5505|A5505 - DIAB SHOE W/METATARSAL BAR|31.42|31.42||
125|A5504|A5504 - DIABETIC SHOE WITH WEDGE|31.42|31.42||
125|A5503|A5503 - DIABETIC SHOE W/ROLLER/ROCKR|31.42|31.42||
125|A5501|A5501 - DIABETIC CUSTOM MOLDED SHOE|191.08|191.08||
125|A5500|A5500 - DIAB SHOE FOR DENSITY INSERT|63.71|63.71||
125|A5200|A5200 - PERCUTANEOUS CATHETER ANCHOR|11.33|11.33||
125|A5131|A5131 - APPLIANCE CLEANER|15.89|15.89||
125|A5126|A5126 - DISK/FOAM PAD +OR- ADHESIVE|1.32|1.32||
125|A5122|A5122 - SOLID SKIN BARRIER 8X8|12.88|12.88||
125|A5121|A5121 - SOLID SKIN BARRIER 6X6|6.36|6.36||
125|A5120|A5120 - SKIN BARRIER -  WIPE OR SWAB|0.29|0.29||
125|A5114|A5114 - FOAM/FABRIC LEG STRAP|7.62|7.62||
125|A5113|A5113 - LATEX LEG STRAP|4.73|4.73||
125|A5112|A5112 - URINARY LEG BAG|34.69|34.69||
125|A5105|A5105 - URINARY SUSPENSORY|40.85|40.85||
125|A5102|A5102 - BEDSIDE DRAIN BTL W/WO TUBE|22.62|22.62||
125|A5093|A5093 - OSTOMY ACCESSORY CONVEX INSE|1.97|1.97||
125|A5083|A5083 - STOMA ABSORPTIVE COVER|0.64|0.64||
125|A5082|A5082 - CONTINENT STOMA CATHETER|11.92|11.92||
125|A5081|A5081 - STOMA PLUG OR SEAL -  ANY TYPE|2.83|2.83||
125|A5073|A5073 - URINARY POUCH ON BARR W/FLNG|3.19|3.19||
125|A5072|A5072 - URINARY POUCH W/O BARRIER|3.54|3.54||
125|A5071|A5071 - URINARY POUCH W/BARRIER|6.02|6.02||
125|A5063|A5063 - DRAIN OSTOMY POUCH W/FLANGE|2.71|2.71||
125|A5062|A5062 - DRNBLE OSTOMY POUCH W/O BARR|2.23|2.23||
125|A5061|A5061 - POUCH DRAINABLE W BARRIER AT|3.54|3.54||
125|A5057|A5057 - 1 PC OST POU W BUILT-IN CONV|9.62|9.62||
125|A5056|A5056 - 1 PC OST POUCH W FILTER|4.68|4.68||
125|A5055|A5055 - STOMA CAP|1.44|1.44||
125|A5054|A5054 - CLSD OSTOMY POUCH W/FLANGE|1.8|1.8||
125|A5053|A5053 - CLSD OSTOMY POUCH FACEPLATE|1.49|1.49||
125|A5052|A5052 - CLSD OSTOMY POUCH W/O BARR|1.49|1.49||
125|A5051|A5051 - POUCH CLSD W BARR ATTACHED|2.08|2.08||
125|A4932|A4932 - REUSABLE RECTAL THERMOMETER|0.17|0.17||
125|A4931|A4931 - REUSABLE ORAL THERMOMETER|0.36|0.36||
125|A4930|A4930 - STERILE -  GLOVES PER PAIR|0.58|0.58||
125|A4929|A4929 - TOURNIQUET FOR DIALYSIS -  EA|0.29|0.29||
125|A4928|A4928 - SURGICAL MASK|1.5|1.5||
125|A4927|A4927 - NON-STERILE GLOVES|2.33|2.33||
125|A4918|A4918 - VENOUS PRESSURE CLAMP|1.2|1.2||
125|A4913|A4913 - MISC DIALYSIS SUPPLIES NOC|9.6|9.6||
125|A4911|A4911 - DRAIN BAG/BOTTLE|12|12||
125|A4890|A4890 - REPAIR/MAINT CONT HEMO EQUIP|305.93|305.93||
125|A4870|A4870 - PLUMB/ELEC WK HM HEMO EQUIP|21.66|21.66||
125|A4860|A4860 - DISPOSABLE CATHETER TIPS|0.3|0.3||
125|A4802|A4802 - PROTAMINE SULFATE PER 50 MG|10.04|10.04||
125|A4774|A4774 - AMMONIA TEST STRIPS|3.84|3.84||
125|A4773|A4773 - OCCULT BLOOD TEST STRIPS|9.59|9.59||
125|A4772|A4772 - BLOOD GLUCOSE TEST STRIPS|15.38|15.38||
125|A4771|A4771 - SERUM CLOTTING TIME TUBE|4.8|4.8||
125|A4770|A4770 - BLOOD COLLECTION TUBE/VACUUM|4.8|4.8||
125|A4766|A4766 - DIALYSATE CONC SOL ADD 10 ML|4.56|4.56||
125|A4765|A4765 - DIALYSATE CONC POW PER PACK|6.54|6.54||
125|A4760|A4760 - DIALYSATE SOL TEST KIT -  EACH|29.96|29.96||
125|A4755|A4755 - COMB ART/VENOUS BLOOD TUBING|9.6|9.6||
125|A4750|A4750 - ART OR VENOUS BLOOD TUBING|7.26|7.26||
125|A4740|A4740 - SHUNT ACCESSORY|34.22|34.22||
125|A4737|A4737 - INJ ANESTHETIC PER 10 ML|4.8|4.8||
125|A4736|A4736 - TOPICAL ANESTHETIC -  PER GRAM|18|18||
125|A4730|A4730 - FISTULA CANNULATION SET -  EA|5.28|5.28||
125|A4728|A4728 - DIALYSATE SOLUTION -  NON-DEX|42|42||
125|A4726|A4726 - DIALYS SOL FLD VOL > 5999CC|42|42||
125|A4725|A4725 - DIALYS SOL FLD VOL > 4999CC|42|42||
125|A4724|A4724 - DIALYS SOL FLD VOL > 3999CC|22.09|22.09||
125|A4723|A4723 - DIALYS SOL FLD VOL > 2999CC|42|42||
125|A4722|A4722 - DIALYS SOL FLD VOL > 1999CC|42|42||
125|A4721|A4721 - DIALYSAT SOL FLD VOL > 999CC|24|24||
125|A4720|A4720 - DIALYSAT SOL FLD VOL > 249CC|23.6|23.6||
125|A4719|A4719 - 'Y SET' TUBING|4.8|4.8||
125|A4714|A4714 - TREATED WATER PER GALLON|2.4|2.4||
125|A4709|A4709 - ACID CONC SOL PER GALLON|6|6||
125|A4708|A4708 - ACETATE CONC SOL PER GALLON|7.2|7.2||
125|A4707|A4707 - BICARBONATE CONC POW PER PAC|6.17|6.17||
125|A4706|A4706 - BICARBONATE CONC SOL PER GAL|7.2|7.2||
125|A4690|A4690 - DIALYZER -  EACH|379.81|379.81||
125|A4680|A4680 - ACTIVATED CARBON FILTER -  EA|38.33|38.33||
125|A4674|A4674 - CHEM/ANTISEPT SOLUTION -  8OZ|7.2|7.2||
125|A4673|A4673 - EXT LINE W EASY LOCK CONNECT|6|6||
125|A4672|A4672 - DRAINAGE EXT LINE -  DIALYSIS|12|12||
125|A4671|A4671 - DISPOSABLE CYCLER SET|18|18||
125|A4670|A4670 - AUTOMATIC BP MONITOR -  DIAL|37.75|37.75||
125|A4663|A4663 - DIALYSIS BLOOD PRESSURE CUFF|14.81|14.81||
125|A4660|A4660 - SPHYG/BP APP W CUFF AND STET|7.55|7.55||
125|A4657|A4657 - SYRINGE W/WO NEEDLE|0.6|0.6||
125|A4653|A4653 - PD CATHETER ANCHOR BELT|5.86|5.86||
125|A4652|A4652 - MICROCAPILLARY TUBE SEALANT|0.18|0.18||
125|A4651|A4651 - CALIBRATED MICROCAP TUBE|0.06|0.06||
125|A4650|A4650 - IMPLANT RADIATION DOSIMETER|6.82|6.82||
125|A4648|A4648 - IMPLANTABLE TISSUE MARKER|114.02|114.02||
125|A4642|A4642 - IN111 SATUMOMAB|1668.3|1668.3||
125|A4640|A4640 - ALTERNATING PRESSURE PAD|44.51|44.51||4.45
125|A4639|A4639 - INFRARED HT SYS REPLCMNT PAD|287.82|287.82||28.79
125|A4638|A4638 - REPL BATT PULSE GEN SYS|6.84|6.84||0.68
125|A4637|A4637 - REPL TIP CANE/CRUTCH/WALKER|1.49|1.49||0.16
125|A4636|A4636 - HANDGRIP FOR CANE ETC|2.66|2.66||0.28
125|A4635|A4635 - UNDERARM CRUTCH PAD|4.37|4.37||0.6
125|A4634|A4634 - REPLACEMENT BULB TH LIGHTBOX|188.4|188.4||18.84
125|A4633|A4633 - UVL REPLACEMENT BULB|41.11|41.11||3.19
125|A4630|A4630 - REPL BAT T.E.N.S. OWN BY PT|5.32|5.32||0.58
125|A4629|A4629 - TRACHEOSTOMY CARE KIT|4.66|4.66||
125|A4628|A4628 - OROPHARYNGEAL SUCTION CATH|3.74|3.74||0.29
125|A4627|A4627 - SPACER BAG/RESERVOIR|9.88|9.88||
125|A4626|A4626 - TRACHEOSTOMY CLEANING BRUSH|3.19|3.19||
125|A4625|A4625 - TRACH CARE KIT FOR NEW TRACH|6.94|6.94||
125|A4624|A4624 - TRACHEAL SUCTION TUBE|2.64|2.64||0.29
125|A4623|A4623 - TRACHEOSTOMY INNER CANNULA|6.28|6.28||
125|A4620|A4620 - VARIABLE CONCENTRATION MASK|0.64|0.64||
125|A4619|A4619 - FACE TENT|1.79|1.79||
125|A4618|A4618 - BREATHING CIRCUITS|8.2|8.2||0.89
125|A4617|A4617 - MOUTH PIECE|3.11|3.11||
125|A4616|A4616 - TUBING (OXYGEN) PER FOOT|0.06|0.06||
125|A4615|A4615 - CANNULA NASAL|0.73|0.73||
125|A4614|A4614 - HAND-HELD PEFR METER|23.82|23.82||
125|A4613|A4613 - BATTERY CHARGER|75.79|75.79||7.55
125|A4612|A4612 - BATTERY CABLES|42.11|42.11||4.36
125|A4611|A4611 - HEAVY DUTY BATTERY|103.37|103.37||10.74
125|A4608|A4608 - TRANSTRACHEAL OXYGEN CATH|50.22|50.22||
125|A4606|A4606 - OXYGEN PROBE USED W OXIMETER|3|3||
125|A4605|A4605 - TRACH SUCTION CATH CLOSE SYS|16.44|16.44||1.16
125|A4604|A4604 - TUBING WITH HEATING ELEMENT|34.69|34.69||2.9
125|A4602|A4602 - REPLACE LITHIUM BATTERY 1.5V|3.73|3.73||0.29
125|A4601|A4601 - LITH ION NON PROSTH RECHARGE|46.08|46.08||
125|A4600|A4600 - SLEEVE -  INTER LIMB COMP DEV|37.46|37.46||
125|A4595|A4595 - TENS SUPPL 2 LEAD PER MONTH|9.31|9.31||
125|A4590|A4590 - SPECIAL CASTING MATERIAL|22.64|22.64||
125|A4580|A4580 - CAST SUPPLIES (PLASTER)|10.8|10.8||
125|A4575|A4575 - HYPERBARIC O2 CHAMBER DISPS|883.5|883.5||
125|A4570|A4570 - SPLINT|10.16|10.16||
125|A4566|A4566 - SHOULD SLING/VEST/ABRESTRAIN|25.45|25.45||
125|A4565|A4565 - SLINGS|7.72|7.72||
125|A4562|A4562 - PESSARY -  NON RUBBER -  ANY TYPE|51.29|51.29||
125|A4561|A4561 - PESSARY RUBBER -  ANY TYPE|20.64|20.64||
125|A4559|A4559 - COUPLING GEL OR PASTE|0.1|0.1||
125|A4558|A4558 - CONDUCTIVE GEL OR PASTE|5.46|5.46||
125|A4557|A4557 - LEAD WIRES -  PAIR|9.48|9.48||
125|A4556|A4556 - ELECTRODES -  PAIR|12.17|12.17||
125|A4555|A4555 - CA TX E-STIM ELECTR/TRANSDUC|10.58|10.58||
125|A4554|A4554 - DISPOSABLE UNDERPADS|1.74|1.74||
125|A4550|A4550 - SURGICAL TRAYS|17.14|17.14||
125|A4520|A4520 - INCONTINENCE GARMENT ANYTYPE|1.2|1.2||
125|A4510|A4510 - FULL LENGTH SURG STOCKING|6.97|6.97||
125|A4500|A4500 - BELOW KNEE SURGICAL STOCKING|2.9|2.9||
125|A4495|A4495 - THIGH LENGTH SURG STOCKING|3.78|3.78||
125|A4490|A4490 - ABOVE KNEE SURGICAL STOCKING|3.78|3.78||
125|A4483|A4483 - MOISTURE EXCHANGER|6|6||6
125|A4481|A4481 - TRACHEOSTOMA FILTER|0.38|0.17|0.17|
125|A4480|A4480 - VABRA ASPIRATOR|2.9|2.9||
125|A4470|A4470 - GRAVLEE JET WASHER|3.78|3.78||
125|A4465|A4465 - NON-ELASTIC EXTREMITY BINDER|5.23|5.23||
125|A4463|A4463 - SURGICAL DRESS HOLDER REUSE|13.34|13.34||
125|A4461|A4461 - SURGICL DRESS HOLD NON-REUSE|3.3|3.3||
125|A4459|A4459 - MANUAL PUMP ENEMA -  REUSABLE|384.68|384.68||
125|A4458|A4458 - REUSABLE ENEMA BAG|2.4|2.4||
125|A4456|A4456 - ADHESIVE REMOVER -  WIPES|0.24|0.24||
125|A4455|A4455 - ADHESIVE REMOVER PER OUNCE|1.43|1.43||
125|A4452|A4452 - WATERPROOF TAPE|0.29|0.29||
125|A4450|A4450 - NON-WATERPROOF TAPE|0.29|0.29||
125|A4435|A4435 - 1PC OST PCH DRAIN HGH OUTPUT|5.78|5.78||
125|A4434|A4434 - OST PCH URINE W LOCK FLNG/FT|3.77|3.77||
125|A4433|A4433 - URINE OST PCH BAR W LOCK FLN|3.36|3.36||
125|A4432|A4432 - OS PCH URINE W BAR/FANGE/TAP|3.6|3.6||
125|A4431|A4431 - OST PCH URINE W BARRIER/TAPV|6.23|6.23||
125|A4430|A4430 - OST URINE PCH W B/BLTIN CONV|8.53|8.53||
125|A4429|A4429 - URINE OST POUCH W BLTINCONV|8.27|8.27||
125|A4428|A4428 - URINE OST POUCH W FAUCET/TAP|6.53|6.53||
125|A4427|A4427 - OST PCH DRAIN/BARR LK FLNG/F|2.8|2.8||
125|A4426|A4426 - OST PCH DRAIN 2 PIECE SYSTEM|2.74|2.74||
125|A4425|A4425 - OST PCH DRAIN FOR BARRIER FL|3.59|3.59||
125|A4424|A4424 - OST PCH DRAIN W BAR & FILTER|4.78|4.78||
125|A4423|A4423 - OST PCH FOR BAR W LK FL/FLTR|1.86|1.86||
125|A4422|A4422 - OST POUCH ABSORBENT MATERIAL|0.12|0.12||
125|A4421|A4421 - OSTOMY SUPPLY MISC|6|6||
125|A4420|A4420 - OST PCH CLSD FOR BAR W LK FL|0.82|0.82||
125|A4419|A4419 - OST PCH FOR BAR W FLANGE/FLT|1.74|1.74||
125|A4418|A4418 - OST PCH CLSD W/O BAR W FILTR|1.82|1.82||
125|A4417|A4417 - OST PCH W BAR/BLTINCONV/FLTR|3.73|3.73||
125|A4416|A4416 - OST PCH CLSD W BARRIER/FILTR|2.76|2.76||
125|A4415|A4415 - OST SKN BARR W/O CONV >4 SQI|6|6||
125|A4414|A4414 - OST SKNBAR W/O CONV<=4 SQ IN|4.93|4.93||
125|A4413|A4413 - 2 PC DRAINABLE OST POUCH|5.52|5.52||
125|A4412|A4412 - OST POUCH DRAIN HIGH OUTPUT|2.71|2.71||
125|A4411|A4411 - OST SKN BARR EXTND =4SQ|5.11|5.11||
125|A4410|A4410 - OST SKN BARR EXTND >4 SQ|9.06|9.06||
125|A4409|A4409 - OST SKN BARR CONVEX <=4 SQ I|6.23|6.23||
125|A4408|A4408 - EXT WEAR OST SKN BARR >4SQ''|9.89|9.89||
125|A4407|A4407 - EXT WEAR OST SKN BARR <=4SQ''|8.77|8.77||
125|A4406|A4406 - PECTIN BASED OSTOMY PASTE|5.74|5.74||
125|A4405|A4405 - NONPECTIN BASED OSTOMY PASTE|3.42|3.42||
125|A4404|A4404 - OSTOMY RING EACH|1.68|1.68||
125|A4402|A4402 - LUBRICANT PER OUNCE|1.36|1.36||
125|A4400|A4400 - OSTOMY IRRIGATION SET|41.62|41.62||
125|A4399|A4399 - OSTOMY IRRIG CONE/CATH W BRS|10.67|10.67||
125|A4398|A4398 - OSTOMY IRRIGATION BAG|12.7|12.7||
125|A4397|A4397 - IRRIGATION SUPPLY SLEEVE|4.42|4.42||
125|A4396|A4396 - PERISTOMAL HERNIA SUPPRT BLT|40.56|40.56||
125|A4395|A4395 - OSTOMY POUCH SOLID DEODORANT|0.05|0.05||
125|A4394|A4394 - OSTOMY POUCH LIQ DEODORANT|2.59|2.59||
125|A4393|A4393 - URINE PCH W EX WEAR BAR CONV|9.06|9.06||
125|A4392|A4392 - URINARY POUCH W ST WEAR BARR|8.2|8.2||
125|A4391|A4391 - URINARY POUCH W EX WEAR BARR|7.08|7.08||
125|A4390|A4390 - DRAINABLE PCH EX WEAR CONVEX|9.62|9.62||
125|A4389|A4389 - DRAINABLE PCH W ST WEAR BARR|6.23|6.23||
125|A4388|A4388 - DRAINABLE PCH W EX WEAR BARR|4.38|4.38||
125|A4387|A4387 - OST CLSD POUCH W ATT ST BARR|2.26|2.26||
125|A4385|A4385 - OST SKN BARRIER SLD EXT WEAR|5.11|5.11||
125|A4384|A4384 - OSTOMY FACEPLT/SILICONE RING|9.64|9.64||
125|A4383|A4383 - URINARY RUBBER POUCH W/O FP|28.25|28.25||
125|A4382|A4382 - URINARY HVY PLSTC PCH W/O FP|24.66|24.66||
125|A4381|A4381 - URINARY PLASTIC POUCH W/O FP|4.63|4.63||
125|A4380|A4380 - URINARY RUBBER POUCH W FCPLT|37.39|37.39||
125|A4379|A4379 - URINARY PLASTIC POUCH W FCPL|15.05|15.05||
125|A4378|A4378 - DRAINABLE RUBBER PCH W/O FP|30.8|30.8||
125|A4377|A4377 - DRAINABLE PLSTIC PCH W/O FP|4.31|4.31||
125|A4376|A4376 - DRAINABLE RUBBER PCH W FCPLT|47.69|47.69||
125|A4375|A4375 - DRAINABLE PLASTIC PCH W FCPL|17.21|17.21||
125|A4373|A4373 - SKIN BARRIER WITH FLANGE|6.29|6.29||
125|A4372|A4372 - SKIN BARRIER SOLID 4X4 EQUIV|4.2|4.2||
125|A4371|A4371 - SKIN BARRIER POWDER PER OZ|3.66|3.66||
125|A4369|A4369 - SKIN BARRIER LIQUID PER OZ|2.44|2.44||
125|A4368|A4368 - OSTOMY FILTER|0.25|0.25||
125|A4367|A4367 - OSTOMY BELT|6.76|6.76||
125|A4366|A4366 - OSTOMY VENT|1.3|1.3||
125|A4364|A4364 - ADHESIVE -  LIQUID OR EQUAL|2.51|2.51||
125|A4363|A4363 - OSTOMY CLAMP -  REPLACEMENT|2.02|2.02||
125|A4362|A4362 - SOLID SKIN BARRIER|2.95|2.95||
125|A4361|A4361 - OSTOMY FACE PLATE|16.15|16.15||
125|A4360|A4360 - DISPOSABLE EXT URETHRAL DEV|0.49|0.49||
125|A4358|A4358 - URINARY LEG OR ABDOMEN BAG|6.5|6.5||
125|A4357|A4357 - BEDSIDE DRAINAGE BAG|8.27|8.27||
125|A4356|A4356 - EXT URETH CLMP OR COMPR DVC|45.71|45.71||
125|A4355|A4355 - BLADDER IRRIGATION TUBING|8.14|8.14||
125|A4354|A4354 - CATH INSERTION TRAY W/BAG|10.06|10.06||
125|A4353|A4353 - INTERMITTENT URINARY CATH|7.01|7.01||
125|A4352|A4352 - COUDE TIP URINARY CATHETER|6.32|6.32||
125|A4351|A4351 - STRAIGHT TIP URINE CATHETER|1.81|1.81||
125|A4349|A4349 - DISPOSABLE MALE EXTERNAL CAT|2.03|2.03||
125|A4346|A4346 - CATH INDW FOLEY 3 WAY|16.68|16.68||
125|A4344|A4344 - CATH INDW FOLEY 2 WAY SILICN|13.63|13.63||
125|A4340|A4340 - INDWELLING CATHETER SPECIAL|27.17|27.17||
125|A4338|A4338 - INDWELLING CATHETER LATEX|10.44|10.44||
125|A4336|A4336 - URETHRAL INSERT|1.44|1.44||
125|A4334|A4334 - URINARY CATH LEG STRAP|4.93|4.93||
125|A4333|A4333 - URINARY CATH ANCHOR DEVICE|2.22|2.22||
125|A4332|A4332 - LUBE STERILE PACKET|0.12|0.12||
125|A4331|A4331 - EXTENSION DRAINAGE TUBING|3.19|3.19||
125|A4330|A4330 - STOOL COLLECTION POUCH|7.18|7.18||
125|A4328|A4328 - FEM URINARY COLLECT POUCH|10.25|10.25||
125|A4327|A4327 - FEM URINARY COLLECT DEV CUP|44.7|44.7||
125|A4326|A4326 - MALE EXTERNAL CATHETER|10.81|10.81||
125|A4322|A4322 - IRRIGATION SYRINGE|2.98|2.98||
125|A4321|A4321 - CATH THERAPEUTIC IRRIG AGENT|1.57|1.57||
125|A4320|A4320 - IRRIGATION TRAY|4.74|4.74||
125|A4316|A4316 - CATH W/DRAINAGE 3-WAY|28.45|28.45||
125|A4315|A4315 - CATH W/DRAINAGE 2-WAY SILCNE|22.46|22.46||
125|A4314|A4314 - CATH W/DRAINAGE 2-WAY LATEX|23.39|23.39||
125|A4313|A4313 - CATHETER W/BAG 3-WAY|15.78|15.78||
125|A4312|A4312 - CATH W/O BAG 2-WAY SILICONE|15.36|15.36||
125|A4311|A4311 - CATHETER W/O BAG 2-WAY LATEX|14.86|14.86||
125|A4310|A4310 - INSERT TRAY W/O BAG/CATH|6.95|6.95||
125|A4306|A4306 - DRUG DELIVERY SYSTEM <=50 ML|10.45|10.45||
125|A4305|A4305 - DRUG DELIVERY SYSTEM >=50 ML|7.55|7.55||
125|A4301|A4301 - IMPLANTABLE ACCESS SYST PERC|38.62|38.62||
125|A4300|A4300 - CATH IMPL VASC ACCESS PORTAL|20.64|20.64||
125|A4290|A4290 - SACRAL NERVE STIM TEST LEAD|69.2|69.2||
125|A4286|A4286 - REPLCMNT BREASTPUMP LOK RING|12|12||
125|A4285|A4285 - REPLCMNT BREAST PUMP BOTTLE|15|15||
125|A4284|A4284 - REPLCMNT BREAST PUMP SHIELD|10.16|9.6|9.6|
125|A4283|A4283 - REPLACEMENT BREASTPUMP CAP|12|12||
125|A4282|A4282 - REPLACEMENT BREASTPUMP ADPT|24|24||
125|A4281|A4281 - REPLACEMENT BREASTPUMP TUBE|24|24||
125|A4280|A4280 - BRST PRSTHS ADHSV ATTCHMNT|5.35|5.35||
125|A4270|A4270 - DISPOSABLE ENDOSCOPE SHEATH|9.83|9.83||
125|A4269|A4269 - SPERMICIDE|0.58|0.58||
125|A4268|A4268 - FEMALE CONDOM|0.53|0.53||
125|A4267|A4267 - MALE CONDOM|0.29|0.29||
125|A4266|A4266 - DIAPHRAGM|33.23|33.23||
125|A4265|A4265 - PARAFFIN|3.41|3.41||
125|A4264|A4264 - INTRATUBAL OCCLUSION DEVICE|1627.2|1627.2||
125|A4263|A4263 - PERMANENT TEAR DUCT PLUG|23.23|23.23||
125|A4262|A4262 - TEMPORARY TEAR DUCT PLUG|0.29|0.29||
125|A4261|A4261 - CERVICAL CAP CONTRACEPTIVE|35.77|35.77||
125|A4259|A4259 - LANCETS PER BOX|1.28|1.28||
125|A4258|A4258 - LANCET DEVICE EACH|1.91|1.91||
125|A4257|A4257 - REPLACE LENSSHIELD CARTRIDGE|12.78|12.78||
125|A4256|A4256 - CALIBRATOR SOLUTION/CHIPS|3.05|3.05||
125|A4255|A4255 - GLUCOSE MONITOR PLATFORMS|4.06|4.06||
125|A4253|A4253 - BLOOD GLUCOSE/REAGENT STRIPS|7.49|7.49||
125|A4252|A4252 - BLOOD KETONE TEST OR STRIP|3.89|3.89||
125|A4250|A4250 - URINE REAGENT STRIPS/TABLETS|10.16|10.16||
125|A4248|A4248 - CHLORHEXIDINE ANTISEPT|1.5|1.5||
125|A4247|A4247 - BETADINE/IODINE SWABS/WIPES|2.62|2.62||
125|A4246|A4246 - BETADINE/PHISOHEX SOLUTION|1.74|1.74||
125|A4245|A4245 - ALCOHOL WIPES PER BOX|1.74|1.74||
125|A4244|A4244 - ALCOHOL OR PEROXIDE PER PINT|0.58|0.58||
125|A4236|A4236 - SILVR OXIDE BATT GLUCOSE MON|1.04|1.04||
125|A4235|A4235 - LITHIUM BATT FOR GLUCOSE MON|0.9|0.9||
125|A4234|A4234 - J-CELL BATT FOR GLUCOSE MON|2.12|2.12||
125|A4233|A4233 - ALKALIN BATT FOR GLUCOSE MON|0.46|0.46||
125|A4232|A4232 - SYRINGE W/NEEDLE INSULIN 3CC|1.1|1.1||
125|A4231|A4231 - INFUSION INSULIN PUMP NEEDLE|11.04|11.04||
125|A4230|A4230 - INFUS INSULIN PUMP NON NEEDL|14.4|14.4||
125|A4225|A4225 - SUP/EXT INSULIN INF PUMP SYR|2.34|2.34||
125|A4224|A4224 - SUPPLY INSULIN INF CATH/WK|17.46|17.46||
125|A4223|A4223 - INFUSION SUPPLIES W/O PUMP|24|24||
125|A4222|A4222 - INFUSION SUPPLIES WITH PUMP|33.11|33.11||
125|A4221|A4221 - SUPP NON-INSULIN INF CATH/WK|17.46|17.46||
125|A4220|A4220 - INFUSION PUMP REFILL KIT|24|24||
125|A4218|A4218 - STERILE SALINE OR WATER|2.1|2.1||
125|A4217|A4217 - STERILE WATER/SALINE -  500 ML|3.14|1.44|1.44|
125|A4216|A4216 - STERILE WATER/SALINE -  10 ML|0.44|0.2|0.2|0.2
125|A4215|A4215 - STERILE NEEDLE|0.18|0.18||
125|A4213|A4213 - 20+ CC SYRINGE ONLY|0.58|0.58||
125|A4212|A4212 - NON CORING NEEDLE OR STYLET|4.93|4.93||
125|A4211|A4211 - SUPP FOR SELF-ADM INJECTIONS|3|3||3
125|A4210|A4210 - NONNEEDLE INJECTION DEVICE|501.19|501.19||
125|A4209|A4209 - 5+ CC STERILE SYRINGE&NEEDLE|0.29|0.18|0.18|
125|A4208|A4208 - 3 CC STERILE SYRINGE&NEEDLE|0.29|0.18|0.18|
125|A4207|A4207 - 2 CC STERILE SYRINGE&NEEDLE|0.18|0.18||
125|A4206|A4206 - 1 CC STERILE SYRINGE&NEEDLE|0.29|0.18|0.18|
125|A0998|A0998 - AMBULANCE RESPONSE/TREATMENT|120.55|120.55||
125|A0888|A0888 - NONCOVERED AMBULANCE MILEAGE|15.44|15.44||
125|A0436|A0436 - ROTARY WING AIR MILEAGE|69.73|69.73||
125|A0435|A0435 - FIXED WING AIR MILEAGE|24.58|24.58||
125|A0434|A0434 - SPECIALTY CARE TRANSPORT|1057.27|1057.27||
125|A0433|A0433 - ALS 2|827.64|827.64||
125|A0432|A0432 - PI VOLUNTEER AMBULANCE CO|351.97|351.97||
125|A0431|A0431 - ROTARY WING AIR TRANSPORT|8119.27|8119.27||
125|A0430|A0430 - FIXED WING AIR TRANSPORT|2690.08|2690.08||
125|A0429|A0429 - BLS-EMERGENCY|232|232||
125|A0428|A0428 - BLS|223.63|223.63||
125|A0427|A0427 - ALS1-EMERGENCY|267.3|267.3||
125|A0426|A0426 - ALS 1|254.29|254.29||
125|A0425|A0425 - GROUND MILEAGE|4.96|4.96||
125|A0424|A0424 - EXTRA AMBULANCE ATTENDANT|304.32|304.32||
125|A0422|A0422 - AMBULANCE 02 LIFE SUSTAINING|25.4|25.4||
125|A0420|A0420 - AMBULANCE WAITING 1/2 HR|34.3|34.3||
125|A0398|A0398 - ALS ROUTINE DISPOSBLE SUPPLS|6.82|6.82||
125|A0396|A0396 - ALS ESOPHAGEAL INTUB SUPPLS|27.25|27.25||
125|A0394|A0394 - ALS IV DRUG THERAPY SUPPLIES|16.42|16.42||
125|A0392|A0392 - ALS DEFIBRILLATION SUPPLIES|34.38|34.38||
125|A0390|A0390 - ADVANCED LIFE SUPPORT MILEAG|4.96|4.96||
125|A0384|A0384 - BLS DEFIBRILLATION SUPPLIES|34.38|34.38||
125|A0382|A0382 - BASIC SUPPORT ROUTINE SUPPLS|6.82|6.82||
125|A0380|A0380 - BASIC LIFE SUPPORT MILEAGE|4.96|4.96||
125|A0225|A0225 - NEONATAL EMERGENCY TRANSPORT|335.14|335.14||
125|A0210|A0210 - NONER TRANSPORT MEALS ESCORT|5.11|5.11||
125|A0200|A0200 - NONER TRANSPORT LODGNG ESCRT|45.62|45.62||
125|A0190|A0190 - NONER TRANSPORT MEALS RECIP|11.47|11.47||
125|A0180|A0180 - NONER TRANSPORT LODGNG RECIP|0.22|0.22||
125|A0160|A0160 - NONER TRANSPORT CASE WORKER|0.31|0.31||
125|A0140|A0140 - NONEMERGENCY TRANSPORT AIR|513.85|513.85||
125|A0130|A0130 - NONER TRANSPORT WHEELCH VAN|5.62|5.62||
125|A0120|A0120 - NONER TRANSPORT MINI-BUS|30.08|30.08||
125|A0110|A0110 - NONEMERGENCY TRANSPORT BUS|12.23|12.23||
125|A0100|A0100 - NONEMERGENCY TRANSPORT TAXI|4.98|4.98||
125|A0090|A0090 - INTEREST ESCORT IN NON ER|0.22|0.22||
125|A0080|A0080 - NONINTEREST ESCORT IN NON ER|1.7|1.7||
125|A0021|A0021 - OUTSIDE STATE AMBULANCE SERV|5.88|5.88||
125|99607|99607 - MEDICATION THERAPY EACH ADDITIONAL 15 MIN(11/19)|49.38|49.38||
125|99606|99606 - MEDICATION THERAPY INITIAL 15 MIN ESTABLISHED PT|52.3|52.3||
125|99605|99605 - MEDICATION THERAPY INITIAL 15 MIN NEW PATIENT|82.27|82.27||
125|99602|99602 - HOME NFS/SPECTY DRUG ADMN PR VST </2 HR EA HR|36|36||
125|99601|99601 - HOME NFS/SPECTY DRUG ADMN PR VST </2 HR|72|72||
125|99600|99600 - UNLISTED HOME VISIT SERVICE/PROCEDURE|30|30||
125|99512|99512 - HOME VISIT HEMODIALYSIS|30|30||
125|99511|99511 - HOME VISIT FECAL IMPACTION MGMT&ENEMA ADMN|30|30||
125|99510|99510 - HOME VISIT INDIV FAM/MARRIAGE COUNSELING|80.84|80.84||
125|99509|99509 - HOME VISIT ASSISTANCE DAILY LIV&PRSONAL CARE|12|12||
125|99507|99507 - HOME VISIT CARE&MAINT CATH|30|30||
125|99506|99506 - HOME VISIT INTRAMUSCULAR INJECTIONS|30|30||
125|99505|99505 - HOME VISIT STOMA CARE&MAINT CLST&CSTOST|30|30||
125|99504|99504 - HOME VISIT MECHANICAL VENTILATION CARE|30|30||
125|99503|99503 - HOME VISIT RESPIRATORY THERAPY CARE|30|30||
125|99502|99502 - HOME VISIT NEWBORN CARE & ASSESSMENT|60|60||
125|99501|99501 - HOME VISIT POSTNATAL ASSMT&F-UP CARE|60|60||
125|99500|99500 - HOME VISIT PRENATAL MONITORING & ASSESSMENT|60|60||
125|99498|99498 - ADVANCE CARE PLANNING EA ADDL 30 MINS|120.52|120.52||
125|99497|99497 - ADVANCE CARE PLANNING FIRST 30 MINS|135.99|135.99||
125|99496|99496 - TRANSITIONAL CARE MANAGE SRVC 7 DAY DISCHARGE|366.7|366.7||
125|99495|99495 - TRANSITIONAL CARE MANAGE SRVC 14 DAY DISCHARGE|258.6|258.6||
125|99494|99494 - 1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS|102.97|102.97||
125|99493|99493 - SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS|198.94|198.94||
125|99492|99492 - 1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS|247.53|247.53||
125|99490|99490 - CHRON CARE MANAGEMENT SRVC 20 MIN PER MONTH|66.8|66.8||
125|99489|99489 - CMPLX CHRON CARE MGMT EA ADDL 30 MIN PER MONTH|72.37|72.37||
125|99487|99487 - CMPLX CHRON CARE MGMT W/O PT VST 1ST HR PER MO|145.28|145.28||
125|99486|99486 - SUPERVISION INTERFACILITY TRANSPORT ADDL 30 MIN|108.23|108.23||
125|99485|99485 - SUPERVISION INTERFACILITY TRANSPORT INIT 30 MIN|124.29|124.29||
125|99484|99484 - CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS|75.24|75.24||
125|99483|99483 - ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT|376.92|376.92||
125|99480|99480 - SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS|194.59|194.59||
125|99479|99479 - SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS|202.14|202.14||
125|99478|99478 - SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS|222.82|222.82||
125|99477|99477 - INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL|567.27|567.27||
125|99476|99476 - SUBSEQUENT PED CRITICAL CARE 2 THRU 5 YEARS|561.34|561.34||
125|99475|99475 - INITIAL PED CRITICAL CARE 2 THRU 5 YEARS|911.22|911.22||
125|99472|99472 - SUBSQ PED CRITICAL CARE 29 DAYS THRU 24 MO|669.39|669.39||
125|99471|99471 - INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS|1294.07|1294.07||
125|99469|99469 - SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<|647.08|647.08||
125|99468|99468 - 1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<|1495.04|1495.04||
125|99467|99467 - CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN|194.05|194.05||
125|99466|99466 - CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN|388.05|388.05||
125|99465|99465 - DELIVERY/BIRTHING ROOM RESUSCITATION|237.18|237.18||
125|99464|99464 - ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN|121.74|121.74||
125|99463|99463 - 1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT|179.69|179.69||
125|99462|99462 - SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN|67.74|67.74||
125|99461|99461 - 1ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER|143.86|143.86||
125|99460|99460 - 1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB|155.57|155.57||
125|99456|99456 - WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS|100.41|100.41||
125|99455|99455 - WORK RELATED/MED DBLT XM TREATING PHYS|100.41|100.41||
125|99450|99450 - BASIC LIFE AND/OR DISABILITY EXAMINATION|13.82|13.82||
125|99449|99449 - NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN|116.2|116.2||
125|99448|99448 - NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN|87.03|87.03||
125|99447|99447 - NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN|57.83|57.83||
125|99446|99446 - NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN|29.18|29.18||
125|99444|99444 - PHYS/QHP ONLINE EVALUATION & MANAGEMENT SERVICE|36|36||
125|99443|99443 - PHYS/QHP TELEPHONE EVALUATION 21-30 MIN|63.93|63.93||
125|99442|99442 - PHYS/QHP TELEPHONE EVALUATION 11-20 MIN|43.36|43.36||
125|99441|99441 - PHYS/QHP TELEPHONE EVALUATION 5-10 MIN|22.69|22.69||
125|99433|99433 - NORMAL NEWBORN CARE/HOSPITAL|67.95|67.95||
125|99432|99432 - NEWBORN CARE -  NOT IN HOSP|115.51|115.51||
125|99431|99431 - INITIAL CARE -  NORMAL NEWBORN|128.73|128.73||
125|99416|99416 - PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN|6.86|6.86||
125|99415|99415 - PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR|14.87|14.87||
125|99412|99412 - PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M|86.45|86.45||
125|99411|99411 - PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M|48.93|48.93||
125|99409|99409 - ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN|110.86|110.86||
125|99408|99408 - ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN|57.02|57.02||
125|99407|99407 - TOBACCO USE CESSATION INTENSIVE >10 MINUTES|45.05|45.05||
125|99406|99406 - TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES|23.26|23.26||
125|99404|99404 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN|155.27|155.27||
125|99403|99403 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN|116.45|116.45||
125|99402|99402 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN|77.64|77.64||
125|99401|99401 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN|42.03|42.03||
125|99397|99397 - PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER|234.74|234.74||
125|99396|99396 - PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS|234.74|234.74||
125|99395|99395 - PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS|234.74|234.74||
125|99394|99394 - PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS|108.53|108.53||
125|99393|99393 - PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS|134.34|134.34||
125|99392|99392 - PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS|99.03|99.03||
125|99391|99391 - PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y|91.54|91.54||
125|99387|99387 - INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>|171.54|171.54||
125|99386|99386 - INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS|170.12|170.12||
125|99385|99385 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS|166.6|166.6||
125|99384|99384 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR|234.74|234.74||
125|99383|99383 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS|234.74|234.74||
125|99382|99382 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS|234.74|234.74||
125|99381|99381 - INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR|114.15|114.15||
125|99380|99380 - SUPERVISION NURS FACILITY PATIENT MONTH 30 MIN/>|123.09|123.09||
125|99379|99379 - SUPERVISION NURS FACILITY PATIENT MO 15-29 MIN|88.64|88.64||
125|99378|99378 - SUPERVISION HOSPICE PATIENT/MONTH 30 MINUTES/>|142.29|142.29||
125|99377|99377 - SUPERVISION HOSPICE PATIENT/MONTH 15-29 MIN|88.64|88.64||
125|99375|99375 - SUPERVISION PT HOME HEALTH AGENCY MONTH 30 MIN/>|128.33|128.33||
125|99374|99374 - SUPVJ PT HOME HEALTH AGENCY MO 15-29 MINUTES|88.64|88.64||
125|99368|99368 - TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN|59.54|59.54||
125|99367|99367 - TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN|91.64|91.64||
125|99366|99366 - TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN|69.19|69.19||
125|99364|99364 - ANTICOAGULANT MGMT OUTPATIENT EA SBSQ 90 DAYS|46.12|46.12||
125|99363|99363 - ANTICOAGULANT MGMT OUTPATIENT INIT 90 DAYS|134.47|134.47||
125|99360|99360 - PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES|132.22|132.22||
125|99359|99359 - PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MINUTES|96.96|96.96||
125|99358|99358 - PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR|193.91|193.91||
125|99357|99357 - PROLONGED SVC I/P REQ UNIT/FLOOR TIME EA 30 MIN|119.71|119.71||
125|99356|99356 - PROLONGED SERVICE I/P REQ UNIT/FLOOR TIME 1ST HR|129.58|129.58||
125|99355|99355 - PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON ADDL 30|133.8|133.8||
125|99354|99354 - PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON 1ST HR|133.8|133.8||
125|99350|99350 - HOME VST EST PT UNSTABLE/SIGNIF NEW PROB 60 MINS|214.41|214.41||
125|99349|99349 - HOME VISIT EST PT MOD-HI SEVERITY 40 MINUTES|145.05|145.05||
125|99348|99348 - HOME VISIT EST PT LOW-MOD SEVERITY 25 MINUTES|93.48|93.48||
125|99347|99347 - HOME VISIT EST PT SELF LIMITED/MINOR 15 MINUTES|58.83|58.83||
125|99345|99345 - HOME VISIT NEW PT UNSTABL/SIGNIF NEW PROB 75 MIN|265.47|265.47||
125|99344|99344 - HOME VISIT NEW PATIENT HI SEVERITY 60 MINUTES|214.41|214.41||
125|99343|99343 - HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES|163.28|163.28||
125|99342|99342 - HOME VISIT NEW PATIENT MOD SEVERITY 30 MINUTES|111.76|111.76||
125|99341|99341 - HOME VISIT NEW PATIENT LOW SEVERITY 20 MINUTES|75.7|75.7||
125|99340|99340 - INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>|173.74|173.74||
125|99339|99339 - INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 15-29 MIN|123.65|123.65||
125|99337|99337 - DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES|197.55|197.55||
125|99336|99336 - DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES|134.28|134.28||
125|99335|99335 - DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES|87.01|87.01||
125|99334|99334 - DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES|54.97|54.97||
125|99333|99333 - REST HOME VST -  ESTAB PT - HIGH COMPLX|73.8|73.8||
125|99332|99332 - REST HOME VST -  ESTAB PT -  MOD COMPLX|59.48|59.48||
125|99331|99331 - REST HOME VST -  ESTAB PT -  LOW COMPLX|46.56|46.56||
125|99328|99328 - DOM/R-HOME E/M NEW PT SIGNIF NEW PROB 75 MINUTES|245.61|245.61||
125|99327|99327 - DOMICIL/REST HOME NEW PT VISIT HI SEVER 60 MIN|198.46|198.46||
125|99326|99326 - DOMICIL/REST HOME NEW PT HI-MOD SEVER 45 MINUTES|150.74|150.74||
125|99325|99325 - DOMICIL/REST HOME NEW PT VISIT MOD SEVER 30 MIN|104.5|104.5||
125|99324|99324 - DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN|71.48|71.48||
125|99323|99323 - REST HOME VST -  NEW PT -  HIGH COMPLEX|93.37|93.37||
125|99322|99322 - REST HOME VST -  NEW PT -  MOD COMPLEX|74.8|74.8||
125|99321|99321 - REST HOME VST -  NEW PT -  LOW COMPLEX|53.08|53.08||
125|99318|99318 - E/M ANNUAL NURSING FACILITY ASSESS STABLE 30 MIN|80.3|80.3||
125|99316|99316 - NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES|106.68|106.68||
125|99315|99315 - NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES|80.49|80.49||
125|99313|99313 - SBSQ NURSING FAC CARE -  HIGH COMPLEX|103.46|103.46||
125|99312|99312 - SBSQ NURSING FAC CARE -  MOD COMPLEX|75.11|75.11||
125|99311|99311 - SBSQ NURSING FAC CARE -  LOW COMPLEX|50.61|50.61||
125|99310|99310 - SBSQ NURS FACIL CARE/DAY UNSTABL/NEW PROB 35 MIN|121.4|121.4||
125|99309|99309 - SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN|97.06|97.06||
125|99308|99308 - SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN|69.1|69.1||
125|99307|99307 - SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN|41.76|41.76||
125|99306|99306 - INITIAL NURSING FACILITY CARE/DAY 45 MINUTES|131.49|131.49||
125|99305|99305 - INITIAL NURSING FACILITY CARE/DAY 35 MINUTES|106.84|106.84||
125|99304|99304 - INITIAL NURSING FACILITY CARE/DAY 25 MINUTES|80.3|80.3||
125|99303|99303 - NURSING FACILITY CARE -  HIGH COMPLEX|181.3|181.3||
125|99302|99302 - NURSING FACILITY CARE -  MOD COMPLEX|119.55|119.55||
125|99301|99301 - NURSING FACILITY CARE -  LOW COMPLEX|86.32|86.32||
125|99300|99300 - IC -  INFANT PBW 2501-5000 GM|214.82|214.82||
125|99299|99299 - IC -  LBW INFANT 1500-2500 GM|174.39|174.39||
125|99298|99298 - IC FOR LBW INFANT < 1500 GM|190.31|190.31||
125|99296|99296 - NEONATE CRITICAL CARE SUBSEQ|538.5|538.5||
125|99292|99292 - CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN|147.68|147.68||
125|99291|99291 - CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN|330.04|330.04||
125|99288|99288 - PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS|61.03|61.03||
125|99285|99285 - EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ|224.69|224.69||
125|99284|99284 - EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY|143.37|143.37||
125|99283|99283 - EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY|93.08|93.08||
125|99282|99282 - EMERGENCY DEPARTMENT VISIT LOW/MODER SEVERITY|50.28|50.28||
125|99281|99281 - EMERGENCY DEPARTMENT VISIT LIMITED/MINOR PROB|33.16|33.16||
125|99275|99275 - CONFIRMATORY CONSULT -  HIGH COMPLEX|239.09|239.09||
125|99274|99274 - CONFIRMATORY CONSULT -  MOD COMPLEX|176.74|176.74||
125|99273|99273 - CONFIRMATORY CONSULT -  LOW COMPLEX|132.35|132.35||
125|99272|99272 - CONFIRMATORY CONSULT -  EXP PROB|96.15|96.15||
125|99271|99271 - CONFIRMATORY CONSULT -  PROB FOC|67.45|67.45||
125|99263|99263 - FOLLOWUP INPT CONSULT -  HIGH COMPLEX|112.6|112.6||
125|99262|99262 - FOLLOWUP INPT CONSULT -  MOD COMPLEX|75.66|75.66||
125|99261|99261 - FOLLOWUP INPT CONSULT -  LOW COMPLEX|45.56|45.56||
125|99255|99255 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN|275.42|275.42||
125|99254|99254 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 80 MIN|206.98|206.98||
125|99253|99253 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 55 MIN|164.22|164.22||
125|99252|99252 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 40 MIN|116.31|116.31||
125|99251|99251 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 20 MIN|72.52|72.52||
125|99245|99245 - OFFICE CONSULTATION NEW/ESTAB PATIENT 80 MIN|287.4|287.4||
125|99244|99244 - OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN|221.74|221.74||
125|99243|99243 - OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN|156.94|156.94||
125|99242|99242 - OFFICE CONSULTATION NEW/ESTAB PATIENT 30 MIN|117.71|117.71||
125|99241|99241 - OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN|75.99|75.99||
125|99239|99239 - HOSPITAL DISCHARGE DAY MANAGEMENT > 30 MIN|168.71|168.71||
125|99238|99238 - HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<|94.96|94.96||
125|99236|99236 - OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES|291.93|291.93||
125|99235|99235 - OBSERVATION/INPATIENT HOSPITAL CARE 50 MINUTES|259.59|259.59||
125|99234|99234 - OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES|200.4|200.4||
125|99233|99233 - SBSQ HOSPITAL CARE/DAY 35 MINUTES|112.15|112.15||
125|99232|99232 - SBSQ HOSPITAL CARE/DAY 25 MINUTES|78.7|78.7||
125|99231|99231 - SBSQ HOSPITAL CARE/DAY 15 MINUTES|53.07|53.07||
125|99226|99226 - SBSQ OBSERVATION CARE/DAY 35 MINUTES|169.86|169.86||
125|99225|99225 - SBSQ OBSERVATION CARE/DAY 25 MINUTES|118.35|118.35||
125|99224|99224 - SBSQ OBSERVATION CARE/DAY 15 MINUTES|64.73|64.73||
125|99223|99223 - INITIAL HOSPITAL CARE/DAY 70 MINUTES|216.48|216.48||
125|99222|99222 - INITIAL HOSPITAL CARE/DAY 50 MINUTES|168.5|168.5||
125|99221|99221 - INITIAL HOSPITAL CARE/DAY 30 MINUTES|103.46|103.46||
125|99220|99220 - INITIAL OBSERVATION CARE/DAY 70 MINUTES|207.31|207.31||
125|99219|99219 - INITIAL OBSERVATION CARE/DAY 50 MINUTES|164.08|164.08||
125|99218|99218 - INITIAL OBSERVATION CARE/DAY 30 MINUTES|103.53|103.53||
125|99217|99217 - OBSERVATION CARE DISCHARGE MANAGEMENT|94.32|94.32||
125|99215|99215 - OFFICE OUTPATIENT VISIT 40 MINUTES|158.49|158.49||
125|99214|99214 - OFFICE OUTPATIENT VISIT 25 MINUTES|108.23|108.23||
125|99213|99213 - OFFICE OUTPATIENT VISIT 15 MINUTES|68.81|68.81||
125|99212|99212 - OFFICE OUTPATIENT VISIT 10 MINUTES|50.26|50.26||
125|99211|99211 - OFFICE OUTPATIENT VISIT 5 MINUTES|27.55|27.55||
125|99205|99205 - OFFICE OUTPATIENT NEW 60 MINUTES|223.1|223.1||
125|99204|99204 - OFFICE OUTPATIENT NEW 45 MINUTES|175.7|175.7||
125|99203|99203 - OFFICE OUTPATIENT NEW 30 MINUTES|123.83|123.83||
125|99202|99202 - OFFICE OUTPATIENT NEW 20 MINUTES|83.03|83.03||
125|99201|99201 - OFFICE OUTPATIENT NEW 10 MINUTES|46.67|46.67||
125|99199|99199 - UNLISTED SPECIAL SERVICE PROCEDURE/REPORT|31.9|31.9||
125|99195|99195 - PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE|30.12|30.12||
125|99192|99192 - ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH 30 MI|478.51|478.51||
125|99191|99191 - ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH 45 MI|717.37|717.37||
125|99190|99190 - ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH EA HR|957.02|957.02||
125|99188|99188 - APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP|19.76|19.76||
125|99184|99184 - INITIAT SELECTIVE HEAD/BODY HYPOTHERMIA NEONATE|363.03|363.03||
125|99183|99183 - PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION|268.08|268.08||
125|99177|99177 - INSTRUMENT BASED OCULAR SCR BI W/ONSITE ANALYSIS|7.48|7.48||
125|99175|99175 - IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED|62.6|62.6||
125|99174|99174 - INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT|9.06|9.06||
125|99173|99173 - SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT|33.34|33.34||
125|99172|99172 - VISUAL FUNCT SCRNG AUTO SEMI-AUTO BI QUAN DETERM|41.18|41.18||3.43
125|99170|99170 - ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG|156.78|156.78||
125|99157|99157 - MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS|95.05|95.05||
125|99156|99156 - MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS|124.73|124.73||
125|99155|99155 - MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS|157.23|157.23||
125|99153|99153 - MOD SED SAME PHYS/QHP EACH ADDL 15 MINS|16.46|16.46||
125|99152|99152 - MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS|78.81|78.81||
125|99151|99151 - MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS|119.53|119.53||
125|99142|99142 - SEDATION CONSCIOUS -  ORL RECT INTNAS|152.71|152.71||
125|99141|99141 - SEDATION -  CONSCIOUS -  IV -  IM -  INH|177.14|177.14||
125|99140|99140 - ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY|63.79|63.79||
125|99135|99135 - ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION|36|36||
125|99116|99116 - ANES COMPLICJ UTILIZATION TOTAL BODY HYPOTHERMIA|36|36||
125|99100|99100 - ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<|31.9|31.9||
125|99091|99091 - COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D|93.22|93.22||
125|99090|99090 - ANALYSIS CLINICAL DATA STORED IN COMPUTERS|0.01|0.01||
125|99082|99082 - UNUSUAL TRAVEL|28.22|28.22||
125|99080|99080 - SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG|99.55|99.55||
125|99078|99078 - PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING|17.63|17.63||
125|99075|99075 - MEDICAL TESTIMONY|211.73|211.73||
125|99071|99071 - EDUCATIONAL SUPPLIES PRV BY THE PHYS AT COST|42.93|42.93||
125|99070|99070 - SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP|32.1|32.1||32.1
125|99060|99060 - SVC PRV EMER OUT OFFICE DISRUPTS OFFICE SVC|12|12||
125|99058|99058 - SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS|47.49|47.49||
125|99056|99056 - SVC TYPICAL PRV OFFICE PRV OUT OFFICE REQUEST PT|51.14|51.14||
125|99054|99054 - MEDICAL SERVICES ON SUNDAY/HOLIDAY|39.11|39.11||
125|99053|99053 - SERVICES PROVIDED BTW 10 PM&8 AM AT 24-HR FACI|12|12||
125|99052|99052 - MEDICAL SERVICES AT NIGHT|39.11|39.11||
125|99051|99051 - SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS|12|12||
125|99050|99050 - SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS|26.65|26.65||
125|99027|99027 - HOSPITAL MANDATED CALL SVC OUT-OF-HOSPITAL EA HR|46.72|46.72||
125|99026|99026 - HOSPITAL MANDATED CALL SERVICE IN-HOSPITAL EA HR|46.72|46.72||
125|99024|99024 - POSTOP FOLLOW UP VISIT RELATED TO ORIGINAL PX|48.19|48.19||
125|99002|99002 - HANDLE/CONVEY/ANY OTH SVC DEVICE FIT PHYS/QHP|19.76|19.76||
125|99001|99001 - HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB|8.67|8.67||
125|99000|99000 - HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB|7.91|7.91||
125|98969|98969 - NONPHYSICIAN ONLINE ASSESSMENT AND MANAGEMENT|36|36||
125|98968|98968 - NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN|63.93|63.93||
125|98967|98967 - NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN|43.36|43.36||
125|98966|98966 - NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN|22.69|22.69||
125|98962|98962 - EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS|14.87|14.87||
125|98961|98961 - EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS|20.67|20.67||
125|98960|98960 - EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT|41.87|41.87||
125|98943|98943 - CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION|27.86|27.86||
125|98942|98942 - CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS|53.54|53.54||
125|98941|98941 - CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS|47.67|47.67||
125|98940|98940 - CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS|34.83|34.83||
125|98929|98929 - OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS|79.47|79.47||
125|98928|98928 - OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS|73.33|73.33||
125|98927|98927 - OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS|63.06|63.06||
125|98926|98926 - OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS|42.26|42.26||
125|98925|98925 - OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS|30.48|30.48||
125|97814|97814 - ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ|23.48|23.48||
125|97813|97813 - ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN|27.53|27.53||
125|97811|97811 - ACUPUNCTURE 1/> NDLS W/O ELEC STIMJ EA 15 MIN|21.45|21.45||
125|97810|97810 - ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN|25.51|25.51||
125|97804|97804 - MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI|7.15|7.15||
125|97803|97803 - MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M|17.21|17.21||
125|97802|97802 - MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI|17.21|17.21||
125|97763|97763 - ORTHOTICS/PROSTH MGMT &/TRAING SBSQ ENCTR 15 MIN|75.32|75.32||
125|97762|97762 - CHECKOUT ORTHOTIC/PROSTHETIC ESTAB PT EA 15 MIN|45.41|45.41||
125|97761|97761 - PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS|45.16|45.16||
125|97760|97760 - ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS|49.92|49.92||
125|97755|97755 - ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN|40.95|40.95||
125|97750|97750 - PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN|39.94|39.94||
125|97703|97703 - ORTHOTIC/PROSTHETIC CHECKOUT|25.58|25.58||
125|97610|97610 - LOW FREQUENCY NON-THERMAL ULTRASOUND PER DAY|202.22|202.22||
125|97608|97608 - NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM|47.3|47.3||
125|97607|97607 - NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM|42.85|42.85||
125|97606|97606 - NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM|81.84|81.84||
125|97605|97605 - NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM|69.41|69.41||
125|97602|97602 - RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS|14.24|14.24||
125|97598|97598 - DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM|62.65|62.65||
125|97597|97597 - DEBRIDEMENT OPEN WOUND 20 SQ CM/<|49.08|49.08||
125|97546|97546 - WORK HARDENING/CONDITIONING EACH HOUR|59.98|59.98||
125|97545|97545 - WORK HARDENING/CONDITIONING 1ST 2 HR|150.4|150.4||
125|97542|97542 - WHEELCHAIR MGMT EA 15 MIN|28.65|28.65||
125|97537|97537 - COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN|30.39|30.39||
125|97535|97535 - SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES|37.72|37.72||
125|97533|97533 - SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES|26.81|26.81||
125|97532|97532 - DEVELOPMENT OF COGNITIVE SKILLS EACH 15 MINUTES|25.44|25.44||
125|97530|97530 - THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN|35.9|35.9||
125|97520|97520 - PROSTH TRAIN -  EXTREMITIES - EA 15 MIN|40.12|40.12||
125|97504|97504 - ORTHOTICS FIT/TRAIN -  EA 15 MIN|35.31|35.31||
125|97172|97172 - ATHLETIC TRAINING RE-EVAL EST PLAN CARE 20 MINS|24.42|24.42||
125|97171|97171 - ATHLETIC TRAINING EVAL HIGH COMPLEX 45 MINS|48.82|48.82||
125|97170|97170 - ATHLETIC TRAINING EVAL MOD COMPLEX 30 MINS|48.82|48.82||
125|97169|97169 - ATHLETIC TRAINING EVAL LOW COMPLEX 15 MINS|48.82|48.82||
125|97168|97168 - OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS|97.07|97.07||
125|97167|97167 - OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS|143.2|143.2||
125|97166|97166 - OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS|143.2|143.2||
125|97165|97165 - OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS|143.2|143.2||
125|97164|97164 - PHYSICAL THERAPY RE-EVAL EST PLAN CARE 20 MINS|89.68|89.68||
125|97163|97163 - PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS|133.17|133.17||
125|97162|97162 - PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS|133.17|133.17||
125|97161|97161 - PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS|133.17|133.17||
125|97150|97150 - THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS|29.16|29.16||
125|97140|97140 - MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES|33.76|33.76||
125|97139|97139 - UNLISTED THERAPEUTIC PROCEDURE SPECIFY|23.54|23.54||
125|97127|97127 - THERAPEUTIC IVNTJ W/FOCUS ON COGNITIVE FUNCTION|26.4|26.4||
125|97124|97124 - THER PX 1/> AREAS EACH 15 MINUTES MASSAGE|28.62|28.62||
125|97116|97116 - THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR|31.83|31.83||
125|97113|97113 - THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS|39.32|39.32||
125|97112|97112 - THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA|34.83|34.83||
125|97110|97110 - THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES|34.83|34.83||
125|97039|97039 - UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND|26.51|26.51||
125|97036|97036 - APPL MODALITY 1/> AREAS HUBBARD TANK EA 15 MIN|33.71|33.71||
125|97035|97035 - APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN|19.8|19.8||
125|97034|97034 - APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN|19.8|19.8||
125|97033|97033 - APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN|25.41|25.41||
125|97032|97032 - APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN|24.08|24.08||
125|97028|97028 - APPL MODALITY 1/> AREAS ULTRAVIOLET|20.86|20.86||
125|97026|97026 - APPLICATION MODALITY 1/> AREAS INFRARED|17.39|17.39||
125|97024|97024 - APPLICATION MODALITY 1/> AREAS DIATHERMY|16.87|16.87||
125|97022|97022 - APPLICATION MODALITY 1/> AREAS WHIRLPOOL|24.88|24.88||
125|97020|97020 - APPLY MODALITY - 1+AREA - MICROWAVE|18.19|18.19||
125|97018|97018 - APPL MODALITY 1/> AREAS PARAFFIN BATH|20.6|20.6||
125|97016|97016 - APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES|24.11|24.11||
125|97014|97014 - APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED|23.06|23.06||
125|97012|97012 - APPL MODALITY 1/> AREAS TRACTION MECHANICAL|27.28|27.28||
125|97010|97010 - APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS|19.85|19.85||
125|96936|96936 - RCM CELULR & SUBCELULR SKN IMGNG I&R EA ADDL|63.57|63.57||
125|96935|96935 - RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ EA ADDL|52.32|52.32||
125|96934|96934 - RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ I&R ADD|115.8|115.8||
125|96933|96933 - RCM CELULR & SUBCELULR SKN IMGNG I&R 1ST LES|66.44|66.44||
125|96932|96932 - RCM CELULR & SUBCELULR SKN IMGNG IMG ACQUISITION|25.95|25.95||
125|96931|96931 - RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ I&R 1ST|257.41|257.41||
125|96922|96922 - LASER SKIN DISEASE PSORIASIS >500 SQ CM|393.31|393.31||
125|96921|96921 - LASER SKIN DISEASE PSORIASIS 250-500 SQ CM|326.75|326.75||
125|96920|96920 - LASER SKIN DISEASE PSORIASIS TOT AREA <250 SQ CM|323.45|323.45||
125|96913|96913 - PHOTOCHEMOTHERAPY DERMATOSES 4-8 HRS SUPERVISION|70.53|70.53||
125|96912|96912 - PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA|49.65|49.65||
125|96910|96910 - PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB|39.65|39.65||
125|96904|96904 - WHOLE BODY INTEGUMENTARY PHOTOGRAPHY|75.45|75.45||
125|96902|96902 - MCRSCP XM HAIR PLUCK/CLIP FOR CNTS/STRUCT ABNORM|31.29|31.29||
125|96900|96900 - ACTINOTHERAPY ULTRAVIOLET LIGHT|21.1|21.1||
125|96574|96574 - DEBRIDEMENT PRMLG HYPERKERATOTIC LES W/PDT|371.54|371.54||
125|96573|96573 - PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP|286.44|286.44||
125|96571|96571 - PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN|72.05|72.05||
125|96570|96570 - PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN|139.47|139.47||
125|96567|96567 - PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY|164|164||
125|96549|96549 - UNLISTED CHEMOTHERAPY PROCEDURE|5.32|5.32||
125|96545|96545 - SUPPLY OF CHEMOTHERAPY AGENT|64.64|64.64||
125|96542|96542 - CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT|216.88|216.88||
125|96530|96530 - REF/MAINT DRUG PUMP/RSVR -  SYSTEMIC|137.55|137.55||
125|96523|96523 - IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST|43.42|43.42||
125|96522|96522 - REFILL&MAINTENANCE PUMP DRUG DLVR SYSTEMIC|173.47|173.47||
125|96521|96521 - REFILLING & MAINTENANCE PORTABLE PUMP|228.87|228.87||
125|96520|96520 - MAINTAIN/REFILL PORTABLE PUMP|197.95|197.95||
125|96450|96450 - CHEMOTX ADMN CNS REQ SPINAL PUNCTURE|428|428||
125|96446|96446 - CHEMOTX ADMN PRTL CAVITY PORT/CATH|315.57|315.57||
125|96440|96440 - CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS|492.2|492.2||
125|96425|96425 - CHEMOTX ADMN IA NFS >8 HR PRTBLE IMPLTBL PMP|235.47|235.47||
125|96423|96423 - CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR|102.16|102.16||
125|96422|96422 - CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR|257.11|257.11||
125|96420|96420 - CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ|145.16|145.16||
125|96417|96417 - CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR|128.71|128.71||
125|96416|96416 - CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP|281.44|281.44||
125|96415|96415 - CHEMOTHERAPY ADMN IV INFUSION TQ EA HR|46.56|46.56||
125|96414|96414 - IV CHEMOTHERAPY -  INFSN PUMP -  >8 HRS|256.8|256.8||
125|96413|96413 - CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG|260.73|260.73||
125|96412|96412 - IV CHEMOTHERAPY INFSN 1-8 HR -  EA HR|72.28|72.28||
125|96411|96411 - CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG|109.13|109.13||
125|96410|96410 - IV CHEMOTHERAPY -  INFSN -  TO 1 HR|157.88|157.88||
125|96409|96409 - CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG|188.46|188.46||
125|96408|96408 - IV CHEMOTHERAPY -  PUSH TECHNIQUE|133.75|133.75||
125|96406|96406 - CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7|143.2|143.2||
125|96405|96405 - CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7|105.28|105.28||
125|96402|96402 - CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO|67.53|67.53||
125|96401|96401 - CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO|92.44|92.44||
125|96400|96400 - SC/IM CHEMOTHERAPY|64.2|64.2||
125|96377|96377 - APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION|31.7|31.7||
125|96376|96376 - THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC|15.7|15.7||
125|96375|96375 - THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG|27.6|27.6||
125|96374|96374 - THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG|70.38|70.38||
125|96373|96373 - THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL|29.6|29.6||
125|96372|96372 - THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM|31.7|31.7||
125|96371|96371 - SUBQ INFUSION ADDITIONAL PUMP INFUSION SITE|94.95|94.95||
125|96370|96370 - SUBCUTANEOUS INFUSION EACH ADDITIONAL HOUR|24.38|24.38||
125|96369|96369 - SUBCUTANEOUS INFUSION INITIAL 1 HR W/PUMP SET-UP|260.57|260.57||
125|96368|96368 - IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS|32.24|32.24||
125|96367|96367 - IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR|48.28|48.28||
125|96366|96366 - IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR|33.87|33.87||
125|96365|96365 - IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR|110.32|110.32||
125|96361|96361 - IV INFUSION HYDRATION EACH ADDITIONAL HOUR|21.21|21.21||
125|96360|96360 - IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR|70.84|70.84||
125|96161|96161 - CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM|5.8|5.8||
125|96160|96160 - PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM|5.8|5.8||
125|96155|96155 - HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/O PT|29.1|29.1||
125|96154|96154 - HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/PT|29.1|29.1||
125|96153|96153 - HLTH&BEHAVIOR IVNTJ EA 15 MIN GRP 2/>PTS|26.1|26.1||
125|96152|96152 - HLTH&BEHAVIOR IVNTJ EA 15 MIN INDIV|25.2|25.2||
125|96151|96151 - HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT RE-ASSMT|26.35|26.35||
125|96150|96150 - HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT 1ST ASSMT|40.75|40.75||
125|96127|96127 - BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT|9.6|9.6||
125|96125|96125 - STANDARDIZED COGNITIVE PERFORMANCE TESTING|188.04|188.04||
125|96120|96120 - NEUROPSYCHOLOG TESTING COMPUTER W/PROF I&R|101.87|101.87||
125|96119|96119 - NEUROPSYC TSTG W/PROF I&R ADMN BY TECH PR HR|122.28|122.28||
125|96118|96118 - NUROPSYC TESTING PR HR W/PT & INTERPJ TIME|215.31|215.31||
125|96117|96117 - NEUROPSYCHOLOGICAL TEST BATTERY|126.53|126.53||
125|96116|96116 - NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR|183.87|183.87||
125|96115|96115 - NEUROBEHAVORIAL STATUS EXAM|126.53|126.53||
125|96111|96111 - DEVELOPMENTAL TESTING W/INTERP & REPORT|150.04|150.04||
125|96110|96110 - DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM|61.25|61.25||
125|96105|96105 - ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR|123.7|123.7||
125|96103|96103 - PSYCHOLOGICAL TESTING COMPUTER W/PROF I&R|66.59|66.59||
125|96102|96102 - PSYCHOLOGICAL TESTING ADMN BY TECH PR HR|85.04|85.04||
125|96101|96101 - PSYCHOLOGICAL TESTING PR HR WITH PATIENT|163.26|163.26||
125|96100|96100 - PSYCHOLOGICAL TESTING|126.53|126.53||
125|96040|96040 - MEDICAL GENETICS COUNSELING EACH 30 MINUTES|71|71||
125|96020|96020 - TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP|181.03|181.03||225.35
125|96004|96004 - PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR|124.71|124.71||
125|96003|96003 - DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC|21.29|21.29||
125|96002|96002 - DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC|22.77|22.77||
125|96001|96001 - COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG|114.7|114.7||
125|96000|96000 - COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS|96.26|96.26||
125|95992|95992 - CANALITH REPOSITIONING PROCEDURE|69.73|69.73||
125|95991|95991 - RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP|85.79|85.79||
125|95990|95990 - REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN|55.99|55.99||
125|95982|95982 - ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG|85.48|85.48||
125|95981|95981 - ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG|52.31|52.31||
125|95980|95980 - ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG|76.1|76.1||
125|95979|95979 - ELEC ALYS NSTIM PLS GEN CPLX DP BRN EA 30 MIN|100.75|100.75||
125|95978|95978 - ELEC ALYS NSTIM PLS GEN CPLX DP BRN 1ST HR|218|218||
125|95975|95975 - ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV EA 30 MIN|159.92|159.92||
125|95974|95974 - ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR|302.16|302.16||
125|95972|95972 - ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG|150.46|150.46||
125|95971|95971 - ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG|77.22|77.22||
125|95970|95970 - ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING|36.38|36.38||
125|95967|95967 - MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL|990.04|990.04||192.9
125|95966|95966 - MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY|1128.78|1128.78||230.39
125|95965|95965 - MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY|2252.12|2252.12||463.94
125|95962|95962 - FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR|291.76|291.76||226.98
125|95961|95961 - FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR|302.09|302.09||230.05
125|95958|95958 - WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG|471.63|471.63||379.07
125|95957|95957 - DIGITAL ANALYSIS ELECTROENCEPHALOGRAM|215.59|215.59||129.43
125|95956|95956 - MNTR SEIZURE CMPTR 16CHAN EEG ATND EA 24 HR|699.15|699.15||263.95
125|95955|95955 - EEG NONINTRACRANIAL SURGERY|205.63|205.63||123.8
125|95954|95954 - RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE|257.72|257.72||219.28
125|95953|95953 - LOCALIZE CEREBRAL SEIZURE CPTR PORTABLE EEG|536.16|536.16||209.43
125|95951|95951 - LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EEG/VIDEO|867.5|867.5||347.02
125|95950|95950 - MONITOR ID& LATERALIZATION SEIZURE FOCUS EEG|456.43|456.43||147.56
125|95943|95943 - PARASYMP & SYMP NRV FUNCJ HRT RATE VARIABILITY|104.21|104.21||39.07
125|95941|95941 - IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR|300.96|300.96||
125|95940|95940 - IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES|53.12|53.12||
125|95939|95939 - CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI|774.61|774.61||194.98
125|95938|95938 - SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB|522.89|522.89||75.24
125|95937|95937 - NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH|85.6|85.6||64.47
125|95933|95933 - ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST|94.14|94.14||55.06
125|95930|95930 - VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R|95.49|95.49||61.4
125|95929|95929 - CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS|179.16|179.16||179.16
125|95928|95928 - CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS|172.37|172.37||172.37
125|95927|95927 - SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD|157.68|157.68||99.2
125|95926|95926 - SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS|139.1|139.1||139.1
125|95925|95925 - SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS|158.23|158.23||158.23
125|95924|95924 - TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT|237.78|237.78||145.36
125|95923|95923 - TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION|112.36|112.36||66.82
125|95922|95922 - TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ|92.5|92.5||71.55
125|95921|95921 - TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP|87.77|87.77||66.82
125|95913|95913 - NERVE CONDUCTION STUDIES 13/> STUDIES|478.29|478.29||307.27
125|95912|95912 - NERVE CONDUCTION STUDIES 11-12 STUDIES|414|414||259.33
125|95911|95911 - NERVE CONDUCTION STUDIES 9-10 STUDIES|371.71|371.71||218.08
125|95910|95910 - NERVE CONDUCTION STUDIES 7-8 STUDIES|311.04|311.04||174.82
125|95909|95909 - NERVE CONDUCTION STUDIES 5-6 STUDIES|236.02|236.02||130.94
125|95908|95908 - NERVE CONDUCTION STUDIES 3-4 STUDIES|198.03|198.03||109.83
125|95907|95907 - NERVE CONDUCTION STUDIES 1-2 STUDIES|153.19|153.19||87.16
125|95905|95905 - MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB|109.18|109.18||4.61
125|95887|95887 - NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION|125.95|125.95||62.12
125|95886|95886 - NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE|142.66|142.66||75.14
125|95885|95885 - NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED|90.91|90.91||30.76
125|95875|95875 - ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB|125.19|125.19||97.64
125|95874|95874 - NEEDLE EMG GUID W/CHEMODENERVATION|62.04|62.04||27.6
125|95873|95873 - ELECTRICAL STIMULATION GUID W/CHEMODENERVATION|61.38|61.38||27.08
125|95872|95872 - NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER|181.25|181.25||134.55
125|95870|95870 - NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI|55.68|55.68||46.43
125|95869|95869 - NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12|62.68|62.68||46.72
125|95868|95868 - NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI|202.76|202.76||202.76
125|95867|95867 - NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI|113.85|113.85||78.35
125|95866|95866 - NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM|150.98|150.98||92.61
125|95865|95865 - NEEDLE ELECTROMYOGRAPHY LARYNX|208.49|208.49||118.38
125|95864|95864 - NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS|341.6|341.6||228.45
125|95863|95863 - NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS|260.28|260.28||200.09
125|95861|95861 - NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS|218.82|218.82||218.82
125|95860|95860 - NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS|127.6|127.6||103.77
125|95858|95858 - TENSILON TEST AND MYOGRAM|148.44|148.44||115.07
125|95857|95857 - CHOLINESTERASE INHIBITOR CHALLENGE TEST|56.23|56.23||
125|95852|95852 - ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID|19.8|19.8||
125|95851|95851 - ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI|27.82|27.82||
125|95834|95834 - MUSC TSTG MNL W/REPRT TOTAL EVAL BODY W/HANDS|107.88|107.88||
125|95833|95833 - MUSC TSTG MNL W/REPRT TOTAL EVAL BODY EX HANDS|87.45|87.45||
125|95832|95832 - MUSC TSTG MNL W/REPRT HAND W/WO CMPRSN NRML SIDE|32.37|32.37||
125|95831|95831 - MUSC TSTG MNL W/REPRT XTR EX HAND/TRNK|34.24|34.24||
125|95830|95830 - INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP|191.05|191.05||
125|95829|95829 - ELECTROCORTICOGRAM SURGERY SPX|1379.72|1379.72||352.83
125|95827|95827 - ELECTROENCEPHALOGRAM ALL NIGHT RECORDING|212.66|212.66||95.73
125|95824|95824 - ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY|108.23|108.23||64.2
125|95822|95822 - ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY|215.75|215.75||107.32
125|95819|95819 - ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP|180.3|180.3||94.96
125|95816|95816 - ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY|182.76|182.76||91.86
125|95813|95813 - EEG EXTENDED MONITORING 61-119 MINUTES|257.92|257.92||134.82
125|95812|95812 - ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN|194.59|194.59||79.76
125|95811|95811 - POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND|989.79|989.79||325.32
125|95810|95810 - POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND|944.28|944.28||408.62
125|95808|95808 - POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND|600.75|600.75||241.76
125|95807|95807 - SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN|510.72|510.72||192.43
125|95806|95806 - SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT|503.11|503.11||224.85
125|95805|95805 - MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG|710.38|710.38||162.8
125|95803|95803 - ACTIGRAPHY TESTING RECORDING ANALYSIS I&R|220.02|220.02||71.69
125|95801|95801 - SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL|142.01|142.01||80.2
125|95800|95800 - SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME|271.66|271.66||84.81
125|95783|95783 - POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM|1481.93|1481.93||224.06
125|95782|95782 - POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND|1389.1|1389.1||205.71
125|95251|95251 - CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R|67.14|67.14||
125|95250|95250 - CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT|162.98|162.98||
125|95249|95249 - CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT|82.61|82.61||
125|95180|95180 - RAPID DESENSITIZATION PROCEDURE EACH HOUR|156.07|156.07||
125|95170|95170 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE|21.5|21.5||
125|95165|95165 - PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN|10.35|10.35||
125|95149|95149 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT|57.01|57.01||
125|95148|95148 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT|46.28|46.28||
125|95147|95147 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT|46.28|46.28||
125|95146|95146 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT|32.31|32.31||
125|95145|95145 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT|21.74|21.74||
125|95144|95144 - PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO|13.62|13.62||
125|95134|95134 - PROF SVCS ALLG IMMNTX W/PRV XTRC 5 STING INSECT|45.97|45.97||
125|95133|95133 - PROF SVCS ALLG IMMNTX W/PRV XTRC 4 STING INSECT|40.67|40.67||
125|95132|95132 - PROF SVCS ALLG IMMNTX W/PRV XTRC 3 STING INSECT|35.82|35.82||
125|95131|95131 - PROF SVCS ALLG IMMNTX W/PRV XTRC 2 STING INSECT|30.83|30.83||
125|95130|95130 - PROF SVCS ALLG IMMNTX W/PRV XTRC 1 STING INSECT|25.31|25.31||
125|95125|95125 - PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 2/> NJX|19.99|19.99||
125|95120|95120 - PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 1 NJX|12.19|12.19||
125|95117|95117 - PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS|27.34|27.34||
125|95115|95115 - PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX|20.92|20.92||
125|95079|95079 - INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES|134.25|134.25||
125|95076|95076 - INGESTION CHALLENGE TEST INITIAL 120 MINUTES|188.33|188.33||
125|95071|95071 - INHLJ BRNCL CHALLENGE TSTG W/AGS/GASES|137.96|137.96||
125|95070|95070 - INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL|107.63|107.63||
125|95065|95065 - DIRECT NASAL MUCOUS MEMBRANE TEST|11.25|11.25||
125|95060|95060 - OPHTHALMIC MUCOUS MEMBRANE TESTS|17.76|17.76||
125|95056|95056 - PHOTO TESTS|8.7|8.7||
125|95052|95052 - PHOTO PATCH TEST SPECIFY NUMBER TSTS|12.12|12.12||
125|95044|95044 - PATCH/APPLICATION TEST SPECIFY NUMBER TESTS|10.97|10.97||
125|95028|95028 - IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING|11.07|11.07||
125|95027|95027 - INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE|9.39|9.39||
125|95024|95024 - INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS|9.15|9.15||
125|95018|95018 - ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R|32.58|32.58||
125|95017|95017 - ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R|12.13|12.13||
125|95012|95012 - NITRIC OXIDE EXPIRED GAS DETERMINATION|25.57|25.57||
125|95004|95004 - PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS|5.38|5.38||
125|94781|94781 - CAR SEAT/BED TEST INFT THRU 12 MO EA ADDL 30 MIN|32.24|32.24||
125|94780|94780 - CAR SEAT/BED TEST INFT THRU 12 MO 60 MIN|81.22|81.22||
125|94777|94777 - PEDIATRIC APNEA MONITOR PHYS/QHP REVIEW|30.54|30.54||
125|94776|94776 - PEDIATRIC APNEA MONITOR ANALYSES COMPUTER|243.52|243.52||
125|94775|94775 - PEDIATRIC APNEA MONITOR ATTACHMENT|51.35|51.35||
125|94774|94774 - PEDIATRIC APNEA MONITOR ATTACHMENT PHYS I&R|325.34|325.34||
125|94772|94772 - CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT|304.14|304.14||92.41
125|94770|94770 - CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER|68.54|68.54||20.15
125|94762|94762 - NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR|71.96|71.96||
125|94761|94761 - NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER|45.66|45.66||
125|94760|94760 - NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER|18.99|18.99||
125|94750|94750 - PULMONARY COMPLIANCE STUDY|67.51|67.51||28.8
125|94729|94729 - CO DIFFUSING CAPACITY|83.1|83.1||14.95
125|94728|94728 - AIRWAY RESISTANCE BY OSCILLOMETRY|63.47|63.47||20.64
125|94727|94727 - GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V|67.69|67.69||20.11
125|94726|94726 - PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST|84.04|84.04||20.11
125|94690|94690 - O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX|75.97|75.97||8.6
125|94681|94681 - O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC|123.99|123.99||38.2
125|94680|94680 - O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP|80.4|80.4||29.13
125|94669|94669 - MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION|49.37|49.37||
125|94668|94668 - MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ|20.66|20.66||
125|94667|94667 - MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL|30.21|30.21||
125|94664|94664 - DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP|33.17|33.17||
125|94662|94662 - CONTINUOUS NEGATIVE PRESSURE VENTJ INITIAT&MGM|75.39|75.39||
125|94660|94660 - CPAP VENTILATION CPAP INITIATION&MGMT|88.85|88.85||
125|94645|94645 - CONTINUOUS INHALATION TREATMENT EA ADDL HR|22.44|22.44||
125|94644|94644 - CONTINUOUS INHALATION TREATMENT 1ST HR|58.4|58.4||
125|94642|94642 - PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH|159.22|159.22||
125|94640|94640 - PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT|23.65|23.65||
125|94621|94621 - CARDIOPULMONARY EXERCISE TESTING|209.05|209.05||75.67
125|94620|94620 - PULMONARY STRESS TESTING SIMPLE|182.44|182.44||93.89
125|94618|94618 - PULMONARY STRESS TESTING|54.33|54.33||37.34
125|94617|94617 - EXERCISE TEST FOR BRONCHOSPASM|147.09|147.09||54.57
125|94610|94610 - INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP|96.9|96.9||
125|94453|94453 - HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION|71.8|71.8||21.29
125|94452|94452 - HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT|50.62|50.62||16.57
125|94450|94450 - BREATHING RESPONSE TO HYPOXIA|79.3|79.3||31.53
125|94400|94400 - BREATHING RESPONSE TO CO2|88.14|88.14||46.22
125|94375|94375 - RESPIRATORY FLOW VOLUME LOOP|53.79|53.79||24.82
125|94250|94250 - EXPIRED GAS COLLECTION QUANT 1 PROCEDURE SPX|28.32|28.32||11.98
125|94200|94200 - MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ|48.94|48.94||14.15
125|94150|94150 - VITAL CAPACITY TOTAL SEPARATE PROCEDURE|20.66|20.66||11.98
125|94070|94070 - BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT|149.53|149.53||58.32
125|94060|94060 - BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN|98.17|98.17||61.85
125|94016|94016 - PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY|41.78|41.78||
125|94015|94015 - PATIENT-INITIATED SPIROMETRIC RECORDING|21.76|21.76||
125|94014|94014 - PT-INITIATE SPIROMETRIC RECORDING PHYS/QHP R&I|53.93|53.93||24.44
125|94013|94013 - MEASUREMENT LUNG VOLUMES INFANT/CHILD/2 YRS|31.75|31.75||
125|94012|94012 - MEAS SPIRO FRCD EXP FLO PRE&POST BRONCH INF/2YRS|230.79|230.79||
125|94011|94011 - MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT&/2 Y|141.79|141.79||
125|94010|94010 - SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ|52.16|52.16||26.73
125|94005|94005 - HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>|148.54|148.54||
125|94004|94004 - VENTILATION ASSIST & MGMT NURSING FAC PR DAY|69.82|69.82||
125|94003|94003 - VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA|95.82|95.82||
125|94002|94002 - VENTILATION ASSIST & MGMT INPATIENT 1ST DAY|139.4|139.4||
125|93990|93990 - DUPLEX SCAN HEMODIALYSIS ACCESS|163.03|163.03||33.24
125|93982|93982 - IMPLANT WIRELESS PRESS SENSOR STUDY ANEURYSM SAC|47.36|47.36||
125|93981|93981 - DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD|214.29|214.29||47.83
125|93980|93980 - DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL|303.14|303.14||119.12
125|93979|93979 - DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD|166.68|166.68||42.79
125|93978|93978 - DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE|251.75|251.75||73.59
125|93976|93976 - DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT|291.31|291.31||72.76
125|93975|93975 - DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM|436.83|436.83||118.92
125|93971|93971 - DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY|220.69|220.69||112.78
125|93970|93970 - DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY|332.24|332.24||180.99
125|93931|93931 - DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY|161.91|161.91||38.48
125|93930|93930 - DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY|248.31|248.31||58.14
125|93926|93926 - DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY|200.36|200.36||49.32
125|93925|93925 - DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY|299.6|299.6||76
125|93924|93924 - N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI|203.34|203.34||57.29
125|93923|93923 - NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS|205.98|205.98||67.89
125|93922|93922 - NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL|118.68|118.68||39.24
125|93895|93895 - CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI|112|112||22.39
125|93893|93893 - TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ|244.16|244.16||65.43
125|93892|93892 - TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT|248.81|248.81||65.43
125|93890|93890 - TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY|233.43|233.43||57.2
125|93888|93888 - TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD|190.83|190.83||52.93
125|93886|93886 - TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL|354.17|354.17||95.5
125|93882|93882 - DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY|173.97|173.97||42.94
125|93880|93880 - DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY|289.97|289.97||107.37
125|93798|93798 - OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING|44.4|44.4||
125|93797|93797 - OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR|33.17|33.17||
125|93793|93793 - ANTICOAGULANT MGMT FOR PT TAKING WARFARIN|19.1|19.1||
125|93792|93792 - PT/CAREGIVER TRAING FOR INITIATION HOME INR MNTR|80.91|80.91||
125|93790|93790 - AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R|90.88|90.88||
125|93788|93788 - AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R|83.49|83.49||
125|93786|93786 - AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY|50.28|50.28||
125|93784|93784 - AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R|139.6|139.6||
125|93770|93770 - DERMINATION OF VENOUS PRESSUE|18.04|18.04||16.55
125|93750|93750 - INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS|89.72|89.72||
125|93745|93745 - 1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB|66.32|66.32||59.45
125|93740|93740 - TEMPRATURE GRADIENT STUDY|59.24|59.24||36.89
125|93724|93724 - ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM|635.41|635.41||401.86
125|93702|93702 - BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT|184.84|184.84||
125|93701|93701 - BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS|80.3|80.3||9.79
125|93668|93668 - PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION|131|131||
125|93662|93662 - INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I|1187.44|1187.44||170.03
125|93660|93660 - CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR|224.74|224.74||161.89
125|93657|93657 - ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN|715.81|715.81||
125|93656|93656 - EPHYS EVL TRNSPTL TX ATRIAL FIB ISOLAT PULM VEIN|1887.38|1887.38||
125|93655|93655 - ICAR CATHETER ABLATION ARRHYTHMIA ADD ON|716.25|716.25||
125|93654|93654 - EPHYS EVAL W/ABLATION VENTRICULAR TACHYCARDIA|1882.41|1882.41||
125|93653|93653 - EPHYS EVAL W/ABLATION SUPRAVENT ARRHYTHMIA|1405.4|1405.4||
125|93650|93650 - ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION|1527.48|1527.48||
125|93644|93644 - EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR|325.74|325.74||244.4
125|93642|93642 - EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS|1083.77|1083.77||750.06
125|93641|93641 - EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN|1189.09|1189.09||743.7
125|93640|93640 - EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE|1074.32|1074.32||516.5
125|93631|93631 - INTRAOP EPICAR& ENDOCAR PACG& MAPG|1146.24|1146.24||759.07
125|93624|93624 - ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT|639.03|639.03||485.16
125|93623|93623 - PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS|1069.34|1069.34||319.23
125|93622|93622 - COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC|3992.35|3992.35||889.84
125|93621|93621 - COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC|4714.4|4714.4||539.82
125|93620|93620 - COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION|2206.39|2206.39||1352.93
125|93619|93619 - COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION|1444.54|1444.54||820.71
125|93618|93618 - INDUCTION ARRHYTHMIA ELECTRICAL PACING|920.24|920.24||542.04
125|93616|93616 - ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG|203.34|203.34||151.65
125|93615|93615 - ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS|107.54|107.54||71.48
125|93613|93613 - INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING|535.05|535.05||331.81
125|93612|93612 - INTRAVENTRICULAR PACING|470.84|470.84||289.19
125|93610|93610 - INTRA-ATRIAL PACING|422.44|422.44||288.04
125|93609|93609 - INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA|1112.84|1112.84||909.77
125|93603|93603 - RIGHT VENTRICULAR RECORDING|377.95|377.95||232.54
125|93602|93602 - INTRA-ATRIAL RECORDING|327.68|327.68||210.44
125|93600|93600 - BUNDLE OF HIS RECORDING|460.14|460.14||257.94
125|93592|93592 - PERQ TRANSCATH CLS PARAVALVR LEAK EACH OCCLS DEV|651.87|651.87||
125|93591|93591 - PERQ TRANSCATH CLS PARAVALVR LEAK 1 AORTIC VALVE|1480.19|1480.19||
125|93590|93590 - PERQ TRANSCATH CLS PARAVALVR LEAK 1 MITRAL VALVE|1782.75|1782.75||
125|93583|93583 - PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER|1253.03|1253.03||
125|93582|93582 - PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS|1123.44|1123.44||
125|93581|93581 - PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT|1391.06|1391.06||
125|93580|93580 - PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT|1819.05|1819.05||
125|93572|93572 - IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL|317.73|317.73||94.3
125|93571|93571 - IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL|438.74|438.74||116.57
125|93568|93568 - NJX PULMONARY ANGIO HRT CATH W/S&I|225.02|225.02||
125|93567|93567 - NJX SUPRAVALV AORTOG HRT CATH W/S&I|213.2|213.2||
125|93566|93566 - NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I|250.76|250.76||
125|93565|93565 - NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I|75.73|75.73||
125|93564|93564 - NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I|103.24|103.24||
125|93563|93563 - NJX SEL HRT ART CONGENITAL HRT CATH W/S&I|97.77|97.77||
125|93562|93562 - INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEA|84.33|84.33||38.49
125|93561|93561 - INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS|210.63|210.63||102.76
125|93533|93533 - CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN|3153.82|3153.82||690.68
125|93532|93532 - CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN|3563.05|3563.05||947.39
125|93531|93531 - CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMA|3453.95|3453.95||984.44
125|93530|93530 - R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY|1377.02|1377.02||432.3
125|93505|93505 - ENDOMYOCARDIAL BIOPSY|559.57|559.57||409.6
125|93503|93503 - INSERTION FLOW DIRECTED CATHETER FOR MONITORING|361.98|361.98||
125|93464|93464 - PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU|394.48|394.48||142.74
125|93463|93463 - MEDICATION ADMIN & HEMODYNAMIC MEASURMENT|161.42|161.42||
125|93462|93462 - LEFT HEART CATH BY TRANSEPTAL PUNCTURE|353.2|353.2||
125|93461|93461 - R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I|2138.15|2138.15||701.29
125|93460|93460 - R & L HRT CATH WINJX HRT ART& L VENTR IMG|1870.2|1870.2||635.37
125|93459|93459 - CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I|1733.93|1733.93||567.68
125|93458|93458 - CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I|1563.15|1563.15||500.31
125|93457|93457 - CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I|1858.44|1858.44||593.01
125|93456|93456 - CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I|1641.31|1641.31||526.86
125|93455|93455 - CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I|1516.29|1516.29||472.54
125|93454|93454 - CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I|1295.51|1295.51||404.73
125|93453|93453 - R & L HRT CATH W/NJX L VENTRICULOG IMG S&I|1661.23|1661.23||536.14
125|93452|93452 - L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I|1276.93|1276.93||400.39
125|93451|93451 - RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT|1111.2|1111.2||219.48
125|93355|93355 - ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN|373.16|373.16||
125|93352|93352 - USE OF ECHO CONTRAST AGENT DURING STRESS ECHO|51.98|51.98||
125|93351|93351 - ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG|361.57|361.57||138.65
125|93350|93350 - ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST|259.21|259.21||161.89
125|93325|93325 - DOP ECHOCARD COLOR FLOW VELOCITY MAPPING|182.47|182.47||6.55
125|93321|93321 - DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD|80.85|80.85||24.41
125|93320|93320 - DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY|151.67|151.67||55.48
125|93318|93318 - ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ|430.74|430.74||111.86
125|93317|93317 - ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT|351.64|351.64||137.14
125|93316|93316 - ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY|104.34|104.34||
125|93315|93315 - ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R|441.29|441.29||226.79
125|93314|93314 - ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY|292.74|292.74||88.75
125|93313|93313 - ECHO R-T 2D W/PROBE PLACEMENT ONLY|117.46|117.46||
125|93312|93312 - ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R|449.44|449.44||194.63
125|93308|93308 - ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD|155.85|155.85||58.33
125|93307|93307 - ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP|340.93|340.93||116.42
125|93306|93306 - ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D|322.95|322.95||119.12
125|93304|93304 - F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY|203.34|203.34||80.29
125|93303|93303 - COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY|374.54|374.54||132.72
125|93299|93299 - REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW|52.7|52.7||10.54
125|93298|93298 - REM INTERROG SCRMS <30 D PHYS/QHP|43.47|43.47||
125|93297|93297 - REM INTERROG ICPMS <30 D PHYS/QHP|42.95|42.95||
125|93296|93296 - REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW|39.67|39.67||
125|93295|93295 - INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB|87.19|87.19||
125|93294|93294 - REM INTERROG PM/LDLS PM <90 D PHYS/QHP|49.86|49.86||
125|93293|93293 - TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL|81.7|81.7||24.63
125|93292|93292 - INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR|57.72|57.72||34.93
125|93291|93291 - INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON|51.46|51.46||29.73
125|93290|93290 - INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON|57.72|57.72||35.45
125|93289|93289 - INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB|86.1|86.1||60.67
125|93288|93288 - INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON|60.36|60.36||34.93
125|93287|93287 - PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB|59.95|59.95||37.69
125|93286|93286 - PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON|46.83|46.83||24.56
125|93285|93285 - PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON|67.22|67.22||42.85
125|93284|93284 - PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB|135.16|135.16||102.35
125|93283|93283 - PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB|123.91|123.91||93.74
125|93282|93282 - PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB|96.71|96.71||69.18
125|93281|93281 - PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER|99.87|99.87||69.7
125|93280|93280 - PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER|92.01|92.01||62.36
125|93279|93279 - PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP|78.01|78.01||52.58
125|93278|93278 - SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG|114.09|114.09||49.97
125|93272|93272 - XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS|56.75|56.75||
125|93271|93271 - XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS|222.08|222.08||
125|93270|93270 - XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS|77.04|77.04||
125|93268|93268 - XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS|298.16|298.16||
125|93261|93261 - INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB|93.42|93.42||61.14
125|93260|93260 - PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM|103.03|103.03||70.24
125|93229|93229 - XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT|1089.96|1089.96||
125|93228|93228 - XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS|42.43|42.43||
125|93227|93227 - XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS|77.08|77.08||
125|93226|93226 - EXTERNAL ECG SCANNING ANALYSIS REPORT|109.61|109.61||
125|93225|93225 - XTRNL ECG & 48 HR RECORDING|73.08|73.08||
125|93224|93224 - XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I|283.55|283.55||
125|93050|93050 - ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE|26|26||13.77
125|93042|93042 - RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON|15.32|15.32||
125|93041|93041 - RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R|15.43|15.43||
125|93040|93040 - RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT|26.22|26.22||
125|93025|93025 - MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS|326.4|326.4||41.95
125|93024|93024 - ERGONOVINE PROVOCATION TST|218.58|218.58||140.59
125|93018|93018 - CV STRS TST XERS&/OR RX CONT ECG I&R ONLY|42.84|42.84||
125|93017|93017 - CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY|99.22|99.22||
125|93016|93016 - CV STRS TST XERS&/OR RX CONT ECG W/O I&R|53.54|53.54||
125|93015|93015 - CV STRS TST XERS&/OR RX CONT ECG W/SI&R|212.22|212.22||
125|93010|93010 - ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY|20.91|20.91||
125|93005|93005 - ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R|29.68|29.68||
125|93000|93000 - ECG ROUTINE ECG W/LEAST 12 LDS W/I&R|46.6|46.6||
125|92998|92998 - PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL|769.39|769.39||
125|92997|92997 - PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL|1685.37|1685.37||
125|92993|92993 - ATRIAL SEPTECT/SEPTOSTOMY BLADE METHOD|3364.15|3364.15||
125|92992|92992 - ATRIAL SEPTECT/SEPTOST TRANSVENOUS BALLOON|4801.51|4801.51||
125|92990|92990 - PRQ BALLOON VALVULOPLASTY PULMONARY VALVE|1441.71|1441.71||
125|92987|92987 - PRQ BALLOON VALVULOPLASTY MITRAL VALVE|1976.78|1976.78||
125|92986|92986 - PRQ BALLOON VALVULOPLASTY AORTIC VALVE|1783.05|1783.05||
125|92979|92979 - ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL|393.63|393.63||181.89
125|92978|92978 - ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL|449.54|449.54||293.02
125|92977|92977 - THROMBOLYSIS CORONARY INTRAVENOUS INFUSION|453.24|453.24||
125|92975|92975 - THROMBOLYSIS INTRACORONARY NFS SLCTV ANGRPH|839.43|839.43||
125|92974|92974 - TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX|344.58|344.58||
125|92973|92973 - PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY|385.24|385.24||
125|92971|92971 - CARDIOASSIST-METH CIRCULATORY ASSIST EXTERNAL|156.22|156.22||
125|92970|92970 - CARDIOASSIST-METH CIRCULATORY ASSIST INTERNAL|390.2|390.2||
125|92961|92961 - CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX|428.04|428.04||
125|92960|92960 - CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL|353.1|353.1||
125|92953|92953 - TEMPORARY TRANSCUTANEOUS PACING|79.94|79.94||
125|92950|92950 - CARDIOPULMONARY RESUSCITATION|386.15|386.15||
125|92944|92944 - PRQ TRLUML CORONRY CHRNIC OCCLUS REVASC ADDL VSL|520.63|520.63||
125|92943|92943 - PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL|1121.15|1121.15||
125|92941|92941 - PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL|1121.26|1121.26||
125|92938|92938 - PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL|301.42|301.42||
125|92937|92937 - PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL|997.14|997.14||
125|92934|92934 - PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH|339.96|339.96||
125|92933|92933 - PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH|1118.93|1118.93||
125|92929|92929 - PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH|390.9|390.9||
125|92928|92928 - PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH|998.26|998.26||
125|92925|92925 - PRQ TRLUML CORONARY ANGIO/ATHEREC ADDL ART/BRNCH|298.34|298.34||
125|92924|92924 - PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH|1069.7|1069.7||
125|92921|92921 - PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH|350.38|350.38||
125|92920|92920 - PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH|897.23|897.23||
125|92640|92640 - ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR|183.02|183.02||
125|92633|92633 - AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS|66.68|66.68||
125|92630|92630 - AUDITORY REHABILITATION PRELINGUAL HEARING LOSS|96.71|96.71||
125|92627|92627 - EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15|30.78|30.78||
125|92626|92626 - EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR|123.62|123.62||
125|92625|92625 - ASSESSMENT TINNITUS|42.4|42.4||
125|92621|92621 - EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN|11.29|11.29||
125|92620|92620 - EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN|43.12|43.12||
125|92618|92618 - EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV ADD 30 MIN|54.9|54.9||
125|92617|92617 - FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V I&R|49.73|49.73||
125|92616|92616 - FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC|199.83|199.83||
125|92615|92615 - FLEXIBLE ENDOSCOPIC EVAL LARYN SENS C/V REC I&R|40.02|40.02||
125|92614|92614 - FLEXIBLE ENDOSCOPIC EVAL LARYN SENSORY C/V REC|142.48|142.48||
125|92613|92613 - FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC I&R|45.06|45.06||
125|92612|92612 - FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC|172.46|172.46||
125|92611|92611 - MOTION FLUOR EVAL SWLNG FUNCJ C/V REC|125.81|125.81||
125|92610|92610 - EVAL ORAL&PHARYNGEAL SWLNG FUNCJ|147.21|147.21||
125|92609|92609 - THER SP-GENRATJ DEV PRGRMG&MODIFICAJ|58.54|58.54||
125|92608|92608 - RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN|25.78|25.78||
125|92607|92607 - RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR|116.65|116.65||
125|92606|92606 - THER SVC N-SP-GENRATJ DEV PRGRMG&MODIFICAJ|133.09|133.09||
125|92605|92605 - EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV F2F 1ST HR|150.66|150.66||
125|92604|92604 - ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG|76.44|76.44||
125|92603|92603 - ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG|123.86|123.86||
125|92602|92602 - ANALYSIS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG|128.53|128.53||
125|92601|92601 - ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG|127.92|127.92||
125|92597|92597 - EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC|127.26|127.26||
125|92596|92596 - EAR PROTECTOR ATTENUATION MEASUREMENTS|31.35|31.35||
125|92595|92595 - ELECTROACOUS EVAL HEARING AID BINAURAL|48.03|48.03||
125|92594|92594 - ELECTROACOUS EVAL HEARING AID MONAURAL|33.43|33.43||
125|92593|92593 - HEARING AID CHECK BINAURAL|43.28|43.28||
125|92592|92592 - HEARING AID CHECK MONAURAL|29.97|29.97||
125|92591|92591 - HEARING AID EXAMINATION & SELECTION BINAURAL|112.29|112.29||
125|92590|92590 - HEARING AID EXAMINATION & SELECTION MONAURAL|86.26|86.26||
125|92588|92588 - DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL|133.75|133.75||32.53
125|92587|92587 - DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD|97.37|97.37||11.84
125|92586|92586 - AUDITORY EVOKED POTENTIALS LIMITED|128.06|128.06||
125|92585|92585 - AUDITORY EVOKED POTENTIALS COMPREHENSIVE|235.94|235.94||97.72
125|92584|92584 - ELECTROCOCHLEOGRAPHY|159.16|159.16||
125|92583|92583 - SELECT PICTURE AUDIOMETRY|47.03|47.03||
125|92582|92582 - CONDITIONING PLAY AUDIOMETRY|45.48|45.48||
125|92579|92579 - VISUAL REINFORCEMENT AUDIOMETRY|51.09|51.09||
125|92577|92577 - STENGER TEST SPEECH|37.57|37.57||
125|92576|92576 - SYNTHETIC SENTENCE IDENTIFICATION TEST|23.73|23.73||
125|92575|92575 - SENSORINEURAL ACUITY LEVEL|18.14|18.14||
125|92572|92572 - STAGGERED SPONDAIC WORD|5.96|5.96||
125|92571|92571 - FILTERED SPEECH TEST|24.34|24.34||
125|92570|92570 - ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY|51.57|51.57||
125|92568|92568 - ACOUSTIC REFLEX THRESHOLD|24.34|24.34||
125|92567|92567 - TYMPANOMETRY|33.97|33.97||
125|92565|92565 - STENGER TEST PURE TONE|20.91|20.91||
125|92564|92564 - SHORT INCREMENT SENSITIVITY INDEX|25.28|25.28||
125|92563|92563 - TONE DECAY TEST|20.42|20.42||
125|92562|92562 - LOUDNESS BALANCE BINAURAL/MONAURAL|21.74|21.74||
125|92561|92561 - BEKESY AUDIOMETRY DIAGNOSTIC|44.04|44.04||
125|92560|92560 - BEKESY AUDIOMETRY SCREENING|24.49|24.49||
125|92559|92559 - AUDIOMETRIC TESTING GROUPS|73.58|73.58||
125|92558|92558 - EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS|15.88|15.88||
125|92557|92557 - COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ|76.24|76.24||
125|92556|92556 - SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ|36.65|36.65||
125|92555|92555 - SPEECH AUDIOMETRY THRESHOLD|24.34|24.34||
125|92553|92553 - PURE TONE AUDIOMETRY AIR & BONE|42.26|42.26||
125|92552|92552 - PURE TONE AUDIOMETRY AIR ONLY|27.55|27.55||
125|92551|92551 - SCREENING TEST PURE TONE AIR ONLY|20.01|20.01||
125|92550|92550 - TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS|34.46|34.46||
125|92548|92548 - CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT|139.36|139.36||52.91
125|92547|92547 - USE VERTICAL ELECTRODES|35.84|35.84||1.1
125|92546|92546 - SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING|83.75|83.75||35.46
125|92545|92545 - OSCILLATING TRACKING TEST W/RECORDING|39.59|39.59||21.82
125|92544|92544 - OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC|45.21|45.21||21.82
125|92542|92542 - POSITIONAL NYSTAGMUS TEST|59.12|59.12||33.28
125|92541|92541 - SPONTANEOUS NYSTAGMUS TEST|66.07|66.07||43.7
125|92540|92540 - VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK|161.53|161.53||128.72
125|92538|92538 - CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL|33.11|33.11||25.62
125|92537|92537 - CALORIC VESTIBULAR TEST W/REC BI BITHERMAL|64.53|64.53||51.23
125|92534|92534 - OPTOKINETIC NYSTAGMUS TEST|25.85|25.85||
125|92533|92533 - CALORIC VESTIBULAR TEST EACH IRRIGATION|36.4|36.4||
125|92532|92532 - POSITIONAL NYSTAGMUS TEST|27.38|27.38||
125|92531|92531 - SPONTANEOUS NYSTAGMUS W/GAZE|21.84|21.84||
125|92526|92526 - TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING|81.75|81.75||
125|92524|92524 - BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE|140.96|140.96||
125|92523|92523 - EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION|314.31|314.31||
125|92522|92522 - EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE|146.86|146.86||
125|92521|92521 - EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)|181.48|181.48||
125|92520|92520 - LARYNGEAL FUNCTION STUDIES|107.3|107.3||
125|92516|92516 - FACIAL NERVE FUNCTION STUDIES|69.14|69.14||
125|92512|92512 - NASAL FUNCTION STUDIES|72.21|72.21||
125|92511|92511 - NASOPHARYNGOSCOPY W/ENDOSCOPE SPX|153.63|153.63||
125|92510|92510 - AURAL REHAB AFTER COCHLEAR IMPLANT|199.56|199.56||
125|92508|92508 - TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV|30.31|30.31||
125|92507|92507 - TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND|61.58|61.58||
125|92504|92504 - BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE|26.93|26.93||
125|92502|92502 - OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA|174.45|174.45||
125|92499|92499 - UNLISTED OPHTHALMOLOGICAL SERVICE/PROCEDURE|12.88|12.88||
125|92396|92396 - SUPPLY OF CONTACT LENSES -  APHAKIA|79.99|79.99||
125|92395|92395 - SUPPLY OF SPECTACLES FOR APHAKIA|49.7|49.7||
125|92393|92393 - SUPPLY OF ARTIFICIAL EYE|492.59|492.59||
125|92392|92392 - SUPPLY OF LOW VISION AIDS|136.34|136.34||
125|92391|92391 - SUPPLY OF CONTACT LENSES|80.31|80.31||
125|92390|92390 - SUPPLY OF SPECTACLES|128.79|128.79||
125|92371|92371 - RPR&REFITG SPECTACLE PROSTHESIS APHAKIA|87.73|87.73||
125|92370|92370 - RPR&REFITG SPECTACLES EXCEPT APHAKIA|107.86|107.86||
125|92358|92358 - PROSTHESIS SERVICE APHAKIA TEMPORARY|36.65|36.65||
125|92355|92355 - FITTING SPECTACLE MOUNTED LW VIS AID TLSCP|233.69|233.69||
125|92354|92354 - FITTING SPECTACLE MOUNTED LW VIS AID 1 ELMNT|482.78|482.78||
125|92353|92353 - FITTING SPECTACLE PROSTH APHAKIA MULTIFOCAL|48.54|48.54||
125|92352|92352 - FITTING SPECTACLE PROSTH APHAKIA MONOFOCAL|41.17|41.17||
125|92342|92342 - FITTING SPECTACLES XCPT APHAKIA MULTIFOCAL|79.72|79.72||
125|92341|92341 - FITTING SPECTACLES XCPT APHAKIA BIFOCAL|64.51|64.51||
125|92340|92340 - FITTING SPECTACLES XCPT APHAKIA MONOFOCAL|54.37|54.37||
125|92335|92335 - FITTING OF ARTIFICIAL EYE|132.13|132.13||
125|92330|92330 - FITTING OF ARTIFICIAL EYE|121.41|121.41||
125|92326|92326 - REPLACEMENT CONTACT LENS|92.13|92.13||
125|92325|92325 - MODIFICAJ CONTACT LENX SPX SUPVJ ADAPTATION|29.85|29.85||
125|92317|92317 - RX CONTACT CORNEOSCLERAL LENS|161.21|161.21||
125|92316|92316 - RX CONTACT CORNEAL LENS APHAKIA BOTH EYES|127.08|127.08||
125|92315|92315 - RX CONTACT CORNEAL LENS APHAKIA 1 EYE|69.45|69.45||
125|92314|92314 - RX&FTG CONTACT CORNEAL LENS EYES XCPT APHAKIA|131.57|131.57||
125|92313|92313 - RX&FITG CORNEOSCLERAL LENS|249.99|249.99||
125|92312|92312 - RX&FITG CONTACT CORNEAL LENS APHAKIA BOTH EYES|195.46|195.46||
125|92311|92311 - RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE|131.17|131.17||
125|92310|92310 - RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK|208.59|208.59||
125|92287|92287 - ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R|133.02|133.02||75.06
125|92286|92286 - ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY|147.61|147.61||67.48
125|92285|92285 - XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE|62.02|62.02||24.62
125|92284|92284 - DARK ADAPTATION XM W/INTERPRETATION & REPORT|92.67|92.67||26.97
125|92283|92283 - COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV|37.72|37.72||18.32
125|92275|92275 - ELECTRORETINOGRAPY W/INTERPRETATION & REPORT|112.3|112.3||75.47
125|92270|92270 - ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT|90.23|90.23||57.78
125|92265|92265 - NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R|100.88|100.88||44.43
125|92260|92260 - OPHTHALMODYNAMOMETRY|45.5|45.5||
125|92250|92250 - FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT|102.69|102.69||39.32
125|92242|92242 - FLUORESCEIN ICG ANGRPH W/MULTIFRAME I&R UNI/BI|347.68|347.68||88.02
125|92240|92240 - INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI|297.51|297.51||92.07
125|92235|92235 - FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI|141.24|141.24||79.72
125|92230|92230 - FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT|84.24|84.24||
125|92228|92228 - REMOTE IMAGING MGT RETINAL DISEASE W/I&R UNI/B|53.04|53.04||32.89
125|92227|92227 - REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/B|22.27|22.27||
125|92226|92226 - OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R SBS|41.88|41.88||
125|92225|92225 - OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R 1ST|59.12|59.12||
125|92145|92145 - CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI|27.6|27.6||15.35
125|92136|92136 - OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL|116.42|116.42||61.7
125|92134|92134 - COMPUTERIZED OPHTHALMIC IMAGING RETINA|65.12|65.12||41.81
125|92133|92133 - COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE|59.02|59.02||36.23
125|92132|92132 - CMPTR OPHTHALMIC DX IMG ANT SEGMT W/I&R UNI/BI|48.93|48.93||26.67
125|92100|92100 - SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES|86.37|86.37||
125|92083|92083 - VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM|84|84||59.65
125|92082|92082 - VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM|62.62|62.62||28.78
125|92081|92081 - VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM|49.01|49.01||24.11
125|92072|92072 - FITTING CONTACT LENS FOR MNGT OF KERATOCONUS|211.26|211.26||
125|92071|92071 - FIT CONTACT LENS TX OCULAR SURFACE DISEASE|60.26|60.26||
125|92065|92065 - ORTHOPTIC &/PLEOPTIC TRAINING W/MEDICAL DIRECTJ|34.79|34.79||26.11
125|92060|92060 - SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX|55.28|55.28||39.13
125|92025|92025 - COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI|40.51|40.51||24.1
125|92020|92020 - GONIOSCOPY SEPARATE PROCEDURE|38.41|38.41||
125|92019|92019 - OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD|83.18|83.18||
125|92018|92018 - OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL|142.38|142.38||
125|92015|92015 - DETERMINATION REFRACTIVE STATE|69.09|69.09||
125|92014|92014 - OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>|111.17|111.17||
125|92012|92012 - OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT|73.43|73.43||
125|92004|92004 - OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST|147.44|147.44||
125|92002|92002 - OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT|86.4|86.4||
125|91200|91200 - LIVER ELASTOGRAPHY W/O IMAG W/I&R|61.94|61.94||22.8
125|91133|91133 - ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG|27.94|27.94||36.44
125|91132|91132 - ELECTROGASTROGRAPHY DX TRANSCUTANEOUS|27.94|27.94||29.06
125|91122|91122 - ANORECTAL MANOMETRY|262.01|262.01||148.1
125|91120|91120 - RECTAL SESATION TONE & COMPLIANCE TEST|436.35|436.35||54.24
125|91117|91117 - COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R|226.21|226.21||
125|91112|91112 - GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP|1623.48|1623.48||177.43
125|91111|91111 - GASTROINTESTINAL TRACT IMAGING ESOPHAGUS W/I&R|699.39|699.39||90.71
125|91110|91110 - GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R|947.14|947.14||196.91
125|91065|91065 - BREATH HYDROGEN/METHANE TEST|81.71|81.71||48.89
125|91040|91040 - ESOPHGL BALO DISTENSION DX STD W/PROVOCATION|442.1|442.1||53.84
125|91038|91038 - ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG|128.71|128.71||60.9
125|91037|91037 - GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD|148.83|148.83||53.84
125|91035|91035 - GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD|455.45|455.45||86.85
125|91034|91034 - GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT|231.44|231.44||53.84
125|91030|91030 - ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS|126.16|126.16||79.78
125|91022|91022 - DUODENAL MOTILITY MANOMETRIC STUDY|340.19|340.19||125.34
125|91020|91020 - GASTRIC MOTILITY MANOMETRIC STUDIES|225.15|225.15||167.21
125|91013|91013 - ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION|39.15|39.15||15.42
125|91010|91010 - ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT|269.64|269.64||166.62
125|90997|90997 - HEMOPERFUSION|305.48|305.48||
125|90993|90993 - DIALYSIS TRAINING PATIENT PER TRAINING SESSION|157.89|157.89||
125|90989|90989 - DIALYSIS TRAINING PATIENT COMPLETED COURSE|695.54|695.54||
125|90970|90970 - ESRD RELATED SVC <FULL MONTH 20/>YR OLD|12.53|12.53||
125|90969|90969 - ESRD RELATED SVC <FULL MONTH 12-19 YR OLD|24.61|24.61||
125|90968|90968 - ESRD RELATED SVC <FULL MONTH 2-11 YR OLD|25.2|25.2||
125|90967|90967 - ESRD RELATED SVC <FULL MONTH <2 YR OLD|29.18|29.18||
125|90966|90966 - ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD|382.2|382.2||
125|90965|90965 - ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD|732.47|732.47||
125|90964|90964 - ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD|770.37|770.37||
125|90963|90963 - ESRD SVC HOME DIALYSIS FULL MONTH <2YR OLD|882.99|882.99||
125|90962|90962 - ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT|295.36|295.36||
125|90961|90961 - ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS|383.36|383.36||
125|90960|90960 - ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS|456.2|456.2||
125|90959|90959 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT|477.93|477.93||
125|90958|90958 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS|705.4|705.4||
125|90957|90957 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS|1041.42|1041.42||
125|90956|90956 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT|511.93|511.93||
125|90955|90955 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS|738.34|738.34||
125|90954|90954 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS|1317.92|1317.92||
125|90953|90953 - ESRD RELATED SVC MONTHLY <2 YR OLD 1 VISIT|526.75|526.75||
125|90952|90952 - ESRD RELATED SVC MONTHLY <2 YR OLD 2/3 VISITS|789.14|789.14||
125|90951|90951 - ESRD RELATED SVC MONTHLY & <2 YR OLD 4/> VISITS|1529.31|1529.31||
125|90947|90947 - DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS|257.34|257.34||
125|90945|90945 - DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL|155.15|155.15||
125|90940|90940 - HEMODIALYSIS ACCESS FLOW STUDY|63.13|63.13||25.25
125|90939|90939 - HEMDIALY ACCESS FLOW STY -  TRANSCUT|81.49|81.49||
125|90937|90937 - HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX|279.27|279.27||
125|90935|90935 - HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION|161.04|161.04||
125|90911|90911 - BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG|173.61|173.61||
125|90901|90901 - BIOFEEDBACK TRAINING ANY MODALITY|77.01|77.01||
125|90889|90889 - PREP REPORT PT PSYCH STATUS AGENCY/PAYER|102.98|102.98||
125|90887|90887 - INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY|105.29|105.29||
125|90885|90885 - PSYCHIATRIC EVAL HOSPITAL RECORDS DX PURPOSES|106.7|106.7||
125|90882|90882 - ENVIRONMENTAL IVNTJ MGMT PURPOSES PSYC PT|132.07|132.07||
125|90880|90880 - HYPNOTHERAPY|130.85|130.85||
125|90876|90876 - INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN|120.49|120.49||
125|90875|90875 - INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN|88.94|88.94||
125|90871|90871 - ELECTROCONVULSIVE THERAPY (ECT)|188.93|188.93||
125|90870|90870 - ELECTROCONVULSIVE THERAPY|147.22|147.22||
125|90869|90869 - REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN|207.11|207.11||
125|90868|90868 - THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG|146.03|146.03||
125|90867|90867 - REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M|227.38|227.38||
125|90865|90865 - NARCOSYNTHESIS PSYC DX&THER PURPOSES|197.13|197.13||
125|90863|90863 - PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY|42.18|42.18||
125|90853|90853 - GROUP PSYCHOTHERAPY|40.86|40.86||
125|90849|90849 - MULTIPLE FAMILY GROUP PSYCHOTHERAPY|51.71|51.71||
125|90847|90847 - FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS|162.64|162.64||
125|90846|90846 - FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS|142.31|142.31||
125|90845|90845 - PSYCHOANALYSIS|101.21|101.21||
125|90840|90840 - PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES|106.47|106.47||
125|90839|90839 - PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES|222.77|222.77||
125|90838|90838 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN|184.74|184.74||
125|90837|90837 - PSYCHOTHERAPY W/PATIENT 60 MINUTES|213.56|213.56||
125|90836|90836 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN|139.74|139.74||
125|90834|90834 - PSYCHOTHERAPY W/PATIENT 45 MINUTES|142.33|142.33||
125|90833|90833 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN|110.89|110.89||
125|90832|90832 - PSYCHOTHERAPY W/PATIENT 30 MINUTES|106.47|106.47||
125|90792|90792 - PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES|244.47|244.47||
125|90791|90791 - PSYCHIATRIC DIAGNOSTIC EVALUATION|218.84|218.84||
125|90788|90788 - IM INJECTION OF ANTIBIOTIC|22.17|22.17||
125|90785|90785 - PSYCHOTHERAPY COMPLEX INTERACTIVE|23.68|23.68||
125|90784|90784 - IV INJECTION|44.94|44.94||
125|90783|90783 - IA INJECTION|25.81|25.81||
125|90782|90782 - SC/IM INJECTION|21.99|21.99||
125|90781|90781 - IV INFUSION -  EA ADD'L HR UP TO 8HRS|48.15|48.15||
125|90780|90780 - IV INFUSION THERAPY -  UP TO 1 HOUR|103.31|103.31||
125|90756|90756 - CCIIV4 VACCINE ANTIBIOTIC FREE 0.5 ML DOS IM USE|37.15|37.15||
125|90750|90750 - HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX|171.36|171.36||
125|90748|90748 - HIB-HEPB VACCINE FOR INTRAMUSCULAR USE|56.1|56.1||
125|90747|90747 - HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM|212.31|212.31||
125|90746|90746 - HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE|106.15|106.15||
125|90744|90744 - HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM|42.61|42.61||
125|90743|90743 - HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM|42.61|42.61||
125|90740|90740 - HEPB VACCINE DIALYSIS/IMMUNSUP PAT 3 DOSE IM|212.31|212.31||
125|90739|90739 - HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE|213.69|213.69||
125|90738|90738 - JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM|297.97|297.97||
125|90736|90736 - ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE|267.6|267.6||
125|90734|90734 - MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE|145.2|145.2||
125|90733|90733 - MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE|155.04|155.04||
125|90732|90732 - PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE|175.63|175.63||
125|90723|90723 - DTAP-HEPB-IPV VACCINE INTRAMUSCULAR|91.8|91.8||
125|90717|90717 - YELLOW FEVER VACCINE LIVE SUBQ|172.16|172.16||
125|90716|90716 - VAR VACCINE LIVE FOR SUBCUTANEOUS USE|121.75|121.75||
125|90715|90715 - TDAP VACCINE 7 YRS/> IM|52.6|52.6||
125|90714|90714 - TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE|39.4|39.4||
125|90713|90713 - POLIOVIRUS VACCINE INACTIVATED SUBQ/IM|38.4|38.4||
125|90710|90710 - MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ|247.13|247.13||
125|90707|90707 - MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ|70.85|70.85||
125|90702|90702 - DT VACCINE YOUNGER THAN 7 YRS FOR IM USE|60.48|60.48||
125|90700|90700 - DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM|34.86|34.86||
125|90698|90698 - DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE|112.5|112.5||
125|90696|90696 - DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE|62.82|62.82||
125|90691|90691 - TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM|153.84|153.84||
125|90690|90690 - TYPHOID VACCINE LIVE ORAL|79.3|79.3||
125|90688|90688 - IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE|29.08|29.08||
125|90687|90687 - IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE|15.32|15.32||
125|90686|90686 - IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE|31.02|31.02||
125|90685|90685 - IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE|34.56|34.56||
125|90682|90682 - RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM|75.49|75.49||
125|90681|90681 - RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE|140.86|140.86||
125|90680|90680 - RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE|101.3|101.3||
125|90676|90676 - RABIES VACCINE INTRADERMAL|94.8|94.8||
125|90675|90675 - RABIES VACCINE INTRAMUSCULAR|468.28|468.28||
125|90674|90674 - CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE|39.2|39.2||
125|90673|90673 - RIV3 VACCINE PRESERVATIVE FREE FOR IM USE|66.19|66.19||
125|90672|90672 - LAIV4 VACCINE FOR INTRANASAL USE|0.01|0.01||
125|90670|90670 - PCV13 VACCINE FOR INTRAMUSCULAR USE|334.33|334.33||
125|90668|90668 - IIV VACCINE PANDEMIC FOR INTRAMUSCULAR USE|0.01|0.01||
125|90667|90667 - IIV VACCINE PANDEMIC ADJUVANT FOR IM USE|0.01|0.01||
125|90666|90666 - INFLUENZA VACCINE PANDEMIC SPLT PRSRV FREE IM|0.01|0.01||
125|90664|90664 - LAIV VACCINE PANDEMIC FORMULA FOR INTRANASAL USE|0.01|0.01||
125|90662|90662 - IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM|79.92|79.92||
125|90661|90661 - CCIIV3 VACCINE PRESERVATIVE FREE 0.5 ML IM USE|23.93|23.93||
125|90660|90660 - LAIV3 VACCINE LIVE FOR INTRANASAL USE|0.01|0.01||
125|90658|90658 - IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE|19|19||
125|90657|90657 - IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE|11.4|11.4||
125|90656|90656 - IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE|31.38|31.38||
125|90655|90655 - IIV3 VACC PRESRV FREE 0.25 ML DOSAGE IM USE|19.56|19.56||
125|90654|90654 - INFLUENZA VACC IIV3 SPLIT VIRUS PRSRV FREE ID|20.3|20.3||
125|90653|90653 - IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE|81.86|81.86||
125|90651|90651 - 9VHPV VACC 2/3 DOSE SCHED IM USE|207.25|207.25||
125|90650|90650 - 2VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE|169.5|169.5||
125|90649|90649 - 4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE|205.68|205.68||
125|90648|90648 - HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE|26.4|26.4||
125|90647|90647 - HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE|32.4|32.4||
125|90644|90644 - HIB-MENCY VACC 4 DOSE SCHED 6 WKS-18 MONTHS IM|31.5|31.5||
125|90636|90636 - HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM|122.4|122.4||
125|90634|90634 - HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE|36.9|36.9||
125|90633|90633 - HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE|39|39||
125|90632|90632 - HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE|77.1|77.1||
125|90630|90630 - INFLUENZA VACC IIV4 SPLIT VIRUS PRSRV FREE ID|33.15|33.15||
125|90625|90625 - CHOLERA VACCINE ADULT 1 DOSE LIVE FOR ORAL USE|275.4|275.4||
125|90621|90621 - MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM|163.4|163.4||
125|90620|90620 - MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM|196.61|196.61||
125|90586|90586 - BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL|224.4|224.4||
125|90585|90585 - BACILLUS CALMETTE-GUERIN VACC FOR TB LIVE PERQ|224.4|224.4||
125|90581|90581 - ANTHRAX VACCINE SUBCUTANEOUS/IM USE|121.18|121.18||
125|90474|90474 - IM ADM INTRANSL/ORAL EA VACCINE|19.98|19.98||
125|90473|90473 - IM ADM INTRANSL/ORAL 1 VACCINE|31.7|31.7||
125|90472|90472 - IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE|24.16|24.16||
125|90471|90471 - IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE|25.72|25.72||
125|90461|90461 - IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT|19.98|19.98||
125|90460|90460 - IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX|31.7|31.7||
125|90396|90396 - VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM|1599.02|1599.02||
125|90389|90389 - TETANUS IMMUNE GLOBULIN TIG HUMAN IM|609.59|609.59||
125|90386|90386 - RHO(D) IMMUNE GLOBULIN HUMAN IV|11.89|11.89||
125|90385|90385 - RHO(D) IMMUNE GLOBULIN HUMAN MINI-DOSE IM|35.44|35.44||
125|90384|90384 - RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM|92.44|92.44||
125|90378|90378 - RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E|1833.92|1833.92||
125|90376|90376 - RABIES IG HEAT-TREATED HUMAN IM/SUBQ|564.47|564.47||
125|90375|90375 - RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ|513.58|513.58||
125|90371|90371 - HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM|185.02|185.02||
125|90291|90291 - CYTOMEGALOVIRUS IMMUNE GLOBULIN HUMAN IV|1572.84|1572.84||
125|90284|90284 - IMMUNE GLOBULIN HUMAN SUBQ INFUSION 100 MG EA|13.13|13.13||
125|90283|90283 - IMMUNE GLOBULIN IGIV HUMAN IV USE|54.52|54.52||
125|90281|90281 - IMMUNE GLOBULIN IG HUMAN IM USE|91.97|91.97||
125|9007F|9007F - OTHER CAROTID STENT IPSIL TIA/STRK 120 DAYS/>|0.01|0.01||
125|9006F|9006F - SYMPT CAROT STENOS IPSIL CAROT TIA/STRK<120DAYS|0.01|0.01||
125|9005F|9005F - ASYMPT CAROT STEN NO ISCHEM/STRK CAROT/VRTBROBAS|0.01|0.01||
125|9004F|9004F - AORTIC ANEURYSM 6/> CM MAX DIAM CTRLN/AXIAL CT|0.01|0.01||
125|9003F|9003F - AORTIC ARYSM 5.5-5.9CM MAX DIAM CTRLN/AXIAL CT|0.01|0.01||
125|9002F|9002F - AORTIC ANEURYSM 5-5.4CM MAX DIAM CTRLN/AXIAL CT|0.01|0.01||
125|9001F|9001F - AORTIC ANEURYSM<5CM MAX DIAM CENTERLINE/AXIAL CT|0.01|0.01||
125|89356|89356 - THAWING CRYOPRESERVED OOCYTES EACH ALIQUOT|9.05|9.05||1.81
125|89354|89354 - THAWING CRYOPRESERVED TESTICULAR/OVARIAN|12.7|12.7||2.54
125|89353|89353 - THAWING CRYOPRESERVED SPERM/SEMEN EACH ALIQUOT|12.7|12.7||2.54
125|89352|89352 - THAWING CRYOPRESERVED EMBRYO|12.7|12.7||2.54
125|89346|89346 - STORAGE PER YEAR OOCYTE|125.75|125.75||25.15
125|89344|89344 - STORAGE PER YR REPRDTVE TISS TSTICULAR/OVARIAN|142.44|142.44||28.49
125|89343|89343 - STORAGE PER YEAR SPERM/SEMEN|201.24|201.24||40.25
125|89342|89342 - STORAGE PER YEAR EMBRYO|147.53|147.53||29.51
125|89337|89337 - CRYOPRESERVATION MATURE OOCYTE(S)|620.76|620.76||124.15
125|89335|89335 - CRYOPRSRV REPRODUCTIVE TISSUE TESTICULAR|278.1|278.1||83.42
125|89331|89331 - SPERM EVALUATION RETROGRADE EJACULATION URINE|39.41|39.41||
125|89330|89330 - SPERM EVALUATION CERVICAL MUCOUS PENETRATION|41.46|41.46||
125|89329|89329 - SPERM EVALUATION HAMSTER PENETRATION TEST|141.08|141.08||
125|89325|89325 - SPERM ANTIBODIES|65.32|65.32||
125|89322|89322 - SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA|31.18|31.18||
125|89321|89321 - SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM|34.61|34.61||
125|89320|89320 - SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT|36.38|36.38||
125|89310|89310 - SEMEN ALYS MOTILITY&CNT X W/HUHNER TST|21.69|21.69||
125|89300|89300 - SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER|29.78|29.78||
125|89291|89291 - BX OOCYTE MICROTQ >5 EMBRY|991.32|991.32||198.26
125|89290|89290 - BX OOCYTE MICROTQ </= 5 EMBRY|910.5|910.5||182.1
125|89281|89281 - ASSTD FERTILIZATION MICROTQ > 10 OOCYTES|787.45|787.45||157.49
125|89280|89280 - ASSTD FERTILIZATION MICROTQ </EQUAL 10 OOCYTES|715.61|715.61||143.12
125|89272|89272 - EXTND CUL OOCYTE/EMBRYO 4-7 DAYS|556.51|556.51||111.3
125|89268|89268 - INSEMINATION OOCYTES|410.14|410.14||82.03
125|89264|89264 - SPRM ID FROM TSTIS TISS FRSH/CRYOPRSRVD|316.34|316.34||63.26
125|89261|89261 - SPRM ISOL CPLX PREP INSEMINATION/DX SEMEN ALYS|97.46|97.46||19.49
125|89260|89260 - SPRM ISOL SMPL PREP INSEMINATION/DX SEMEN ALYS|112.22|112.22||22.44
125|89259|89259 - CRYOPRSRV SPRM|146.96|146.96||29.39
125|89258|89258 - CRYOPRSRV EMBRYO|586.32|586.32||117.26
125|89257|89257 - SPRM ID FROM ASPIR OTH/THN SEMINAL|303.24|303.24||60.65
125|89255|89255 - PREPJ EMBRYO TR|341.11|341.11||68.22
125|89254|89254 - OOCYTE ID FROM FOLLICULAR FLU|432.07|432.07||86.41
125|89253|89253 - ASSTD EMBRYO HATCHING MICROTQS ANY METH|270|270||81
125|89251|89251 - CUL OOCYTE/EMBRYO < 4 D CO-CULT OCYTE/EMBRY|995.17|995.17||
125|89250|89250 - CUL OOCYTE/EMBRYO <4 DAYS|1551.5|1551.5||
125|89230|89230 - SWEAT COLLECTION IONTOPHORESIS|46.16|46.16||
125|89220|89220 - SPUTUM OBTAINING SPEC AEROSOL INDUCED TX SPX|24.22|24.22||
125|89190|89190 - NASAL SMEAR EOSINOPHILS|12.07|12.07||
125|89160|89160 - MEAT FIBERS FECES|10.41|10.41||
125|89125|89125 - FAT STAIN FECES URINE/RESPIR SECRETIONS|11.45|11.45||
125|89060|89060 - CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID|14.39|14.39||21.22
125|89055|89055 - LEUKOCYTE ASSMT FECAL QUAL/SEMIQUANTITATIVE|15.79|15.79||
125|89051|89051 - CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT|11.84|11.84||
125|89050|89050 - CELL COUNT MISCELLANEOUS BODY FLUIDS|12.8|12.8||
125|89049|89049 - CAFFEINE HALOTHANE CONTRACTURE TEST|415.47|415.47||253.68
125|88741|88741 - HEMOGLOBIN QUANTITATIVE TC PER DAY METHEMOGLOBIN|15.27|15.27||
125|88740|88740 - HEMOGLOBIN QUAN TC PER DAY CARBOXYHEMOGLOBIN|15.27|15.27||
125|88738|88738 - HGB QUANTITATIVE TRANSCUTANEOUS|10.09|10.09||
125|88720|88720 - BILIRUBIN TOTAL TRANSCUTANEOUS|10.09|10.09||
125|88388|88388 - MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SE|54.57|54.57||39.69
125|88387|88387 - MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA|56.2|56.2||47.14
125|88381|88381 - MICRODISSECTION PREP IDENTIFIED TARGET MANUAL|186.5|186.5||41.76
125|88380|88380 - MICRODISSECTION PREP IDENTIFIED TARGET LASER|212.37|212.37||91.36
125|88377|88377 - M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB|620.64|620.64||106.62
125|88375|88375 - OPTICAL ENDOMICROSCOPIC IMAGE INTERP & REPORT|82.4|82.4||46.64
125|88374|88374 - M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB|520.59|520.59||73.14
125|88373|88373 - M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH|121.17|121.17||45.74
125|88372|88372 - PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA|80.91|80.91||29.96
125|88371|88371 - PROTEIN ANAL TISSUE WESTERN BLOT W/INTERP&REPO|57.83|57.83||29.96
125|88369|88369 - M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH|167.89|167.89||53.84
125|88368|88368 - M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL|186.65|186.65||80.58
125|88367|88367 - M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN|204.41|204.41||74.38
125|88366|88366 - IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN|400.77|400.77||103.67
125|88365|88365 - IN SITU HYBRIDIZATION 1ST PROBE STAIN|126.8|126.8||68.07
125|88364|88364 - IN SITU HYBRIDIZATION EA ADDL PROBE STAIN|202.28|202.28||58.16
125|88363|88363 - EXAM & SELECT ARCHIVE TISSUE MOLECULAR ANALYSI|38.27|38.27||23.48
125|88362|88362 - NERVE TEASING PREPARATIONS|262|262||124.82
125|88361|88361 - M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST|162.91|162.91||117.24
125|88360|88360 - M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL|152.41|152.41||63.76
125|88358|88358 - MORPHOMETRIC ANALYSIS TUMOR|318.9|318.9||156.22
125|88356|88356 - MORPHOMETRIC ANALYSIS NERVE|295.96|295.96||172.71
125|88355|88355 - MORPHOMETRIC ANALYSIS SKELETAL MUSCLE|393.77|393.77||130.42
125|88350|88350 - IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN|111.74|111.74||47.91
125|88348|88348 - ELECTRON MICROSCOPY DIAGNOSTIC|400.73|400.73||150.15
125|88346|88346 - IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN|92.98|92.98||49.06
125|88344|88344 - IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE|266.52|266.52||64.91
125|88342|88342 - IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE|124.16|124.16||67.8
125|88341|88341 - IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE|142.17|142.17||47.2
125|88334|88334 - PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE|104.22|104.22||72.77
125|88333|88333 - PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE|177.9|177.9||125.38
125|88332|88332 - PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION|78.11|78.11||69.02
125|88331|88331 - PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC|187.52|187.52||138.29
125|88329|88329 - PATHOLOGY CONSULTATION DURING SURGERY|75.7|75.7||51.31
125|88325|88325 - CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL|198.34|198.34||186.41
125|88323|88323 - CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES|130.1|130.1||93.41
125|88321|88321 - CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE|116.1|116.1||102.38
125|88319|88319 - SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS|145.02|145.02||42.13
125|88314|88314 - SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU|93.49|93.49||40.66
125|88313|88313 - SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT|77.05|77.05||18.63
125|88312|88312 - SPECIAL STAIN GROUP 1 MICROORGANISMS I&R|108.25|108.25||43.31
125|88311|88311 - DECALCIFICATION PROCEDURE|35.18|35.18||27.93
125|88309|88309 - LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM|357.67|357.67||254.93
125|88307|88307 - LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM|254|254||187.46
125|88305|88305 - LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM|150.39|150.39||110.8
125|88304|88304 - LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM|79.99|79.99||58.19
125|88302|88302 - LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM|60.4|60.4||44.4
125|88300|88300 - LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY|28.26|28.26||18
125|88291|88291 - CYTOGENETICS&MOLEC CYTOGENETICS INTERP&REP|42.55|42.55||32.27
125|88289|88289 - CHRMSM ANALYSIS ADDL HIGH RESOLUTION STUDY|77.68|77.68||
125|88285|88285 - CHRMSM ANALYSIS ADDL CELLS COUNTED EACH STUDY|75.94|75.94||
125|88283|88283 - CHRMSM ANALYSIS ADDL SPECIALIZED BANDING|91.42|91.42||
125|88280|88280 - CHRMSM ANALYSIS ADDL KARYOTYP EACH STUDY|83.39|83.39||
125|88275|88275 - MOLEC CYTG INTERPHASE ISH ANALYZE 100-300 CLL|68.89|68.89||
125|88274|88274 - MOLECULAR CYTOGENETICS INTERPHASE ISH 25-99 CLL|59.71|59.71||
125|88273|88273 - MOLECULAR CYTOGENETICS CHRMOML ISH 10-30 CLL|55.1|55.1||
125|88272|88272 - MOLECULAR CYTOGENETICS CHRMOML ISH 3-5 CELLS|45.92|45.92||
125|88271|88271 - MOLECULAR CYTOGENETICS DNA PROBE EACH|36.74|36.74||
125|88269|88269 - CHRMSM SITU AMNIOTIC CLL 6-12 COLONIES 1KARYOTYP|445.84|445.84||
125|88267|88267 - CHRMSM ALYS AMNIOTIC/VILLUS 15 CELL 1KARYOTYPE|401.09|401.09||
125|88264|88264 - CHRMSM ANALYZE 20-25 CELLS|257.66|257.66||
125|88263|88263 - CHRMSM COUNT 45 CELL MOSAICISM 2KARYOTYPE|350.04|350.04||
125|88262|88262 - CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING|396.44|396.44||
125|88261|88261 - CHRMSM COUNT 5 CELL 1KARYOTYPE BANDING|360.43|360.43||
125|88249|88249 - CHRMSM BREAKAGE SYNDS SCORE 100 CLL|377.76|377.76||
125|88248|88248 - CHRMSM BREAKAGE BASELINE BREAKAGE 50-100 CLL|358.02|358.02||
125|88245|88245 - CHRMSM BREAKAGE BASELINE SISTER 20-25 CLL|308.59|308.59||
125|88241|88241 - THAWING&EXPANSION FROZEN CELLS EACH ALIQUOT|54.79|54.79||
125|88240|88240 - CRYOPRSRV FRZING&STORAGE CELLS EA CELL LINE|54.79|54.79||
125|88239|88239 - TISS CUL NEO DISORDERS SOLID TUMOR|305.59|305.59||
125|88237|88237 - TISS CUL NEO DISORDERS BONE MARROW BLOOD CELLS|203.59|203.59||
125|88235|88235 - TISS CUL NON-NEO DISORDERS AMNIOTIC/CHORNC CELLS|237.95|237.95||
125|88233|88233 - TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX|290.61|290.61||
125|88230|88230 - TISS CUL NON-NEO DISORDERS LYMPHOCYTE|241.18|241.18||
125|88189|88189 - FLOW CYTOMETRY INTERPRETATION 16/> MARKERS|164.73|164.73||91.45
125|88188|88188 - FLOW CYTOMETRY INTERPJ 9-15 MARKERS|124.84|124.84||73.74
125|88187|88187 - FLOW CYTOMETRY INTERPJ 2-8 MARKERS|100.31|100.31||57.17
125|88185|88185 - FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY EA|23.67|23.67||
125|88184|88184 - FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST|47.99|47.99||
125|88182|88182 - FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS|146.31|146.31||89.34
125|88180|88180 - CELL MARKER STUDY -  EACH|109.91|109.91||45.88
125|88177|88177 - CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL|48.49|48.49||36.89
125|88175|88175 - CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS|55.4|55.4||
125|88174|88174 - CYTP C/V AUTO THIN LYR PREPJ SCR SYS PHYS|32.96|32.96||
125|88173|88173 - CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT|189.57|189.57||124.66
125|88172|88172 - CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST|92.96|92.96||69.28
125|88167|88167 - CYTP SLIDES C/V MNL SCR&CPTR RESCR CELL S&I|16.12|16.12||
125|88166|88166 - CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS SUPV|15.79|15.79||
125|88165|88165 - CYTP SLIDES C/V MNL SCR&RESCR PHYS SUPV|15.79|15.79||
125|88164|88164 - CYTP SLIDES CERV/VAG MNL SCRN PHYSICIAN SUPV|22.21|22.21||
125|88162|88162 - CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES|95.33|95.33||46.07
125|88161|88161 - CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ|77.29|77.29||39.7
125|88160|88160 - CYTP SMRS ANY OTH SRC SCR&INTERPJ|54.28|54.28||39.7
125|88155|88155 - CYTP SLIDES C/V DEFINITIVE HORMONAL EVAL|18.19|18.19||
125|88154|88154 - CYTP SLIDES C/V MNL SCR&CPTR-RESCR CELL S&I|22.75|22.75||
125|88153|88153 - CYTP SLIDES C/V MNL SCR&RESCR PHYS|22.77|22.77||
125|88152|88152 - CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS|18.17|18.17||
125|88150|88150 - CYTP SLIDES C/V MNL SCR UNDER PHYS|16.46|16.46||
125|88148|88148 - CYTP SMRS C/V SCR AUTO SYS MNL RESCR PHYS|27.4|27.4||
125|88147|88147 - CYTP SMRS C/V SCR AUTOMATED SYSTEM PHYS SUPV|26.22|26.22||
125|88143|88143 - CYTP C/V FLU AUTO THIN MNL SCR&RESCR PHYS|30.29|30.29||
125|88142|88142 - CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN|42.28|42.28||
125|88141|88141 - CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN|48.2|48.2||31.9
125|88140|88140 - SEX CHROMATIN IDENTJ PERIPHERAL BLOOD SMEAR|18.04|18.04||
125|88130|88130 - SEX CHROMATIN IDENTIFICATION BARR BODIES|31.46|31.46||
125|88125|88125 - CYTOPATHOLOGY FORENSIC|27.11|27.11||17.98
125|88121|88121 - CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA|800.17|800.17||82.62
125|88120|88120 - CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL|959.81|959.81||96.58
125|88112|88112 - CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V|176.61|176.61||141.29
125|88108|88108 - CYTP CONCENTRATION SMEARS & INTERPRETATION|94.51|94.51||44.92
125|88106|88106 - CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ|72.56|72.56||32.08
125|88104|88104 - CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ|76.08|76.08||44.92
125|88045|88045 - NECROPSY CORONER CALL|85.09|85.09||56.93
125|88040|88040 - NECROPSY FORENSIC EXAMINATION|1021.04|1021.04||569.33
125|88037|88037 - NECROPSY LIMITD GROSS&/MCRSCP SINGLE ORGAN|187.19|187.19||91.16
125|88036|88036 - NECROPSY LIMITED GROSS&/MCRSCP REGIONAL|255.26|255.26||102.35
125|88029|88029 - NECROPSY GROSS&MCRSCP STILLBORN/NEWBORN BRAIN|394.81|394.81||205.02
125|88028|88028 - NECROPSY GROSS & MICROSCOPIC INFANT W/BRAIN|394.81|394.81||205.02
125|88027|88027 - NECROPSY GROSS&MCRSCP BRAIN & SPINAL CORD|711.31|711.31||364.31
125|88025|88025 - NECROPSY GROSS & MICROSCOPIC W/BRAIN|663.68|663.68||341.59
125|88020|88020 - NECROPSY GROSS & MICROSCOPIC W/O CNS|616.03|616.03||353.11
125|88016|88016 - NECROPSY GROSS EXAM MACERATED STILLBORN|479.9|479.9||261.96
125|88014|88014 - NECROPSY GROSS EXAM STILLBORN/NEWBORN W/BRAIN|394.81|394.81||187.91
125|88012|88012 - NECROPSY GROSS EXAMINATION INFANT W/BRAIN|394.81|394.81||205.02
125|88007|88007 - NECROPSY GROSS EXAMINATION W/BRAIN&SPINAL CORD|524.13|524.13||250.44
125|88005|88005 - NECROPSY GROSS EXAMINATION W/BRAIN|476.48|476.48||239.26
125|88000|88000 - NECROPSY GROSS EXAMINATION ONLY W/O CNS|428.83|428.83||205.02
125|87912|87912 - NFCT AGENT GENOTYPE HEPATITIS B VIRUS|518.08|518.08||
125|87910|87910 - NFCT AGT GENOTYPE NUCLEIC ACID CYTOMEGALOVIRUS|518.08|518.08||
125|87906|87906 - NFCT GEXYP DNA/RNA HIV 1 OTHER REGION|259.04|259.04||
125|87905|87905 - INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS|24.58|24.58||
125|87904|87904 - NFCT PHEXYP RESIST TISS CUL HIV EA ADDL DRUG|165.26|165.26||
125|87903|87903 - NFCT PHEXYP RESIST TISS CUL HIV FIRST 1-10 DRUGS|505.64|505.64||
125|87902|87902 - NFCT AGNT GENOTYP NUCLEIC ACID HEPATITIS C VIRUS|130.38|130.38||
125|87901|87901 - NFCT GEXYP NUCLEIC ACID HIV REV TRNSCR&PROTEAS|130.38|130.38||
125|87900|87900 - NFCT AGT DRUG SUSCEPT PHENOTYPE PREDICTION|262.3|262.3||
125|87899|87899 - IAADIADOO NOT OTHERWISE SPECIFIED|42.26|42.26||
125|87880|87880 - IAADIADOO STREPTOCOCCUS GROUP A|27.86|27.86||
125|87850|87850 - IAADIADOO NEISSERIA GONORRHOEAE|42.26|42.26||
125|87810|87810 - CHLAMYDIA TRACHOMATIS|42.26|42.26||
125|87809|87809 - INFECTIOUS AGENT IMMUNOASSAY OPTICAL ADENOVIRUS|35.47|35.47||
125|87808|87808 - IAADIADOO TRICHOMONAS VAGINALIS|24.92|24.92||
125|87807|87807 - IAADIADOO RESPIRATORY SYNCTIAL VIRUS|17.93|17.93||
125|87806|87806 - IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES|53.42|53.42||
125|87804|87804 - IAADIADOO INFLUENZA|40.38|40.38||
125|87803|87803 - IAADIADOO CLOSTRIDIUM DIFFICILE TOXIN|40.38|40.38||
125|87802|87802 - IAADIADOO STREPTOCOCCUS GROUP B|40.38|40.38||
125|87801|87801 - IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ|58.66|58.66||
125|87800|87800 - IADNA MULTIPLE ORGANISMS DIRECT PROBE TQ|58.96|58.96||
125|87799|87799 - IADNA NOS QUANTIFICATION EACH ORGANISM|97.21|97.21||
125|87798|87798 - IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM|131.97|131.97||
125|87797|87797 - IADNA NOS DIRECT PROBE TQ EACH ORGANISM|48.31|48.31||
125|87662|87662 - IADNA DNA/RNA ZIKA VIRUS AMPLIFIED PROBE TQ|103.26|103.26||
125|87661|87661 - IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH|70.63|70.63||
125|87660|87660 - IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ|46.16|46.16||
125|87653|87653 - IADNA STREPTOCOCCUS GROUP B AMPLIFIED PROBE TQ|70.63|70.63||
125|87652|87652 - IADNA STREPTOCOCCUS GROUP A QUANTIFICATION|97.21|97.21||
125|87651|87651 - IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ|96.61|96.61||
125|87650|87650 - IADNA STREPTOCOCCUS GROUP A DIRECT PROBE TQ|48.3|48.3||
125|87641|87641 - IADNA S AUREUS METHICILLIN RESIST AMP PROBE TQ|70.63|70.63||
125|87640|87640 - IADNA S AUREUS AMPLIFIED PROBE TQ|70.63|70.63||
125|87634|87634 - IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE|141.26|141.26||
125|87633|87633 - IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET|838.72|838.72||
125|87632|87632 - IADNA RESPIRATRY PROBE & REV TRNSCR 6-11 TARGETS|429.49|429.49||
125|87631|87631 - IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS|258.16|258.16||
125|87625|87625 - IADNA HUMAN PAPILLOMAVIRUS TYPES 16 & 18 ONLY|70.63|70.63||
125|87624|87624 - IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES|70.63|70.63||
125|87623|87623 - IADNA HUMAN PAPILLOMAVIRUS LOW-RISK TYPES|70.63|70.63||
125|87592|87592 - IADNA NEISSERIA GONORRHOEAE QUANTIFICATION|94.16|94.16||
125|87591|87591 - IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ|80.04|80.04||
125|87590|87590 - IADNA NEISSERIA GONORRHOEAE DIRECT PROBE TQ|65.91|65.91||
125|87582|87582 - IADNA MYCOPLSM PNEUMONIAE QUANTIFICATION|97.21|97.21||
125|87581|87581 - IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ|96.61|96.61||
125|87580|87580 - IADNA MYCOPLSM PNEUMONIAE DIRECT PROBE TQ|48.3|48.3||
125|87562|87562 - IADNA MYCOBACTERIA AVIUM-INTRACELLULARE QUANT|97.21|97.21||
125|87561|87561 - IADNA MYCOBACTERIA AVIUM-INTRACLRE AMP PRB|96.61|96.61||
125|87560|87560 - IADNA MYCOBACTERIA AVIUM-INTRACLRE DIR PRB|48.3|48.3||
125|87557|87557 - IADNA MYCOBACTERIA TUBERCULOSIS QUANTIFICATION|97.21|97.21||
125|87556|87556 - IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB|96.61|96.61||
125|87555|87555 - IADNA MYCOBACTERIA TUBERCULOSIS DIR PRB|48.3|48.3||
125|87552|87552 - IADNA MYCOBACTERIA SPECIES QUANTIFICATION|97.21|97.21||
125|87551|87551 - IADNA MYCOBACTERIA SPECIES AMPLIFIED PROBE TQ|96.61|96.61||
125|87550|87550 - IADNA MYCOBACTERIA SPECIES DIRECT PROBE TQ|48.3|48.3||
125|87542|87542 - IADNA LEGIONELLA PNEUMOPHILA QUANTIFICATION|97.21|97.21||
125|87541|87541 - IADNA LEGIONELLA PNEUMOPHILA AMPLIFIED PROBE TQ|96.61|96.61||
125|87540|87540 - IADNA LEGIONELLA PNEUMOPHILA DIRECT PROBE TQ|48.3|48.3||
125|87539|87539 - IADNA HIV-2 QUANT & REVERSE TRANSCRIPTION|97.21|97.21||
125|87538|87538 - IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIPJ|96.61|96.61||
125|87537|87537 - IADNA HIV-2 DIRECT PROBE TECHNIQUE|48.3|48.3||
125|87536|87536 - IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION|281.54|281.54||
125|87535|87535 - IADNA HIV-1 AMPLIFIED PROBE & REVERSE TRANSCRPJ|131.97|131.97||
125|87534|87534 - IADNA HIV-1 DIRECT PROBE TECHNIQUE|132.65|132.65||
125|87533|87533 - IADNA HERPES VIRUS-6 QUANTIFICATION|97.21|97.21||
125|87532|87532 - IADNA HERPES VIRUS-6 AMPLIFIED PROBE TQ|96.61|96.61||
125|87531|87531 - IADNA HERPES VIRUS-6 DIRECT PROBE TQ|48.3|48.3||
125|87530|87530 - IADNA HERPES SOMPLX VIRUS QUANTIFICATION|97.21|97.21||
125|87529|87529 - IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ|96.61|96.61||
125|87528|87528 - IADNA HERPES SIMPLX VIRUS DIRECT PROBE TQ|48.3|48.3||
125|87527|87527 - IADNA HEPATITIS G QUANTIFICATION|97.21|97.21||
125|87526|87526 - IADNA HEPATITIS G AMPLIFIED PROBE TECHNIQUE|96.61|96.61||
125|87525|87525 - IADNA HEPATITIS G DIRECT PROBE TECHNIQUE|48.3|48.3||
125|87522|87522 - IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION|265.53|265.53||
125|87521|87521 - IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR|131.97|131.97||
125|87520|87520 - IADNA HEPATITIS C DIRECT PROBE TECHNIQUE|132.65|132.65||
125|87517|87517 - IADNA HEPATITIS B VIRUS QUANTIFICATION|97.21|97.21||
125|87516|87516 - IADNA HEPATITIS B VIRUS AMPLIFIED PROBE TQ|96.61|96.61||
125|87515|87515 - IADNA HEPATITIS B VIRUS DIRECT PROBE TECHNIQUE|48.3|48.3||
125|87512|87512 - IADNA GARDNERELLA VAGINALIS QUANTIFICATION|97.21|97.21||
125|87511|87511 - IADNA GARDNERELLA VAGINALIS AMPLIFIED PROBE TQ|96.61|96.61||
125|87510|87510 - IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ|48.3|48.3||
125|87507|87507 - IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25|838.72|838.72||
125|87506|87506 - IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 6-11|429.49|429.49||
125|87505|87505 - NFCT AGENT DNA/RNA GASTROINTESTINAL PATHOGEN|258.16|258.16||
125|87503|87503 - NFCT AGENT DNA/RNA INFLUENZA >2 TYPES EA ADDL|47.63|47.63||
125|87502|87502 - INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES|171.25|171.25||
125|87501|87501 - INFECTIOUS AGENT DNA/RNA INFLUENZA EA TYPE|103.26|103.26||
125|87500|87500 - INFECTIOUS AGENT DNA/RNA VANCOMYCIN RESISTANCE|70.63|70.63||
125|87498|87498 - IADNA ENTEROVIRUS AMPLIF PROBE & REVRSE TRNSCRIP|70.63|70.63||
125|87497|87497 - IADNA CYTOMEGALOVIRUS QUANTIFICATION|97.21|97.21||
125|87496|87496 - IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ|96.61|96.61||
125|87495|87495 - IADNA CYTOMEGALOVIRUS DIRECT PROBE TQ|48.3|48.3||
125|87493|87493 - INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE|70.63|70.63||27.46
125|87492|87492 - IADNA CHLAMYDIA TRACHOMATIS QUANTIFICATION|150.66|150.66||
125|87491|87491 - IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ|131.82|131.82||
125|87490|87490 - IADNA CHLAMYDIA TRACHOMATIS DIRECT PROBE TQ|109.73|109.73||
125|87487|87487 - IADNA CHLAMYDIA PNEUMONIAE QUANTIFICATION|97.21|97.21||
125|87486|87486 - IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ|96.61|96.61||
125|87485|87485 - IADNA CHLAMYDIA PNEUMONIAE DIRECT PROBE TQ|48.3|48.3||
125|87483|87483 - CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25|838.72|838.72||
125|87482|87482 - IADNA CANDIDA SPECIES QUANTIFICATION|97.21|97.21||
125|87481|87481 - IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ|96.61|96.61||
125|87480|87480 - IADNA CANDIDA SPECIES DIRECT PROBE TQ|48.3|48.3||
125|87477|87477 - IADNA BORRELIA BURGDORFERI QUANTIFICATION|97.21|97.21||
125|87476|87476 - IADNA BORRELIA BURGDORFERI AMPLIFIED PROBE TQ|96.61|96.61||
125|87475|87475 - IADNA BORRELIA BURGDORFERI DIRECT PROBE TQ|48.3|48.3||
125|87472|87472 - IADNA BARTONELLA HENSELAE&QUINTANA QUANTJ|97.21|97.21||
125|87471|87471 - IADNA BARTONELLA AMPLIFIED PROBE TECHNIQUE|96.61|96.61||
125|87470|87470 - IADNA BARTONELLA DIRECT PROBE TECHNIQUE|48.3|48.3||
125|87451|87451 - IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM|14.33|14.33||
125|87450|87450 - IAAD IA SINGLE STEP METHOD NOS EA ORGANISM|49.43|49.43||
125|87449|87449 - IAAD IA MULT STEP METHOD NOS EACH ORGANISM|43.88|43.88||
125|87430|87430 - IAAD IA STREPTOCOCCUS GROUP A|28.89|28.89||
125|87427|87427 - IAAD IA SHIGA-LIKE TOXIN|25.39|25.39||
125|87425|87425 - IAAD IA ROTAVIRUS|27.86|27.86||
125|87420|87420 - IAAD IA RESPIRATORY SYNCTIAL VIRUS|27.86|27.86||
125|87400|87400 - IAAD IA INFLUENZA A/B EACH|25.39|25.39||
125|87391|87391 - IAAD IA HIV-2|44.99|44.99||
125|87390|87390 - IAAD IA HIV-1|44.24|44.24||
125|87389|87389 - IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE|48.46|48.46||
125|87385|87385 - IAAD IA HISTOPLASM CAPSULATUM|46.51|46.51||
125|87380|87380 - IAAD IA HEPATITIS DELTA ANTIGEN|46.14|46.14||
125|87350|87350 - IAAD IA HEPATITIS BE ANTIGEN|30.03|30.03||
125|87341|87341 - IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION|25.39|25.39||
125|87340|87340 - IAAD IA HEPATITIS B SURFACE ANTIGEN|23.58|23.58||
125|87339|87339 - IAAD IA HPYLORI|25.39|25.39||
125|87338|87338 - IAAD IA HPYLORI STOOL|21.51|21.51||
125|87337|87337 - IAAD IA ENTAMOEBA HISTOLYTICA GRP|25.39|25.39||
125|87336|87336 - IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP|25.39|25.39||
125|87335|87335 - IAAD IA ESCHERICHIA COLI 0157|46.14|46.14||
125|87332|87332 - IAAD IA CYTOMEGALOVIRUS|46.14|46.14||
125|87329|87329 - IAAD IA GIARDIA|25.39|25.39||
125|87328|87328 - IAAD IA CRYPTOSPORIDIUM|23.72|23.72||
125|87327|87327 - IAAD IA CRYPTOCOCCUS NEOFORMANS|25.39|25.39||
125|87324|87324 - IAAD IA CLOSTRIDIUM DIFFICILE TOXIN|23.54|23.54||
125|87320|87320 - IAAD IA CHLAMYDIA TRACHOMATIS|24.86|24.86||
125|87305|87305 - IAAD IA QUAL/SEMIQUAN MULTIPLE STEP ASPERGILLUS|24.12|24.12||
125|87301|87301 - IAAD IA ADENOVIRUS ENTERIC TYP 40/41|46.14|46.14||
125|87300|87300 - IAADI POLYV MLT ORGANISMS EA POLYV ANTISERUM|17.93|17.93||
125|87299|87299 - IAADI NOT OTHERWISE SPECIFIED EACH ORGANISM|36.06|36.06||
125|87290|87290 - IAADI VARICELLA ZOSTER VIRUS|33.57|33.57||
125|87285|87285 - IAADI TREPONEMA PALLIDUM|33.14|33.14||
125|87283|87283 - IAADI RUBEOLA|46.16|46.16||
125|87281|87281 - IAADI PNEUMOCUSTIS CARINII|46.16|46.16||
125|87280|87280 - IAADI RESPIRATORY SYNCTIAL VIRUS|33.14|33.14||
125|87279|87279 - IAADI PARAINFLUENZA VIRUS EACH TYPE|46.16|46.16||
125|87278|87278 - IAADI LEGIONELLA PNEUMOPHILA|37.29|37.29||
125|87277|87277 - IAADI LEGIONELLA MICDADEI|46.16|46.16||
125|87276|87276 - IAADI INFFLUENZA A VIRUS|65.63|65.63||
125|87275|87275 - IAADI INFLUENZA B VIRUS|46.16|46.16||
125|87274|87274 - IAADI HERPES SMPLX VIRUS TYPE 1|35.43|35.43||
125|87273|87273 - IAADI HERPES SMPLX VIRUS TYPE 2|46.16|46.16||
125|87272|87272 - IAADI CRYPTOSPORIDIUM|65.63|65.63||
125|87271|87271 - IAADI CYTOMEGALOVIRUS DIR FLUORESCENT ANTIBODY|46.16|46.16||
125|87270|87270 - IAADI CHLAMYDIA TRACHOMATIS|34.58|34.58||
125|87269|87269 - IAADI GIARDIA|46.16|46.16||
125|87267|87267 - IAADI ENTEROVIRUS DIRECT FLUORESCENT ANTIBODY|46.16|46.16||
125|87265|87265 - IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS|76.46|76.46||
125|87260|87260 - IAADI ADENOVIRUS|36.39|36.39||
125|87255|87255 - VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC|57.69|57.69||
125|87254|87254 - VIRUS CENTRIFUGE ENHNCD ID IMFLUOR STAIN EA|57.69|57.69||
125|87253|87253 - VIRUS TISSUE CULTURE ADDL STDY/ID EACH ISOLATE|38.54|38.54||
125|87252|87252 - VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT|44.97|44.97||
125|87250|87250 - VIRUS INOCULATION EGGS/SM ANIMAL OBS&DSJ|45.79|45.79||
125|87230|87230 - TOXIN/ANTITOXIN ASSAY TISSUE CULTURE|42.17|42.17||
125|87220|87220 - TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT|14.72|14.72||
125|87210|87210 - SMR PRIM SRC WET MOUNT NFCT AGT|12.07|12.07||5.98
125|87209|87209 - SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS|36.17|36.17||25.15
125|87207|87207 - SMR PRIM SRC SPEC STAIN BODIES/PARASITS|20.53|20.53||21.22
125|87206|87206 - SMR PRIM SRC FLUORESCENT&/AFS BCT FNGI PARASIT|17.43|17.43||7.54
125|87205|87205 - SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL|11|11||3.28
125|87199|87199 - ENTEROVIRUS ANTIBODY DFA|46.16|46.16||
125|87198|87198 - CYTOMEGLAVIRUS ANTIBODY DFA|46.16|46.16||
125|87197|87197 - SERUM BACTERICIDAL TITER|35.01|35.01||
125|87190|87190 - SUSCEPTIBLTY STDY ANTMCRB MYCOBACT PROPORJ MTHD|32.75|32.75||
125|87188|87188 - SC STD ANTMCRB AGT MACROBROTH DIL METH EA AGT|21.84|21.84||
125|87187|87187 - SUSCEPTIBLTY STDY ANTMCRB MICRO/AGAR DILUTJ EA|23.13|23.13||
125|87186|87186 - SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ|21.94|21.94||
125|87185|87185 - SUSCEPTIBILITY STUDY ANTIMICROBIAL ENZYME DETCJ|23.08|23.08||
125|87184|87184 - SUSCEPTIBILITY STUDY ANTIMICROBIAL DISK METHOD|17.86|17.86||
125|87181|87181 - SUSCEPTBILTY STDY ANTIMICRBIAL AGNT AGAR DILUTJ|17.38|17.38||
125|87177|87177 - OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID|22.94|22.94||
125|87176|87176 - HOMOGENIZATION TISSUE CULTURE|14.01|14.01||
125|87172|87172 - PINWORM EXAMINATION|9.22|9.22||
125|87169|87169 - MACROSCOPIC EXAMINATION PARASITE|9.22|9.22||
125|87168|87168 - MACROSCOPIC EXAMINATION ARTHROPOD|9.22|9.22||
125|87166|87166 - DARK FIELD EXAM ANY SOURCE W/O SPECIMEN COLLECT|22.63|22.63||
125|87164|87164 - DARK FIELD EXAM ANY SOURCE W/SPECIMEN COLLECTION|38.82|38.82||23.95
125|87158|87158 - CULTURE TYPING OTHER METHODS|35.19|35.19||
125|87153|87153 - CULTYP NUCLEIC ACID SEQUENCING METH EA ISOLATE|232.14|232.14||99.13
125|87152|87152 - CULTURE TYPING IDENTIFJ PULSE FIELD GEL TYPING|7.82|7.82||
125|87150|87150 - CULTYP NUC ACID AMP PRB CULT/ISOLATE EA ORGNISM|70.63|70.63||27.46
125|87149|87149 - CULTURE TYPING NUCLEIC ACID PROBE DIR EA ORGANSM|46.16|46.16||
125|87147|87147 - CULTURE TYPING IMMUNOLOGIC OTH/THN IMMUNOFLUORES|12.64|12.64||
125|87143|87143 - CULTURE TYPING GAS/HIGH PRES LIQ CHROMATOGRAPHY|29.33|29.33||
125|87140|87140 - CULTURE TYPING IMMUNOFLUORESCENT EACH ANTISERUM|13.72|13.72||
125|87118|87118 - CULTURE MYCOBACTERIAL DEFINITIVE ID EA ISOL|40.21|40.21||
125|87116|87116 - CULTURE TUBERCLE/OTH ACID-FAST BACILLI ANY ISOL|32.47|32.47||
125|87110|87110 - CULTURE CHLAMYDIA ANY SOURCE|41.26|41.26||
125|87109|87109 - CULTURE MYCOPLASMA ANY SOURCE|46.91|46.91||
125|87107|87107 - CULTURE FUNGI DEFINITIVE ID EACH ORGANISM MOLD|31.16|31.16||
125|87106|87106 - CULTURE FUNGI DEFINITIVE ID EACH ORGANISM YEAST|23.87|23.87||
125|87103|87103 - CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD|27.25|27.25||
125|87102|87102 - CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD|21.31|21.31||
125|87101|87101 - CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL|24.08|24.08||
125|87088|87088 - CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE|20.45|20.45||
125|87086|87086 - CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE|23.14|23.14||
125|87084|87084 - CUL PRSMPTV PTHGNC ORGANISMS SCR DNS CHART|18.75|18.75||
125|87081|87081 - CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ|16.99|16.99||
125|87077|87077 - CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL|35.76|35.76||
125|87076|87076 - CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL|27.72|27.72||
125|87075|87075 - CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID|32.95|32.95||
125|87073|87073 - CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL|35.76|35.76||
125|87071|87071 - CUL BACT QUAN AEROBIC ISOL XCPT UR BLOOD/STOOL|32.3|32.3||
125|87070|87070 - CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL|20.84|20.84||
125|87046|87046 - CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA|32.3|32.3||
125|87045|87045 - CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL|27.25|27.25||
125|87040|87040 - CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES|26.36|26.36||
125|87015|87015 - CONCENTRATION INFECTIOUS AGENTS|21.72|21.72||
125|87003|87003 - ANIMAL INOCULATION SMALL ANIMAL W/OBS&DSJ|41.21|41.21||
125|86985|86985 - SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT|28.7|28.7||
125|86978|86978 - PRETX SERUM RBC ANTIBODY ID DIFFIAL EACH ABSRPJ|30.07|30.07||
125|86977|86977 - PRETX SERUM RBC ANTB ID INCUBATION INHIBITORS EA|13.66|13.66||
125|86976|86976 - PRETX SERUM RBC ANTIBODY IDENTIFICATION DILUTION|10.94|10.94||
125|86975|86975 - PRETX SERUM RBC ANTIBODY INCUBATION DRUGS EACH|13.66|13.66||
125|86972|86972 - PRETX RBC ANTIBODY INCUBAT W/DENSITY GRAD SEP|20.49|20.49||
125|86971|86971 - PRETX RBC ANTIBODY INCUBAT W/ENZYMES EACH|21.86|21.86||
125|86970|86970 - PRETX RBC ANTIBODY INCUBAT W/CHEM AGNTS/DRUGS EA|21.86|21.86||
125|86965|86965 - POOLING PLATELETS/OTHER BLOOD PRODUCTS|14.94|14.94||
125|86960|86960 - VOLUME REDUCTION BLOOD/BLOOD PRODUCT EACH UNIT|29.62|29.62||
125|86950|86950 - LEUKOCYTE TRANSFUSION|75.14|75.14||
125|86945|86945 - IRRADIATION BLOOD PRODUCT EACH UNIT|40.98|40.98||
125|86941|86941 - HEMOLYSINS&AGGLUTININS INCUBATED|28.99|28.99||
125|86940|86940 - HEMOLYSINS&AGGLUTININS AUTO SCREEN EACH|20.34|20.34||
125|86932|86932 - FROZEN BLOOD EACH UNIT FREEZING & THAWING|163.95|163.95||
125|86931|86931 - FROZEN BLOOD EACH UNIT THAWING|150.28|150.28||
125|86930|86930 - FROZEN BLOOD EACH UNIT FREEZING|136.62|136.62||
125|86927|86927 - FRESH FROZEN PLASMA THAWING EACH UNIT|15.03|15.03||
125|86923|86923 - COMPATIBILITY EACH UNIT ELECTRONIC|25.34|25.34||
125|86922|86922 - COMPATIBILITY EACH UNIT ANTIGLOBULIN|16.39|16.39||
125|86921|86921 - COMPATIBILITY EACH UNIT INCUBATION|27.93|27.93||
125|86920|86920 - COMPATIBILITY EACH UNIT IMMEDIATE SPIN TECHNIQUE|30.06|30.06||
125|86911|86911 - BLOOD TYPING PATERNITY INDIV ADDL ANTIGEN SYS|23.22|23.22||
125|86910|86910 - BLOOD TYPING PATERNITY PR INDIV ABO RH&MN|30.06|30.06||
125|86906|86906 - BLOOD TYPING SEROLOGIC RH PHENOTYPING COMPLETE|52.14|52.14||
125|86905|86905 - BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH|25.71|25.71||
125|86904|86904 - BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT|19.76|19.76||
125|86902|86902 - BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH|10.35|10.35||
125|86901|86901 - BLOOD TYPING SEROLOGIC RH (D)|9.8|9.8||
125|86900|86900 - BLOOD TYPING SEROLOGIC ABO|8.12|8.12||
125|86891|86891 - AUTOL BLD/COMPONENT COLLJ STORAGE SALVAGE|170.77|170.77||
125|86890|86890 - AUTOL BLD/COMPONENT COLLJ STORAGE PREDEPOSITED|109.29|109.29||
125|86886|86886 - ANTIHUMAN GLOBULIN INDIRECT EACH ANTIBODY TITER|14.91|14.91||
125|86885|86885 - ANTIHUMAN GLOBULIN INDIR QUAL EA REAGENT CELL|12.27|12.27||
125|86880|86880 - ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM|10.68|10.68||
125|86870|86870 - ANTIBODY ID RBC ANTIBODIES EA PANEL EA SERUM TQ|47.82|47.82||
125|86860|86860 - ANTIBODY ELUTION RBC EACH ELUTION|27.33|27.33||
125|86850|86850 - ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE|18.91|18.91||
125|86835|86835 - ANTIBODY HLA CLASS II SEMIQUANTITATIVE PANEL|649.91|649.91||
125|86834|86834 - ANTIBODY HLA CLASS I SEMIQUANTITATIVE PANEL|719.53|719.53||
125|86833|86833 - ANTIBODY HLA CLASS II HIGH DEFINITION PANEL QUAL|531.05|531.05||
125|86832|86832 - ANTIBODY HLA CLASS I HIGH DEFINITION PANEL QUAL|527.71|527.71||
125|86831|86831 - ANTIBODY HLA CLASS II PHENOTYPE PANEL QUAL|139.27|139.27||
125|86830|86830 - ANTIBODY HLA CLASS I PHENOTYPE PANEL QUALITATIVE|162.48|162.48||
125|86829|86829 - ANTIBODY HLA CLASS I OR CLASS II ANTIGENS QUAL|104.63|104.63||
125|86828|86828 - ANTIBODY HLA CLASS I & CLASS II ANTIGENS QUAL|104.63|104.63||
125|86826|86826 - HLA CROSSMATCH NONCYTOTOXIC ADDL SERUM/DILUTION|59.54|59.54||36.54
125|86825|86825 - HLA CROSSMATCH NONCYTOTOXIC 1ST SERUM/DILUTION|178.47|178.47||109.58
125|86822|86822 - HLA TYPING LYMPHOCYTE CULTURE PRIMED|80.58|80.58||
125|86821|86821 - HLA TYPING LYMPHOCYTE CULTURE MIXED|183.23|183.23||
125|86817|86817 - HLA TYPING DR/DQ MULTIPLE ANTIGENS|189.02|189.02||
125|86816|86816 - HLA TYPING DR/DQ SINGLE ANTIGEN|85.74|85.74||
125|86813|86813 - HLA TYPING A/B/C MULTIPLE ANTIGENS|111.4|111.4||
125|86812|86812 - HLA TYPING A/B/C SINGLE ANTIGEN|58.66|58.66||
125|86808|86808 - SERUM SCREENING % REACTIVE ANTIBODY QUICK METH|72.46|72.46||
125|86807|86807 - SERUM SCREENING % REACTIVE ANTIBODY STANDRD METH|72.27|72.27||
125|86806|86806 - LMPHOCYTOTOXICITY ASSAY VIS CROSSMTCH W/O TITRAT|71.14|71.14||
125|86805|86805 - LYMPHOCYTOTOXICITY ASSAY VIS CROSSMATCH TITRATJ|194.98|194.98||
125|86804|86804 - HEPATITIS C ANTIBODY CONFIRMATORY TEST|62.11|62.11||
125|86803|86803 - HEPATITIS C ANTIBODY|33.21|33.21||
125|86800|86800 - THYROGLOBULIN ANTIBODY|37.05|37.05||
125|86794|86794 - ZIKA VIRUS IGM ANTIBODY|33.9|33.9||
125|86793|86793 - ANTIBODY YERSINIA|46.33|46.33||
125|86790|86790 - ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED|35.98|35.98||
125|86789|86789 - ANTIBODY WEST NILE VIRUS|28.97|28.97||
125|86788|86788 - ANTIBODY WEST NILE VIRUS IGM|33.9|33.9||
125|86787|86787 - ANTIBODY VARICELLA-ZOSTER|34.29|34.29||
125|86784|86784 - ANTIBODY TRICHINELLA|36.35|36.35||
125|86780|86780 - ANTIBODY TREPONEMA PALLIDUM|26.63|26.63||
125|86778|86778 - ANTIBODY TOXOPLASMA IGM|38.15|38.15||
125|86777|86777 - ANTIBODY TOXOPLASMA|32.4|32.4||
125|86774|86774 - ANTIBODY TETANUS|50.8|50.8||
125|86771|86771 - ANTIBODY SHIGELLA|52.7|52.7||
125|86768|86768 - ANTIBODY SALMONELLA|37.87|37.87||
125|86765|86765 - ANTIBODY RUBEOLA|34.08|34.08||
125|86762|86762 - ANTIBODY RUBELLA|20.68|20.68||
125|86759|86759 - ANTIBODY ROTAVIRUS|41.9|41.9||
125|86757|86757 - ANTIBODY RICKETTSIA|46.16|46.16||
125|86756|86756 - ANTIBODY RESPIRATORY SYNCTIAL VIRUS|35.6|35.6||
125|86753|86753 - ANTIBODY PROTOZOA NES|71.56|71.56||
125|86750|86750 - ANTIBODY PLASMODIUM MALARIA|72.88|72.88||
125|86747|86747 - ANTIBODY PARVOVIRUS|45.98|45.98||
125|86744|86744 - ANTIBODY NOCARDIA|58.85|58.85||
125|86741|86741 - ANTIBODY NEISSERIA MENINGITIDIS|33.37|33.37||
125|86738|86738 - ANTIBODY MYCOPLSM|32.09|32.09||
125|86735|86735 - ANTIBODY MUMPS|32.29|32.29||
125|86732|86732 - ANTIBODY MUCORMYCOSIS|37.75|37.75||
125|86729|86729 - ANTIBODY LYMPHOGRANULOMA VENEREUM|37.03|37.03||
125|86727|86727 - ANTIBODY LYMPHOCYTIC CHORIOMENINGITIS|42.56|42.56||
125|86723|86723 - ANTIBODY LISTERIA MONOCYTOGENES|52.54|52.54||
125|86720|86720 - ANTIBODY LEPTOSPIRA|35.02|35.02||
125|86717|86717 - ANTIBODY LEISHMANIA|37.16|37.16||
125|86713|86713 - ANTIBODY LEGIONELLA|42.65|42.65||
125|86711|86711 - ANTIBODY JOHN CUNNINGHAM VIRUS|28.97|28.97||
125|86710|86710 - ANTIBODY INFLUENZA VIRUS|35.55|35.55||
125|86709|86709 - HEPATITIS ANTIBODY HAAB IGM ANTIBODY|32.39|32.39||
125|86708|86708 - HEPATITIS A ANTIBODY HAAB|33.39|33.39||
125|86707|86707 - HEPATITIS BE ANTIBODY HBEAB|30.37|30.37||
125|86706|86706 - HEPATITIS B SURF ANTIBODY HBSAB|28.28|28.28||
125|86705|86705 - HEPATITIS B CORE ANTIBODY HBCAB IGM ANTIBODY|34.95|34.95||
125|86704|86704 - HEPATITIS B CORE ANTIBODY HBCAB TOTAL|31.28|31.28||
125|86703|86703 - ANTIBODY HIV-1&HIV-2 SINGLE RESULT|39.88|39.88||
125|86702|86702 - ANTIBODY HIV-2|52.54|52.54||
125|86701|86701 - ANTIBODY HIV-1|26.76|26.76||
125|86698|86698 - ANTIBODY HISTOPLASMA|34.52|34.52||
125|86696|86696 - ANTIBODY HERPES SMPLX TYPE 2|50.78|50.78||
125|86695|86695 - ANTIBODY HERPES SMPLX TYPE 1|37.87|37.87||
125|86694|86694 - ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST|32.74|32.74||
125|86692|86692 - ANTIBODY HEP DELTA AGENT|41.23|41.23||
125|86689|86689 - ANTIBODY HTLV/HIV ANTIBODY CONFIRMATORY TEST|46.03|46.03||
125|86688|86688 - ANTIBODY HTLV-II|37.47|37.47||
125|86687|86687 - ANTIBODY HTLV-I|37.58|37.58||
125|86684|86684 - ANTIBODY HAEMOPHILUS INFLUENZA|37.15|37.15||
125|86682|86682 - ANTIBODY HELMINTH NOT ELSEWHERE SPECIFIED|44.67|44.67||
125|86677|86677 - ANTIBODY HELICOBACTER PYLORI|46.25|46.25||
125|86674|86674 - ANTIBODY GIARDIA LAMBLIA|34.57|34.57||
125|86671|86671 - ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED|39.85|39.85||
125|86668|86668 - ANTIBODY FRANCISELLA TULARENSIS|26.1|26.1||
125|86666|86666 - ANTIBODY EHRLICHIA|51.93|51.93||
125|86665|86665 - ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA|40.24|40.24||
125|86664|86664 - ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA|40.22|40.22||
125|86663|86663 - ANTIBODY EPSTEIN-BARR EB VIRUS EARLY ANTIGEN EA|35.64|35.64||
125|86658|86658 - ANTIBODY ENTEROVIRUS|32.27|32.27||
125|86654|86654 - ANTIBODY ENCEPHALITIS WESTRN EQUINE|34.61|34.61||
125|86653|86653 - ANTIBODY ENCEPHALITIS ST. LOUIS|34.61|34.61||
125|86652|86652 - ANTIBODY ENCEPHALITIS EASTERN EQUINE|34.61|34.61||
125|86651|86651 - ANTIBODY ENCEPHALITIS CALIFORNIA LA CROSSE|34.61|34.61||
125|86648|86648 - ANTIBODY DIPHTHERIA|41.28|41.28||
125|86645|86645 - ANTIBODY CYTOMEGALOVIRUS CMV IGM|39.47|39.47||
125|86644|86644 - ANTIBODY CYTOMEGALOVIRUS CMV|33.12|33.12||
125|86641|86641 - ANTIBODY CRYPTOCOCCUS|29.47|29.47||
125|86638|86638 - ANTIBODY COXIELLA BURNETII Q FEVER|32.99|32.99||
125|86635|86635 - ANTIBODY COCCIDIOIDES|41.11|41.11||
125|86632|86632 - ANTIBODY CHLAMYDIA IGM|38.59|38.59||
125|86631|86631 - ANTIBODY CHLAMYDIA|33.07|33.07||
125|86628|86628 - ANTIBODY CANDIDA|44.06|44.06||
125|86625|86625 - ANTIBODY CAMPYLOBACTER|44.31|44.31||
125|86622|86622 - ANTIBODY BRUCELLA|25.78|25.78||
125|86619|86619 - ANTIBODY BORRELIA RELAPSING FEVER|82.39|82.39||
125|86618|86618 - ANTIBODY BORRELIA BURGDORFERI LYME DISEASE|41.26|41.26||
125|86617|86617 - ANTIBODY BORRELIA BURGDORFERI CONFIRMATORY TST|46.8|46.8||
125|86615|86615 - ANTIBODY BORDETELLA|44.32|44.32||
125|86612|86612 - ANTIBODY BLASTOMYCES|39.42|39.42||
125|86611|86611 - ANTIBODY BARTONELLA|51.93|51.93||
125|86609|86609 - ANTIBODY BACTERIUM NOT ELSEWHERE SPECIFIED|71.84|71.84||
125|86606|86606 - ANTIBODY ASPERGILLUS|40.71|40.71||
125|86603|86603 - ANTIBODY ADENOVIRUS|36.63|36.63||
125|86602|86602 - ANTIBODY ACTINOMYCES|33.82|33.82||
125|86593|86593 - SYPHILIS TEST QUANTITATIVE|11.53|11.53||
125|86592|86592 - SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL|10.79|10.79||
125|86590|86590 - STREPTOKINASE ANTIBODY|25.69|25.69||
125|86587|86587 - STEM CELLS -  TOTAL COUNT|35.21|35.21||
125|86585|86585 - TB TINE TEST|13.38|13.38||
125|86580|86580 - SKIN TEST TUBERCULOSIS INTRADERMAL|18.74|18.74||
125|86510|86510 - SKIN TEST HISTOPLASMOSIS|20.88|20.88||
125|86490|86490 - SKIN TEST COCCIDIOIDOMYCOSIS|19.38|19.38||
125|86486|86486 - SKIN TEST UNLISTED ANTIGEN EACH|7.48|7.48||
125|86485|86485 - SKIN TEST CANDIDA|20.49|20.49||
125|86481|86481 - TB ANTIGEN RESPONSE GAMMA INTERFERON T-CELL SUSP|163|163||
125|86480|86480 - TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON|124.73|124.73||
125|86431|86431 - RHEUMATOID FACTOR QUANTITATIVE|16.18|16.18||
125|86430|86430 - RHEUMATOID FACTOR QUALITATIVE|15.35|15.35||
125|86406|86406 - PARTICLE AGGLUTINATION TITER EACH ANTIBODY|30.7|30.7||
125|86403|86403 - PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY|20.34|20.34||
125|86386|86386 - NUCLEAR MATRIX PROTEIN 22 NMP22 QUALITATIVE|35.5|35.5||
125|86384|86384 - NITROBLUE TETRAZOLIUM DYE TEST NTD|58.48|58.48||
125|86382|86382 - NEUTRALIZATION TEST VIRAL|60.59|60.59||
125|86379|86379 - NATURAL KILLER CELLS -  TOTAL COUNT|35.21|35.21||
125|86378|86378 - MIGRATION INHIBITORY FACTOR TEST MIF|59.29|59.29||
125|86376|86376 - MICROSOMAL ANTIBODIES EACH|34.89|34.89||
125|86367|86367 - STEM CELLS TOTAL COUNT|126.78|126.78||
125|86361|86361 - T CELLS ABSOLUTE CD4 COUNT|83.71|83.71||
125|86360|86360 - T CELLS ABSOLUTE CD4&CD8 COUNT RATIO|105.46|105.46||
125|86359|86359 - T CELLS TOTAL COUNT|76.17|76.17||
125|86357|86357 - NATURAL KILLER CELLS TOTAL COUNT|75.93|75.93||
125|86356|86356 - MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA|53.89|53.89||
125|86355|86355 - B CELLS TOTAL COUNT|75.93|75.93||
125|86353|86353 - LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS|126.25|126.25||
125|86352|86352 - CELLULAR FUNCTION ASSAY STIMUL&DETECT BIOMARKE|273.4|273.4||190.09
125|86344|86344 - LEUKOCYTE PHAGOCYTOSIS|32.93|32.93||
125|86343|86343 - LEUKOCYTE HISTAMINE RELEASE TEST LHR|56.65|56.65||
125|86341|86341 - ISLET CELL ANTIBODY|37.08|37.08||
125|86340|86340 - INTRINSIC FACTOR ANTIBODIES|35.41|35.41||
125|86337|86337 - INSULIN ANTIBODIES|48.75|48.75||
125|86336|86336 - INHIBIN A|57.69|57.69||
125|86335|86335 - IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS|43.87|43.87||20.4
125|86334|86334 - IMMUNOFIXJ ELECTROPHORESIS SERUM|69.21|69.21||37.5
125|86332|86332 - IMMUNE COMPLEX ASSAY|52.9|52.9||
125|86331|86331 - IMMUNODIFFUSION GEL DIFFUSION QUAL EA AG/ANTBDY|40.08|40.08||
125|86329|86329 - IMMUNODIFFUSION NOT ELSEWHERE SPECIFIED|41.29|41.29||
125|86327|86327 - IMMUNOELECTROPHORESIS CROSSED|45.95|45.95||32.68
125|86325|86325 - IMMUNOELECTROPHORESIS OTHER FLUIDS CONCENTRATION|63.98|63.98||30.22
125|86320|86320 - IMMUNOELECTROPHORESIS SERUM|57.17|57.17||30.32
125|86318|86318 - IMMUNOASSAY NFCT AGT ANTB QUAL/SEMIQUAN 1 STEP|29.38|29.38||
125|86317|86317 - IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUAN NOS|29.07|29.07||
125|86316|86316 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE|60.74|60.74||
125|86310|86310 - HETEROPHILE ANTIBODIES TITER AFTER ABSORPTION|23.13|23.13||
125|86309|86309 - HETEROPHILE ANTIBODIES TITER|18.36|18.36||
125|86308|86308 - HETEROPHILE ANTIBODIES SCREEN|15.39|15.39||
125|86305|86305 - HUMAN EPIDIDYMIS PROTEIN 4 (HE4)|41.89|41.89||
125|86304|86304 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125|60.01|60.01||
125|86301|86301 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9|60.01|60.01||
125|86300|86300 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3|36.42|36.42||
125|86294|86294 - IMMUNOASSAY TUMOR ANTIGEN QUAL/SEMIQUANTITATIVE|60.01|60.01||
125|86280|86280 - HEMAGGLUTINATION INHIBITION TEST HAI|26.96|26.96||
125|86277|86277 - GROWTH HORMONE HUMAN ANTIBODY|30.87|30.87||
125|86256|86256 - FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY|40.14|40.14||30.22
125|86255|86255 - FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY|36.95|36.95||30
125|86243|86243 - FC RECEPTOR|47.96|47.96||
125|86235|86235 - EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD|38.45|38.45||
125|86226|86226 - DNA ANTIBODY SINGLE STRANDED|43.04|43.04||
125|86225|86225 - DNA ANTIBODY NATIVE/DOUBLE STRANDED|35.33|35.33||
125|86215|86215 - DEOXYRIBONUCLEASE ANTIBODY|35.09|35.09||
125|86200|86200 - CYCLIC CITRULLINATED PEPTIDE ANTIBODY|26.05|26.05||
125|86185|86185 - CNTERIMMUNOELECTROPHORESIS EACH ANTIGEN|22.93|22.93||
125|86171|86171 - COMPLEMENT FIXATION TESTS EACH ANTIGEN|30.32|30.32||
125|86162|86162 - COMPLEMENT TOTAL HEMOLYTIC|55.05|55.05||
125|86161|86161 - COMPLEMENT FUNCTIONAL ACTIVITY EACH COMPONENT|27.82|27.82||
125|86160|86160 - COMPLEMENT ANTIGEN EACH COMPONENT|46.95|46.95||
125|86157|86157 - COLD AGGLUTININ TITER|20.04|20.04||
125|86156|86156 - COLD AGGLUTININ SCREEN|15.35|15.35||
125|86155|86155 - CHEMOTAXIS ASSAY SPECIFY METHOD|38.43|38.43||
125|86153|86153 - CELL ENUMERATION IMMUNE SELECTJ & ID PHYS INTERP|34.46|34.46||55.99
125|86152|86152 - CELL ENUMERATION IMMUNE SELECTJ & ID FLUID SPEC|494.44|494.44||
125|86148|86148 - ANTI-PHOSPHATIDYLSERINE ANTIBODY|24.01|24.01||
125|86147|86147 - CARDIOLIPIN ANTIBODY EACH IG CLASS|77.61|77.61||
125|86146|86146 - BETA 2 GLYCOPROTEIN I ANTIBODY EACH|80.77|80.77||
125|86141|86141 - C-REACTIVE PROTEIN HIGH SENSITIVITY|27.69|27.69||
125|86140|86140 - C-REACTIVE PROTEIN|14.26|14.26||
125|86079|86079 - BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT|69.33|69.33||55.97
125|86078|86078 - BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT|91.84|91.84||56.29
125|86077|86077 - BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP|69.49|69.49||56.29
125|86064|86064 - B CELLS -  TOTAL COUNT|35.21|35.21||
125|86063|86063 - ANTISTREPTOLYSIN O SCREEN|17.19|17.19||
125|86060|86060 - ANTISTREPTOLYSIN O TITER|20.58|20.58||
125|86039|86039 - ANTINUCLEAR ANTIBODIES ANA TITER|30.85|30.85||
125|86038|86038 - ANTINUCLEAR ANTIBODIES ANA|26.87|26.87||
125|86023|86023 - ANTIBODY IDENTIFICATION PLATELET IMMUNOGL ASSAY|52.1|52.1||
125|86022|86022 - ANTIBODY IDENTIFICATION PLATELET ANTIBODIES|52.52|52.52||
125|86021|86021 - ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES|41.95|41.95||
125|86008|86008 - ALLERGEN SPEC IGE RECOMBINANT/PURIFIED COMPNT EA|36.09|36.09||
125|86005|86005 - ALLERGEN SPEC IGE QUAL MULTIALLERGEN SCREEN|30.26|30.26||
125|86003|86003 - ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH|12.43|12.43||
125|86001|86001 - ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA ALLERGEN|12.69|12.69||
125|86000|86000 - AGGLUTININS FEBRILE EACH ANTIGEN|16.88|16.88||
125|85810|85810 - VISCOSITY|24.94|24.94||
125|85732|85732 - THROMBOPLASTIN TIME PRTL SUBSTIT PLASMA FRCTJ EA|15.81|15.81||
125|85730|85730 - THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD|15.35|15.35||
125|85705|85705 - THROMBOPLASTIN INHIBITION TISSUE|33.42|33.42||
125|85675|85675 - THROMBIN TIME TITER|17.16|17.16||
125|85670|85670 - THROMBIN TIME PLASMA|15.27|15.27||
125|85660|85660 - SICKLING RBC REDUCTION|12.21|12.21||
125|85652|85652 - SEDIMENTATION RATE RBC AUTOMATED|5.82|5.82||
125|85651|85651 - SEDIMENTATION RATE RBC NON-AUTOMATED|13.43|13.43||
125|85635|85635 - REPTILASE TEST|18.07|18.07||
125|85613|85613 - RUSSELL VIPER VENOM TIME DILUTED|42.75|42.75||
125|85612|85612 - RUSSELL VIPER VENON TIME UNDILUTED|28.39|28.39||
125|85611|85611 - PROTHROMBIN TIME SUBSTITUTION PLASMA FRCTJ EACH|12.77|12.77||
125|85610|85610 - PROTHROMBIN TIME|15.57|15.57||
125|85598|85598 - PHOSPHOLIPID NEUTRALIZATION HEXAGONAL|36.17|36.17||
125|85597|85597 - PHOSPHOLIPID NEUTRALIZATION PLATELET|70.62|70.62||
125|85576|85576 - PLATELET AGGREGATION IN VITRO EACH AGENT|52.95|52.95||21.22
125|85557|85557 - OSMOTIC FRAGILITY RBC INCUBATED|45.71|45.71||
125|85555|85555 - OSMOTIC FRAGILITY RBC UNINCUBATED|20.17|20.17||
125|85549|85549 - MURAMIDASE|46.06|46.06||
125|85547|85547 - MECHANICAL FRAGILITY RBC|22.25|22.25||
125|85540|85540 - WBC ALKALINE PHOSPHATASE COUNT|21.3|21.3||
125|85536|85536 - IRON STAIN PERIPHERAL BLOOD|19.62|19.62||
125|85530|85530 - HEPARIN-PROTAMINE TOLERANCE TST|39.85|39.85||
125|85525|85525 - HEPARIN NEUTRALIZATION|51.81|51.81||
125|85520|85520 - HEPARIN ASSAY|37.21|37.21||
125|85475|85475 - HEMOLYSIN ACID|35.05|35.05||
125|85461|85461 - HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE|22.86|22.86||
125|85460|85460 - HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS|16.27|16.27||
125|85445|85445 - HEINZ BODIES INDUCED ACETYL PHENYLHYDRAZINE|14.78|14.78||
125|85441|85441 - HEINZ BODIES DIRECT|13.48|13.48||
125|85421|85421 - FBRNLYC FACTORS&INHIBITORS PLSMNG AGIC ASSAY|62.46|62.46||
125|85420|85420 - FBRNLYC FACTORS&INHIBITRS PLSMNG XCPT AGIC ASS|43.97|43.97||
125|85415|85415 - FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR|55.36|55.36||
125|85410|85410 - FBRNLYC FACTORS&INHIBITORS ALPHA-2 ANTIPLASMIN|37.02|37.02||
125|85400|85400 - FIBRINOLYTIC FACTORS & INHIBITORS PLASMIN|39.34|39.34||
125|85397|85397 - COAGJ&FIBRINOLYSIS FUNCTIONAL ACTV NOS EA ANAL|50.3|50.3||
125|85396|85396 - COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY|28.85|28.85||20.86
125|85390|85390 - FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR|21.97|21.97||20.51
125|85385|85385 - FIBRINOGEN ANTIGEN|25.73|25.73||
125|85384|85384 - FIBRINOGEN ACTIVITY|18.03|18.03||
125|85380|85380 - FIBRIN DGRADJ PRODUCTS D-DIMER ULTRASENSITIVE|34.61|34.61||
125|85379|85379 - FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE|28.14|28.14||
125|85378|85378 - FIBRIN DGRADJ PRODUCTS D-DIMER QUAL/SEMIQUAN|25.89|25.89||
125|85370|85370 - FIBRIN DGRADJ SPLT PRODUCTS QUANTITATIVE|37.31|37.31||
125|85366|85366 - FIBRIN DGRADJ SPLT PRODUXS PARACOAGJ|28.63|28.63||
125|85362|85362 - FIBRIN DGRADJ SPLT PRODUXS AGGLUJ SLIDE SEMIQUAN|21.91|21.91||
125|85360|85360 - EUGLOBULIN LYSIS|26.46|26.46||
125|85348|85348 - COAGULATION TIME OTHER METHODS|11.53|11.53||
125|85347|85347 - COAGULATION TIME ACTIVATED|9.48|9.48||
125|85345|85345 - COAGULATION TIME LEE AND WHITE|10.41|10.41||
125|85337|85337 - THROMBOMODULIN|64.78|64.78||
125|85335|85335 - FACTOR INHIBITOR TEST|39.09|39.09||
125|85307|85307 - ACTIVATED PROTEIN C APC RESISTANCE ASSAY|63.46|63.46||
125|85306|85306 - CLOTTING INHIBITORS PROTEIN S FREE|45.1|45.1||
125|85305|85305 - CLOTTING INHIBITORS PROTEIN S TOTAL|65.27|65.27||
125|85303|85303 - CLOTTING INHIBITORS PROTEIN C ACTIVITY|42.75|42.75||
125|85302|85302 - CLOTTING INHIBITORS PROTEIN C ANTIGEN|44.34|44.34||
125|85301|85301 - CLOTTING INHIBITRS ANTITHROMBN III ANTIGEN ASSAY|59.57|59.57||
125|85300|85300 - CLOTTING INHIBITORS ANTITHROMBIN III ACTIVITY|59.57|59.57||
125|85293|85293 - CLOTTING HI MOLEC WEIGHT KININOGEN ASSAY|55.57|55.57||
125|85292|85292 - CLOTTING PREKALLIKREIN ASSAY FLETCHER FACT ASSAY|55.57|55.57||
125|85291|85291 - CLOTTING FACTOR XIII FIBRN STABILIZ SCREEN SOLUB|23.71|23.71||
125|85290|85290 - CLOTTING FACTOR XIII FIBRIN STABILIZING|37.5|37.5||
125|85280|85280 - CLOTTING FACTOR XII HAGEMAN|50.99|50.99||
125|85270|85270 - CLOTTING FACTOR XI PTA|50.57|50.57||
125|85260|85260 - CLOTTING FACTOR X STUART-PROWER|48.65|48.65||
125|85250|85250 - CLOTTING FACTOR IX PTC/CHRISTMAS|50.89|50.89||
125|85247|85247 - CLOTTING FACTOR VIII MULTIMETRIC ANALYSIS|72.97|72.97||
125|85246|85246 - CLOTTING FACTOR VIII VW FACTOR ANTIGEN|72.97|72.97||
125|85245|85245 - CLOTTING FACTOR VIII VW FACTOR RISTOCETIN COFACT|55.36|55.36||
125|85244|85244 - CLOTTING FACTOR VIII RELATED ANTIGEN|59.72|59.72||
125|85240|85240 - CLOTTING FACTOR VIII AHG 1 STAGE|50.57|50.57||
125|85230|85230 - CLOTTING FACTOR VII PROCONVERTIN STABLE FACTOR|48.65|48.65||
125|85220|85220 - CLOTTING FACTOR V ACG/PROACCELERIN LABILE FACTOR|48.58|48.58||
125|85210|85210 - CLOTTING FACTOR II PROTHROMBIN SPECIFIC|27.72|27.72||
125|85175|85175 - CLOT LYSIS TIME WHOLE BLOOD DILUTION|17.43|17.43||
125|85170|85170 - BLOOD CLOT RETRACTION|9.9|9.9||
125|85130|85130 - CHROMOGENIC SUBSTRATE ASSAY|38.86|38.86||
125|85097|85097 - BONE MARROW SMEAR INTERPRETATION|150.8|150.8||88.21
125|85060|85060 - BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT|41.4|41.4||25.09
125|85055|85055 - RETICULATED PLATELET ASSAY|39.02|39.02||
125|85049|85049 - BLOOD COUNT PLATELET AUTOMATED|16.16|16.16||
125|85048|85048 - BLOOD COUNT LEUKOCYTE WBC AUTOMATED|8.4|8.4||
125|85046|85046 - BLOOD COUNT RETICULOCYTES AUTO 1/> CELL MEAS|9.58|9.58||
125|85045|85045 - BLOOD COUNT RETICULOCYTE AUTOMATED|10.87|10.87||
125|85044|85044 - BLOOD COUNT RETICULOCYTE AUTOMATED|9.21|9.21||
125|85041|85041 - BLOOD COUNT RED BLOOD CELL AUTOMATED|9.43|9.43||
125|85032|85032 - BLOOD COUNT MANUAL CELL COUNT EACH|10.75|10.75||
125|85027|85027 - BLOOD COUNT COMPLETE AUTOMATED|16.05|16.05||
125|85025|85025 - BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC|16.05|16.05||
125|85018|85018 - BLOOD COUNT HEMOGLOBIN|9.15|9.15||
125|85014|85014 - BLOOD COUNT HEMATOCRIT|9|9||
125|85013|85013 - BLOOD COUNT SPUN MICROHEMATOCRIT|7.86|7.86||
125|85009|85009 - BLOOD COUNT MANUAL DIFRNTL WBC COUNT BUFFY COAT|10.8|10.8||
125|85008|85008 - BLD COUNT SMEAR MCRSCP W/O MNL DIFRNTL WBC COUNT|6.51|6.51||
125|85007|85007 - BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT|10.17|10.17||
125|85004|85004 - BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT|17.31|17.31||
125|85002|85002 - BLEEDING TIME TEST|11.25|11.25||
125|84999|84999 - UNLISTED CHEMISTRY PROCEDURE|57.59|57.59||
125|84830|84830 - OVULATION TEST VISUAL COLOR COMPARISON HLH|30.2|30.2||
125|84704|84704 - GONADOTROPIN CHORIONIC HCG FREE BETA CHAIN|30.3|30.3||
125|84703|84703 - GONADOTROPIN CHORIONIC QUALITATIVE|18.02|18.02||
125|84702|84702 - GONADOTROPIN CHORIONIC QUANTITATIVE|38.04|38.04||
125|84681|84681 - ASSAY OF C-PEPTIDE|52.88|52.88||
125|84630|84630 - ASSAY OF ZINC|30.26|30.26||
125|84620|84620 - XYLOSE ABSORPTION TEST BLOOD &/URINE|41.95|41.95||
125|84600|84600 - ASSAY OF VOLATILES|38.47|38.47||
125|84597|84597 - ASSAY OF VITAMIN K|55.54|55.54||
125|84591|84591 - ASSAY OF VITAMIN NOT OTHERWISE SPECIFIED|53.07|53.07||
125|84590|84590 - ASSAY OF VITAMIN A|40.52|40.52||
125|84588|84588 - ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE|80.44|80.44||
125|84586|84586 - ASSAY OF VASOACTIVE INTESTINAL PEPTIDE|73.74|73.74||
125|84585|84585 - ASSAY OF VANILLYLMANDELIC ACID URINE|38.17|38.17||
125|84583|84583 - ASSAY OF UROBILINOGEN URINE SEMIQUANTITATIVE|11.57|11.57||
125|84580|84580 - UROBILINOGEN URINE QUANTITATIVE TIMED SPECIMEN|16.66|16.66||
125|84578|84578 - ASSAY OF UROBILINOGEN URINE QUALITATIVE|10.72|10.72||
125|84577|84577 - ASSAY OF UROBILINOGEN FECES QUANTITATIVE|27.76|27.76||
125|84560|84560 - ASSAY OF URIC ACID OTHER SOURCE|14.05|14.05||
125|84550|84550 - ASSAY OF BLOOD/URIC ACID|9.33|9.33||
125|84545|84545 - UREA NITROGEN CLEARANCE|17.64|17.64||
125|84540|84540 - ASSAY OF UREA NITROGEN URINE|14.04|14.04||
125|84525|84525 - ASSAY OF UREA NITROGEN SEMIQUANTITATIVE|14.4|14.4||
125|84520|84520 - ASSAY OF UREA NITROGEN QUANTITATIVE|8.75|8.75||
125|84512|84512 - ASSAY OF TROPONIN QUALITATIVE|42.56|42.56||
125|84510|84510 - ASSAY OF TYROSINE|26.26|26.26||
125|84490|84490 - TRYPSIN FECES QUANTITATIVE 24-HR COLLECTION|23.02|23.02||
125|84488|84488 - ASSAY OF TRYPSIN FECES QUALITATIVE|22.45|22.45||
125|84485|84485 - ASSAY OF TRYPSIN DUODENAL FLUID|23.02|23.02||
125|84484|84484 - ASSAY OF TROPONIN QUANTITATIVE|16.88|16.88||
125|84482|84482 - TRIIODOTHYRONINE T3 REVERSE|65.63|65.63||
125|84481|84481 - ASSAY OF TRIIODOTHYRONINE T3 FREE|58.37|58.37||
125|84480|84480 - ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3|37.14|37.14||
125|84479|84479 - THYROID HORM UPTK/THYROID HORMONE BINDING RATIO|13.89|13.89||
125|84478|84478 - ASSAY OF TRIGLYCERIDES|18.48|18.48||
125|84466|84466 - ASSAY OF L7383TRANSFERRIN|35.55|35.55||
125|84460|84460 - TRANSFERASE ALANINE AMINO ALT SGPT|10.64|10.64||
125|84450|84450 - TRANSFERASE ASPARTATE AMINO AST SGOT|10.69|10.69||
125|84449|84449 - ASSAY OF TRANSCORTIN CORTISOL BINDING GLOBULIN|42.68|42.68||
125|84446|84446 - ASSAY OF TOCOPHEROL ALPHA VITAMIN E|38.62|38.62||
125|84445|84445 - THYROID STIMULATING IMMUNE GLOBULINS TSI|56.96|56.96||
125|84443|84443 - ASSAY OF THYROID STIMULATING HORMONE TSH|47.67|47.67||
125|84442|84442 - ASSAY OF THYROXINE BINDING GLOBULIN|34.18|34.18||
125|84439|84439 - ASSAY OF FREE THYROXINE|36.44|36.44||
125|84437|84437 - ASSAY OF THYROXINE REQUIRING ELUTION|18.35|18.35||
125|84436|84436 - ASSAY OF THYROXINE TOTAL|14.74|14.74||
125|84432|84432 - ASSAY OF THYROGLOBULIN|46.9|46.9||
125|84431|84431 - THROMBOXANE METABOLITE W/WO THROMBOXANE URINE|57.23|57.23||
125|84430|84430 - ASSAY OF THIOCYANATE|31.67|31.67||
125|84425|84425 - ASSAY OF THIAMINE-VITAMIN B-1|49.81|49.81||
125|84410|84410 - ASSAY BIOVLBL TESTOSTERONE DIRECT MEASUREMENT|103.21|103.21||
125|84403|84403 - ASSAY OF TESTOSTERONE TOTAL|56.57|56.57||
125|84402|84402 - ASSAY OF TESTOSTERONE FREE|86.16|86.16||
125|84392|84392 - ASSAY OF SULFATE URINE|8.14|8.14||
125|84379|84379 - SUGARS MONO DI&OLIGOS MLT QUANTITATIVE EA SPEC|19.75|19.75||
125|84378|84378 - SUGARS MONO DI&OLIGOS 1 QUANTITATIVE EACH SPEC|19.75|19.75||
125|84377|84377 - SUGARS MONO DI&OLIGOS MLT QUALITATIVE EACH SPE|9.44|9.44||
125|84376|84376 - SUGARS MONO DI&OLIGOS 1 QUALITATAIVE EACH SPEC|9.44|9.44||
125|84375|84375 - SUGARS CHROMATOGRAPHIC TLC/PAPER CHROMATOGRAPHY|44.89|44.89||
125|84315|84315 - SPECIFIC GRAVITY EXCEPT URINE|8.01|8.01||
125|84311|84311 - SPECTROPHOTOMETRY ANALYT NOT ELSEWHERE SPECIFIED|18.14|18.14||
125|84307|84307 - ASSAY OF SOMATOSTATIN|66.58|66.58||
125|84305|84305 - ASSAY OF SOMATOMEDIN|66.91|66.91||
125|84302|84302 - ASSAY OF SODIUM OTHER SOURCE|15|15||
125|84300|84300 - ASSAY OF URINE SODIUM|11.38|11.38||
125|84295|84295 - SODIUM SERUM PLASMA OR WHOLE BLOOD|10.15|10.15||
125|84285|84285 - ASSAY OF SILICA|59.68|59.68||
125|84275|84275 - ASSAY OF SIALIC ACID|35.17|35.17||
125|84270|84270 - ASSAY OF SEX HORMONE BINDING GLOBULIN|47.93|47.93||
125|84260|84260 - ASSAY OF SEROTONIN|90.28|90.28||
125|84255|84255 - ASSAY OF SELENIUM|52.41|52.41||
125|84252|84252 - ASSAY OF RIBOFLAVIN-VITAMIN B-2|54.44|54.44||
125|84244|84244 - ASSAY OF RENIN|51.67|51.67||
125|84238|84238 - RECEPTOR ASSAY NON-ENDOCRINE SPECIFY RECEPTOR|87.91|87.91||
125|84235|84235 - RECEPTOR ASSAY ENDOCRINE OTH/THN ESTRGN/PROGST|92.51|92.51||
125|84234|84234 - ASSAY OF RECEPTOR ASSAY PROGESTERONE|121.05|121.05||
125|84233|84233 - ASSAY OF RECEPTOR ASSAY ESTROGEN|121.05|121.05||
125|84228|84228 - ASSAY OF QUININE|41.49|41.49||
125|84220|84220 - ASSAY OF PYRUVATE KINASE|24.92|24.92||
125|84210|84210 - ASSAY OF PYRUVATE|30.7|30.7||
125|84207|84207 - ASSAY OF PYRIDOXAL PHOSPHATE|73.84|73.84||
125|84206|84206 - ASSAY OF PROINSULIN|60.58|60.58||
125|84203|84203 - PROTOPORPHYRIN RBC SCREEN|21.92|21.92||
125|84202|84202 - PROTOPORPHYRIN RBC QUANTITATIVE|28.75|28.75||
125|84182|84182 - PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL|95.76|95.76||25.67
125|84181|84181 - PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID|74.76|74.76||21.34
125|84166|84166 - PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI|26.66|26.66||20.4
125|84165|84165 - PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM|33.23|33.23||20.86
125|84163|84163 - PREGNANCY-ASSOCIATED PLASMA PROTEIN-A|9.6|9.6||
125|84160|84160 - PROTEIN TOTAL REFRACTOMETRY ANY SRC|8.81|8.81||
125|84157|84157 - PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC|19|19||
125|84156|84156 - PROTEIN TOTAL XCPT REFRACTOMETRY URINE|19|19||
125|84155|84155 - PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD|7.94|7.94||
125|84154|84154 - ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE|44.57|44.57||
125|84153|84153 - ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL|57.03|57.03||
125|84152|84152 - ASSAY OF PROSTATE SPECIFIC ANTIGEN COMPLEXED|57.69|57.69||
125|84150|84150 - ASSAY OF PROSTAGLNDIN EACH|50.46|50.46||
125|84146|84146 - ASSAY OF PROLACTIN|49.28|49.28||
125|84145|84145 - PROCALCITONIN (PCT)|53.92|53.92||
125|84144|84144 - ASSAY OF PROGESTERONE|43.68|43.68||
125|84143|84143 - 17-HYDROXYPREGNENOLONE|61.91|61.91||
125|84140|84140 - PREGNENOLONE|51.39|51.39||
125|84138|84138 - PREGNANETRIOL|54.53|54.53||
125|84135|84135 - PREGNANEDIOL|53.32|53.32||
125|84134|84134 - PREALBUMIN|27.55|27.55||
125|84133|84133 - POTASSIUM URINE|12.11|12.11||
125|84132|84132 - POTASSIUM SERUM PLASMA/WHOLE BLOOD|9.94|9.94||
125|84126|84126 - PORPHYRINS FECES QUANTITATIVE|50.24|50.24||
125|84120|84120 - PORPHYRINS URINE QUANTITATION & FRACTIONATION|42.82|42.82||
125|84119|84119 - PORPHYRINS URINE QUALITATAIVE|25.92|25.92||
125|84112|84112 - EVAL C/V AMNIOTIC FLUID PROTEIN QUAL EA SPECIMEN|159.92|159.92||
125|84110|84110 - ASSAY OF PORPHOBILINOGEN URINE QUANTITATIVE|20.91|20.91||
125|84106|84106 - PORPHOBILINOGEN URINE QUALITATIVE|14.76|14.76||
125|84105|84105 - ASSAY OF PHOSPHORUS INORGANIC URINE|14.56|14.56||
125|84100|84100 - ASSAY OF PHOSPHORUS INORGANIC|10.19|10.19||
125|84087|84087 - ASSAY OF PHOSPHOHEXOSE ISOMERASE|25.21|25.21||
125|84085|84085 - PHOSPHOGLUCONATE 6-DEHYD RBC|21.75|21.75||
125|84081|84081 - PHOSPHATIDYLGLYCEROL|48.57|48.57||
125|84080|84080 - ASSAY OF PHOSPHATASE ALKALINE ISOENZYMES|42.07|42.07||
125|84078|84078 - ASSAY OF PHOSPHATASE ALKALINE HEAT STABLE|20.81|20.81||
125|84075|84075 - ASSAY OF PHOSPHATASE ALKALINE|11.31|11.31||
125|84066|84066 - ASSAY OF PHOSPHATASE ACID PROSTATIC|27.09|27.09||
125|84061|84061 - PHOSPHATASE ACID FORENSIC EXAMINATION|35.76|35.76||
125|84060|84060 - ASSAY OF PHOSPHATASE ACID TOTAL|19.5|19.5||
125|84035|84035 - ASSAY OF PHENYLKETONES QUALITATIVE|12.04|12.04||
125|84030|84030 - ASSAY OF PHENYLALANINE BLOOD|11.63|11.63||
125|83993|83993 - ASSAY OF CALPROTECTIN FECAL|39.51|39.51||
125|83992|83992 - ASSAY OF PHENCYCLIDINE|36.73|36.73||
125|83987|83987 - PH EXHALED BREATH CONDENSATE|7.2|7.2||
125|83986|83986 - PH BODY FLUID NOT ELSEWHERE SPECIFIED|9.06|9.06||
125|83970|83970 - ASSAY OF PARATHORMONE|119.16|119.16||
125|83951|83951 - ONCOPROTEIN DES-GAMMA-CARBOXY-PROTHROMBIN DCP|129.62|129.62||
125|83950|83950 - ONCOPROTEIN HER-2/NEU|96.29|96.29||
125|83945|83945 - ASSAY OF OXALATE|36.03|36.03||
125|83937|83937 - ASSAY OF OSTEOCALCIN|62.55|62.55||
125|83935|83935 - ASSAY OF OSMOLALITY URINE|19.02|19.02||
125|83930|83930 - ASSAY OF OSMOLALITY BLOOD|14.88|14.88||
125|83921|83921 - ORGANIC ACID 1 QUANTITATIVE|57.69|57.69||
125|83919|83919 - ORGANIC ACIDS QUALITATIVE EACH SPECIMEN|110.74|110.74||
125|83918|83918 - ORGANIC ACIDS TOTAL QUANTITATIVE EACH SPECIMEN|59.2|59.2||
125|83916|83916 - OLIGOCLONAL IMMUNE|41.94|41.94||
125|83915|83915 - ASSAY OF NUCLEOTIDASE 5'-|28.57|28.57||
125|83885|83885 - ASSAY OF NICKEL|59.83|59.83||
125|83883|83883 - ASSAY OF NEPHELOMETRY EACH ANALYTE NES|31.82|31.82||
125|83880|83880 - NATRIURETIC PEPTIDE|50.75|50.75||
125|83876|83876 - MYELOPEROXIDASE MPO|82.9|82.9||
125|83874|83874 - MYOGLOBIN|39.85|39.85||
125|83873|83873 - MYELIN BASIC PROTEIN CEREBROSPINAL FLUID|45.71|45.71||
125|83872|83872 - MUCIN SYNOVIAL FLUID ROPES TEST|12.59|12.59||
125|83864|83864 - MUCOPOLYSACCHARIDES ACID QUANTITATIVE|56.84|56.84||
125|83861|83861 - MICROFLUIDIC ANALYSIS TEAR OSMOLARITY|36.64|36.64||
125|83857|83857 - METHEMALBUMIN|25.38|25.38||
125|83835|83835 - METANEPHRINES|43.66|43.66||
125|83825|83825 - ASSAY OF MERCURY QUANTITATIVE|42.17|42.17||
125|83789|83789 - MASS SPECT&TANDEM MASS SPECT NONDRG ANAL NES EA|10.3|10.3||
125|83785|83785 - ASSAY OF MANGANESE|61.45|61.45||
125|83775|83775 - ASSAY OF MALATE DEHYDROGENASE|20.58|20.58||
125|83735|83735 - ASSAY OF MAGNESIUM|15.01|15.01||
125|83727|83727 - LUTEINIZING RELEASING FACTOR|52.14|52.14||
125|83721|83721 - LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL|20.45|20.45||
125|83719|83719 - LIPOPROTEIN DIRECT MEASUREMENT VLDL CHOLESTEROL|20.76|20.76||
125|83718|83718 - LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL|23.06|23.06||
125|83716|83716 - ASSAY -  BLOOD LIPOPROTEINS -  HIGH RES|46.97|46.97||
125|83715|83715 - ASSAY BLOOD LIPOPROTEINS -  ELECTROPH|34.3|34.3||
125|83704|83704 - LIPOPROTEIN BLOOD QUAN NUMBERS & SUBCLASSES|63.49|63.49||
125|83701|83701 - LIPOPROTEIN BLOOD HIGH RESOLTJ&QUANTJ SUBCLASS|55.19|55.19||
125|83700|83700 - LIPOPROTEIN BLOOD ELECTROPHORECTIC SEP&QUAN|22.66|22.66||
125|83698|83698 - LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2|75.49|75.49||
125|83695|83695 - LIPOPROTEIN (A)|26.05|26.05||
125|83690|83690 - ASSAY OF LIPASE|18.08|18.08||
125|83670|83670 - LEUCINE AMINOPEPTIDASE LAP|24.94|24.94||
125|83664|83664 - FETAL LUNG MATURITY LAMELLAR BODY DENSITY|28.85|28.85||
125|83663|83663 - FETAL LUNG MATURITY FLUORESCENCE POLARIZATION|28.85|28.85||
125|83662|83662 - FETAL LUNG MATURITY FOAM STABILITY TEST|31.82|31.82||
125|83661|83661 - FETAL LUNG MATURITY LECITHIN SPHINGOMYELIN RATIO|67.65|67.65||
125|83655|83655 - ASSAY OF LEAD|28.69|28.69||
125|83633|83633 - LACTOSE URINE QUALITATIVE|10.72|10.72||
125|83632|83632 - LACTOGEN HPL HUMAN CHORIONIC SOMATOMAMMOTROPIN|59.11|59.11||
125|83631|83631 - LACTOFERRIN FECAL QUANTITATIVE|39.51|39.51||
125|83630|83630 - LACTOFERRIN FECAL QUALITATIVE|15.99|15.99||
125|83625|83625 - LACTATE DEHYDROGENASE ISOENZYMES SEP&QUAN|32.15|32.15||
125|83615|83615 - LACTATE DEHYDROGENASE LDH|12.06|12.06||
125|83605|83605 - ASSAY OF LACTATE|32.45|32.45||
125|83593|83593 - KETOSTEROIDS 17- FRACTIONATION|89.01|89.01||
125|83586|83586 - ASSAY OF KETOSTEROIDS 17- TOTAL|33.68|33.68||
125|83582|83582 - ASSAY OF KETOGENIC STEROIDS FRACTIONATION|37.4|37.4||
125|83570|83570 - ISOCITRIC DEHYDROGENASE|21.28|21.28||
125|83550|83550 - IRON BINDING CAPACITY|19|19||
125|83540|83540 - ASSAY OF IRON|14.97|14.97||
125|83528|83528 - ASSAY OF INTRINSIC FACTOR|42.05|42.05||
125|83527|83527 - ASSAY OF INSULIN FREE|36.26|36.26||
125|83525|83525 - ASSAY OF INSULIN TOTAL|30.01|30.01||
125|83520|83520 - IMMUNOASSAY ANALYTE QUANTITATIVE NOS|46.78|46.78||
125|83519|83519 - IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY|42.01|42.01||
125|83518|83518 - IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP|18.41|18.41||
125|83516|83516 - IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP|27.85|27.85||
125|83505|83505 - ASSAY OF HYDROXYPROLINE TOTAL|85.04|85.04||
125|83500|83500 - ASSAY OF HYDROXYPROLINE FREE|66.78|66.78||
125|83499|83499 - ASSAY OF HYDROXYPROGESTERONE 20-|48.48|48.48||
125|83498|83498 - ASSAY OF HYDROXYPROGESTERONE 17-D|55.46|55.46||
125|83497|83497 - ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA|37.04|37.04||
125|83491|83491 - HYDROXYCORTICOSTEROIDS 17|58.18|58.18||
125|83150|83150 - ASSAY OF HOMOVANILLIC ACID|52.39|52.39||
125|83090|83090 - ASSAY OF HOMOCYSTEINE|33.47|33.47||
125|83088|83088 - ASSAY OF HISTAMINE|70.42|70.42||
125|83080|83080 - ASSAY OF B-HEXOSAMINIDASE EACH ASSAY|72.5|72.5||
125|83070|83070 - ASSAY OF HEMOSIDERIN QUALITATIVE|21.47|21.47||
125|83069|83069 - ASSAY OF HEMOGLOBIN URINE|9.31|9.31||
125|83068|83068 - HEMOGLOBIN UNSTABLE SCREEN|14.46|14.46||
125|83065|83065 - HEMOGLOBIN THERMOLABILE|14.46|14.46||
125|83060|83060 - HEMOGLOBIN SULFHEMOGLOBIN QUANTITATIVE|22.72|22.72||
125|83051|83051 - ASSAY OF HEMOGLOBIN PLASMA|30.41|30.41||
125|83050|83050 - HEMOGLOBIN METHEMOGLOBIN QUANTITATIVE|21.35|21.35||
125|83045|83045 - HEMOGLOBIN METHEMOGLOBIN QUALITATIVE|12.48|12.48||
125|83037|83037 - HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE|19.54|19.54||
125|83036|83036 - HEMOGLOBIN GLYCOSYLATED A1C|25.2|25.2||
125|83033|83033 - HEMOGLOBIN F FETAL QUALITATIVE|14.76|14.76||
125|83030|83030 - HEMOGLOBIN F FETAL CHEMICAL|20.6|20.6||
125|83026|83026 - HEMOGLOBIN COPPER SULFATE METHOD NON-AUTOMATED|8.01|8.01||
125|83021|83021 - HEMOGLOBIN FRACTJ/QUANTJ CHROMOTOGRAPHY|40.4|40.4||
125|83020|83020 - HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS|38.95|38.95||20.86
125|83018|83018 - HEAVY METAL QUANTIATIVE EACH NES|51.21|51.21||
125|83015|83015 - HEAVY METAL QUALITATIVE ANY ANALYTES|47.24|47.24||
125|83014|83014 - HPYLORI DRUG ADMINISTRATION|13.48|13.48||
125|83013|83013 - HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE|23.2|23.2||
125|83012|83012 - ASSAY OF HAPTOGLOBIN PHENOTYPES|42.08|42.08||
125|83010|83010 - ASSAY OF HAPTOGLOBIN QUANTITATIVE|25.09|25.09||
125|83009|83009 - HPYLORI BLOOD ANAL UREASE ACT NON-RADACT ISOTOPE|20.22|20.22||
125|83006|83006 - GROWTH STIMULATION EXPRESSED GENE 2|123.23|123.23||
125|83003|83003 - ASSAY OF GROWTH HORMONE HUMAN|41.48|41.48||
125|83002|83002 - GONADOTROPIN LUTEINIZING HORMONE|43.19|43.19||
125|83001|83001 - GONADOTROPIN FOLLICLE STIMULATING HORMONE|42.4|42.4||
125|82985|82985 - ASSAY OF GLYCATED PROTEIN|24.36|24.36||
125|82979|82979 - ASSAY OF GLUTATHIONE REDUCTASE RBC|20|20||
125|82978|82978 - ASSAY OF GLUTATHIONE|28.41|28.41||
125|82977|82977 - ASSAY OF GLUTAMYLTRASE GAMMA|11.55|11.55||
125|82965|82965 - ASSAY OF GLUTAMATE DEHYDROGENASE|17.55|17.55||
125|82963|82963 - ASSAY OF GLUCOSIDASE BETA|80.46|80.46||
125|82962|82962 - GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE|10.97|10.97||
125|82960|82960 - GLUC-6-PHOSPHATE DEHYDROGENASE SCREEN|18.66|18.66||
125|82955|82955 - GLUC-6-PHOSPHATE DEHYDROGENASE QUANTITATIVE|27.36|27.36||
125|82952|82952 - GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS|8.04|8.04||
125|82951|82951 - GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS|28.46|28.46||
125|82950|82950 - GLUCOSE POST GLUCOSE DOSE|11.82|11.82||
125|82948|82948 - GLUCOSE BLOOD REAGENT STRIP|7.93|7.93||
125|82947|82947 - GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP|13.55|13.55||
125|82946|82946 - GLUCOSE TOLERANCE TEST|52.37|52.37||
125|82945|82945 - GLUCOSE BODY FLUID OTHER THAN BLOOD|26.39|26.39||
125|82943|82943 - ASSAY OF GLUCAGON|36.52|36.52||
125|82941|82941 - ASSAY OF GASTRIN|38.18|38.18||
125|82938|82938 - GASTRIN AFTER SECRETIN STIMULATION|39.38|39.38||
125|82930|82930 - GASTRIC ACID ANALYIS W/PH EACH SPECIMEN|10.95|10.95||
125|82820|82820 - HGB-O2 AFFINITY PO2 50% SATURATION OXYGEN|46.51|46.51||
125|82810|82810 - GASES BLOOD O2 SATURATION ONLY DIRECT MEAS|37.21|37.21||
125|82805|82805 - GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY|77.75|77.75||
125|82803|82803 - BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3|43.87|43.87||
125|82800|82800 - GASES BLOOD PH ONLY|24.09|24.09||
125|82787|82787 - GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES|53.93|53.93||
125|82785|82785 - ASSAY OF GAMMAGLOBULIN IGE|36.62|36.62||
125|82784|82784 - ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH|31.13|31.13||
125|82777|82777 - GALECTIN-3|72.13|72.13||
125|82776|82776 - GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE SCREEN|17.82|17.82||
125|82775|82775 - GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE QUAN|46.58|46.58||
125|82760|82760 - ASSAY OF GALACTOSE|26.65|26.65||
125|82759|82759 - ASSAY OF GALACTOKINASE RBC|47.91|47.91||
125|82757|82757 - ASSAY OF FRUCTOSE SEMEN|28.8|28.8||
125|82747|82747 - ASSAY OF FOLIC ACID RBC|42.5|42.5||
125|82746|82746 - ASSAY OF FOLIC ACID SERUM|35.18|35.18||
125|82735|82735 - ASSAY OF FLUORIDE|38.96|38.96||
125|82731|82731 - FTL FIBRONECTIN CERVICOVAG SECRETIONS SEMI-QUAN|96.29|96.29||
125|82728|82728 - ASSAY OF FERRITIN|31.94|31.94||
125|82726|82726 - VERY LONG CHAIN FATTY ACIDS|40.4|40.4||
125|82725|82725 - FATTY ACIDS NONESTERIFIED|31.12|31.12||
125|82715|82715 - FAT DIFFIAL FECES QUANTITATIVE|27.31|27.31||
125|82710|82710 - FAT/LIPIDS FECES QUANTITATIVE|69.03|69.03||
125|82705|82705 - FAT/LIPIDS FECES QUALITATIVE|14.89|14.89||
125|82696|82696 - ASSAY OF ETIOCHOLANOLONE|62.88|62.88||
125|82693|82693 - ASSAY OF ETHYLENE GLYCOL|39.76|39.76||
125|82679|82679 - ASSAY OF ESTRONE|65.6|65.6||
125|82677|82677 - ASSAY OF ESTRIOL|39.14|39.14||
125|82672|82672 - ASSAY OF ESTROGENS TOTAL|42.71|42.71||
125|82671|82671 - ASSAY OF ESTROGENS FRACTIONATED|87.91|87.91||
125|82670|82670 - ASSAY OF ESTRADIOL|59.92|59.92||
125|82668|82668 - ASSAY OF ERYTHROPOIETIN|54.1|54.1||
125|82664|82664 - ELCTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED|51.36|51.36||
125|82658|82658 - NZYM ACTV BLOOD CELLS/TISS RADACT SUBSTRATE EA|40.4|40.4||
125|82657|82657 - NZYM ACTIV BLD CELLS/TISS NONRADACT SUBSTRATE EA|29.38|29.38||
125|82656|82656 - ELASTASE PANCREATIC FECAL QUAL/SEMI-QUAN|15.99|15.99||
125|82652|82652 - 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED|118.46|118.46||
125|82638|82638 - ASSAY OF DIBUCAINE NUMBER|24.89|24.89||
125|82634|82634 - DEOXYCORTISOL 11-|70.56|70.56||
125|82633|82633 - DESOXYCORTICOSTERONE 11-|75.98|75.98||
125|82627|82627 - DEHYDROEPIANDROSTERONE-SULFATE|56.75|56.75||
125|82626|82626 - DEHYDROEPIANDROSTERONE|65.68|65.68||
125|82615|82615 - CSTINE&HOMOCSTINE URINE QUALITATIVE|22.25|22.25||
125|82610|82610 - CYSTATIN C|30.19|30.19||
125|82608|82608 - CYANOCOBALAMIN VIT B-12 UNSAT BINDING CAPACITY|38.98|38.98||
125|82607|82607 - CYANOCOBALAMIN VITAMIN B-12|49.52|49.52||
125|82600|82600 - ASSAY OF CYANIDE|51.96|51.96||
125|82595|82595 - CRYOGLOBULIN QUALITATIVE/SEMI-QUANTITATIVE|14.26|14.26||
125|82585|82585 - ASSAY OF CRYOFIBRN|25.84|25.84||
125|82575|82575 - CREATININE CLEARANCE|23.37|23.37||
125|82570|82570 - CREATININE OTHER SOURCE|14.26|14.26||
125|82565|82565 - CREATININE BLOOD|13.38|13.38||
125|82554|82554 - CREATINE KINASE ISOFORMS|29.94|29.94||
125|82553|82553 - CREATINE KINASE MB FRACTION ONLY|20.29|20.29||
125|82552|82552 - CREATINE KINASE ISOENZYMES|33.5|33.5||
125|82550|82550 - CREATINE KINASE TOTAL|17.63|17.63||
125|82542|82542 - COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC|40.4|40.4||
125|82540|82540 - ASSAY OF CREATINE|13.16|13.16||
125|82533|82533 - CORTISOL TOTAL|37.78|37.78||
125|82530|82530 - CORTISOL FREE|43.61|43.61||
125|82528|82528 - CORTICOSTERONE|56.4|56.4||
125|82525|82525 - ASSAY OF COPPER|28.77|28.77||
125|82523|82523 - COLLAGEN CROSS LINKS ANY METHOD|32.06|32.06||
125|82507|82507 - ASSAY OF CITRATE|70.94|70.94||
125|82495|82495 - ASSAY OF CHROMIUM|43.96|43.96||
125|82485|82485 - CHONDROITIN B SULFATE QUANTITATIVE|56.56|56.56||
125|82482|82482 - CHOLINESTERASE RBC|29.54|29.54||
125|82480|82480 - CHOLINESTERASE SERUM|21.95|21.95||
125|82465|82465 - CHOLESTEROL SERUM/WHOLE BLOOD TOTAL|13.93|13.93||
125|82441|82441 - CHLORINATED HYDROCARBONS SCREEN|26.31|26.31||
125|82438|82438 - CHLORIDE OTHER SOURCE|13.04|13.04||
125|82436|82436 - CHLORIDE URINE|12.91|12.91||
125|82435|82435 - CHLORIDE BLD|9.17|9.17||
125|82415|82415 - CHLORAMPHENICOL|42.1|42.1||
125|82397|82397 - CHEMILUMINESCENT ASSAY|39.39|39.39||
125|82390|82390 - CERULOPLASMIN|26.43|26.43||
125|82387|82387 - CATHEPSIN-D|58.63|58.63||
125|82384|82384 - CATECHOLAMINES FRACTIONATED|75.64|75.64||
125|82383|82383 - CATECHOLAMINES BLOOD|56.3|56.3||
125|82382|82382 - CATECHOLAMINES TOTAL URINE|43.9|43.9||
125|82380|82380 - CAROTENE|24.95|24.95||
125|82379|82379 - CARNITINE QUANTITATIVE EACH SPECIMEN|61.2|61.2||
125|82378|82378 - CARCINOEMBRYONIC ANTIGEN CEA|43.36|43.36||
125|82376|82376 - CARBOXYHEMOGLOBIN QUALITATIVE|14.25|14.25||
125|82375|82375 - CARBOXYHEMOGLOBIN QUANTITATIVE|19.36|19.36||
125|82374|82374 - CARBON DIOXIDE BICARBONATE|10.61|10.61||
125|82373|82373 - CARBOHYDRATE DEFICIENT TRANSFERRIN|40.38|40.38||
125|82370|82370 - CALCULUS XRAY DIFFRACTION|35.36|35.36||
125|82365|82365 - CALCULUS INFRARED SPECTROSCOPY|40.17|40.17||
125|82360|82360 - CALCULUS QUANTITATIVE CHEMICAL|36.63|36.63||
125|82355|82355 - CALCULUS QUALITATIVE ANALYSIS|31.13|31.13||
125|82340|82340 - CALCIUM URINE QUANTITATIVE TIMED SPECIMEN|17.12|17.12||
125|82331|82331 - CALCIUM AFTER CALCIUM INFUSION TEST|11.12|11.12||
125|82330|82330 - CALCIUM IONIZED|32.99|32.99||
125|82310|82310 - CALCIUM TOTAL|10.59|10.59||
125|82308|82308 - CALCITONIN|72.91|72.91||
125|82306|82306 - 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED|114.17|114.17||
125|82300|82300 - CADMIUM|61.81|61.81||
125|82286|82286 - BRADYKININ|46.32|46.32||
125|82274|82274 - BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3|57.69|57.69||
125|82273|82273 - BLOOD OCCULT QUAL -  OTH SOURCES|8.75|8.75||
125|82272|82272 - BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC|6.89|6.89||
125|82271|82271 - BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES|8.67|8.67||
125|82270|82270 - BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER|14.5|14.5||
125|82261|82261 - BIOTINIDASE EACH SPECIMEN|37.66|37.66||
125|82252|82252 - BILIRUBIN FECES QUALITATIVE|10.25|10.25||
125|82248|82248 - BILIRUBIN DIRECT|11.28|11.28||
125|82247|82247 - BILIRUBIN TOTAL|11.62|11.62||
125|82240|82240 - BILE ACIDS CHOLYLGLYCINE|61.46|61.46||
125|82239|82239 - BILE ACIDS TOTAL|48.68|48.68||
125|82232|82232 - BETA-2 MICROGLOBULIN|40.31|40.31||
125|82190|82190 - ATOMIC ABSRPJ SPECTROSCOPY EA ANALYTE|49.63|49.63||
125|82180|82180 - ASSAY OF ASCORBIC ACID BLOOD|24.13|24.13||
125|82175|82175 - ASSAY OF ARSENIC|59.85|59.85||
125|82172|82172 - APOLIPOPROTEIN EACH|27.83|27.83||
125|82164|82164 - ANGIOTENSIN I-CONVERTING ENZYME|42.08|42.08||
125|82163|82163 - ANGIOTENSIN II|58.8|58.8||
125|82160|82160 - ANDROSTERONE|64.86|64.86||
125|82157|82157 - ANDROSTENEDIONE|64.55|64.55||
125|82154|82154 - ANDROSTANEDIOL GLUCURONIDE|67.12|67.12||
125|82150|82150 - ASSAY OF AMYLASE|15.94|15.94||
125|82143|82143 - AMNIOTIC FLU SCAN|21.36|21.36||
125|82140|82140 - ASSAY OF AMMONIA|31.3|31.3||
125|82139|82139 - AMINO ACIDS 6/> AMINO ACIDS QUANTITATIVE EA SPE|113.48|113.48||
125|82136|82136 - AMINO ACIDS 2-5 AMINO ACIDS QUANTITATIVE EA SPEC|113.48|113.48||
125|82135|82135 - AMINOLEVULINIC ACID DELTA|38.48|38.48||
125|82131|82131 - AMINO ACIDS 1 QUANTITATIVE EACH SPECIMEN|156.58|156.58||
125|82128|82128 - AMINO ACIDS MULTIPLE QUALITATIVE EACH SPECIMEN|32.93|32.93||
125|82127|82127 - AMINO ACIDS 1 QUALITATIVE EACH SPECIMEN|38.54|38.54||
125|82120|82120 - AMINES VAGINAL FLUID QUALITATIVE|4.14|4.14||
125|82108|82108 - ASSAY OF ALUMINUM|54.15|54.15||
125|82107|82107 - AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO|129.62|129.62||
125|82106|82106 - ALPHA-FETOPROTEIN AMNIOTIC FLUID|43.11|43.11||
125|82105|82105 - ALPHA-FETOPROTEIN SERUM|40.48|40.48||
125|82104|82104 - ALPHA-1-ANTITRYPSIN PHENOTYPE|48.05|48.05||
125|82103|82103 - ALPHA-1-ANTITRYPSIN TOTAL|32.91|32.91||
125|82088|82088 - ASSAY OF ALDOSTERONE|82.78|82.78||
125|82085|82085 - ASSAY OF ALDOLASE|26.75|26.75||
125|82075|82075 - ASSAY OF ALCOHOL BREATH|76.64|76.64||
125|82045|82045 - ALBUMIN ISCHEMIA MODIFIED|50.75|50.75||
125|82044|82044 - URINE ALBUMIN SEMIQUANTITATIVE|14.83|14.83||
125|82043|82043 - URINE ALBUMIN QUANTITATIVE|12.41|12.41||
125|82042|82042 - OTHER SOURCE ALBUMIN QUANTITATIVE EACH SPECIMEN|12.93|12.93||
125|82040|82040 - ALBUMIN SERUM PLASMA/WHOLE BLOOD|10.28|10.28||
125|82030|82030 - ADENOSINE 5-MONOPHOSPHATE CYCLIC|70.77|70.77||
125|82024|82024 - ADRENOCORTICOTROPIC HORMONE ACTH|95.01|95.01||
125|82017|82017 - ACYLCARNITINES QUANTIATIVE EACH SPECIMEN|61.2|61.2||
125|82016|82016 - ACYLCARNITINES QUALITATIVE EACH SPECIMEN|74.42|74.42||
125|82013|82013 - ASSAY OF ACETYLCHOLINESTERASE|36.7|36.7||
125|82010|82010 - KETONE BODIES SERUM QUANTITATIVE|19.7|19.7||
125|82009|82009 - KETONE BODIES SERUM QUALITATIVE|8.6|8.6||
125|81595|81595 - CARDIOLOGY HRT TRNSPL MRNA GENE EXPRESS 20 GENES|5281.2|5281.2||0.01
125|81545|81545 - ONCOLOGY THYROID GENE EXPRESSION 142 GENES|5868|5868||0.01
125|81541|81541 - ONC PRST8 MRNA GENE XPRSN PRFL RT-PCR 46 GENES|6312.99|6312.99||
125|81540|81540 - ONCOLOGY TUM UNKNOWN ORIGIN MRNA 92 GENES|6112.5|6112.5||0.01
125|81539|81539 - ONCOLOGY PROSTATE BIOCHEMICAL ASSAY 4 PROTEINS|1238.8|1238.8||
125|81538|81538 - ONCOLOGY LUNG MS 8-PROTEIN SIGNATURE|4679.73|4679.73||0.01
125|81536|81536 - ONCOLOGY GYNE LIVE TUM CELL CLTR&CHEMO RESP ADD|289.42|289.42||0.01
125|81535|81535 - ONCOLOGY GYNE LIVE TUM CELL CLTR&CHEMO RESP 1ST|944.52|944.52||0.01
125|81528|81528 - ONCOLOGY COLORECTAL SCREENING QUAN 10 DNA MARKRS|829.46|829.46||0.01
125|81525|81525 - ONCOLOGY COLON MRNA GENE EXPRESSION 12 GENES|5079.08|5079.08||0.01
125|81521|81521 - ONC BREAST MRNA MICRORA GENE XPRSN PRFL 70 GENES|6312.99|6312.99||
125|81520|81520 - ONC BREAST MRNA GENE XPRSN PRFL HYBRD 58 GENES|5051.4|5051.4||
125|81519|81519 - ONCOLOGY BREAST MRNA GENE EXPRESSION 21 GENES|6312.99|6312.99||0.01
125|81512|81512 - FETAL CONGENITAL ABNOR ASSAY FIVE ANAL|113.32|113.32||0.01
125|81511|81511 - FETAL CONGENITAL ABNOR ASSAY FOUR ANAL|250.2|250.2||0.01
125|81510|81510 - FETAL CONGENITAL ABNOR ASSAY THREE ANAL|90.53|90.53||0.01
125|81509|81509 - FETAL CONGENITAL ABNOR ASSAY 3 PROTEINS|2424.41|2424.41||0.01
125|81508|81508 - FETAL CONGENITAL ABNOR ASSAY TWO PROTEINS|88.51|88.51||0.01
125|81507|81507 - FETAL ANEUPLOIDY 21 18 13 SEQ ANALY TRISOM RISK|1295.85|1295.85||0.01
125|81506|81506 - ENDOCRINOLOGY BIOCHEMICAL ASSAY SEVEN ANAL|132.08|132.08||0.01
125|81504|81504 - ONCOLOGY TISSUE OF ORIGIN SIMILAR SCOR ALGORITHM|847.6|847.6||0.01
125|81503|81503 - ONCO (OVARIAN) BIOCHEMICAL ASSAY FIVE PROTEINS|1462.11|1462.11||0.01
125|81500|81500 - ONCO (OVARIAN) BIOCHEMICAL ASSAY TWO PROTEINS|424.61|424.61||0.01
125|81493|81493 - COR ART DISEASE MRNA GENE EXPRESSION 23 GENES|1711.5|1711.5||0.01
125|81490|81490 - AUTOIMMUNE RHEUMATOID ARTHRTS ANALYS 12 BIOMRKRS|1370.26|1370.26||0.01
125|81471|81471 - X-LINKED INTELLECTUAL DBLT DUP/DEL GENE ANALYS|0.01|0.01||0.01
125|81470|81470 - X-LINKED INTELLECTUAL DBLT GENOMIC SEQ ANALYS|505.75|505.75||0.01
125|81465|81465 - WHOLE MITOCHONDRIAL GENOME ANALYSIS PANEL|1525.68|1525.68||0.01
125|81460|81460 - WHOLE MITOCHONDRIAL GENOME|2097.81|2097.81||0.01
125|81455|81455 - GEN SEQ ANALYS SOL ORG/HEMTOLMPHOID NEO 51/> GEN|4758.95|4758.95||0.01
125|81450|81450 - GEN SEQ ANALYS HEMATOLYMPHOID NEO 5-50 GENE|1238.03|1238.03||0.01
125|81448|81448 - HEREDITARY PERIPHERAL NEUROPATHY GEN SEQ PNL|1177.02|1177.02||
125|81445|81445 - GEN SEQ ANALYS SOLID ORGAN NEOPLASM 5-50 GENE|974.59|974.59||0.01
125|81442|81442 - NOONAN SPECTRUM DISORDERS GEN SEQ ANALYS 12 GEN|3494.07|3494.07||0.01
125|81440|81440 - NUCLEAR MITOCHONDRIAL 100 GENE GENOMIC SEQ|5418.12|5418.12||0.01
125|81439|81439 - HEREDITARY CARDIOMYOPATHY GEN SEQ ANALYS 5 GEN|1177.02|1177.02||
125|81438|81438 - HEREDTRY NURONDCRN TUM DSRDRS DUP/DEL ANALYSIS|883.28|883.28||0.01
125|81437|81437 - HEREDTRY NURONDCRN TUM DSRDRS GEN SEQ ANAL 6 GEN|883.28|883.28||0.01
125|81436|81436 - HEREDITARY COLON CA DSRDRS DUP/DEL ANALYS 5 GEN|1177.02|1177.02||
125|81435|81435 - HEREDITARY COLON CA DSRDRS GEN SEQ ANALYS 10 GEN|1177.02|1177.02||0.01
125|81434|81434 - HEREDITARY RETINAL DSRDRS GEN SEQ ANALYS 15 GEN|974.59|974.59||0.01
125|81433|81433 - HEREDITARY BRST CA-RELATED DUP/DEL ANALYSIS|883.28|883.28||0.01
125|81432|81432 - HEREDITARY BRST CA-RELATED GEN SEQ ANALYS 10 GEN|1366.48|1366.48||0.01
125|81431|81431 - HEARING LOSS DUP/DEL ANALYSIS|1107.7|1107.7||0.01
125|81430|81430 - HEARING LOSS GENOMIC SEQUENCE ANALYSIS 60 GENES|2648.75|2648.75||0.01
125|81427|81427 - GENOME RE-EVALUATION OF PREC OBTAINED GENOME SEQ|0.01|0.01||0.01
125|81426|81426 - GENOME SEQUENCE ANALYSIS EACH COMPARATOR GENOME|0.01|0.01||0.01
125|81425|81425 - GENOME SEQUENCE ANALYSIS|0.01|0.01||0.01
125|81422|81422 - FETAL CHROMOSOMAL MICRODELTJ GENOMIC SEQ ANALYS|1237.25|1237.25||
125|81420|81420 - FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS|1237.25|1237.25||0.01
125|81417|81417 - EXOME RE-EVAL OF PREVIOUSLY OBTAINED EXOME SEQ|521.6|521.6||0.01
125|81416|81416 - EXOME SEQUENCE ANALYSIS EACH COMPARATOR EXOME|19560|19560||0.01
125|81415|81415 - EXOME SEQUENCE ANALYSIS|7791.4|7791.4||0.01
125|81414|81414 - CAR ION CHNNLPATH DUP/DEL GN ALYS PANEL 2 GENES|1177.02|1177.02||
125|81413|81413 - CAR ION CHNNLPATH GENOMIC SEQ ALYS INC 10 GNS|1177.02|1177.02||
125|81412|81412 - ASHKENAZI JEWISH ASSOC DSRDRS GEN SEQ ANAL 9 GEN|3991.15|3991.15||0.01
125|81411|81411 - AORTIC DYSFUNCTION/DILATION DUP/DEL ANALYSIS|2200.81|2200.81||0.01
125|81410|81410 - AORTIC DYSFUNCTION/DILATION GENOMIC SEQ ANALYSIS|821.52|821.52||0.01
125|81408|81408 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 9|3260|3260||0.01
125|81407|81407 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 8|1379.42|1379.42||0.01
125|81406|81406 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 7|461.09|461.09||0.01
125|81405|81405 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 6|491.2|491.2||0.01
125|81404|81404 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 5|447.97|447.97||0.01
125|81403|81403 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 4|301.88|301.88||0.01
125|81402|81402 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 3|245.04|245.04||0.01
125|81401|81401 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 2|223.31|223.31||0.01
125|81400|81400 - MOLECULAR PATHOLOGY PROCEDURE LEVEL 1|104.25|104.25||0.01
125|81383|81383 - HLA II HIGH RESOLUTION 1 ALLELE/ALLELE GROUP|219.61|219.61||0.01
125|81382|81382 - HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA|248.88|248.88||0.01
125|81381|81381 - HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP|276.94|276.94||0.01
125|81380|81380 - HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA|356.69|356.69||0.01
125|81379|81379 - HLA CLASS I TYPING HIGH RESOLUTION COMPLETE|674.9|674.9||0.01
125|81378|81378 - HLA I&II HIGH RESOLUTION HLA-A -B -C AND -DRB1|695.41|695.41||0.01
125|81377|81377 - HLA II LOW RESOLUTION ONE ANTIGEN EQUIVALENT EA|184.76|184.76||0.01
125|81376|81376 - HLA CLASS II TYPING LOW RESOLUTION ONE LOCUS EA|245.95|245.95||0.01
125|81375|81375 - HLA II LOW RESOLUTION HLA-DRB1/3/4/5 AND -DQB1|444.21|444.21||0.01
125|81374|81374 - HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH|146.39|146.39||0.01
125|81373|81373 - HLA CLASS I TYPING LOW RESOLUTION ONE LOCUS EACH|224.09|224.09||0.01
125|81372|81372 - HLA CLASS I TYPING LOW RESOLUTION COMPLETE|657.85|657.85||0.01
125|81371|81371 - HLA I&LI LOW RESOLUTION HLA-A -B&-DRB1|659.37|659.37||0.01
125|81370|81370 - HLA CLASS I&II LOW HLA-A -B -C -DRB1/3/4/5&DQB|809.21|809.21||0.01
125|81364|81364 - HBB FULL GENE SEQUENCE|529.07|529.07||
125|81363|81363 - HBB DUPLICATION/DELETION VARIANTS|329.91|329.91||
125|81362|81362 - HBB KNOWN FAMILIAL VARIANTS|611.66|611.66||
125|81361|81361 - HBB COMMON VARIANTS|284.94|284.94||
125|81355|81355 - VKORC1 GENE ANALYSIS COMMON VARIANT(S)|143.77|143.77||0.01
125|81350|81350 - UGT1A1 GENE ANALYSIS COMMON VARIANTS|381.42|381.42||0.01
125|81346|81346 - TYMS GENE ANALYSIS COMMON VARIANTS|284.94|284.94||
125|81342|81342 - TRG@ GENE REARRANGEMENT ANALYSIS|405.48|405.48||0.01
125|81341|81341 - TRB@ REARRANGEMENT ANAL DIRECT PROBE METHODOLOGY|99.79|99.79||0.01
125|81340|81340 - TRB@ REARRANGEMENT ANAL AMPLIFICATION METHOD|420.41|420.41||0.01
125|81335|81335 - TPMT GENE ANALAYSIS COMMON VARIANTS|284.94|284.94||
125|81334|81334 - RUNX1 GENE ANALYSIS TARGETED SEQUENCE ANALYSIS|537.1|537.1||
125|81332|81332 - SERPINA1 GENE ANALYSIS COMMON VARIANTS|87.84|87.84||0.01
125|81331|81331 - SNRPN/UBE3A METHYLATION ANALYSIS|83.24|83.24||0.01
125|81330|81330 - SMPD1 GENE ANALYSIS COMMON VARIANTS|76.61|76.61||0.01
125|81328|81328 - SLCO1B1 GENE ANALYSIS COMMON VARIANTS|284.94|284.94||
125|81327|81327 - SEPT9 GENE PROMOTER METHYLATION ANALYSIS|85.34|85.34||
125|81326|81326 - PMP22 GENE ANALYSIS KNOWN FAMILIAL VARIANT|86.15|86.15||0.01
125|81325|81325 - PMP22 GENE ANALYSIS FULL SEQUENCE ANALYSIS|1254.42|1254.42||0.01
125|81324|81324 - PMP22 GENE ANAL DUPLICATION/DELETION ANALYSIS|1236.13|1236.13||0.01
125|81323|81323 - PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT|489|489||0.01
125|81322|81322 - PTEN GENE ANALYSIS KNOWN FAMILIAL VARIANT|86.15|86.15||0.01
125|81321|81321 - PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS|978|978||0.01
125|81319|81319 - PMS2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS|331.7|331.7||0.01
125|81318|81318 - PMS2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS|539.53|539.53||0.01
125|81317|81317 - PMS2 GENE ANALYSIS FULL SEQUENCE|1152.44|1152.44||0.01
125|81316|81316 - PML/RARALPHA SINGLE BREAKPOINT QUAL/QUAN|417.18|417.18||0.01
125|81315|81315 - PML/RARALPHA COMMON BREAKPOINTS QUAL/QUANT|417.18|417.18||0.01
125|81314|81314 - PDGFRA GENE ANALYS TARGETED SEQUENCE ANALYS|537.1|537.1||0.01
125|81313|81313 - PCA3/KLK3 PROSTATE SPECIFIC ANTIGEN RATIO|415.73|415.73||0.01
125|81311|81311 - NRAS GENE ANALYSIS VARIANTS IN EXON 2&3|482.14|482.14||0.01
125|81310|81310 - NPM1 NUCLEOPHOSMIN GENE ANAL EXON 12 VARIANTS|401.83|401.83||0.01
125|81304|81304 - MECP2 GENE ANALYSIS DUPLICATION/DELETION VARIANT|244.5|244.5||0.01
125|81303|81303 - MECP2 GENE ANALYSIS KNOWN FAMILIAL VARIANT|195.6|195.6||0.01
125|81302|81302 - MECP2 GENE ANALYSIS FULL SEQUENCE|860.43|860.43||0.01
125|81301|81301 - MICROSATELLITE INSTAB ANAL MISMATCH REPAIR DEF|582.69|582.69||0.01
125|81300|81300 - MSH6 GENE ANALYSIS DUPLICATION/DELETION VARIA|387.94|387.94||0.01
125|81299|81299 - MSH6 GENE ANALYSIS KNOWN FAMILIAL VARIANTS|502.04|502.04||
125|81298|81298 - MSH6 GENE ANALYSIS FULL SEQUENCE ANALYSIS|1046.22|1046.22||0.01
125|81297|81297 - MSH2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS|347.68|347.68||0.01
125|81296|81296 - MSH2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS|550.5|550.5||0.01
125|81295|81295 - MSH2 GENE ANALYSIS FULL SEQUENCE ANALYSIS|622.17|622.17||0.01
125|81294|81294 - MLH1 GENE ANALYSIS DUPLICATION/DELETION VARIANTS|329.91|329.91||0.01
125|81293|81293 - MLH1 GENE ANALYSIS KNOWN FAMILIAL VARIANTS|539.53|539.53||0.01
125|81292|81292 - MLH1 GENE ANALYSIS FULL SEQUENCE ANALYSIS|1100.9|1100.9||0.01
125|81291|81291 - MTHFR GENE ANALYSIS COMMON VARIANTS|106.5|106.5||0.01
125|81290|81290 - MCOLN1 MUCOLIPIN1 GENE ANALYSIS COMMON VARIANTS|64.08|64.08||0.01
125|81288|81288 - MLH1 GENE ANALYSIS PROMOTER METHYLATION ANALYSIS|313.48|313.48||0.01
125|81287|81287 - MGMT GENE PROMOTER METHYLATION ANALYSIS|203.16|203.16||0.01
125|81283|81283 - IFNL3 GENE ANALYSIS RS12979860 VARIANT|122.97|122.97||
125|81276|81276 - KRAS GENE ANALYSIS ADDITIONAL VARIANT(S)|315|315||0.01
125|81275|81275 - KRAS GENE ANALYSIS VARIANTS IN EXON 2|315|315||0.01
125|81273|81273 - KIT GENE ANALYSIS D816 VARIANT(S)|203.54|203.54||0.01
125|81272|81272 - KIT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS|537.1|537.1||0.01
125|81270|81270 - JAK2 GENE ANALYSIS P.VAL617PHE VARIANT|184.47|184.47||0.01
125|81269|81269 - HBA1/HBA2 GENE ANALYSIS DUP/DEL VARIANTS|329.91|329.91||
125|81268|81268 - CHIMERISM W/COMP TO BASELINE W/CELL SELECTION EA|524.79|524.79||0.01
125|81267|81267 - CHIMERISM W/COMP TO BASELINE W/O CELL SELECTION|417.48|417.48||0.01
125|81266|81266 - COMPARATIVE ANAL STR MARKERS EA ADDL SPECIMEN|496.84|496.84||0.01
125|81265|81265 - COMPARATIVE ANAL STR MARKERS PATIENT&COMP SPEC|432.75|432.75||0.01
125|81264|81264 - IGK@ GENE REARRANGE DETECT ABNORMAL CLONAL POP|300.49|300.49||0.01
125|81263|81263 - IGH@ VARIABLE REGION SOMATIC MUTATION ANALYSIS|592.67|592.67||0.01
125|81262|81262 - IGH@ REARRANGE ABNORMAL CLONAL POP DIRECT PROBE|111.74|111.74||0.01
125|81261|81261 - IGH@ REARRANGE ABNORMAL CLONAL POP AMPLIFIED|398.42|398.42||0.01
125|81260|81260 - IKBKAP GENE ANALYSIS COMMON VARIANTS|64.08|64.08||0.01
125|81259|81259 - HBA1/HBA2 GENE ANALYSIS FULL GENE SEQUENCE|978|978||
125|81258|81258 - HBA1/HBA2 GENE ANALYSIS KNOWN FAMILIAL VARIANT|611.66|611.66||
125|81257|81257 - HBA1/HBA2 GENE ANALYSIS COMMON DELETIONS/VARIANT|166.68|166.68||0.01
125|81256|81256 - HFE HEMOCHROMATOSIS GENE ANAL COMMON VARIANTS|131.52|131.52||0.01
125|81255|81255 - HEXA GENE ANALYSIS COMMON VARIANTS|83.86|83.86||0.01
125|81254|81254 - GJB6 GENE ANALYSIS COMMON VARIANTS|57.05|57.05||0.01
125|81253|81253 - GJB2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS|100.28|100.28||0.01
125|81252|81252 - GJB2 GENE ANALYSIS FULL GENE SEQUENCE|164.83|164.83||0.01
125|81251|81251 - GBA GLUCOSIDASE/BETA/ACID ANAL COMM VARIANTS|77.02|77.02||0.01
125|81250|81250 - G6PC GENE ANALYSIS COMMON VARIANTS|95.34|95.34||0.01
125|81249|81249 - G6PD GENE ANALYSIS FULL GENE SEQUENCE|978|978||
125|81248|81248 - G6PD GENE ANALYSIS KNOWN FAMILIAL VARIANTS|611.66|611.66||
125|81247|81247 - G6PD GENE ANALYSIS COMMON VARIANTS|284.94|284.94||
125|81246|81246 - FLT3 GENE ANLYS TYROSINE KINASE DOMAIN VARIANTS|135.29|135.29||0.01
125|81245|81245 - FLT3 GENE ANALYSIS INTERNAL TANDEM DUP VARIANTS|269.78|269.78||0.01
125|81244|81244 - FMR1 GENE ANALYSIS CHARACTERIZATION OF ALLELES|73.17|73.17||0.01
125|81243|81243 - FMR1 ANALYSIS EVAL TO DETECT ABNORMAL ALLELES|92.98|92.98||0.01
125|81242|81242 - FANCC GENE ANALYSIS COMMON VARIANT|59.69|59.69||0.01
125|81241|81241 - F5 COAGULATION FACTOR V ANAL LEIDEN VARIANT|122.97|122.97||0.01
125|81240|81240 - F2 GENE ANALYSIS 20210G >A VARIANT|107.07|107.07||0.01
125|81238|81238 - F9 FULL GENE SEQUENCE|978|978||
125|81235|81235 - EGFR GENE ANALYSIS COMMON VARIANTS|529.07|529.07||0.01
125|81232|81232 - DYPD GENE ANALYSIS COMMON VARIANTS|284.94|284.94||
125|81231|81231 - CYP3A5 GENE ANALYSIS COMMON VARIANTS|284.94|284.94||
125|81230|81230 - CYP3A4 GENE ANALYSIS COMMON VARIANTS|284.94|284.94||
125|81229|81229 - CYTOGENOM CONST MICROARRAY COPY NUMBER&SNP VAR|1890.8|1890.8||0.01
125|81228|81228 - CYTOGENOM CONST MICROARRAY COPY NUMBER VARIANTS|1467|1467||0.01
125|81227|81227 - CYP2C9 GENE ANALYSIS COMMON VARIANTS|284.94|284.94||0.01
125|81226|81226 - CYP2D6 GENE ANALYSIS COMMON VARIANTS|734.98|734.98||0.01
125|81225|81225 - CYP2C19 GENE ANALYSIS COMMON VARIANTS|474.92|474.92||0.01
125|81224|81224 - CFTR GENE ANALYSIS INTRON 8 POLY-T ANALYSIS|275.06|275.06||0.01
125|81223|81223 - CFTR GENE ANALYSIS FULL GENE SEQUENCE|813.37|813.37||0.01
125|81222|81222 - CFTR GENE ANALYSIS DUPLICATION/DELETION VARIANTS|709.16|709.16||0.01
125|81221|81221 - CFTR GENE ANALYSIS KNOWN FAMILIAL VARIANTS|158.47|158.47||0.01
125|81220|81220 - CFTR GENE ANALYSIS COMMON VARIANTS|907.26|907.26||0.01
125|81219|81219 - CALR GENE ANALYSIS COMMON VARIANTS IN EXON 9|244.76|244.76||0.01
125|81218|81218 - CEBPA GENE ANALYSIS FULL GENE SEQUENCE|486.78|486.78||0.01
125|81217|81217 - BRCA2 GENE ANALYSIS KNOWN FAMILIAL VARIANT|611.66|611.66||0.01
125|81216|81216 - BRCA2 GENE ANALYSIS FULL SEQUENCE ANALYSIS|301.75|301.75||0.01
125|81215|81215 - BRCA1 GENE ANALYSIS KNOWN FAMILIAL VARIANT|611.66|611.66||0.01
125|81214|81214 - BRCA1 FULL SEQ ANAL&COMMON DUP/DEL VARIANTS|2121.31|2121.31||0.01
125|81213|81213 - BRCA1&BRCA2 ANAL UNCOMMON DUP/DEL VARIANTS|901.39|901.39||0.01
125|81212|81212 - BRCA1 BRCA 2 GEN ALYS 185DELAG 5385INSC 6174DELT|717.2|717.2||0.01
125|81211|81211 - BRCA1&BRCA2 FULL SEQ ANALYS/COMM DUP/DEL BRCA|3905.22|3905.22||0.01
125|81210|81210 - BRAF GENE ANALYSIS V600 VARIANT(S)|285.9|285.9||0.01
125|81209|81209 - BLM GENE ANALYSIS 2281DEL6INS7 VARIANT|64.08|64.08||0.01
125|81208|81208 - BCR/ABL1 OTHER BREAKPNT QUALITATIVE/QUANTITATIVE|349.83|349.83||0.01
125|81207|81207 - BCR/ABL1 MINOR BREAKPNT QUALITATIVE/QUANTITATIVE|291.46|291.46||0.01
125|81206|81206 - BCR/ABL1 MAJOR BREAKPNT QUALITATIVE/QUANTITATIVE|329.94|329.94||0.01
125|81205|81205 - BCKDHB GENE ANALYSIS COMMON VARIANTS|154.83|154.83||0.01
125|81203|81203 - APC GENE ANALYSIS DUPLICATION/DELETION VARIANTS|326|326||0.01
125|81202|81202 - APC GENE ANALYSIS KNOWN FAMILIAL VARIANTS|456.4|456.4||0.01
125|81201|81201 - APC GENE ANALYSIS FULL GENE SEQUENCE|1271.4|1271.4||0.01
125|81200|81200 - ASPA GENE ANALYSIS COMMON VARIANTS|77.02|77.02||0.01
125|81176|81176 - ASXL1 GENE ANALYSIS TARGETED SEQ ANALYSIS|486.78|486.78||
125|81175|81175 - ASXL1 GENE ANALYSIS FULL GENE SEQUENCE|1152.44|1152.44||
125|81170|81170 - ABL1 GENE ANALYSIS KINASE DOMAIN VARIANTS|489|489||
125|81162|81162 - BRCA1 BRCA2 GENE ALYS FULL SEQ FULL DUP/DEL ALYS|3672.28|3672.28||
125|81161|81161 - DMD DUPLICATION/DELETION ANALYSIS|454.77|454.77||
125|81121|81121 - IDH2 COMMON VARIANTS|482.14|482.14||
125|81120|81120 - IDH1 COMMON VARIANTS|315|315||
125|81112|81112 - HPA-15 GENOTYPING GENE ANALYSIS COMMON VARIANT|245.95|245.95||
125|81111|81111 - HPA-9 GENOTYPING GENE ANALYSIS COMMON VARIANT|245.95|245.95||
125|81110|81110 - HPA-6 GENOTYPING GENE ANALYSIS COMMON VARIANT|245.95|245.95||
125|81109|81109 - HPA-5 GENOTYPING GENE ANALYSIS COMMON VARIANT|245.95|245.95||
125|81108|81108 - HPA-4 GENOTYPING GENE ANALYSIS COMMON VARIANT|245.95|245.95||
125|81107|81107 - HPA-3 GENOTYPING GENE ANALYSIS COMMON VARIANT|245.95|245.95||
125|81106|81106 - HPA-2 GENOTYPING GENE ANALYSIS COMMON VARIANT|245.95|245.95||
125|81105|81105 - HPA-1 GENOTYPING GENE ANALYSIS COMMON VARIANT|245.95|245.95||
125|81099|81099 - UNLISTED URINALYSIS PROCEDURE|10.64|10.64||
125|81050|81050 - VOLUME MEASUREMENT TIMED COLLECTION EACH|8|8||
125|81025|81025 - URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS|12.63|12.63||
125|81020|81020 - URINALYSIS 2/3 GLASS TEST|9.41|9.41||
125|81015|81015 - URINALYSIS MICROSCOPIC ONLY|7.81|7.81||
125|81007|81007 - URINALYSIS BACTERIURIA SCR XCPT CULTURE/DIPSTICK|10.23|10.23||
125|81005|81005 - URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS|7.17|7.17||
125|81003|81003 - URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY|10.22|10.22||
125|81002|81002 - URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP|8.83|8.83||
125|81001|81001 - URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY|17.11|17.11||
125|81000|81000 - URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY|11.29|11.29||
125|80502|80502 - CLINICAL PATHOLOGY CONSULTATION COMPREHENSIVE|99.47|99.47||73.93
125|80500|80500 - CLINICAL PATHOLOGY CONSULTATION LIMITED|38.15|38.15||23.15
125|80439|80439 - THYROTROPIN RELEASING HORMONE STMLJ PANEL 2 HR|108.48|108.48||
125|80438|80438 - THYROTROPIN RELEASING HORMONE STMLJ PANEL 1 HR|84.38|84.38||
125|80436|80436 - METYRAPONE PANEL|198.78|198.78||
125|80435|80435 - INSULIN TOLERANCE PANEL GROWTH HORM DEFNCY|175.24|175.24||
125|80434|80434 - INSULIN TOLERANCE PANEL ACTH INSUFFICIENCY|173.63|173.63||
125|80432|80432 - INSULIN-INDUCED C-PEPTIDE SUPRESSION PANEL|241.17|241.17||
125|80430|80430 - GROWTH HORMONE SUPRJ PANEL GLUCOSE ADMN|136.98|136.98||
125|80428|80428 - GROWTH HORMONE STIMULATION PANEL|113.76|113.76||
125|80426|80426 - GONADOTROPIN RELEASING HORMONE STIMJ PANEL|245.23|245.23||
125|80424|80424 - GLUCOSE TOLERANCE PANEL PHEOCHROMOCYTOMA|116.39|116.39||
125|80422|80422 - GLUCOSE TOLERANCE PANEL INSULINOMA|92.62|92.62||
125|80420|80420 - DEXMETHASONE SUPPRESSION PANEL 48 HR|183.55|183.55||
125|80418|80418 - COMBINED RAPID ANT PITUITARY EVALUATION PANEL|1626.92|1626.92||
125|80417|80417 - PERIPHERAL VEIN RENIN STIMULATION PANEL|87.8|87.8||
125|80416|80416 - RENAL VEIN RENIN STIMULATION PANEL|226.05|226.05||
125|80415|80415 - CHORNC GONAD STIMJ PANEL ESTRADIOL RESPONSE|83.55|83.55||
125|80414|80414 - CHORNC GONAD STIMJ PANEL TSTOSTERONE RESPONSE|77.21|77.21||
125|80412|80412 - CORTICOTROPIC RELEASING HORM STIMJ PANEL|492.74|492.74||
125|80410|80410 - CALCITONIN STIMULATION PANEL|192.17|192.17||
125|80408|80408 - ALDOSTERONE SUPPRESSION EVALUATION PANEL|270.06|270.06||
125|80406|80406 - ACTH STIMJ PANEL 3 BETA-HYDROXYDEHYD DEFNCY|183.86|183.86||
125|80402|80402 - ACTH STIMULATION PANEL 21 HYDROXYLASE DEFICIENCY|210.08|210.08||
125|80400|80400 - ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY|86.27|86.27||
125|80377|80377 - DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 7/MORE|0.01|0.01||
125|80376|80376 - DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 4-6|0.01|0.01||
125|80375|80375 - DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 1-3|0.01|0.01||
125|80374|80374 - DRUG SCREEN STEREOISOMER ANALYSIS 1 DRUG CLASS|0.01|0.01||
125|80373|80373 - DRUG SCREENING TRAMADOL|0.01|0.01||
125|80372|80372 - DRUG SCREENING TAPENTADOL|0.01|0.01||
125|80371|80371 - DRUG SCREENING STIMULANTS SYNTHETIC|0.01|0.01||
125|80370|80370 - DRUG SCREENING SKEL MUSCLE RELAXANTS 3 OR MORE|0.01|0.01||0.01
125|80369|80369 - DRUG SCREENING SKELETAL MUSCLE RELAXANTS 1 OR 2|0.01|0.01||
125|80368|80368 - DRUG SCREENING SEDATIVE HYPNOTICS|0.01|0.01||
125|80367|80367 - DRUG SCREENING PROPOXYPHENE|0.01|0.01||
125|80366|80366 - DRUG SCREENING PREGABALIN|0.01|0.01||
125|80365|80365 - DRUG SCREENING OXYCODONE|0.01|0.01||
125|80364|80364 - DRUG SCREENING OPIOIDS & OPIATE ANALOGS 5/MORE|0.01|0.01||0.01
125|80363|80363 - DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 3 OR 4|0.01|0.01||0.01
125|80362|80362 - DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 1 OR 2|0.01|0.01||
125|80361|80361 - DRUG SCREENING OPIATES 1 OR MORE|0.01|0.01||
125|80360|80360 - DRUG SCREENING METHYLPHENIDATE|0.01|0.01||
125|80359|80359 - DRUG SCREENING METHYLENEDIOXYAMPHETAMINES|0.01|0.01||
125|80358|80358 - DRUG SCREENING METHADONE|0.01|0.01||
125|80357|80357 - DRUG SCREENING KETAMINE AND NORKETAMINE|0.01|0.01||
125|80356|80356 - DRUG SCREENING HEROIN METABOLITE|0.01|0.01||
125|80355|80355 - DRUG SCREENING GABAPENTIN NON-BLOOD|0.01|0.01||
125|80354|80354 - DRUG SCREENING FENTANYL|0.01|0.01||
125|80353|80353 - DRUG SCREENING COCAINE|0.01|0.01||
125|80352|80352 - DRUG SCREENING CANNABINOIDS SYNTHETIC 7/MORE|0.01|0.01||0.01
125|80351|80351 - DRUG SCREENING CANNABINOIDS SYNTHETIC 4-6|0.01|0.01||0.01
125|80350|80350 - DRUG SCREENING CANNABINOIDS SYNTHETIC 1-3|0.01|0.01||
125|80349|80349 - DRUG SCREENING CANNABINOIDS NATURAL|0.01|0.01||
125|80348|80348 - DRUG SCREENING BUPRENORPHINE|0.01|0.01||0.01
125|80347|80347 - DRUG SCREENING BENZODIAZEPINES 13 OR MORE|0.01|0.01||0.01
125|80346|80346 - DRUG SCREENING BENZODIAZEPINES 1-12|0.01|0.01||
125|80345|80345 - DRUG SCREENING BARBITURATES|0.01|0.01||
125|80344|80344 - ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 7/MORE|0.01|0.01||0.01
125|80343|80343 - ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 4-6|0.01|0.01||0.01
125|80342|80342 - ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 1-3|0.01|0.01||
125|80341|80341 - ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 7/MORE|0.01|0.01||0.01
125|80340|80340 - ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 4-6|0.01|0.01||0.01
125|80339|80339 - ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 1-3|0.01|0.01||
125|80338|80338 - ANTIDEPRESSANTS NOT OTHERWISE SPECIFIED|0.01|0.01||0.01
125|80337|80337 - ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 6/MORE|0.01|0.01||0.01
125|80336|80336 - ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 3-5|0.01|0.01||0.01
125|80335|80335 - ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2|0.01|0.01||
125|80334|80334 - ANTIDEPRESSANTS SEROTONERGIC CLASS 6 OR MORE|0.01|0.01||0.01
125|80333|80333 - ANTIDEPRESSANTS SEROTONERGIC CLASS 3-5|0.01|0.01||0.01
125|80332|80332 - ANTIDEPRESSANTS SEROTONERGIC CLASS 1 OR 2|0.01|0.01||
125|80331|80331 - DRUG SCREEN ANALGESICS NON-OPIOID 6 OR MORE|0.01|0.01||0.01
125|80330|80330 - DRUG SCREEN ANALGESICS NON-OPIOID 3-5|0.01|0.01||0.01
125|80329|80329 - DRUG SCREEN ANALGESICS NON-OPIOID 1 OR 2|0.01|0.01||
125|80328|80328 - DRUG SCREEN QUANT ANABOLIC STEROID 3 OR MORE|0.01|0.01||0.01
125|80327|80327 - DRUG SCREEN QUANT ANABOLIC STEROID 1 OR 2|0.01|0.01||
125|80326|80326 - DRUG SCREEN QUANT AMPHETAMINES 5 OR MORE|0.01|0.01||0.01
125|80325|80325 - DRUG SCREEN QUANT AMPHETAMINES 3 OR 4|0.01|0.01||0.01
125|80324|80324 - DRUG SCREEN QUANT AMPHETAMINES 1 OR 2|0.01|0.01||
125|80323|80323 - ALKALOIDS NOT OTHERWISE SPECIFIED|0.01|0.01||
125|80322|80322 - DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 3 OR MORE|0.01|0.01||0.01
125|80321|80321 - DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2|0.01|0.01||0.01
125|80320|80320 - DRUG SCREEN QUANTITATIVE ALCOHOLS|0.01|0.01||
125|80307|80307 - DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE|117.08|117.08||
125|80306|80306 - DRUG TST PRSMV READ INSTRMNT ASSTD DIR OPT OBS|29.27|29.27||
125|80305|80305 - DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE|21.94|21.94||
125|80299|80299 - QUANTITATION DRUG NOT ELSEWHERE SPECIFIED|49.08|49.08||
125|80203|80203 - DRUG SCREEN QUANTITATIVE ZONISAMIDE|26.67|26.67||
125|80202|80202 - DRUG SCREEN QUANTITATIVE VANCOMYCIN|43.62|43.62||
125|80201|80201 - DRUG SCREEN QUANTITATIVE TOPIRAMATE|33.42|33.42||
125|80200|80200 - DRUG SCREEN QUANTITATIVE TOBRAMYCIN|40.3|40.3||
125|80199|80199 - DRUG SCREEN QUANTITATIVE TIAGABINE|44.19|44.19||
125|80198|80198 - DRUG SCREEN QUANTITATIVE THEOPHYLLINE|33.89|33.89||
125|80197|80197 - DRUG SCREEN QUANTITATIVE TACROLIMUS|73.01|73.01||
125|80195|80195 - DRUG SCREEN QUANTITATIVE SIROLIMUS|27.64|27.64||
125|80194|80194 - DRUG SCREEN QUANTITATIVE QUINIDINE|34.33|34.33||
125|80192|80192 - DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE|50.95|50.95||
125|80190|80190 - DRUG SCREEN QUANTITATIVE PROCAINAMIDE|37.48|37.48||
125|80188|80188 - DRUG SCREEN QUANTITATIVE PRIMIDONE|47.23|47.23||
125|80186|80186 - DRUG SCREEN QUANTITATIVE PHENYTOIN FREE|35.94|35.94||
125|80185|80185 - DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL|32.77|32.77||
125|80184|80184 - DRUG SCREEN QUANTITATIVE PHENOBARBITAL|33.5|33.5||
125|80183|80183 - DRUG SCREEN QUANTITATIVE OXCARBAZEPINE|26.67|26.67||
125|80180|80180 - DRUG SCREEN QUANTITATIVE MYCOPHENOLATE|36.32|36.32||
125|80178|80178 - DRUG SCREEN QUANTITATIVE LITHIUM|17.8|17.8||
125|80177|80177 - DRUG SCREEN QUANTITATIVE LEVETIRACETAM|26.67|26.67||
125|80176|80176 - DRUG SCREEN QUANTITATIVE LIDOCAINE|35.33|35.33||
125|80175|80175 - DRUG SCREEN QUANTITATIVE LAMOTRIGINE|26.67|26.67||
125|80173|80173 - DRUG SCREEN QUANTITATIVE HALOPRIDOL|57.69|57.69||
125|80171|80171 - DRUG SCREEN QUANTITATIVE GABAPENTIN|35.32|35.32||
125|80170|80170 - DRUG SCREEN QUANTITATIVE GENTAMICIN|40.54|40.54||
125|80169|80169 - DRUG ASSAY EVEROLIMUS|27.64|27.64||
125|80168|80168 - DRUG SCREEN QUANTITATIVE ETHOSUXIMIDE|37.98|37.98||
125|80165|80165 - DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE|27.25|27.25||
125|80164|80164 - DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL|37.05|37.05||
125|80163|80163 - DRUG SCREEN QUANTITATIVE DIGOXIN FREE|26.72|26.72||
125|80162|80162 - DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL|31.71|31.71||
125|80159|80159 - DRUG ASSAY CLOZAPINE|37.21|37.21||
125|80158|80158 - DRUG ASSAY CYCLOSPORINE|40.1|40.1||
125|80157|80157 - DRUG ASSAY CARBAMAZEPINE FREE|46.16|46.16||
125|80156|80156 - DRUG ASSAY CARBAMAZEPINE TOTAL|34.98|34.98||
125|80155|80155 - DRUG ASSAY CAFFEINE|62.87|62.87||
125|80150|80150 - DRUG SCREEN QUANTITATIVE AMIKACIN|46.88|46.88||
125|80081|80081 - OBSTETRIC PANEL|150.64|150.64||
125|80076|80076 - HEPATIC FUNCTION PANEL|18.54|18.54||
125|80074|80074 - ACUTE HEPATITIS PANEL|95.08|95.08||
125|80069|80069 - RENAL FUNCTION PANEL|20.72|20.72||
125|80061|80061 - LIPID PANEL|36.97|36.97||
125|80055|80055 - OBSTETRIC PANEL|62.52|62.52||
125|80053|80053 - COMPREHENSIVE METABOLIC PANEL|26.27|26.27||
125|80051|80051 - ELECTROLYTE PANEL|16.09|16.09||
125|80050|80050 - GENERAL HEALTH PANEL|76.4|76.4||
125|80048|80048 - BASIC METABOLIC PANEL CALCIUM TOTAL|19.38|19.38||
125|80047|80047 - BASIC METABOLIC PANEL CALCIUM IONIZED|22.38|22.38||
125|79445|79445 - RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN|231.32|231.32||131.35
125|79440|79440 - RP THERAPY INTRA-ARTICULAR ADMINISTRATION|381.56|381.56||189.56
125|79403|79403 - RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS|285.19|285.19||197.22
125|79300|79300 - RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN|370.8|370.8||120.69
125|79200|79200 - RP THERAPY INRACAVITARY ADMINISTRATION|412.23|412.23||214.22
125|79101|79101 - RP THERAPY INTRAVENOUS ADMINISTRATION|234.58|234.58||121.5
125|79005|79005 - RP THERAPY ORAL ADMINISTRATION|224.33|224.33||111.25
125|78816|78816 - PET IMAGING FOR CT ATTENUATION WHOLE BODY|1800|1800||105.68
125|78815|78815 - PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH|1800|1800||103.26
125|78814|78814 - PET IMAGING CT FOR ATTENUATION LIMITED AREA|1800|1800||93.52
125|78813|78813 - PET IMAGING WHOLE BODY|1800|1800||85.41
125|78812|78812 - PET IMAGING SKULL BASE TO MID-THIGH|1800|1800||82.57
125|78811|78811 - PET IMAGING LIMITED AREA CHEST HEAD/NECK|1800|1800||66.76
125|78808|78808 - NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS|60.36|60.36||
125|78807|78807 - RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT|538.87|538.87||106.27
125|78806|78806 - RP LOCLZJ INFLAMMATORY PROCESS WHOLE BODY|530.22|530.22||76.3
125|78805|78805 - RP LOCLZJ INFLAMMATORY PROCESS LIMITED AREA|311.72|311.72||72.51
125|78804|78804 - RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING|465.5|465.5||82.18
125|78803|78803 - RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING|566.3|566.3||106.27
125|78802|78802 - RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING|472.62|472.62||85.02
125|78801|78801 - RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D|375.35|375.35||77.52
125|78800|78800 - RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING|302.87|302.87||62.21
125|78761|78761 - TESTICULAR IMAGING WITH VASCULAR FLOW|296.39|296.39||71.26
125|78740|78740 - URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM|206.82|206.82||56.26
125|78730|78730 - URINARY BLADDER RESIDUAL STUDY|138.47|138.47||35.01
125|78725|78725 - KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY|163.8|163.8||37.51
125|78710|78710 - KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC|455.1|455.1||66.27
125|78709|78709 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE|439.19|439.19||123.26
125|78708|78708 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX|439.19|439.19||128.14
125|78707|78707 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX|407.16|407.16||92.52
125|78701|78701 - KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW|297|297||47.51
125|78700|78700 - KIDNEY IMAGING MORPHOLOGY|189.76|189.76||37.08
125|78660|78660 - RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY|150.73|150.73||37.93
125|78650|78650 - CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO|294.65|294.65||50.9
125|78647|78647 - CEREBROSPINAL FLUID FLOW W/O MATL TOMOG SPECT|349.65|349.65||66.94
125|78645|78645 - CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ|282.57|282.57||56.26
125|78635|78635 - CEREBROSPINAL FLUID FLOW W/O MATL VENTRICLGRAPHY|191.24|191.24||45.46
125|78630|78630 - CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY|400.09|400.09||67.52
125|78610|78610 - BRAIN IMAGING VASCULAR FLOW ONLY|140.83|140.83||30
125|78609|78609 - BRAIN IMAGING PET PERFUSION EVALUATION|90.22|90.22||130.87
125|78608|78608 - BRAIN IMAGING PET METABOLIC EVALUATION|88.04|88.04||130.87
125|78607|78607 - BRAIN IMAGING TOMOGRAPHIC SPECT|580.41|580.41||120.03
125|78606|78606 - BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW|317.58|317.58||62.52
125|78605|78605 - BRAIN IMAGING MINIMUM 4 STATIC VIEWS|277.57|277.57||53.77
125|78601|78601 - BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW|234.22|234.22||44.09
125|78600|78600 - BRAIN IMAGING <4 STATIC VIEWS|201.53|201.53||37.98
125|78598|78598 - QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN|477.46|477.46||67.17
125|78597|78597 - QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING|318.94|318.94||58.03
125|78582|78582 - PULMONARY VENTILATION & PERFUSION IMAGING|524.34|524.34||86.08
125|78580|78580 - PULMONARY PERFUSION IMAGING PARTICULATE|315.84|315.84||73.77
125|78579|78579 - PULMONARY VENTILATION IMAGING|292.5|292.5||38.97
125|78496|78496 - CARD BL POOL GATED 1 STDY REST RT VENT EJCT FRCT|333.01|333.01||48.05
125|78494|78494 - CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT|443.12|443.12||104.04
125|78492|78492 - MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS|419.58|419.58||130.05
125|78491|78491 - MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS|355.69|355.69||110.01
125|78483|78483 - CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT|558.69|558.69||123.24
125|78481|78481 - CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT|464.92|464.92||96.27
125|78473|78473 - CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT|530.22|530.22||114.74
125|78472|78472 - CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS|484.37|484.37||93.99
125|78469|78469 - MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ|457.28|457.28||90.02
125|78468|78468 - MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ|320.08|320.08||78.77
125|78466|78466 - MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN|255.72|255.72||67.15
125|78459|78459 - MYOCRD IMG PET METAB EVAL SINGLE STUDY|857.71|857.71||137.44
125|78458|78458 - VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL|371.23|371.23||88.77
125|78457|78457 - VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL|251.31|251.31||76.27
125|78456|78456 - ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE|232.93|232.93||58.51
125|78455|78455 - NUCLEAR STUDY OF VEIN CLOT|335.08|335.08||72.51
125|78454|78454 - MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES|684.93|684.93||108.36
125|78453|78453 - MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS|476.87|476.87||80.29
125|78452|78452 - MYOCARDIAL SPECT MULTIPLE STUDIES|744.19|744.19||129.01
125|78451|78451 - MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS|535.67|535.67||109.55
125|78445|78445 - NONCARDIAC VASCULAR FLOW IMAGING|181.49|181.49||50.01
125|78428|78428 - CARDIAC SHUNT DETECTION|226.3|226.3||77.52
125|78414|78414 - CARD-VASC HEMODYNAM W/WO PHARM/EXER 1/MLT DETERM|433.1|433.1||41.45
125|78351|78351 - BONE DENSTY 1/> SITES DUAL PHOTON ABSORPTIOMETR|84.44|84.44||5.27
125|78350|78350 - BONE DENSITY 1/> SITES 1 PHOTON ABSORPTIOMETRY|76.59|76.59||22.5
125|78320|78320 - BONE &/JOINT IMAGING TOMOGRAPHIC SPECT|516.79|516.79||102.53
125|78315|78315 - BONE &/JOINT IMAGING 3 PHASE STUDY|437.21|437.21||100.02
125|78306|78306 - BONE &/JOINT IMAGING WHOLE BODY|385.95|385.95||85.02
125|78305|78305 - BONE &/JOINT IMAGING MULTIPLE AREAS|341.17|341.17||82.52
125|78300|78300 - BONE &/JOINT IMAGING LIMITED AREA|238.63|238.63||61.27
125|78291|78291 - PERITONEAL-VENOUS SHUNT PATENCY TEST|287.57|287.57||86.27
125|78290|78290 - INTESTINE IMAGING|281.67|281.67||67.52
125|78282|78282 - GASTROINTESTINAL PROTEIN LOSS|339.33|339.33||29.19
125|78278|78278 - ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING|441.33|441.33||98.77
125|78272|78272 - VITAMIN B-12 ABSRPJ STDY W/WO INTRINSIC FACT|138.06|138.06||22.91
125|78271|78271 - VITAMIN B-12 ABSRPJ STUDY W/INTRINSIC FACTOR|99.71|99.71||17.01
125|78270|78270 - VITAMIN B-12 ABSRPJ STUDY W/O INTRINSIC FACTOR|128.47|128.47||20.01
125|78268|78268 - UREA BREATH TEST C-14 ISOTOPIC ANALYSIS|20.22|20.22||
125|78267|78267 - UREA BREATH TEST C-14 ISOTOPIC ACQUISJ ANALYSIS|13.41|13.41||
125|78266|78266 - GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY|742.37|742.37||87.2
125|78265|78265 - GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT|591.33|591.33||78.58
125|78264|78264 - GASTRIC EMPTYING IMAGING STUDY|367.11|367.11||77.52
125|78262|78262 - GASTROESOPHAGEAL REFLUX STUDY|347.58|347.58||67.52
125|78261|78261 - GASTRIC MUCOSA IMAGING|338.83|338.83||68.77
125|78258|78258 - ESOPHAGEAL MOTILITY|212.93|212.93||53.34
125|78232|78232 - SALIVARY GLAND FUNCTION STUDY|218.61|218.61||38.66
125|78231|78231 - SALIVARY GLAND IMAGING SERIAL IMAGES|201.62|201.62||40.22
125|78230|78230 - SALIVARY GLAND IMAGING|146.4|146.4||33.11
125|78227|78227 - HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ|700.57|700.57||72.84
125|78226|78226 - HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER|517.43|517.43||59.66
125|78216|78216 - LIVER & SPLEEN IMAGING W/VASCULAR FLOW|301.12|301.12||56.26
125|78215|78215 - LIVER & SPLEEN IMAGING STATIC ONLY|253.96|253.96||47.51
125|78206|78206 - LIVER IMAGING SPECT W/VASCULAR FLOW|494.02|494.02||91.55
125|78205|78205 - LIVER IMAGING SPECT|483.22|483.22||71.26
125|78202|78202 - LIVER IMAGING W/VASCULAR FLOW|240.05|240.05||51.26
125|78201|78201 - LIVER IMAGING STATIC ONLY|209.18|209.18||42.51
125|78199|78199 - UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED|389.82|389.82||
125|78195|78195 - LYMPHATICS & LYMPH NODES IMAGING|341.73|341.73||93.05
125|78191|78191 - PLATELET SURVIVAL STUDY|397.01|397.01||49.29
125|78190|78190 - KINETICS PLATELET W/WO DIFFRNTL ORGAN/TIS LOCLZJ|351.73|351.73||75.34
125|78185|78185 - SPLEEN IMAGING ONLY W/WO VASCULAR FLOW|196.29|196.29||40.01
125|78172|78172 - NUCLEAR EXAM OF TOTAL BODY IRON|177.07|177.07||37.72
125|78170|78170 - NUCLEAR EXAM OF RED CELL IRON|284.92|284.92||33.51
125|78162|78162 - NUCLEAR EXAM OF IRON ABSORPTION|203.34|203.34||36.94
125|78160|78160 - NUCLEAR EXAM OF PLASMA IRON|199.83|199.83||25.58
125|78140|78140 - LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE|251.09|251.09||48.05
125|78135|78135 - RBC SURVIVAL STUDY DIFFERNTL ORGAN/TISS KINETICS|383.84|383.84||62.52
125|78130|78130 - RED CELL SURVIVAL STUDY|248.81|248.81||60.02
125|78122|78122 - WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU|347.58|347.58||43.76
125|78121|78121 - RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS|167.4|167.4||26.8
125|78120|78120 - RED CELL VOLUME DETERMINATION SPX 1 SAMPLING|114.22|114.22||20.42
125|78111|78111 - PLASMA VOL RADIOPHARM VOL DILUTE SPX MULT SMPLES|141.26|141.26||20.09
125|78110|78110 - PLASMA VOL RADIOPHARM VOL DILUTION SPX 1 SAMPLE|71.76|71.76||15.41
125|78104|78104 - BONE MARROW IMAGING WHOLE BODY|347.58|347.58||78.77
125|78103|78103 - BONE MARROW IMAGING MULTIPLE AREAS|230.79|230.79||54.88
125|78102|78102 - BONE MARROW IMAGING LIMITED AREA|148.51|148.51||38.77
125|78075|78075 - ADRENAL IMAGING CORTEX &/MEDULLA|431.35|431.35||73.77
125|78072|78072 - PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT|651.12|651.12||125.84
125|78071|78071 - PARATHYROID PLANAR IMAGING W/WO SUBTRACTION|560.98|560.98||95.83
125|78070|78070 - PARATHYROID PLANAR IMAGING|201.87|201.87||64.15
125|78020|78020 - THYROID CARCINOMA METASTASES UPTAKE|121.98|121.98||32.62
125|78018|78018 - THYROID CARCINOMA METASTASES IMG WHOLE BODY|474.37|474.37||93.04
125|78016|78016 - THYROID CARCINOMA METASTASES IMG ADDL STUDY|227.87|227.87||59.12
125|78015|78015 - THYROID CARCINOMA METASTASES IMG LMTD AREA|186.79|186.79||50.35
125|78014|78014 - THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS|377.07|377.07||40.2
125|78013|78013 - THYROID IMAGING WITH VASCULAR FLOW|299.71|299.71||29.83
125|78012|78012 - THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT|126.46|126.46||15.47
125|77790|77790 - SUPERVISION HANDLING LOADING RADIATION SOURCE|111.09|111.09||97.42
125|77789|77789 - SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE|107.34|107.34||80.34
125|77778|77778 - INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX|1116.59|1116.59||1005.85
125|77772|77772 - HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS|1425.61|1425.61||454.79
125|77771|77771 - HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL|935.91|935.91||321.16
125|77770|77770 - HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL|502.85|502.85||164.3
125|77768|77768 - HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES|546.96|546.96||118.63
125|77767|77767 - HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN|349.31|349.31||88.39
125|77763|77763 - INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX|870.47|870.47||768.1
125|77762|77762 - INTRACAVITARY RADIATION SOURCE APPLIC INTERMED|762.66|762.66||517.27
125|77761|77761 - INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE|430.66|430.66||285.35
125|77750|77750 - NFS/INSTLJ RADIOELMNT SLN 3 MO FOLLOW-UP CARE|440.74|440.74||440.39
125|77620|77620 - HYPERTHERMIA INTRACAVITARY PROBES|277.91|277.91||118.97
125|77615|77615 - HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS|426.47|426.47||178.74
125|77610|77610 - HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS|329.69|329.69||137.77
125|77605|77605 - HYPERTHERMIA EXTERNAL GENERATED DEEP|426.48|426.48||178.75
125|77600|77600 - HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL|322.1|322.1||137.68
125|77525|77525 - PROTON TX DELIVERY COMPLEX|1103.63|1103.63||220.73
125|77523|77523 - PROTON TX DELIVERY INTERMEDIATE|991.26|991.26||198.25
125|77522|77522 - PROTON TX DELIVERY SIMPLE W/COMPENSATION|857.3|857.3||171.46
125|77520|77520 - PROTON TX DELIVERY SIMPLE W/O COMPENSATION|842.76|842.76||168.55
125|77470|77470 - SPECIAL TREATMENT PROCEDURE|764.53|764.53||195.74
125|77469|77469 - INTRAOPERATIVE RADIATION TREATMENT MANAGEMENT|518.75|518.75||
125|77435|77435 - STEREOTACTIC BODY RADIATION MANAGEMENT|1161.89|1161.89||
125|77432|77432 - STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION|820.56|820.56||
125|77431|77431 - RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY|167.5|167.5||
125|77427|77427 - RADIATION TREATMENT MANAGEMENT 5 TREATMENTS|267.5|267.5||
125|77425|77425 - INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS|312.01|312.01||62.4
125|77424|77424 - INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION|442.15|442.15||88.43
125|77423|77423 - HIGH ENERGY NEUTRON RADJ TX DLVR 1/> ISOCENTER|222.29|222.29||
125|77422|77422 - HIGH ENERGY NEUTRON RADJ TX DLVR 1 TX AREA|164.79|164.79||
125|77417|77417 - THERAPEUTIC RADIOLOGY PORT IMAGES(S)|53.85|53.85||
125|77412|77412 - RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX|122.09|122.09||
125|77407|77407 - RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE|109.4|109.4||
125|77402|77402 - RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE|92.79|92.79||
125|77401|77401 - RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTA|92.59|92.59||
125|77387|77387 - GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR|65.44|65.44||27.07
125|77386|77386 - INTENSITY MODULATED RADIATION TX DLVR COMPLEX|339.88|339.88||
125|77385|77385 - INTENSITY MODULATED RADIATION TX DLVR SIMPLE|338.72|338.72||
125|77373|77373 - STEREOTACTIC BODY RADIATION DELIVERY|2667.64|2667.64||
125|77372|77372 - RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR|1430.93|1430.93||
125|77371|77371 - RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT|1884.91|1884.91||
125|77370|77370 - SPEC MEDICAL RADJ PHYSICS CONSLTJ|188.62|188.62||
125|77338|77338 - MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN|800.7|800.7||362.23
125|77336|77336 - CONTINUING MEDICAL PHYSICS CONSLTJ PR WK|160.23|160.23||
125|77334|77334 - TX DEVICES DESIGN & CONSTRUCTION COMPLEX|303.39|303.39||115.35
125|77333|77333 - TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE|172.51|172.51||69.61
125|77332|77332 - TX DEVICES DESIGN & CONSTRUCTION SIMPLE|128.54|128.54||50.93
125|77331|77331 - SPEC DOSIM ONLY PRESCRIBED TREATING PHYS|98.99|98.99||69.69
125|77321|77321 - SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY|296.91|296.91||89.61
125|77318|77318 - BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL|558.68|558.68||244.19
125|77317|77317 - BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL|385.56|385.56||154.1
125|77316|77316 - BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL|295.67|295.67||118.63
125|77307|77307 - TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY|457.1|457.1||244.19
125|77306|77306 - TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION|236.48|236.48||118.63
125|77301|77301 - NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS|1488.12|1488.12||431.22
125|77300|77300 - BASIC RADIATION DOSIMETRY CALCULATION|138.76|138.76||57.67
125|77295|77295 - 3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS|1865.4|1865.4||425.89
125|77293|77293 - RESPIRATORY MOTION MANAGEMENT SIMULATION|723.56|723.56||168.92
125|77290|77290 - THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX|571.1|571.1||147.29
125|77285|77285 - THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED|453.79|453.79||97.42
125|77280|77280 - THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE|297.89|297.89||66.37
125|77263|77263 - THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX|310.02|310.02||
125|77262|77262 - THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE|208.32|208.32||
125|77261|77261 - THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE|137.3|137.3||
125|77086|77086 - VERTEBRAL FRACTURE ASSESSMENT VIA DXA|55.55|55.55||14.3
125|77085|77085 - DXA BONE DENSITY STUDY AXIAL SKELETON|87.01|87.01||24.66
125|77084|77084 - BONE MARROW BLOOD SUPPLY|910.01|910.01||139.22
125|77081|77081 - DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL|77.55|77.55||19.92
125|77080|77080 - DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL|161.7|161.7||19.12
125|77078|77078 - CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE|251.61|251.61||21.36
125|77077|77077 - JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS|96.77|96.77||27.54
125|77076|77076 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT|71.16|71.16||60.67
125|77075|77075 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL|161.52|161.52||47.51
125|77074|77074 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED|100.37|100.37||39.24
125|77073|77073 - BONE LENGTH STUDIES|76.22|76.22||23.41
125|77072|77072 - BONE AGE STUDIES|41.34|41.34||15.92
125|77071|77071 - MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS|43.16|43.16||
125|77067|77067 - SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD|210.74|210.74||61.89
125|77066|77066 - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI|261.96|261.96||81.97
125|77065|77065 - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI|207.45|207.45||66.5
125|77063|77063 - SCREENING DIGITAL BREAST TOMOSYNTHESIS BI|86.16|86.16||48.7
125|77062|77062 - DIGITAL BREAST TOMOSYNTHESIS BILATERAL|170.36|170.36||52.21
125|77061|77061 - DIGITAL BREAST TOMOSYNTHESIS UNILATERAL|134.4|134.4||42.02
125|77059|77059 - MRI BREAST BILATERAL|1883.03|1883.03||141.35
125|77058|77058 - MRI BREAST UNILATERAL|1335.37|1335.37||141.35
125|77054|77054 - MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE|244.36|244.36||39.24
125|77053|77053 - MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE|171.21|171.21||31.65
125|77022|77022 - MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION|510|510||371.45
125|77021|77021 - MRI GUIDANCE NEEDLE PLACEMENT RS&I|717.65|717.65||132.9
125|77014|77014 - CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT|304.82|304.82||74.37
125|77013|77013 - CT GUIDANCE &MONITORING VISC TISS ABLATION|330|330||347.34
125|77012|77012 - CT GUIDANCE NEEDLE PLACEMENT|569.54|569.54||100.61
125|77011|77011 - CT GUIDANCE STEREOTACTIC LOCALIZATION|858.15|858.15||105.43
125|77003|77003 - FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON|104.57|104.57||49.88
125|77002|77002 - FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON|144.95|144.95||46.27
125|77001|77001 - FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT|106.65|106.65||33.02
125|76998|76998 - ULTRASONIC GUIDANCE INTRAOPERATIVE|68.53|68.53||110.14
125|76977|76977 - US BONE DENSITY MEAS & INTERP PERIPH ANY METHO|76.06|76.06||13.91
125|76975|76975 - GI ENDOSCOPIC US S&I|190.04|190.04||72.87
125|76970|76970 - US STUDY FOLLOW UP|110.82|110.82||43.09
125|76965|76965 - US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION|513.05|513.05||192.7
125|76948|76948 - US GUIDANCE ASPIRATION OVA IMG S&I|132.64|132.64||50.75
125|76946|76946 - US GUIDANCE AMNIOCENTESIS IMG S&I|139.55|139.55||42.4
125|76945|76945 - US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I|136.7|136.7||62.74
125|76942|76942 - US GUIDANCE NEEDLE PLACEMENT IMG S&I|187.74|187.74||72.43
125|76941|76941 - US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I|167.92|167.92||94.49
125|76940|76940 - US &MNTR PARENCHYMAL TISSUE ABLATION|272.14|272.14||115.71
125|76937|76937 - US VASC ACCESS SITS VSL PATENCY NDL ENTRY|58.24|58.24||17.45
125|76936|76936 - US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL|456.6|456.6||143.89
125|76932|76932 - US ENDOMYOCARDIAL BIOPSY RS&I|136.52|136.52||52.75
125|76930|76930 - US GUIDANCE PERICARDIOCENTESIS RS&I|141.74|141.74||68.16
125|76886|76886 - US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ|174.78|174.78||59.83
125|76885|76885 - US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ|183.03|183.03||73.25
125|76882|76882 - US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG|89.83|89.83||40.13
125|76881|76881 - US COMPL JOINT R-T W/IMAGE DOCUMENTATION|156.59|156.59||51.52
125|76873|76873 - US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX|217.03|217.03||84.26
125|76872|76872 - US TRANSRECTAL|179.13|179.13||68.77
125|76870|76870 - US SCROTUM & CONTENTS|172.48|172.48||62.52
125|76857|76857 - US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U|93.49|93.49||35.6
125|76856|76856 - US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE|179.13|179.13||70.53
125|76831|76831 - SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER|180.58|180.58||70.81
125|76830|76830 - US TRANSVAGINAL|163.85|163.85||63.76
125|76828|76828 - DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT|115.16|115.16||49.36
125|76827|76827 - DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE|175.67|175.67||73.99
125|76826|76826 - ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD|130.52|130.52||71.18
125|76825|76825 - ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING|213.98|213.98||110.32
125|76821|76821 - DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART|101.5|101.5||39.22
125|76820|76820 - DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY|90.53|90.53||28.25
125|76819|76819 - FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING|160.39|160.39||42.41
125|76818|76818 - FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING|181.97|181.97||84.83
125|76817|76817 - US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG|266.01|266.01||61.33
125|76816|76816 - US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS|129.81|129.81||106.83
125|76815|76815 - US PREGNANT UTERUS LIMITED 1/> FETUSES|155.71|155.71||63.76
125|76814|76814 - US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION|136.54|136.54||83.67
125|76813|76813 - US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION|203.46|203.46||99.54
125|76812|76812 - US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT|269.18|269.18||98.92
125|76811|76811 - US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION|373.59|373.59||159.39
125|76810|76810 - US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO|199.28|199.28||139.01
125|76805|76805 - US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION|221.01|221.01||97.46
125|76802|76802 - US PREG UTERUS 14 WK TRANSABDL EACH GESTATION|276.26|276.26||45.59
125|76801|76801 - US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT|206.62|206.62||80.89
125|76800|76800 - ULTRASOUND SPINAL CANAL & CONTENTS|179.87|179.87||80.06
125|76776|76776 - US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN|224.95|224.95||64.86
125|76775|76775 - US RETROPERITONEAL REAL TIME W/IMAGE LIMITED|160.38|160.38||57.51
125|76770|76770 - US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE|215.06|215.06||73.78
125|76706|76706 - US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA|145.67|145.67||45.35
125|76705|76705 - US ABDOMINAL REAL TIME W/IMAGE LIMITED|160.95|160.95||58.75
125|76700|76700 - US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION|221.54|221.54||81.3
125|76642|76642 - US BREAST UNI REAL TIME WITH IMAGE LIMITED|136.95|136.95||55.62
125|76641|76641 - US BREAST UNI REAL TIME WITH IMAGE COMPLETE|166.26|166.26||59.59
125|76604|76604 - US CHEST REAL TIME W/IMAGE DOCUMENTATION|148.42|148.42||55.01
125|76536|76536 - US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM|157.92|157.92||56.26
125|76529|76529 - OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION|129.34|129.34||47.85
125|76519|76519 - OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL|119.17|119.17||48.64
125|76516|76516 - OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN|130.66|130.66||48.39
125|76514|76514 - OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI|24.65|24.65||12.6
125|76513|76513 - OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM|148.36|148.36||56.03
125|76512|76512 - OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN|145.43|145.43||56.04
125|76511|76511 - OPHTHALMIC ULTRASOUND DX QUAN A-SCAN ONLY|140.07|140.07||61.97
125|76510|76510 - OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR|169.06|169.06||88.35
125|76506|76506 - ECHOENCEPHALOGRAPHY REAL TIME IMAGING|164.79|164.79||62.52
125|76498|76498 - UNLISTED MAGNETIC RESONANCE PROCEDURE|510|510||102
125|76497|76497 - UNLISTED COMPUTED TOMOGRAPHY PROCEDURE|330|330||304.95
125|76496|76496 - UNLISTED FLUOROSCOPIC PROCEDURE||#REF!|#REF!|
125|76390|76390 - MRI SPECTROSCOPY|728.57|728.57||113.96
125|76380|76380 - CT LIMITED/LOCALIZED FOLLOW UP STUDY|369.96|369.96||137.15
125|76377|76377 - 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION|303.59|303.59||72.26
125|76376|76376 - 3D RENDERING W/INTERP & POSTPROCESS SUPERVISION|229.09|229.09||18.55
125|76375|76375 - 3-D/HOLO RECONSTRUCT CT/MRI/OTHER|284.65|284.65||22.53
125|76140|76140 - CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT|37.87|37.87||26.17
125|76125|76125 - CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE EXAMINATION|68.83|68.83||22.02
125|76120|76120 - CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC|91.88|91.88||30.36
125|76102|76102 - RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI|153.08|153.08||48.61
125|76101|76101 - RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI|126.45|126.45||44.19
125|76100|76100 - RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY|147.81|147.81||57.51
125|76098|76098 - RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN|46.5|46.5||15
125|76080|76080 - RADEX ABSCESS/FISTULA/SINUS TRACT RS&I|129.81|129.81||53.77
125|76010|76010 - RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD|52.52|52.52||17.51
125|76001|76001 - FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME|272.37|272.37||73.99
125|76000|76000 - FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME|117.34|117.34||18.15
125|75989|75989 - RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I|366.97|366.97||128.33
125|75984|75984 - CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I|225.3|225.3||77.19
125|75970|75970 - TRANSCATHETER BIOPSY RS&I|962.95|962.95||90.48
125|75959|75959 - PLMT DSTL XTN PRSTH EVASC DESC THORAC AORTA RS&I|184.76|184.76||324.94
125|75958|75958 - PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I|215.71|215.71||371
125|75957|75957 - EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I|323.78|323.78||557.17
125|75956|75956 - EVASC RPR DESCND THORCIC AORTA SUBCLAV ORIG RS&I|377.08|377.08||649.93
125|75954|75954 - EVASC RPR ILIAC ART W/ILIO-ILIAC PROSTH RS&I|1283.95|1283.95||137.79
125|75953|75953 - PLMT XTN PROSTH EVASC RPR INFRARENAL RS&I|1165.62|1165.62||101.52
125|75952|75952 - EVASC RPR INFRARENAL AAA/DISSECTION RS&I|1283.95|1283.95||263.99
125|75902|75902 - MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I|446.36|446.36||21.25
125|75901|75901 - MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I|469.15|469.15||26.38
125|75898|75898 - ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS|241.24|241.24||162.54
125|75894|75894 - TRANSCATHETER EMBOLIZATION ANY METH RS&I|1935.11|1935.11||143.26
125|75893|75893 - VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&|883.96|883.96||53.77
125|75891|75891 - HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I|941.47|941.47||111.28
125|75889|75889 - HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I|941.47|941.47||111.28
125|75887|75887 - PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP|708.47|708.47||99.8
125|75885|75885 - PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I|971.47|971.47||141.28
125|75880|75880 - VENOGRAPHY ORBITAL RS&I|132.53|132.53||70.02
125|75872|75872 - VENOGRAPHY EPIDURAL RS&I|941.47|941.47||111.28
125|75870|75870 - VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I|941.47|941.47||111.28
125|75860|75860 - VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I|941.47|941.47||111.28
125|75842|75842 - VENOGRAPHY ADRENAL BILATERAL SELECTIVE RS&I|976.48|976.48||146.28
125|75840|75840 - VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I|687.24|687.24||78.57
125|75833|75833 - VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I|976.48|976.48||146.28
125|75831|75831 - VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I|941.47|941.47||111.28
125|75827|75827 - VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I|941.47|941.47||111.28
125|75825|75825 - VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I|988.25|988.25||111.28
125|75822|75822 - VENOGRAPHY EXTREMITY BILATERAL RS&I|201.3|201.3||103.78
125|75820|75820 - VENOGRAPHY EXTREMITY UNILATERAL RS&I|139.12|139.12||70.02
125|75810|75810 - SPLENOPORTOGRAPY RS&I|701.61|701.61||83.68
125|75809|75809 - SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I|96.27|96.27||45.01
125|75807|75807 - LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I|516.37|516.37||115.02
125|75805|75805 - LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I|399.02|399.02||64.55
125|75803|75803 - LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I|471.36|471.36||115.02
125|75801|75801 - LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I|436.36|436.36||80.01
125|75774|75774 - ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I|906.4|906.4||35.01
125|75756|75756 - ANGIOGRAPHY INTERNAL MAMMARY RS&I|739|739||87.02
125|75746|75746 - ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I|941.47|941.47||111.28
125|75743|75743 - ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I|992.74|992.74||163.78
125|75741|75741 - ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I|957.72|957.72||128.79
125|75736|75736 - ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I|988.25|988.25||111.28
125|75733|75733 - ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I|957.72|957.72||128.79
125|75731|75731 - ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I|941.47|941.47||111.28
125|75726|75726 - ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I|988.25|988.25||111.28
125|75716|75716 - ANGIOGRAPHY EXTREMITY BILATERAL RS&I|1006.48|1006.48||136.62
125|75710|75710 - ANGIOGRAPHY EXTREMITY UNILATERAL RS&I|988.25|988.25||111.28
125|75705|75705 - ANGIOGRAPHY SPINAL SELECTIVE RS&I|1045.25|1045.25||215.05
125|75658|75658 - ANIOGRAPHY BRACHIAL RETROGRADE RS&I|957.72|957.72||128.79
125|75635|75635 - CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP|1860.83|1860.83||232.6
125|75630|75630 - AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I|1043.65|1043.65||144.2
125|75625|75625 - AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I|988.25|988.25||111.28
125|75605|75605 - AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I|988.25|988.25||111.28
125|75600|75600 - AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I|675.19|675.19||41.14
125|75574|75574 - CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST|563.23|563.23||192.7
125|75573|75573 - CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT D|575.72|575.72||205.2
125|75572|75572 - CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH|437.74|437.74||141.58
125|75571|75571 - CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM|138.37|138.37||46.99
125|75565|75565 - CARDIAC MRI FOR VELOCITY FLOW MAPPING|83.36|83.36||20.05
125|75563|75563 - CARDIAC MRI W/W/O CONTRAST W/STRESS|790.45|790.45||238.99
125|75561|75561 - CARDIAC MRI W/WO CONTRAST & FURTHER SEQ|665.17|665.17||208.13
125|75559|75559 - CARDIAC MRI W/O CONTRAST W/STRESS IMAGING|573.14|573.14||232.78
125|75557|75557 - CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST|507.34|507.34||188.61
125|74775|74775 - PERINEOGRAM|128.67|128.67||46.79
125|74742|74742 - TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I|266.31|266.31||58.76
125|74740|74740 - HYSTEROSALPINGOGRAPHY RS&I|130.23|130.23||37.51
125|74713|74713 - FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES|368.27|368.27||151.88
125|74712|74712 - FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES|585.66|585.66||245.3
125|74710|74710 - PELVIMETRY W/WOPLACENTAL LOCALIZATION|103.78|103.78||33.76
125|74485|74485 - DILATION URETERS/URETHRA RS&I|296.95|296.95||58.3
125|74470|74470 - RADEX RENAL CYST STUDY TRANSLUMBAR RS&I|136.29|136.29||53.77
125|74455|74455 - URETHROCYSTOGRAPHY VOIDING RS&I|143.2|143.2||32.51
125|74450|74450 - URETHROCYSTOGRAPHY RETROGRADE RS&I|136.1|136.1||32.51
125|74445|74445 - CORPORA CAVERNOSOGRAPY RS&I|186.3|186.3||111.28
125|74440|74440 - VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I|112.53|112.53||37.51
125|74430|74430 - CYSTOGRAPHY MINIMUM 3 VIEWS RS&I|106.66|106.66||31.25
125|74425|74425 - UROGRAPHY ANTEGRADE RS&I|127.86|127.86||35.01
125|74420|74420 - X-RAY URINARY TRACT EXAM WITH CONTRAST MATERIAL|219.79|219.79||35.01
125|74415|74415 - UROGRAPY INFUSION DRIP &/BOLUS TECHQ W/WO TOMO|197.97|197.97||47.51
125|74410|74410 - UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE|185.61|185.61||47.51
125|74400|74400 - UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY|167.92|167.92||47.51
125|74363|74363 - PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I|557.44|557.44||95.25
125|74360|74360 - INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I|298.38|298.38||59.74
125|74355|74355 - PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I|280.24|280.24||81.87
125|74340|74340 - INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I|177.41|177.41||44.44
125|74330|74330 - CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I|309.96|309.96||78.77
125|74329|74329 - ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I|230.6|230.6||60.62
125|74328|74328 - ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I|230.95|230.95||60.7
125|74301|74301 - CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS|113.53|113.53||15.46
125|74300|74300 - CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I|86.83|86.83||35.44
125|74290|74290 - CHOLECYSTOGRAPHY ORAL CONTRST|84.32|84.32||31.25
125|74283|74283 - THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ|264.29|264.29||140.17
125|74280|74280 - RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY|259.03|259.03||98.77
125|74270|74270 - RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY|191.49|191.49||68.77
125|74263|74263 - CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING|1152.31|1152.31||184.61
125|74262|74262 - CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST|574.48|574.48||204.04
125|74261|74261 - CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST|363.93|363.93||196.07
125|74260|74260 - DUODENOGRAPY HYPOTONIC|114.18|114.18||37.88
125|74251|74251 - RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY|113.29|113.29||43.72
125|74250|74250 - RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY|139.08|139.08||46.26
125|74249|74249 - RADEX GI UPR W/WO GLUCOSE W/SM INTEST FOLLW-THRU|273.96|273.96||90.02
125|74247|74247 - RADEX UPPER GI W/WO GLUCAGON/DELAY IMAGES W/KUB|145.27|145.27||51.69
125|74246|74246 - RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY|187.24|187.24||68.77
125|74245|74245 - RADEX GI TRACT UPR W/SM INT W/MULT SERIAL IMAGES|261.59|261.59||90.02
125|74241|74241 - RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/KUB|176.33|176.33||68.77
125|74240|74240 - RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY|174.1|174.1||68.77
125|74235|74235 - RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I|325.44|325.44||127.04
125|74230|74230 - RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY|146.19|146.19||53.77
125|74220|74220 - RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY|130.23|130.23||45.01
125|74210|74210 - RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY|87.67|87.67||27.25
125|74190|74190 - PERITONEOGRAM RS&I|92.01|92.01||29.19
125|74185|74185 - MRA ABDOMEN W/WO CONTRAST MATERIAL|908.96|908.96||174.46
125|74183|74183 - MRI ABDOMEN W/O & W/CONTRAST MATERIAL|1623.54|1623.54||122.02
125|74182|74182 - MRI ABDOMEN W/CONTRAST MATERIAL|911.23|911.23||93.67
125|74181|74181 - MRI ABDOMEN W/O CONTRAST MATERIAL|942.25|942.25||157.44
125|74178|74178 - CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE|533.91|533.91||163.37
125|74177|74177 - CT ABDOMEN & PELVIS W/CONTRAST MATERIAL|477.18|477.18||148.97
125|74176|74176 - CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL|311.07|311.07||142.15
125|74175|74175 - CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST|1147.21|1147.21||102.36
125|74174|74174 - CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG|548.43|548.43||177.9
125|74170|74170 - CT ABDOMEN W/O & W/CONTRAST MATERIAL|732.46|732.46||137.54
125|74160|74160 - CT ABDOMEN W/CONTRAST MATERIAL|655.21|655.21||179.06
125|74150|74150 - CT ABDOMEN W/O CONTRAST MATERIAL|556.69|556.69||166.82
125|74022|74022 - RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES|90.02|90.02||44.05
125|74021|74021 - RADIOLOGIC EXAM ABDOMEN 3+ VIEWS|59.94|59.94||22.38
125|74020|74020 - RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS|71.79|71.79||27.5
125|74019|74019 - RADIOLOGIC EXAM ABDOMEN 2 VIEWS|51.15|51.15||18.88
125|74018|74018 - RADIOLOGIC EXAM ABDOMEN 1 VIEW|58.43|58.43||22.13
125|74010|74010 - RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS|64.23|64.23||23.67
125|74000|74000 - RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW|24.12|24.12||9.8
125|73725|73725 - MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL|905.21|905.21||167.54
125|73723|73723 - MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL|1444.51|1444.51||116.49
125|73722|73722 - MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL|934.81|934.81||155.81
125|73721|73721 - MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL|872.76|872.76||116.14
125|73720|73720 - MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR|1038.88|1038.88||145.04
125|73719|73719 - MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL|907.68|907.68||87.39
125|73718|73718 - MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL|773.17|773.17||72.83
125|73706|73706 - CT ANGIOGRAPHY LOWER EXTREMITY|1071.12|1071.12||256.85
125|73702|73702 - CT LOWER EXTREMITY W/O & W/CONTRAST MATRL|608.89|608.89||118.78
125|73701|73701 - CT LOWER EXTREMITY W/CONTRAST MATERIAL|502.62|502.62||113.77
125|73700|73700 - CT LOWER EXTREMITY W/O CONTRAST MATERIAL|456.67|456.67||106.27
125|73660|73660 - RADEX TOE MINIMUM 2 VIEWS|43.02|43.02||12.51
125|73650|73650 - RADEX CALCANEUS MINIMUM 2 VIEWS|48.9|48.9||15
125|73630|73630 - RADEX FOOT COMPLETE MINIMUM 3 VIEWS|58.34|58.34||21.22
125|73620|73620 - RADIOLOGIC EXAMINATION FOOT 2 VIEWS|50.34|50.34||15
125|73615|73615 - RADEX ANKLE ARTHROGRAPHY RS&I|202.7|202.7||53.77
125|73610|73610 - RADEX ANKLE COMPLETE MINIMUM 3 VIEWS|58.34|58.34||21.22
125|73600|73600 - RADIOLOGIC EXAMINATION ANKLE 2 VIEWS|50.34|50.34||15
125|73592|73592 - RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS|50.34|50.34||15
125|73590|73590 - RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS|53.63|53.63||18.86
125|73580|73580 - RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I|239.24|239.24||53.77
125|73565|73565 - RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST|51.26|51.26||16.25
125|73564|73564 - RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS|71.11|71.11||26.59
125|73562|73562 - RADIOLOGIC EXAMINATION KNEE 3 VIEWS|63.08|63.08||18.76
125|73560|73560 - RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS|56.85|56.85||16.25
125|73552|73552 - RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS|50.33|50.33||15.42
125|73551|73551 - RADIOLOGIC EXAMINATION FEMUR 1 VIEW|42.82|42.82||13.71
125|73525|73525 - RADEX HIP ARTHROGRAPHY RS&I|202.7|202.7||53.77
125|73523|73523 - RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS|86.55|86.55||26.31
125|73522|73522 - RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS|74.82|74.82||24.61
125|73521|73521 - RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS|57.42|57.42||18.29
125|73503|73503 - RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS|78.92|78.92||23.44
125|73502|73502 - RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS|63.23|63.23||18.29
125|73501|73501 - RADEX HIP UNILATERAL WITH PELVIS 1 VIEW|46.11|46.11||15.42
125|73225|73225 - MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL|929.46|929.46||124.55
125|73223|73223 - MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL|1442.97|1442.97||116.49
125|73222|73222 - MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL|934.84|934.84||162.3
125|73221|73221 - MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL|872.76|872.76||116.14
125|73220|73220 - MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS|1039.24|1039.24||145.04
125|73219|73219 - MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL|907.68|907.68||87.75
125|73218|73218 - MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL|868.09|868.09||72.83
125|73206|73206 - CT ANGIOGRAPHY UPPER EXTREMITY|1058.34|1058.34||244.07
125|73202|73202 - CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL|608.89|608.89||118.78
125|73201|73201 - CT UPPER EXTREMITY W/CONTRAST MATERIAL|529.15|529.15||113.77
125|73200|73200 - CT UPPER EXTREMITY W/O CONTRAST MATERIAL|456.67|456.67||106.27
125|73140|73140 - RADEX FINGR MINIMUM 2 VIEWS|45.8|45.8||15.96
125|73130|73130 - RADEX HAND MINIMUM 3 VIEWS|58.34|58.34||21.22
125|73120|73120 - RADEX HAND 2 VIEWS|50.34|50.34||15
125|73115|73115 - RADEX WRIST ARTHROGRAPHY RS&I|166.16|166.16||53.77
125|73110|73110 - RADEX WRIST COMPLETE MINIMUM 3 VIEWS|58.34|58.34||21.22
125|73100|73100 - RADEX WRIST 2 VIEWS|53.37|53.37||15
125|73092|73092 - RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS|47.51|47.51||15
125|73090|73090 - RADEX FOREARM 2 VIEWS|56.1|56.1||19.51
125|73085|73085 - RADEX ELBOW ARTHROGRAPHY RS&I|192.55|192.55||53.77
125|73080|73080 - RADEX ELBOW COMPLETE MINIMUM 3 VIEWS|62.11|62.11||21.22
125|73070|73070 - RADEX ELBOW 2 VIEWS|51.87|51.87||15
125|73060|73060 - RADEX HUMERUS MINIMUM 2 VIEWS|57.75|57.75||17.51
125|73050|73050 - RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ|67.34|67.34||19.83
125|73040|73040 - RADEX SHOULDER ARTHROGRAPHY RS&I|202.7|202.7||53.77
125|73030|73030 - RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS|63.58|63.58||22.13
125|73020|73020 - RADEX SHOULDER 1 VIEW|48.73|48.73||15
125|73010|73010 - RADEX SCAPULA COMPLETE|53.63|53.63||17.51
125|73000|73000 - RADEX CLAVICLE COMPLETE|53.02|53.02||15
125|72295|72295 - DISKOGRAPY LUMBAR RS&I|628.77|628.77||82.52
125|72285|72285 - DISKOGRAPY CERVICAL/THORACIC RS&I|635.15|635.15||82.52
125|72275|72275 - EPIDUROGRAPY RS&I|216.2|216.2||62.35
125|72270|72270 - MYELOGRAPY 2/MORE REGIONS RS&I|560.96|560.96||131.28
125|72265|72265 - MYELOGRAPY LUMBOSACRAL RS&I|369.47|369.47||82.52
125|72255|72255 - MYELOGRAPHY THORACIC RS&I|375.09|375.09||90.02
125|72240|72240 - MYELOGRAPHY CERVICAL RS&I|423.1|423.1||87.89
125|72220|72220 - RADEX SACRUM & COCCYX MINIMUM 2 VIEWS|57.75|57.75||17.51
125|72202|72202 - RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS|63.49|63.49||18.76
125|72200|72200 - RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS|53.63|53.63||17.51
125|72198|72198 - MRA PELVIS W/WO CONTRAST MATERIAL|958.65|958.65||134.57
125|72197|72197 - MRI PELVIS W/O & W/CONTRAST MATERIAL|1148.82|1148.82||122.02
125|72196|72196 - MRI PELVIS W/CONTRAST MATERIAL|942.25|942.25||157.54
125|72195|72195 - MRI PELVIS W/O CONTRAST MATERIAL|726.64|726.64||79.12
125|72194|72194 - CT PELVIS W/O & W/CONTRAST MATERIAL|711.86|711.86||118.78
125|72193|72193 - CT PELVIS W/CONTRAST MATERIAL|642.65|642.65||162.73
125|72192|72192 - CT PELVIS W/O CONTRAST MATERIAL|565.1|565.1||153.49
125|72191|72191 - CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST|1136.29|1136.29||244.98
125|72190|72190 - RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS|68.35|68.35||21.25
125|72170|72170 - RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS|57.52|57.52||18.86
125|72159|72159 - MRA SPINAL CANAL W/WO CONTRAST MATERIAL|864.24|864.24||133.78
125|72158|72158 - MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL|1965.91|1965.91||233.81
125|72157|72157 - MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL|1986.51|1986.51||252.56
125|72156|72156 - MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL|1986.51|1986.51||252.56
125|72149|72149 - MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL|1115.51|1115.51||175.04
125|72148|72148 - MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL|1013.59|1013.59||145.03
125|72147|72147 - MRI SPINAL CANAL THORACIC W/CONTRAST MATRL|1130.23|1130.23||188.79
125|72146|72146 - MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL|1026.56|1026.56||157.54
125|72142|72142 - MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL|1130.23|1130.23||188.79
125|72141|72141 - MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL|942.25|942.25||161.38
125|72133|72133 - CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL|743.06|743.06||125.03
125|72132|72132 - CT LUMBAR SPINE W/CONTRAST MATERIAL|666.18|666.18||170.91
125|72131|72131 - CT LUMBAR SPINE W/O CONTRAST MATERIAL|572.2|572.2||162.73
125|72130|72130 - CT THORACIC SPINE W/O & W/CONTRAST MATERIAL|706.41|706.41||125.03
125|72129|72129 - CT THORACIC SPINE W/CONTRAST MATERIAL|666.96|666.96||171.93
125|72128|72128 - CT THORACIC SPINE W/O CONTRAST MATERIAL|572.2|572.2||162.73
125|72127|72127 - CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL|706.41|706.41||125.03
125|72126|72126 - CT CERVICAL SPINE W/CONTRAST MATERIAL|666.18|666.18||170.91
125|72125|72125 - CT CERVICAL SPINE W/O CONTRAST MATERIAL|572.2|572.2||162.73
125|72120|72120 - RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS|84.83|84.83||21.25
125|72114|72114 - RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6|119.63|119.63||36.26
125|72110|72110 - RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS|102.87|102.87||37.21
125|72100|72100 - RADEX SPINE LUMBOSACRAL 2/3 VIEWS|72.45|72.45||21.26
125|72084|72084 - RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW|133.14|133.14||34.91
125|72083|72083 - RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW|114.21|114.21||29.71
125|72082|72082 - RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW|95|95||26.31
125|72081|72081 - RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW|59.35|59.35||21.79
125|72080|72080 - RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS|69.56|69.56||21.25
125|72074|72074 - RADEX SPINE THORACIC MINIMUM 4 VIEWS|86.05|86.05||21.25
125|72072|72072 - RADEX SPINE THORACIC 3 VIEWS|74.23|74.23||21.25
125|72070|72070 - RADEX SPINE THORACIC 2 VIEWS|67.74|67.74||21.26
125|72052|72052 - RADEX SPINE CERVICAL 6 OR MORE VIEWS|123.65|123.65||36.65
125|72050|72050 - RADEX SPINE CERVICAL 4 OR 5 VIEWS|101.44|101.44||33.07
125|72040|72040 - RADEX SPINE CERVICAL 2 OR 3 VIEWS|64.23|64.23||21.26
125|72020|72020 - RADEX SPINE 1 VIEW SPECIFY LEVEL|48.14|48.14||18.59
125|71555|71555 - MRA CHEST W/O & W/CONTRAST MATERIAL|908.96|908.96||174.7
125|71552|71552 - MRI CHEST W/O & W/CONTRAST MATERIAL|1418|1418||122.02
125|71551|71551 - MRI CHEST W/CONTRAST MATERIAL|1181.33|1181.33||93.67
125|71550|71550 - MRI CHEST W/O CONTRAST MATERIAL|942.25|942.25||157.44
125|71275|71275 - CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST|1175.72|1175.72||259.8
125|71270|71270 - CT THORAX W/O & W/CONTRAST MATERIAL|754.28|754.28||135.03
125|71260|71260 - CT THORAX W/CONTRAST MATERIAL|669.31|669.31||174.97
125|71250|71250 - CT THORAX W/O CONTRAST MATERIAL|572.2|572.2||162.73
125|71130|71130 - RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS|70.72|70.72||21.25
125|71120|71120 - RADEX STERNUM MINIMUM 2 VIEWS|65.99|65.99||19.83
125|71111|71111 - RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS|96.05|96.05||31.25
125|71110|71110 - RADEX RIBS BILATERAL 3 VIEWS|83.07|83.07||27.51
125|71101|71101 - RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS|74.84|74.84||27.51
125|71100|71100 - RADEX RIBS UNILATERAL 2 VIEWS|63.49|63.49||22.5
125|71048|71048 - RADIOLOGIC EXAM CHEST 4+ VIEWS|64.29|64.29||26.21
125|71047|71047 - RADIOLOGIC EXAM CHEST 3 VIEWS|59.84|59.84||22.8
125|71046|71046 - RADIOLOGIC EXAM CHEST 2 VIEWS|65.86|65.86||30.72
125|71045|71045 - RADIOLOGIC EXAM CHEST SINGLE VIEW|50.88|50.88||25.57
125|71035|71035 - RADEX CHEST SPECIAL VIEWS|55.38|55.38||17.51
125|71034|71034 - RADEX CHEST COMPLETE MINIMUM 4 VIEWS W/FLUORO|148.46|148.46||45.01
125|71030|71030 - RADEX CHEST COMPLETE MINIMUM 4 VIEWS|87.19|87.19||30
125|71023|71023 - RADEX CH 2 VIEWS FRONTAL & LATERAL W/FLUORO|94.23|94.23||37.51
125|71022|71022 - RADEX CH 2 VIEWS FRONTAL & LATERAL OBLIQUE PRJCJ|83.07|83.07||30
125|71021|71021 - RADEX CH 2 VIEWS FRNT & LAT APICAL LORDOTIC PX|78.96|78.96||26.26
125|71020|71020 - RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LATERAL|28.46|28.46||11.7
125|71015|71015 - RADIOLOGIC EXAMINATION CHEST STERO FRONTAL|46.27|46.27||16.32
125|71010|71010 - RADIOLOGIC EXAMINATION CHEST SINGLE VIEW FRONTAL|23.08|23.08||9.8
125|70559|70559 - MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST|510|510||178.81
125|70558|70558 - MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL|510|510||178.03
125|70557|70557 - MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL|510|510||161.14
125|70555|70555 - MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION|510|510||214.9
125|70554|70554 - MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION|974.47|974.47||179.65
125|70553|70553 - MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL|2138.13|2138.13||332.56
125|70552|70552 - MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL|1115.51|1115.51||175.04
125|70551|70551 - MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL|1007.93|1007.93||208.74
125|70549|70549 - MRA NECK W/O &W/CONTRAST MATERIAL|1039.73|1039.73||97.23
125|70548|70548 - MRA NECK W/CONTRAST MATERIAL|790.74|790.74||64.56
125|70547|70547 - MRA NECK W/O CONTRST MATERIAL|784.73|784.73||64.56
125|70546|70546 - MRA HEAD W/O & W/CONTRAST MATERIAL|1039.73|1039.73||97.23
125|70545|70545 - MRA HEAD W/CONTRAST MATERIAL|790.74|790.74||64.56
125|70544|70544 - MRA HEAD W/O CONTRST MATERIAL|784.73|784.73||64.93
125|70543|70543 - MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL|1907.05|1907.05||116.49
125|70542|70542 - MRI ORBIT FACE & NECK W/CONTRAST MATERIAL|1081.02|1081.02||87.39
125|70540|70540 - MRI ORBIT FACE &/NECK W/O CONTRAST|928.14|928.14||145.04
125|70498|70498 - CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST|1039.77|1039.77||236.2
125|70496|70496 - CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST|1039.77|1039.77||236.2
125|70492|70492 - CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL|640.52|640.52||142.53
125|70491|70491 - CT SOFT TISSUE NECK W/CONTRAST MATERIAL|535.63|535.63||135.03
125|70490|70490 - CT SOFT TISSUE NECK W/O CONTRAST MATERIAL|495.76|495.76||180.11
125|70488|70488 - CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL|638.16|638.16||140.03
125|70487|70487 - CT MAXILLOFACIAL W/CONTRAST MATERIAL|526.78|526.78||127.53
125|70486|70486 - CT MAXILLOFACIAL W/O CONTRAST MATERIAL|446.06|446.06||111.27
125|70482|70482 - CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR|640.52|640.52||142.53
125|70481|70481 - CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL|535.63|535.63||135.03
125|70480|70480 - CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL|460.8|460.8||126.28
125|70470|70470 - CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL|621.68|621.68||125.03
125|70460|70460 - CT HEAD/BRAIN W/CONTRAST MATERIAL|509.69|509.69||111.28
125|70450|70450 - CT HEAD/BRAIN W/O CONTRAST MATERIAL|449.3|449.3||119.72
125|70390|70390 - SIALOGRAPHY RS&I|163.8|163.8||37.51
125|70380|70380 - RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS|64.23|64.23||17.51
125|70371|70371 - CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC|189.7|189.7||65.08
125|70370|70370 - RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ|102.45|102.45||28.68
125|70360|70360 - RADIOLOGIC EXAMINATION NECK SOFT TISSUE|47.11|47.11||17.51
125|70355|70355 - ORTHOPANTOGRAM|60.11|60.11||20.01
125|70350|70350 - CEPHALOGRAM ORTHODONTIC|40.55|40.55||14.48
125|70336|70336 - MRI TEMPOROMANDIBULAR JOINT|872.76|872.76||115.99
125|70332|70332 - TEMPOROMANDBLE JT ARTHROGRAPHY RS&I|202.7|202.7||53.77
125|70330|70330 - RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT|83.07|83.07||23.75
125|70328|70328 - RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT|53.63|53.63||18.76
125|70320|70320 - RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH|60.37|60.37||18.31
125|70310|70310 - RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH|34.31|34.31||11.68
125|70300|70300 - RADIOLOGIC EXAMINATION TEETH 1 VIEW|20.95|20.95||7.12
125|70260|70260 - RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS|97.81|97.81||33.76
125|7025F|7025F - INFO SYSTEM ANALYSIS ABNORMAL INTERPRATE|0.01|0.01||
125|70250|70250 - RADIOLOGIC EXAMINATION SKULL 4/> VIEWS|68.35|68.35||23.75
125|70240|70240 - RADIOLOGIC EXAMINATION SELLA TURCICA|48.73|48.73||18.76
125|70220|70220 - RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS|81.33|81.33||25.01
125|70210|70210 - RADEX SINUSES PARANASAL <3 VIEWS|61.26|61.26||17.51
125|7020F|7020F - MAMMO ASSESSMENT CAT IN DATABASE FOR RATE|0.01|0.01||
125|70200|70200 - RADEX ORBITS COMPLETE MINIMUM 4 VIEWS|84.32|84.32||27.51
125|70190|70190 - RADEX OPTIC FORAMINA|65.11|65.11||21.25
125|70170|70170 - DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I|74.4|74.4||22.9
125|70160|70160 - RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS|53.63|53.63||17.51
125|70150|70150 - RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS|82.09|82.09||26.26
125|70140|70140 - RADEX FACIAL BONES < 3 VIEWS|63.49|63.49||18.76
125|70134|70134 - RADEX INTERNAL AUDITORY MEATI COMPLETE|76.55|76.55||27.55
125|70130|70130 - RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE|90.38|90.38||33.76
125|70120|70120 - RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE|67.15|67.15||18.76
125|70110|70110 - RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS|69.56|69.56||25.01
125|7010F|7010F - PT INFORMATION ENTERED INTO RECALL SYSTEM|0.01|0.01||
125|70100|70100 - RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS|55.38|55.38||18.76
125|70030|70030 - RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY|48.42|48.42||16.25
125|70015|70015 - CISTERNOGRAPHY POSITIVE CONTRAST RS&I|206.3|206.3||116.28
125|70010|70010 - MYELOGRAPY POST FOSSA RS&I|291|291||82.26
125|69990|69990 - MICROSURG TQS REQ USE OPERATING MICROSCOPE|338.66|338.66||
125|69970|69970 - REMOVAL TUMOR TEMPORAL BONE|3946.18|3946.18||
125|69960|69960 - DECOMPRESSION INTERNAL AUDITORY CANAL|3314.71|3314.71||
125|69955|69955 - TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR|3446.36|3446.36||
125|69950|69950 - VESTIBULAR NRV SECTION TRANSCRANIAL APPROACH|3334.21|3334.21||
125|69930|69930 - COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY|2500.59|2500.59||
125|69915|69915 - VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR|2991.17|2991.17||
125|69910|69910 - LABYRINTHECTOMY W/MASTOIDECTOMY|2206.63|2206.63||
125|69905|69905 - LABYRINTHECTOMY TRANSCANAL|1900.23|1900.23||
125|69840|69840 - REVISION FENESTRATION OPERATION|1271.82|1271.82||
125|69820|69820 - FENESTRATION SEMICIRCULAR CANAL|1805.5|1805.5||
125|69806|69806 - ENDOLYMPHATIC SAC SHUNT|1923.86|1923.86||
125|69805|69805 - ENDOLYMPHATIC SAC W/O SHUNT|2053.27|2053.27||
125|69801|69801 - LABYRINTHOTOMY TRANSCANAL|1556.64|1556.64||
125|69745|69745 - SUTR NRV ITPRL W/WO GRF/DCMPRN MEDIAL GENICULATE|2928.68|2928.68||
125|69740|69740 - SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE|2403.51|2403.51||
125|69725|69725 - DCMPRN NRV INTRATEMPORAL MEDIAL GENICULATE|3082.81|3082.81||
125|69720|69720 - DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION|2249.34|2249.34||
125|69718|69718 - RPLMCT OSSEOINTEGRATE IMPLNT W/MASTOIDECTOMY|3688.68|3688.68||
125|69717|69717 - RPLMCT OSSEOINTEGRATE IMPLNT W/O MASTOIDECTOMY|3277.28|3277.28||
125|69715|69715 - IMPLJ OSSEOINTEGRATED TEMPORAL BONE W/O MASTOID|3644.76|3644.76||
125|69714|69714 - IMPLTJ OSSEOINTEGRATED TEMPORAL BONE W/MASTOID|3187.14|3187.14||
125|69711|69711 - RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE|1047.95|1047.95||
125|69710|69710 - IMPLTJ/RPLCMT EMGNT BONE CNDJ DEV TEMPORAL BONE|1606.54|1606.54||
125|69700|69700 - CLOSURE POSTAURICULAR FISTULA MASTOID SPX|878.18|878.18||
125|69676|69676 - TYMPANIC NEURECTOMY|1301.84|1301.84||
125|69670|69670 - MASTOID OBLITERATION SEPARATE PROCEDURE|1867.45|1867.45||
125|69667|69667 - REPAIR ROUND WINDOW FISTULA|1935.95|1935.95||
125|69666|69666 - REPAIR OVAL WINDOW FISTULA|1946.68|1946.68||
125|69662|69662 - REVISION STAPEDECTOMY/STAPEDOTOMY|2479.19|2479.19||
125|69661|69661 - STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT|2212.37|2212.37||
125|69660|69660 - STAPEDECTOMY/STAPEDOTOMY|1650.21|1650.21||
125|69650|69650 - STAPES MOBILIZATION|1304.91|1304.91||
125|69646|69646 - TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR|2720.09|2720.09||
125|69645|69645 - TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR|2488.37|2488.37||
125|69644|69644 - TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR|2772.49|2772.49||
125|69643|69643 - TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR|2565.65|2565.65||
125|69642|69642 - TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ|2665.83|2665.83||
125|69641|69641 - TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ|2678.56|2678.56||
125|69637|69637 - TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP|2433.66|2433.66||
125|69636|69636 - TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ|2438.51|2438.51||
125|69635|69635 - TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ|2309.66|2309.66||
125|69633|69633 - TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP|2079.04|2079.04||
125|69632|69632 - TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ|2126.18|2126.18||
125|69631|69631 - TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ|2480.6|2480.6||
125|69620|69620 - MYRINGOPLASTY|979.32|979.32||
125|69610|69610 - TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH|391.84|391.84||
125|69605|69605 - REVJ MASTOIDECTOMY W/APICECTOMY|2278.07|2278.07||
125|69604|69604 - REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY|2224.09|2224.09||
125|69603|69603 - REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY|2130.8|2130.8||
125|69602|69602 - REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC|2085.36|2085.36||
125|69601|69601 - REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY|1800.37|1800.37||
125|69554|69554 - EXCISION AURAL GLOMUS TUMOR EXTENDED|3207.03|3207.03||
125|69552|69552 - EXCISION AURAL GLOMUS TUMOR TRANSMASTOID|2374.14|2374.14||
125|69550|69550 - EXCISION AURAL GLOMUS TUMOR TRANSCANAL|1817.04|1817.04||
125|69540|69540 - EXCISION AURAL POLYP|186.34|186.34||
125|69535|69535 - RESCJ TEMPORAL BONE EXTERNAL APPROACH|3509.33|3509.33||
125|69530|69530 - PETROUS APICECTOMY RADICAL MASTOIDECTOMY|2621.45|2621.45||
125|69511|69511 - MASTOIDECTOMY RADICAL|2097.8|2097.8||
125|69505|69505 - MASTOIDECTOMY MODIFIED RADICAL|2035.56|2035.56||
125|69502|69502 - MASTOIDECTOMY COMPLETE|1723.86|1723.86||
125|69501|69501 - TRANSMASTOID ANTROTOMY|1138.09|1138.09||
125|69450|69450 - TYMPANOLYSIS TRANSCANAL|1439.32|1439.32||
125|69440|69440 - MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC|1047.68|1047.68||
125|69436|69436 - TYMPANOSTOMY GENERAL ANESTHESIA|511.61|511.61||
125|69433|69433 - TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA|190.46|190.46||
125|69424|69424 - VENTILATING TUBE RMVL REQUIRING GENERAL ANES|150.63|150.63||
125|69421|69421 - MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES|244.91|244.91||
125|69420|69420 - MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ|170.91|170.91||
125|69410|69410 - INSET MIDDLE EAR BAFFLE|89.67|89.67||
125|69320|69320 - RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG|2033.32|2033.32||
125|69310|69310 - RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX|1696.99|1696.99||
125|69300|69300 - OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ|876.59|876.59||
125|69222|69222 - DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX|226.11|226.11||
125|69220|69220 - DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE|120.81|120.81||
125|69210|69210 - REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT|49.94|49.94||
125|69209|69209 - REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT|21.21|21.21||
125|69205|69205 - RMVL FB XTRNL AUDITORY CANAL ANES|143.11|143.11||
125|69200|69200 - RMVL FB XTRNL AUDITORY CANAL W/O ANES|118.71|118.71||
125|69155|69155 - RAD EXC XTRNL AUDITORY CANAL LES NCK DSJ|2302.01|2302.01||
125|69150|69150 - RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ|1500.07|1500.07||
125|69145|69145 - EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL|363.97|363.97||
125|69140|69140 - EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL|1473.9|1473.9||
125|69120|69120 - EXCISION EXTERNAL EAR COMPLETE AMPUTATION|788.12|788.12||
125|69110|69110 - EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR|532.9|532.9||
125|69105|69105 - BIOPSY EXTERNAL AUDITORY CANAL|120.9|120.9||
125|69100|69100 - BIOPSY EXTERNAL EAR|105.75|105.75||
125|69090|69090 - EAR PIERCING|43.97|43.97||
125|69020|69020 - DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS|207.42|207.42||
125|69005|69005 - DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX|251.36|251.36||
125|69000|69000 - DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE|167.62|167.62||
125|68850|68850 - INJECTION CONTRAST MEDIUM DACRYOCYSTOGRAPY|615.07|615.07||
125|68840|68840 - PROBE LACRIMAL CANALICULI W/WO IRRIGATION|110.66|110.66||
125|68816|68816 - PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION|988.42|988.42||
125|68815|68815 - PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT|431.52|431.52||
125|68811|68811 - PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES|244.52|244.52||
125|68810|68810 - PROBE NASOLACRIMAL DUCT W/WO IRRIGATION|212.26|212.26||
125|68801|68801 - DILATION LACRIMAL PUNCTUM W/WO IRRGATION|109.46|109.46||
125|68770|68770 - CLOSURE LACRIMAL FISTULA SPX|747.34|747.34||
125|68761|68761 - CLSR LACRIMAL PUNCTUM PLUG EACH|159.67|159.67||
125|68760|68760 - CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER|214.34|214.34||
125|68750|68750 - CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT|1281.19|1281.19||
125|68745|68745 - CONJUNCTIVORHINOSTOMY W/O TUBE|1149.9|1149.9||
125|68720|68720 - DACRYOCSTORHINOSTOMY|1213.71|1213.71||
125|68705|68705 - CORRECTION EVERTED PUNCTUM CAUTERY|280.32|280.32||
125|68700|68700 - PLASTIC REPAIR CANALICULI|748.37|748.37||
125|68550|68550 - EXC LACRIMAL GLAND TUMOR W/OSTEOTOMY|1452.82|1452.82||
125|68540|68540 - EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH|1269.47|1269.47||
125|68530|68530 - RMVL FB/DACRYOLITH LACRIMAL PASSAGES|540.57|540.57||
125|68525|68525 - BIOPSY LACRIMAL SAC|407.46|407.46||
125|68520|68520 - EXCISION LACRIMAL SAC|1046.72|1046.72||
125|68510|68510 - BIOPSY LACRIMAL GLAND|492.57|492.57||
125|68505|68505 - EXCISION LACRIMAL GLAND XCPT TUMOR PRTL|1163.18|1163.18||
125|68500|68500 - EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL|1138.42|1138.42||
125|68440|68440 - SNIP INCISION LACRIMAL PUNCTUM|215.14|215.14||
125|68420|68420 - INCISION DRAINAGE LACRIMAL SAC|378.68|378.68||
125|68400|68400 - INCISION DRAINAGE LACRIMAL GLAND|341.75|341.75||
125|68371|68371 - HARVESTING CONJUNCIVAL ALLOGRAPHY LIVING DONOR|741.9|741.9||
125|68362|68362 - CONJUNCTIVAL FLAP TOTAL|933.72|933.72||
125|68360|68360 - CONJUNCTIVAL FLAP BRIDGE/PARTIAL SPX|577.26|577.26||
125|68340|68340 - RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE|673|673||
125|68335|68335 - RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB|949.49|949.49||
125|68330|68330 - RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT|614.46|614.46||
125|68328|68328 - CONJUNCTPL CUL-DE-SAC W/BUCCAL MUC MEMB GRAFT|1277.59|1277.59||
125|68326|68326 - CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT|1104.42|1104.42||
125|68325|68325 - CONJUNCTIVOPLASTY W/BUCCAL MUC MEMB GRAFT|1122.82|1122.82||
125|68320|68320 - CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT|895.2|895.2||
125|68200|68200 - SUBCONJUNCTIVAL INJECTION|74.49|74.49||
125|68135|68135 - DESTRUCTION LESION CONJUNCTIVA|266.13|266.13||
125|68130|68130 - EXCISION LESION CONJUNCTIVA ADJACENT SCLERA|532.9|532.9||
125|68115|68115 - EXCISION LESION CONJUNCTIVA > 1 CM|313.56|313.56||
125|68110|68110 - EXCISION LESION CONJUNCTIVA </1 CM|289.71|289.71||
125|68100|68100 - BIOPSY CONJUNCTIVA|235.13|235.13||
125|68040|68040 - EXPRESSION CONJUNCTIVAL FOLLICLES|207.25|207.25||
125|68020|68020 - INCISION CONJUNCTIVA DRAINAGE OF CYST|260.16|260.16||
125|67975|67975 - RCNSTJ EYELID FULL THICKNESS SECOND STAGE|669.96|669.96||
125|67974|67974 - RCNSTJ EYELID FULL THICKNESS UPPER EYELID 1 STG|1649.51|1649.51||
125|67973|67973 - RCNSTJ EYELID FULL THICKNESS LOWER EYELID 1 STG|1513.35|1513.35||
125|67971|67971 - RCNSTJ EYELID FULL THICKNESS </TWO-THIRDS 1 STG|1233.91|1233.91||
125|67966|67966 - EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN|1040.96|1040.96||
125|67961|67961 - EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN|880.62|880.62||
125|67950|67950 - CANTHOPLASTY|857.63|857.63||
125|67938|67938 - REMOVAL EMBEDDED FOREIGN BODY EYELID|262.85|262.85||
125|67935|67935 - SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK|666.22|666.22||
125|67930|67930 - SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK|451.86|451.86||
125|67924|67924 - REPAIR ENTROPION EXTENSIVE|861.08|861.08||
125|67923|67923 - REPAIR ENTROPION EXCISION TARSAL WEDGE|779.89|779.89||
125|67922|67922 - REPAIR ENTROPION THERMOCAUTERIZATION|408.43|408.43||
125|67921|67921 - REPAIR ENTROPION SUTURE|466.54|466.54||
125|67917|67917 - REPAIR ECTROPION EXTENSIVE|878.22|878.22||
125|67916|67916 - REPAIR ECTROPION EXCISION TARSAL WEDGE|746.38|746.38||
125|67915|67915 - REPAIR ECTROPION THERMOCAUTERIZATION|414.65|414.65||
125|67914|67914 - REPAIR ECTROPION SUTURE|538.97|538.97||
125|67912|67912 - CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD|1978.39|1978.39||
125|67911|67911 - CORRECTION LID RETRACTION|1071.54|1071.54||
125|67909|67909 - REDUCTION OVERCORRECTION PTOSIS|915.04|915.04||
125|67908|67908 - RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ|911.36|911.36||
125|67906|67906 - RPR BLEPHAROPTOSIS SUPERIOR RECTUS FASCIAL SLING|1107.57|1107.57||
125|67904|67904 - RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL|923.92|923.92||
125|67903|67903 - RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL|1189.74|1189.74||
125|67902|67902 - RPR BLEPHAROPT FRONTALIS MUSC AUTOL FASCAL SLING|1213.36|1213.36||
125|67901|67901 - RPR BLEPHAROPTOSIS FRONTALIS MUSC SUTR/OTH MATRL|1029.03|1029.03||
125|67900|67900 - REPAIR BROW PTOSIS|633.83|633.83||
125|67882|67882 - CONSTJ INTERMARGIN ADHES/TARSOR/CANTHOR W/TRPOS|701.02|701.02||
125|67880|67880 - CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY|502.88|502.88||
125|67875|67875 - TEMPORARY CLOSURE EYELIDS SUTURE|307.83|307.83||
125|67850|67850 - DESTRUCTION LESION LID MARGIN </ 1 CM|286.51|286.51||
125|67840|67840 - EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE|282.28|282.28||
125|67835|67835 - CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF|861.85|861.85||
125|67830|67830 - CORRECTION TRICHIASIS INCCISION LID MARGIN|337.52|337.52||
125|67825|67825 - CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS|126.23|126.23||
125|67820|67820 - CORRECTION TRICHIASIS EPILATION FORCEPS ONLY|111.39|111.39||
125|67810|67810 - INCISIONAL BIOPSY EYELID SKIN & LID MARGIN|191.86|191.86||
125|67808|67808 - EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT|345.77|345.77||
125|67805|67805 - EXCISION CHALAZION MULTIPLE DIFFERENT LIDS|288.51|288.51||
125|67801|67801 - EXCISION CHALAZION MULTIPLE SAME LID|269.2|269.2||
125|67800|67800 - EXCISION CHALAZION SINGLE|179.34|179.34||
125|67715|67715 - CANTHOTOMY SEPARATE PROCEDURE|243.89|243.89||
125|67710|67710 - SEVERING TARSORRHAPHY|235.38|235.38||
125|67700|67700 - BLEPHAROTOMY DRAINAGE ABSCESS EYELID|272.8|272.8||
125|67570|67570 - OPTIC NERVE DECOMPRESSION|1537.95|1537.95||
125|67560|67560 - ORBITAL IMPLANT REMOVAL/REVISION|1227.5|1227.5||
125|67550|67550 - ORBITAL IMPLANT INSERTION|1259.85|1259.85||
125|67515|67515 - INJECTION MEDICATION/OTHER SUBST TENON CAPSULE|94.87|94.87||
125|67505|67505 - RETROBULBAR INJECTION ALCOHOL|160.49|160.49||
125|67500|67500 - RETROBULBAR INJECTION MEDICATION SPX|145.79|145.79||
125|67450|67450 - ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX|1964.63|1964.63||
125|67445|67445 - ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN|1399.08|1399.08||
125|67440|67440 - ORBITOTOMY BONE FLAP/WINDOW LATERAL W/DRG|1934.66|1934.66||
125|67430|67430 - ORBITOTOMY BONE FLAP/WINDOW LATERAL RMVL FB|1810.83|1810.83||
125|67420|67420 - ORBITOTOMY BONE FLAP/WINDOW LAT RMVL LESION|2240.54|2240.54||
125|67415|67415 - FINE NEEDLE ASPIRATION ORBITAL CONTENTS|215.03|215.03||
125|67414|67414 - ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN|1066.93|1066.93||
125|67413|67413 - ORBITOTOMY W/O BONE FLAP W/RMVL FOREIGN BODY|1323.66|1323.66||
125|67412|67412 - ORBITOTOMY W/O BONE FLAP W/REMOVAL LESION|1411.61|1411.61||
125|67405|67405 - ORBITOTOMY W/O BONE FLAP EXPL W/DRAINAGE ONLY|1147.09|1147.09||
125|67400|67400 - ORBITOTOMY W/O BONE FLAP EXPL W/WO BIOPSY|1324.01|1324.01||
125|67346|67346 - BIOPSY EXTRAOCULAR MUSCLE|320.66|320.66||
125|67345|67345 - CHEMODENERVATION EXTRAOCULAR MUSCLE|336.92|336.92||
125|67343|67343 - RLS XTNSV SCAR TISS W/O DETACHING EO MUSC SPX|725.61|725.61||
125|67340|67340 - STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC|1226.05|1226.05||
125|67335|67335 - PLACEMENT ADJUSTABLE SUTURE STRABISMUS|364.55|364.55||
125|67334|67334 - STRABISMUS POST FIXJ SUTR TQ W/WO MUSC RECESSION|1036.47|1036.47||
125|67332|67332 - STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY|1168.57|1168.57||
125|67331|67331 - STRABISMUS PREVIOUS EYE X INVOLVE EO MUSC|1070.31|1070.31||
125|67320|67320 - TRANSPOSITION PROCEDURE EXTRAOCULAR MUSC|1126.86|1126.86||
125|67318|67318 - STRABISMUS ANY SUPERIOR OBLIQUE MUSCLE|871.52|871.52||
125|67316|67316 - STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC|1189.04|1189.04||
125|67314|67314 - STRABISMUS RECESSION/RESCJ 1 VER MUSC|1175.83|1175.83||
125|67312|67312 - STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC|1089.8|1089.8||
125|67311|67311 - STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC|887.03|887.03||
125|67255|67255 - SCLERAL REINFORCEMENT SPX W/GRAFT|1712.47|1712.47||
125|67250|67250 - SCLERAL REINFORCEMENT SPX W/O GRAFT|1371.88|1371.88||
125|67229|67229 - EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT|1861.62|1861.62||
125|67228|67228 - TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION|1358.9|1358.9||
125|67227|67227 - DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY|986.57|986.57||
125|67225|67225 - DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION|127.9|127.9||
125|67221|67221 - DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY|485.35|485.35||
125|67220|67220 - DSTRJ LESION CHOROID PC 1/> SESS|1136.34|1136.34||
125|67218|67218 - DSTRJ LESION RETINA 1/> SESS RADJ IMPLTJ|1969.02|1969.02||
125|67210|67210 - DSTRJ LOCLZD LESION RETINA 1/> SESS PC|1117.88|1117.88||
125|67208|67208 - DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM|902.81|902.81||
125|67145|67145 - PROPH RTA DTCHMNT W/O DRG 1/> SESS|753.01|753.01||
125|67141|67141 - PROPH RTA DTCHMNT W/O DRG 1/> SESS CRTX DTHRM|848.78|848.78||
125|67121|67121 - RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR|1213.79|1213.79||
125|67120|67120 - RMVL IMPLNT MATL POSTERIOR SEGMENT EXTRAOCULAR|904.83|904.83||
125|67115|67115 - RELEASE ENCIRCLING MATERIAL POSTERIOR SEGMENT|772.55|772.55||
125|67113|67113 - RPR COMPLEX RETINA DETACH VITRECT &MEMBRANE PEEL|2141.22|2141.22||
125|67110|67110 - RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS|1278.59|1278.59||
125|67108|67108 - RPR RETINAL DTCHMNT W/VITRECTOMY ANY METH|2815.71|2815.71||
125|67107|67107 - REPAIR RETINAL DETACHMENT SCLERAL BUCKLING|1959.71|1959.71||
125|67105|67105 - RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID PC|1532.99|1532.99||
125|67101|67101 - RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID CRTX|1515.25|1515.25||
125|67043|67043 - VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE|1947.13|1947.13||
125|67042|67042 - VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA|1841.75|1841.75||
125|67041|67041 - VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE|1841.75|1841.75||
125|67040|67040 - VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC|2402.65|2402.65||
125|67039|67039 - VITRECTOMY MCHNL PARS PLNA FOCAL ENDOLASER PC|2057.01|2057.01||
125|67036|67036 - VITRECTOMY MECHANICAL PARS PLANA|1719.79|1719.79||
125|67031|67031 - SEVERING VITREOUS STRANS LASER 1/> STAGES|790.59|790.59||
125|67030|67030 - DISCISSION VITREOUS STRANS PARS PLANA APPROACH|947.92|947.92||
125|67028|67028 - INTRAVITREAL NJX PHARMACOLOGIC AGT SPX|419.19|419.19||
125|67027|67027 - IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS|2774.14|2774.14||
125|67025|67025 - INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX|982.42|982.42||
125|67015|67015 - ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL|795.57|795.57||
125|67010|67010 - RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT|1558.17|1558.17||
125|67005|67005 - RMVL VITREOUS ANT APPR PARTIAL REMOVAL|1378.81|1378.81||
125|66990|66990 - USE OPHTHALMIC ENDOSCOPE|89.05|89.05||
125|66986|66986 - EXCHANGE INTRAOCULAR LENS|1600.62|1600.62||
125|66985|66985 - INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL|1555.97|1555.97||
125|66984|66984 - XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP|1446.48|1446.48||
125|66983|66983 - ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG|1796.96|1796.96||
125|66982|66982 - XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX WO ECP|1846.32|1846.32||
125|66940|66940 - REMOVAL LENS MATERIAL EXTRACAPSULAR|1485.42|1485.42||
125|66930|66930 - REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS|1636.38|1636.38||
125|66920|66920 - RMVL LENS MATERIAL INTRACAPSULAR|1475|1475||
125|66852|66852 - RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY|1718.55|1718.55||
125|66850|66850 - RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR|1577.48|1577.48||
125|66840|66840 - RMVL LENS MATERIAL ASPIR TQ 1/> STAGES|1407.99|1407.99||
125|66830|66830 - RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ|981.96|981.96||
125|66825|66825 - REPOSITIONING IO LENS PROSTHESIS REQ INC SPX|1176.34|1176.34||
125|66821|66821 - POST-CATARACT LASER SURGERY|393.81|393.81||
125|66820|66820 - DISCISSION SECONDARY MEMBRANOUS CATARACT|635.67|635.67||
125|66770|66770 - DSTRJ CYST/LESION IRIS/CILIARY BODY|721.05|721.05||
125|66762|66762 - IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS|729.74|729.74||
125|66761|66761 - IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION|577.25|577.25||
125|66740|66740 - CILIARY BODY DESTRUCTION CYCLODIALYSIS|866.75|866.75||
125|66720|66720 - CILIARY BODY DESTRUCTION CRYOTHERAPY|704.53|704.53||
125|66711|66711 - ECP CILIARY BODY DSTRJ W/O RMVL CRYSTALLINE LENS|510.79|510.79||
125|66710|66710 - CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL|662.06|662.06||
125|66700|66700 - CILIARY BODY DESTRUCTION DIATHERMY|693.4|693.4||
125|66682|66682 - SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE|906.39|906.39||
125|66680|66680 - REPAIR IRIS CILIARY BODY|967.99|967.99||
125|66635|66635 - IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX|880.75|880.75||
125|66630|66630 - IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX|871.96|871.96||
125|66625|66625 - IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX|818.68|818.68||
125|66605|66605 - IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY|1779.51|1779.51||
125|66600|66600 - IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES|1190.55|1190.55||
125|66505|66505 - IRIDOTOMY STAB INC SPX TRANSFIXION|580.92|580.92||
125|66500|66500 - IRIDOTOMY STAB INC SPX XCP TRANSFIXION|482.46|482.46||
125|66250|66250 - REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT|947.63|947.63||
125|66225|66225 - REPAIR SCLERAL STAPHYLOMA W/GRAFT|1827.89|1827.89||
125|66220|66220 - REPAIR SCLERAL STAPHYLOMA W/O GRAFT|1306.35|1306.35||
125|66185|66185 - REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT|1128.48|1128.48||
125|66184|66184 - REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT|1244.42|1244.42||
125|66183|66183 - INSERT ANTER DRAINAGE DEV W/O EXTRAOC RESERVOIR|1636.75|1636.75||
125|66180|66180 - AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT|1838.8|1838.8||
125|66179|66179 - AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT|1713.85|1713.85||
125|66175|66175 - TRLUML DILAT AQUEOUS CANAL W/DEVICE/STENT|1582.45|1582.45||
125|66174|66174 - TRLUML DILAT AQUEOUS CANAL W/O DEVICE/STENT|1510.41|1510.41||
125|66172|66172 - FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING|1744.64|1744.64||
125|66170|66170 - FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO|1476.06|1476.06||
125|66160|66160 - FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT|1288.38|1288.38||
125|66155|66155 - FSTLJ SCLERA GLAUCOMA THERMOCAUT IRRIDEC|1179.62|1179.62||
125|66150|66150 - FSTLJ SCLERA GLAUCOMA TREPHIN W/IRIDECTOMY|1187.83|1187.83||
125|66130|66130 - EXCISION LESION SCLERA|852.57|852.57||
125|66030|66030 - INJX ANTERIOR CHAMBER EYE MEDICATION SPX|158.91|158.91||
125|66020|66020 - INJX ANTERIOR CHAMBER EYE AIR/LIQUID SPX|202.93|202.93||
125|65930|65930 - RMVL BLOOD CLOT ANTERIOR SEGMENT EYE|989.41|989.41||
125|65920|65920 - RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE|1199.26|1199.26||
125|65900|65900 - RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE|1241.41|1241.41||
125|65880|65880 - SEVERING ADS ANT SEG INCAL SPX CORNEOVITREAL|889.66|889.66||
125|65875|65875 - SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE|858.44|858.44||
125|65870|65870 - SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE|836.84|836.84||
125|65865|65865 - SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE|926.5|926.5||
125|65860|65860 - SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX|598.98|598.98||
125|65855|65855 - TRABECULOPLASTY BY LASER SURGERY|690.55|690.55||
125|65850|65850 - TRABECULOTOMY AB EXTERNO|1264.25|1264.25||
125|65820|65820 - GONIOTOMY|1092.72|1092.72||
125|65815|65815 - PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN|650.65|650.65||
125|65810|65810 - PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX|688.73|688.73||
125|65800|65800 - PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX|187.25|187.25||
125|65785|65785 - IMPLANTATION INTRASTROMAL CORNEAL RING SEGMENTS|3806.16|3806.16||
125|65782|65782 - OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT|2472.98|2472.98||
125|65781|65781 - OCULAR SURFACE RECONSTRUCTION LIMBAL ALLOGRAFT|2845.09|2845.09||
125|65780|65780 - OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE|1855.89|1855.89||
125|65779|65779 - PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED|1834.61|1834.61||
125|65778|65778 - PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES|2127.72|2127.72||
125|65775|65775 - CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM|892.26|892.26||
125|65772|65772 - CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM|579.67|579.67||
125|65771|65771 - RADIAL KERATOTOMY|1452.66|1452.66||
125|65770|65770 - KERATOPROSTHESIS|2479.48|2479.48||
125|65767|65767 - EPIKERATOPLASTY|3107.3|3107.3||
125|65765|65765 - KERATOPHAKIA|2876.23|2876.23||
125|65760|65760 - KERATOMILEUSIS|2761.98|2761.98||
125|65757|65757 - BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT|137.51|137.51||
125|65756|65756 - KERATOPLASTY ENDOTHELIAL|1892.56|1892.56||
125|65755|65755 - KERATOPLASTY PENETRATING PSEUDOPHAKIA|2468.66|2468.66||
125|65750|65750 - KERATOPLASTY PENETRAING APHAKIA|2377.38|2377.38||
125|65730|65730 - KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA|2321.94|2321.94||
125|65710|65710 - KERATOPLASTY ANTERIOR LAMELLAR|1966.65|1966.65||
125|65600|65600 - MULTIPLE PUNCTURES ANTERIOR CORNEA|549.18|549.18||
125|65450|65450 - DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION|394.02|394.02||
125|65436|65436 - RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT|383.45|383.45||
125|65435|65435 - RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION|100.39|100.39||
125|65430|65430 - CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE|237.79|237.79||
125|65426|65426 - EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG|755.82|755.82||
125|65420|65420 - EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT|548.34|548.34||
125|65410|65410 - BIOPSY CORNEA|164.17|164.17||
125|65400|65400 - EXCISION LESION CORNEA XCP PTERYGIUM|763.61|763.61||
125|65290|65290 - RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU|765.53|765.53||
125|65286|65286 - RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA|632.03|632.03||
125|65285|65285 - RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T|1606.53|1606.53||
125|65280|65280 - RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS|1120.27|1120.27||
125|65275|65275 - RPR LAC CORNEA NONPERFOR W/WO RMVL FOREIGN BODY|597.43|597.43||
125|65273|65273 - RPR LAC CJNC MOBLJ & REARGMT W/HOSPIZATION|407.17|407.17||
125|65272|65272 - RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION|438.08|438.08||
125|65270|65270 - RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR|267.66|267.66||
125|65265|65265 - RMVL FB IO FROM POST SEG NONMAGNETIC XTRJ|1442.52|1442.52||
125|65260|65260 - RMVL FB IO FROM POST SEG MAG XTRJ ANT/POST ROUTE|1163.55|1163.55||
125|65235|65235 - RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS|948.92|948.92||
125|65222|65222 - RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP|120.33|120.33||
125|65220|65220 - RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP|85.24|85.24||
125|65210|65210 - RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR|78.41|78.41||
125|65205|65205 - REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL|100.91|100.91||
125|65175|65175 - REMOVAL OCULAR IMPLANT|819.3|819.3||
125|65155|65155 - REINSERTION OCULAR IMPLT RNFCMT &/ ATTACH MUSCLE|1239.71|1239.71||
125|65150|65150 - REINSERTION OCULAR IMPLT W/WO CONJUNCTIVAL GRAFT|902.79|902.79||
125|65140|65140 - INSJ OC IMPLT AFTER ENCL MUSC ATTACHED|1074.79|1074.79||
125|65135|65135 - INSJ OC IMPLT AFTER ENCL MUSC X ATTACHED|946.88|946.88||
125|65130|65130 - INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL|944.82|944.82||
125|65125|65125 - MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX|460.41|460.41||
125|65114|65114 - EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP|2138.04|2138.04||
125|65112|65112 - EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE|1938.37|1938.37||
125|65110|65110 - EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY|1822.81|1822.81||
125|65105|65105 - ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT|1206.6|1206.6||
125|65103|65103 - ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT|1046.02|1046.02||
125|65101|65101 - ENUCLEATION OF EYE W/O IMPLANT|932.89|932.89||
125|65093|65093 - EVISCERATION OCULAR CONTENTS W/IMPLANT|973.79|973.79||
125|65091|65091 - EVISCERATION OCULAR CONTENTS W/O IMPLANT|896.21|896.21||
125|64913|64913 - NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND|261.97|261.97||
125|64912|64912 - NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND|1270.23|1270.23||
125|64911|64911 - NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE|1205.1|1205.1||
125|64910|64910 - NERVE REPAIR W/CONDUIT EACH NERVE|990.64|990.64||
125|64907|64907 - NERVE PEDICAL TRANSFER SECOND STAGE|1645.8|1645.8||
125|64905|64905 - NERVE PEDICLE TRANSFER FIRST STAGE|1150.75|1150.75||
125|64902|64902 - NERVE GRAFT EACH NERVE MULTIPLE STRANDS|1199.12|1199.12||
125|64901|64901 - NERVE GRAFT EACH NERVE 1 STRAND|1028.91|1028.91||
125|64898|64898 - NERVE GRAFT MLT STRANDS ARM/LEG >4 CM|2065.62|2065.62||
125|64897|64897 - NERVE GRAFT MLT STRANDS ARM/LEG </4 CM|1882.4|1882.4||
125|64896|64896 - NERVE GRAFT MLT STRANDS HAND/FOOT > 4 CM|2174.95|2174.95||
125|64895|64895 - NERVE GRAFT MLT STRANDS HAND/FOOT </4 CM|1931.42|1931.42||
125|64893|64893 - NERVE GRAFT 1 STRAND ARM/LEG >4 CM|1725.65|1725.65||
125|64892|64892 - NERVE GRAFT 1 STRAND ARM/LEG <4 CM|1507.48|1507.48||
125|64891|64891 - NRV GRF 1 STRAND HAND/FOOT >4 CM|1622.98|1622.98||
125|64890|64890 - NERVE GRAFT 1 STRAND HAND/FOOT </4 CM|1575.71|1575.71||
125|64886|64886 - NERVE GRAFT HEAD/NECK >4 CM|2017.82|2017.82||
125|64885|64885 - NERVE GRAFT HEAD/NECK </ 4 CM|1673.15|1673.15||
125|64876|64876 - SUTURE NERVE REQ SHORTENING BONE EXTREMITY|313.53|313.53||
125|64874|64874 - SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE|277.74|277.74||
125|64872|64872 - SUTURE NERVE REQ SECONDARY/DELAYED SUTURE|185.2|185.2||
125|64868|64868 - ANASTOMOSIS FACIAL HYPOGLOSSAL|2011.28|2011.28||
125|64866|64866 - ANASTOMOSIS FACIAL-SPINAL ACCESSORY|2005.89|2005.89||
125|64865|64865 - SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT|1610.13|1610.13||
125|64864|64864 - SUTURE FACIAL NERVE EXTRACRANIAL|1270.46|1270.46||
125|64862|64862 - SUTURE LUMBAR PLEXUS|2181.38|2181.38||
125|64861|64861 - SUTURE BRACHIAL PLEXUS|1752.37|1752.37||
125|64859|64859 - SUTURE EACH ADDITIONAL PERIPHERAL NERVE|524.91|524.91||
125|64858|64858 - SUTURE SCIATIC NERVE|1589.58|1589.58||
125|64857|64857 - SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS|1328.45|1328.45||
125|64856|64856 - SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS|1311.92|1311.92||
125|64840|64840 - SUTURE POSTERIOR TIBIAL NERVE|1278.84|1278.84||
125|64837|64837 - SUTURE EACH ADDITIONAL NERVE HAND/FOOT|656.97|656.97||
125|64836|64836 - SUTURE 1 NERVE ULNAR MOTOR|1124.54|1124.54||
125|64835|64835 - SUTURE 1 NERVE MEDIAN MOTOR THENAR|1012.21|1012.21||
125|64834|64834 - SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE|850.79|850.79||
125|64832|64832 - SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV|426.46|426.46||
125|64831|64831 - SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE|737.03|737.03||
125|64823|64823 - SYMPATHECTOMY SUPERFICIAL PALMAR ARCH|915|915||
125|64822|64822 - SYMPATHECTOMY ULNAR ARTERY|915|915||
125|64821|64821 - SYMPATHECTOMY RADIAL ARTERY|915|915||
125|64820|64820 - SYMPATHECTOMY DIGITAL ARTERIES EACH DIGIT|931.9|931.9||
125|64818|64818 - SYMPATHECTOMY LUMBAR|1350.27|1350.27||
125|64809|64809 - SYMPATHECTOMY THORACOLUMBAR|1751.19|1751.19||
125|64804|64804 - SYMPATHECTOMY CERVICOTHORACIC|1866.78|1866.78||
125|64802|64802 - SYMPATHECTOMY CERVICAL|1104.44|1104.44||
125|64795|64795 - BIOPSY NERVE|338.6|338.6||
125|64792|64792 - EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV|1373.24|1373.24||
125|64790|64790 - EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV|1065.33|1065.33||
125|64788|64788 - EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV|515.47|515.47||
125|64787|64787 - IMPLANTATION NERVE END BONE/MUSCLE|541.63|541.63||
125|64786|64786 - EXCISION NEUROMA SCIATIC NERVE|1556.88|1556.88||
125|64784|64784 - EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC|1009.36|1009.36||
125|64783|64783 - EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT|361.52|361.52||
125|64782|64782 - EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE|648.6|648.6||
125|64778|64778 - EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT|303.59|303.59||
125|64776|64776 - EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT|458.92|458.92||
125|64774|64774 - EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE|605.77|605.77||
125|64772|64772 - TRANSECTION/AVULSION OTH SPINAL NRV XDRL|744.76|744.76||
125|64771|64771 - TRANSECTION/AVULSION OTH CRANIAL NRV XDRL|949.52|949.52||
125|64766|64766 - TRNSXJ/AVLSN OBTURAT NRV INPELV W/WO TENOTOMY|995.59|995.59||
125|64763|64763 - TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY|695.22|695.22||
125|64760|64760 - TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL|1106.01|1106.01||
125|64755|64755 - TRANSECTION/AVULSION VAGUS NERVES|1913.67|1913.67||
125|64746|64746 - TRANSECTION/AVULSION PHRENIC NERVE|582.56|582.56||
125|64744|64744 - TRANSECTION/AVULSION GREATER OCCIPITAL NERVE|726.73|726.73||
125|64742|64742 - TRANSECTION/AVULSION FACIAL NRV DIFFERENT/CMPL|847.43|847.43||
125|64740|64740 - TRANSECTION/AVULSION LINGUAL NERVE|832.51|832.51||
125|64738|64738 - TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO|795.21|795.21||
125|64736|64736 - TRANSECTION/AVULSION MENTAL NERVE|604.07|604.07||
125|64734|64734 - TRANSECTION/AVULSION INFRAORBITAL NERVE|626.58|626.58||
125|64732|64732 - TRANSECTION/AVULSION SUPRAORBITAL NERVE|602.76|602.76||
125|64727|64727 - INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE|395.33|395.33||
125|64726|64726 - DECOMPRESSION PLANTAR DIGITAL NERVE|366.51|366.51||
125|64722|64722 - DECOMPRESSION UNSPECIFIED NERVE|749.13|749.13||
125|64721|64721 - NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE|1062.03|1062.03||
125|64719|64719 - NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST|713.22|713.22||
125|64718|64718 - NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW|850.65|850.65||
125|64716|64716 - NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE|972.82|972.82||
125|64714|64714 - NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS|1065.29|1065.29||
125|64713|64713 - NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS|1238.85|1238.85||
125|64712|64712 - NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV|1125.31|1125.31||
125|64708|64708 - NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC|1011.87|1011.87||
125|64704|64704 - NEUROPLASTY NERVE HAND/FOOT|704.8|704.8||
125|64702|64702 - NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT|521.11|521.11||
125|64681|64681 - DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS|940.66|940.66||
125|64680|64680 - DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS|477.71|477.71||
125|64653|64653 - CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY|93.26|93.26||
125|64650|64650 - CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE|80.7|80.7||
125|64647|64647 - CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES|288.51|288.51||
125|64646|64646 - CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES|241.99|241.99||
125|64645|64645 - CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES|183.9|183.9||
125|64644|64644 - CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES|263.34|263.34||
125|64643|64643 - CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE|149.47|149.47||
125|64642|64642 - CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE|231|231||
125|64640|64640 - DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE|272.39|272.39||
125|64636|64636 - DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL|264.7|264.7||
125|64635|64635 - DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL|647.32|647.32||
125|64634|64634 - DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA|291.7|291.7||
125|64633|64633 - DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA|654.64|654.64||
125|64632|64632 - DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE|136.92|136.92||
125|64630|64630 - DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE|274.62|274.62||
125|64620|64620 - DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE|303.97|303.97||
125|64617|64617 - CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG|255.83|255.83||
125|64616|64616 - CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA|211.67|211.67||
125|64615|64615 - CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE|239.38|239.38||
125|64612|64612 - CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL|222.02|222.02||
125|64611|64611 - CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS|192.08|192.08||
125|64610|64610 - DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR|759.27|759.27||
125|64605|64605 - DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH|598.8|598.8||
125|64600|64600 - DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH|486.83|486.83||
125|64595|64595 - REVISION/RMVL PERIPHERAL/GASTRIC NPGR|460.32|460.32||
125|64590|64590 - INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR|372.84|372.84||
125|64585|64585 - REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE|507.91|507.91||
125|64581|64581 - INC IMPLTJ NEUROSTIMULATOR ELTRD SACRAL NERVE|779.81|779.81||
125|64580|64580 - INC IMPLTJ NSTIM ELTRD NEUROMUSCULAR|351.68|351.68||
125|64575|64575 - INC IMPLTJ PERIPH NERVE NEUROSTIMULATOR ELTRD|382.34|382.34||
125|64570|64570 - REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO|1225.35|1225.35||
125|64569|64569 - REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV|1279.83|1279.83||
125|64568|64568 - INC IMPLTJ CRNL NRV NSTIM ELTRDS & PULSE GENER|1057.79|1057.79||
125|64566|64566 - POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE|198.31|198.31||
125|64565|64565 - PRQ IMPLTJ NSTIM ELTRD NEUROMUSCULAR|193.77|193.77||
125|64561|64561 - PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING|1367.63|1367.63||
125|64555|64555 - PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV|210.76|210.76||
125|64553|64553 - PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE|204.37|204.37||
125|64550|64550 - APPLICATION OF SURFACE NEUROSTIMULATOR|41.69|41.69||
125|64530|64530 - INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG|287.89|287.89||
125|64520|64520 - INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC|241.71|241.71||
125|64517|64517 - INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS|409.08|409.08||
125|64510|64510 - NJX ANES STELLATE GANGLION CRV SYMPATHETIC|175.61|175.61||
125|64508|64508 - INJECTION ANESTHETIC AGENT CAROTID SINUS SPX|166.9|166.9||
125|64505|64505 - INJECTION ANES AGENT SPHENOPALATINE GANGLION|113.41|113.41||
125|64495|64495 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL|136.09|136.09||
125|64494|64494 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL|136.09|136.09||
125|64493|64493 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL|267.78|267.78||
125|64492|64492 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL|148.75|148.75||
125|64491|64491 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL|147.69|147.69||
125|64490|64490 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL|296.24|296.24||
125|64489|64489 - TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S)|285.89|285.89||
125|64488|64488 - TAP BLOCK BILATERAL BY INJECTION(S)|212.96|212.96||
125|64487|64487 - TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S)|210.45|210.45||
125|64486|64486 - TAP BLOCK UNILATERAL BY INJECTION(S)|184.42|184.42||
125|64484|64484 - NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC EA LV|278.24|278.24||
125|64483|64483 - NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL|428.05|428.05||
125|64480|64480 - NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC EA LV|295.36|295.36||
125|64479|64479 - NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC 1 LVL|395.95|395.95||
125|64463|64463 - PVB THORACIC CONT CATHETER INFUSION W/IMG GID|250.71|250.71||
125|64462|64462 - PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID|129.93|129.93||
125|64461|64461 - PVB THORACIC SINGLE INJECTION SITE W/IMG GID|234.93|234.93||
125|64455|64455 - NJX ANES&/STEROID PLANTAR COMMON DIGITAL NERVE|76.81|76.81||
125|64450|64450 - INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH|183.1|183.1||
125|64449|64449 - INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH|221.88|221.88||
125|64448|64448 - INJECTION AA&/STRD FEMORAL NERVE CONT NFS CATH|247.3|247.3||
125|64447|64447 - INJECTION AA&/STRD FEMORAL NERVE|161.78|161.78||
125|64446|64446 - INJECTION AA&/STRD SCIATIC NERVE CONT NFS CATH|247.3|247.3||
125|64445|64445 - INJECTION AA&/STRD SCIATIC NERVE|159.43|159.43||
125|64435|64435 - INJECTION AA&/STRD PARACERVICAL NERVE|156.71|156.71||
125|64430|64430 - INJECTION AA&/STRD PUDENDAL NERVE|155.57|155.57||
125|64425|64425 - INJECTION AA&/STRD ILIOINGUINAL IH NERVES|138.04|138.04||
125|64421|64421 - INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL|290.28|290.28||
125|64420|64420 - INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL|190.15|190.15||
125|64418|64418 - INJECTION AA&/STRD SUPRASCAPULAR NERVE|150.37|150.37||
125|64417|64417 - INJECTION AA&/STRD AXILLARY NERVE|171.82|171.82||
125|64416|64416 - INJECTION AA&/STRD BRACHIAL PLEXUS CONT NFS CATH|247.3|247.3||
125|64415|64415 - INJECTION AA&/STRD BRACHIAL PLEXUS|164.14|164.14||
125|64413|64413 - INJECTION ANESTHETIC AGENT CERVICAL PLEXUS|132.23|132.23||
125|64410|64410 - INJECTION ANESTHETIC AGENT PHRENIC NERVE|152.15|152.15||
125|64408|64408 - INJECTION AA&/STRD VAGUS NERVE|126.99|126.99||
125|64405|64405 - INJECTION AA&/STRD GREATER OCCIPITAL NERVE|118.32|118.32||
125|64402|64402 - INJECTION ANESTHETIC AGENT FACIAL NERVE|120.23|120.23||
125|64400|64400 - INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH|118.63|118.63||
125|63746|63746 - RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT|859.38|859.38||
125|63744|63744 - RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT|1016.14|1016.14||
125|63741|63741 - CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM|1278.85|1278.85||
125|63740|63740 - CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM|2015.22|2015.22||
125|63710|63710 - DURAL GRAFT SPINAL|1926.9|1926.9||
125|63709|63709 - RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM|2718.4|2718.4||
125|63707|63707 - RPR DURAL/CEREBROSPINAL FLUID LEAK X REQ LAM|1722.57|1722.57||
125|63706|63706 - REPAIR MYELOMENINGOCELE > 5 CM DIAMETER|2556.08|2556.08||
125|63704|63704 - REPAIR MYELOMENINGOCELE < 5 CM DIAMETER|2346.56|2346.56||
125|63702|63702 - REPAIR MENINGOCELE > 5 CM DIAMETER|2057.87|2057.87||
125|63700|63700 - REPAIR MENINGOCELE < 5 CM DIAMETER|1902.28|1902.28||
125|63688|63688 - REVJ/RMVL IMPLANTED SPINAL NEUROSTIM GENERATOR|818.5|818.5||
125|63685|63685 - INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING|965.14|965.14||
125|63664|63664 - REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR|1444.33|1444.33||
125|63663|63663 - REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR|1242.35|1242.35||
125|63662|63662 - RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR|1386.23|1386.23||
125|63661|63661 - RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR|920.93|920.93||
125|63655|63655 - LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL|1655.02|1655.02||
125|63650|63650 - PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL|1825.45|1825.45||
125|63621|63621 - STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION|436.2|436.2||
125|63620|63620 - STEREOTACTIC RADIOSURGERY 1 SPINAL LESION|1887.49|1887.49||
125|63615|63615 - STRTCTC BX ASPIRAT/EXC LESION SPINAL CORD|2202.69|2202.69||
125|63610|63610 - STRTCTC STIMJ SPI CORD PRQ SPX N/FLWD OTH SURG|2521.77|2521.77||
125|63600|63600 - CREATION LES SPINAL CORD STEREOTACTIC METHOD PRQ|1590.05|1590.05||
125|63308|63308 - VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG|878.36|878.36||
125|63307|63307 - VCRPEC LES 1 SEG IDRL LMBR/SAC TRANSPRTL/RPR|3064.45|3064.45||
125|63306|63306 - VERTEBRL CORPECT LES 1 SEG IDRL THRC THORACOLMBR|3026.76|3026.76||
125|63305|63305 - VERTEBRAL CORPECTOMY LES 1 SEG IDRL THRC TTHRC|3039.61|3039.61||
125|63304|63304 - VERTEBRAL CORPECTOMY EXC LES 1 SEG IDRL CERVICAL|2871.97|2871.97||
125|63303|63303 - VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR|2859.72|2859.72||
125|63302|63302 - VCRPEC LES 1 SEG XDRL THRC THORACOLMBR|2836.98|2836.98||
125|63301|63301 - VCRPEC LES 1 SGM XDRL THORACIC TTHRC|2750.68|2750.68||
125|63300|63300 - VCRPEC LES 1 SGM XDRL CERVICAL|2530.43|2530.43||
125|63295|63295 - OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX|329.77|329.77||
125|63290|63290 - LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL|3647.33|3647.33||
125|63287|63287 - LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR|4196.38|4196.38||
125|63286|63286 - LAM BX/EXC ISPI NEO IDRL IMED THORACIC|4215.31|4215.31||
125|63285|63285 - LAM BX/EXC ISPI NEO IDRL IMED CERVICAL|4079.17|4079.17||
125|63283|63283 - LAM BX/EXC ISPI NEO IDRL SACRAL|3301.53|3301.53||
125|63282|63282 - LAM BX/EXC ISPI NEO IDRL XMED LUMBAR|3639.93|3639.93||
125|63281|63281 - LAM BX/EXC ISPI NEO IDRL XMED THORACIC|3662.3|3662.3||
125|63280|63280 - LAM BX/EXC ISPI NEO IDRL XMED CERVICAL|3686.55|3686.55||
125|63278|63278 - LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL|3025.17|3025.17||
125|63277|63277 - LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR|3044.48|3044.48||
125|63276|63276 - LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC|3427.25|3427.25||
125|63275|63275 - LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL|3421.27|3421.27||
125|63273|63273 - LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL|2814.05|2814.05||
125|63272|63272 - LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR|3061.54|3061.54||
125|63271|63271 - LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC|3368.66|3368.66||
125|63270|63270 - LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL|3057.99|3057.99||
125|63268|63268 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL|2366.48|2366.48||
125|63267|63267 - LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR|2889.3|2889.3||
125|63266|63266 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC|3066.43|3066.43||
125|63265|63265 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL|2943.1|2943.1||
125|63252|63252 - LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR|4157.06|4157.06||
125|63251|63251 - LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC|3709.11|3709.11||
125|63250|63250 - LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL|3870.3|3870.3||
125|63200|63200 - LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR|2559.42|2559.42||
125|63199|63199 - LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES THORACIC|3434.94|3434.94||
125|63198|63198 - LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES CERVICAL|3235.85|3235.85||
125|63197|63197 - LAM CORDOTOMY SCTJ BOTH SPINOTHALMIC TRACT THRC|2652.16|2652.16||
125|63196|63196 - LAM CORDOTOMY SCTJ BOTH SPINOTHALMIC TRACTS CRV|2698.81|2698.81||
125|63195|63195 - LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT THORACIC|2538.87|2538.87||
125|63194|63194 - LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT CERVICAL|2530.3|2530.3||
125|63191|63191 - LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE|2403.01|2403.01||
125|63190|63190 - LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS|2865.44|2865.44||
125|63185|63185 - LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS|2333.45|2333.45||
125|63182|63182 - LAM&SCTJ DENTATE LIG W/WO DURAL GRF CRV >2 SEG|2572.95|2572.95||
125|63180|63180 - LAM&SCTJ DENTATE LIG W/WO DURAL GRF CRV 1/2 SEG|2753.85|2753.85||
125|63173|63173 - LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL|2683.59|2683.59||
125|63172|63172 - LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID|2978.86|2978.86||
125|63170|63170 - LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR|2700.89|2700.89||
125|63103|63103 - VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG|1151.61|1151.61||
125|63102|63102 - VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG|5687.86|5687.86||
125|63101|63101 - VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG|5687.86|5687.86||
125|63091|63091 - VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG|749.57|749.57||
125|63090|63090 - VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG|3383.88|3383.88||
125|63088|63088 - VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG|900.01|900.01||
125|63087|63087 - VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG|3612.8|3612.8||
125|63086|63086 - VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG|819.57|819.57||
125|63085|63085 - VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG|3640.68|3640.68||
125|63082|63082 - VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG|922.38|922.38||
125|63081|63081 - VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG|3553.74|3553.74||
125|63078|63078 - DISCECTOMY ANT DCMPRN CORD THORACIC EA NTRSPC|767.63|767.63||
125|63077|63077 - DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC|2940.77|2940.77||
125|63076|63076 - DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC|1080.7|1080.7||
125|63075|63075 - DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC|3954.24|3954.24||
125|63066|63066 - COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG|973.42|973.42||
125|63064|63064 - COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG|3243.93|3243.93||
125|63057|63057 - TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR|1130.31|1130.31||
125|63056|63056 - TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR|3010.88|3010.88||
125|63055|63055 - TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC|3203.17|3203.17||
125|63051|63051 - LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ|1646.86|1646.86||
125|63050|63050 - LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG|1446.64|1446.64||
125|63048|63048 - LAM FACETECTOMY&FORAMTOMY 1 SGM EA CRV THRC/LMBR|736.46|736.46||
125|63047|63047 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR|4074.08|4074.08||
125|63046|63046 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT THORACIC|3011.02|3011.02||
125|63045|63045 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT CERVICAL|2455.12|2455.12||
125|63044|63044 - LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR|1409.83|1409.83||
125|63043|63043 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV|1483.79|1483.79||
125|63042|63042 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR|4545.36|4545.36||
125|63040|63040 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL|2962.87|2962.87||
125|63035|63035 - LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR|543.92|543.92||
125|63030|63030 - LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR|3213.8|3213.8||
125|63020|63020 - LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC|2066.44|2066.44||
125|63017|63017 - LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR|3279.76|3279.76||
125|63016|63016 - LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC|3032.53|3032.53||
125|63015|63015 - LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL|3581.95|3581.95||
125|63012|63012 - LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR|2222.66|2222.66||
125|63011|63011 - LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL|2174.48|2174.48||
125|63005|63005 - LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR|3201.28|3201.28||
125|63003|63003 - LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC|3239.13|3239.13||
125|63001|63001 - LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG CRV|3182.21|3182.21||
125|62370|62370 - ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP|196.06|196.06||
125|62369|62369 - ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL|184.56|184.56||
125|62368|62368 - ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG|84.77|84.77||83.98
125|62367|62367 - ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL|55.49|55.49||53.61
125|62365|62365 - RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS|625.73|625.73||
125|62362|62362 - IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP|884.52|884.52||
125|62361|62361 - IMPLTJ/RPLCMT FS NON-PRGRBL PUMP|758.51|758.51||
125|62360|62360 - IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR|575.32|575.32||
125|62355|62355 - RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH|765.12|765.12||
125|62351|62351 - IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM|1703.57|1703.57||
125|62350|62350 - IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM|1781.53|1781.53||
125|62327|62327 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN|349.98|349.98||
125|62326|62326 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN|242.09|242.09||
125|62325|62325 - NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN|345.64|345.64||
125|62324|62324 - NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN|231.13|231.13||
125|62323|62323 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN|379.46|379.46||
125|62322|62322 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN|244.84|244.84||
125|62321|62321 - NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN|385.1|385.1||
125|62320|62320 - NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN|261.71|261.71||
125|62305|62305 - MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS|407.5|407.5||
125|62304|62304 - MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL|375.14|375.14||
125|62303|62303 - MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC|388.58|388.58||
125|62302|62302 - MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL|380.23|380.23||
125|62294|62294 - NJX ARTERIAL OCCLUSION ARVEN MALFRMJ SPINAL|830.18|830.18||
125|62292|62292 - INJECTION PX CHEMONUCLEOLYSIS 1/MLT LUMBAR|1591.1|1591.1||
125|62291|62291 - INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC|340.27|340.27||
125|62290|62290 - INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR|386.45|386.45||
125|62287|62287 - DCMPRN PERQ NUCLEUS PULPOSUS 1/> LEVELS LUMBAR|1470.58|1470.58||
125|62284|62284 - INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR|412.54|412.54||
125|62282|62282 - INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL|400.92|400.92||
125|62281|62281 - INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC|318.75|318.75||
125|62280|62280 - INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID|366.65|366.65||
125|62273|62273 - INJECTION EPIDURAL BLOOD/CLOT PATCH|245.28|245.28||
125|62272|62272 - THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF|190.51|190.51||
125|62270|62270 - DIAGNOSTIC LUMBAR SPINAL PUNCTURE|164.3|164.3||
125|62269|62269 - BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE|898.56|898.56||
125|62268|62268 - PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX|885.36|885.36||
125|62267|62267 - PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS|393.4|393.4||
125|62264|62264 - PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY|753.45|753.45||
125|62263|62263 - PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS|724.79|724.79||
125|62258|62258 - RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT|2227.95|2227.95||
125|62256|62256 - RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT|980.08|980.08||
125|62252|62252 - REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT|90.42|90.42||50.29
125|62230|62230 - RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS|1959.54|1959.54||
125|62225|62225 - RPLCMT/IRRIGATION VENTRICULAR CATHETER|1004.23|1004.23||
125|62223|62223 - CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS|2610.85|2610.85||
125|62220|62220 - CRTJ SHUNT VENTRICULO-ATR-JUG-AUR|1907.28|1907.28||
125|62201|62201 - VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC|3080.31|3080.31||
125|62200|62200 - VENTRICULOCISTERNOSTOMY 3RD VENTRICLE|2580.71|2580.71||
125|62194|62194 - RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER|575.16|575.16||
125|62192|62192 - CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH|1965.04|1965.04||
125|62190|62190 - CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR|1928.48|1928.48||
125|62180|62180 - VENTRICULOCISTERNOSTOMY|2403.08|2403.08||
125|62165|62165 - NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID|5070.77|5070.77||
125|62164|62164 - NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY|5565.37|5565.37||
125|62163|62163 - NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY|4804.36|4804.36||
125|62162|62162 - NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG|4698.67|4698.67||
125|62161|62161 - NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS|4698.67|4698.67||
125|62160|62160 - NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS|205.75|205.75||
125|62148|62148 - INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT|346.68|346.68||
125|62147|62147 - CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER|2742.89|2742.89||
125|62146|62146 - CRANIOPLASTY W/AUTOGRAFT </ 5 CM DIAMETER|2355.75|2355.75||
125|62145|62145 - CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG|2417.83|2417.83||
125|62143|62143 - RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL|1743.37|1743.37||
125|62142|62142 - RMVL BONE FLAP/PROSTHETIC PLATE SKULL|1558.26|1558.26||
125|62141|62141 - CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER|2985.6|2985.6||
125|62140|62140 - CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER|2383.3|2383.3||
125|62121|62121 - CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE|2859.25|2859.25||
125|62120|62120 - RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY|2654.46|2654.46||
125|62117|62117 - RDCTJ CRANIOMEGALIC CRANIO&RECNSTJ W/WO GRAFT|2554.05|2554.05||
125|62115|62115 - RDCTJ CRANIOMEGALIC SKULL W/O GRAFT/CRANIOPLASTY|2067.82|2067.82||
125|62100|62100 - CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA|2957.59|2957.59||
125|62010|62010 - ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN|3481.18|3481.18||
125|62005|62005 - ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL|2007.61|2007.61||
125|62000|62000 - ELEVATION DEPRESSED SKULL FX SIMPLE EXTRADURAL|1910.74|1910.74||
125|61888|61888 - REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR|463.17|463.17||
125|61886|61886 - INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS|885.17|885.17||
125|61885|61885 - INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR|503.51|503.51||
125|61880|61880 - REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS|1778.6|1778.6||
125|61870|61870 - CRNEC IMPLTJ NSTIM ELTRD CEREBELLAR CORTICAL|1830.89|1830.89||
125|61868|61868 - STRTCTC IMPLTJ NSTIM ELTRD W/RECORD EA ARRAY|2275.19|2275.19||
125|61867|61867 - STRTCTC IMPLTJ NSTIM ELTRD W/RECORD 1ST ARRAY|5731.78|5731.78||
125|61864|61864 - STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD EA ARRAY|1367.64|1367.64||
125|61863|61863 - STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY|3940.6|3940.6||
125|61860|61860 - CRNEC/CRX IMPLTJ NSTIM ELTRD CERE CORTICAL|2067.58|2067.58||
125|61850|61850 - TWIST/BURR HOLE IMPLTJ NSTIM ELTRD CORTICAL|2018.11|2018.11||
125|61800|61800 - APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY|261.6|261.6||
125|61799|61799 - STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX|520.98|520.98||
125|61798|61798 - STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES|2331.63|2331.63||
125|61797|61797 - STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE|379.27|379.27||
125|61796|61796 - STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES|1706.17|1706.17||
125|61791|61791 - CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC|1750.09|1750.09||
125|61790|61790 - CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN|1812.36|1812.36||
125|61783|61783 - STEREOTACTIC COMPUTER ASSISTED PX SPINAL|394.74|394.74||
125|61782|61782 - STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL|288.14|288.14||
125|61781|61781 - STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL|403.96|403.96||
125|61770|61770 - STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC|2811.36|2811.36||
125|61760|61760 - STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING|2863.96|2863.96||
125|61751|61751 - STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR|2817.95|2817.95||
125|61750|61750 - STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES|2620.59|2620.59||
125|61735|61735 - CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN|2825.41|2825.41||
125|61720|61720 - CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS|3025.77|3025.77||
125|61711|61711 - ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES|4279.08|4279.08||
125|61710|61710 - ARYSM VASC MALFRMJ IA EMBOLIZATION|2953.53|2953.53||
125|61708|61708 - ARYSM VASC MALFRMJ/ICRA ELECTROTHROMBOSIS|3625.95|3625.95||
125|61705|61705 - ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART|4181.04|4181.04||
125|61703|61703 - ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART|2126.57|2126.57||
125|61702|61702 - SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ|5450.04|5450.04||
125|61700|61700 - SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION|6955|6955||
125|61698|61698 - CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ|5334.25|5334.25||
125|61697|61697 - COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION|5539.95|5539.95||
125|61692|61692 - INTRACRANIAL ARVEN MALFRMJ DURAL CMPL|4222.68|4222.68||
125|61690|61690 - INTRACRANIAL ARVEN MALFRMJ DURAL SMPL|3677.61|3677.61||
125|61686|61686 - INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL|5661.43|5661.43||
125|61684|61684 - INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL|4475.4|4475.4||
125|61682|61682 - INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL|5300.71|5300.71||
125|61680|61680 - INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL|4073.54|4073.54||
125|61651|61651 - EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL|386.41|386.41||
125|61650|61650 - EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST|909.26|909.26||
125|61645|61645 - PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL|1392.51|1392.51||
125|61642|61642 - PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER|582.46|582.46||
125|61641|61641 - PERQ BALO DILA IC VSPSM EA VSL SM VASC TER|291.23|291.23||
125|61640|61640 - BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL|829.34|829.34||
125|61635|61635 - TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD|2445.9|2445.9||
125|61630|61630 - BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS|2295.72|2295.72||
125|61626|61626 - TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS|2003.66|2003.66||
125|61624|61624 - TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS|2664.61|2664.61||
125|61623|61623 - EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK|590.53|590.53||
125|61619|61619 - SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP|3240.38|3240.38||
125|61618|61618 - SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT|2255.31|2255.31||
125|61616|61616 - RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL|4971.29|4971.29||
125|61615|61615 - RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL|3660.17|3660.17||
125|61613|61613 - OBLTRJ CAROTID ARYSM ARTVEN CAROTID FISTULA DSJ|4733.01|4733.01||
125|61612|61612 - TRNSXJ/LIG CRTD ART PETROUS CANAL RPR ANAST/GRF|3311.18|3311.18||
125|61611|61611 - TRNSXJ/LIG CAROTID ARTERY PETROUS CANAL W/O RPR|849.9|849.9||
125|61610|61610 - TRNSXJ/LIG CAROTID ARTERY SINUS W/RPR ANAST/GRFT|3527.2|3527.2||
125|61608|61608 - RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL|4830.61|4830.61||
125|61607|61607 - RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL|4160.37|4160.37||
125|61606|61606 - RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR|4445.32|4445.32||
125|61605|61605 - RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL|3335.29|3335.29||
125|61601|61601 - RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF|3157.73|3157.73||
125|61600|61600 - RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL|2944.34|2944.34||
125|61598|61598 - TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM|3287.25|3287.25||
125|61597|61597 - TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL|4218.18|4218.18||
125|61596|61596 - TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART|3684.81|3684.81||
125|61595|61595 - TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV|3194.55|3194.55||
125|61592|61592 - ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE|3992.69|3992.69||
125|61591|61591 - INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI|4271.74|4271.74||
125|61590|61590 - INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN|4082.25|4082.25||
125|61586|61586 - BICORONAL TRANSZYGMTC&/LEFORT I W/O BONE GRFT|2947.27|2947.27||
125|61585|61585 - ORBITOCRANIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ|3804.09|3804.09||
125|61584|61584 - ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ|3266.78|3266.78||
125|61583|61583 - CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE|3760.56|3760.56||
125|61582|61582 - CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT|3404.44|3404.44||
125|61581|61581 - CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ|3517.95|3517.95||
125|61580|61580 - CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ|2891.54|2891.54||
125|61576|61576 - TRNSRL SKUL BSE/BR STM/CORD BX/DCMP/ SPLT TONGUE|3857.68|3857.68||
125|61575|61575 - TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES|3721.46|3721.46||
125|61571|61571 - CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN|3365.31|3365.31||
125|61570|61570 - CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN|3142.72|3142.72||
125|61567|61567 - CRANIOTOMY MULTIPLE SUBPIAL TRANSECTIONS W/ECOG|5812.67|5812.67||
125|61566|61566 - CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY|5093.88|5093.88||
125|61564|61564 - EXC BENIGN TUM CRANIAL BONE W/OPTIC NRV DCMPRN|4374.84|4374.84||
125|61563|61563 - EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN|3556.08|3556.08||
125|61559|61559 - XTN CRNEC MLT SUTR CRANIOSYNOSTOSIS W/BONE GRAFT|3792.64|3792.64||
125|61558|61558 - XTN CRANIECT MULTIPLE SUTURE CRANIOSYNOSTOSIS|3298.71|3298.71||
125|61557|61557 - CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP|3065.85|3065.85||
125|61556|61556 - CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP|2772.25|2772.25||
125|61552|61552 - CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES|2515.74|2515.74||
125|61550|61550 - CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE|1845.7|1845.7||
125|61548|61548 - HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL|3076.79|3076.79||
125|61546|61546 - CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR|3593.23|3593.23||
125|61545|61545 - CRANIOTOMY EXCISION CRANIOPHARYNGIOMA|4353.02|4353.02||
125|61544|61544 - CRANIOTOMY EXCISION/COAGULATION CHOROID PLEXUS|3137.2|3137.2||
125|61543|61543 - CRANIOTOMY PARTIAL/SUBTOTAL HEMISPHERECTOMY|3505.32|3505.32||
125|61541|61541 - CRANIOTOMY TRANSECTION CORPUS CALLOSUM|3741.63|3741.63||
125|61540|61540 - CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG|4966.77|4966.77||
125|61539|61539 - CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/ECOG|3663.78|3663.78||
125|61538|61538 - CRANIOT LOBEC TEMPORAL LOBE W/ELECTROCORTCOGRPHY|3863.98|3863.98||
125|61537|61537 - CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY|4726.4|4726.4||
125|61536|61536 - CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY|3601.1|3601.1||
125|61535|61535 - CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX|1929.25|1929.25||
125|61534|61534 - CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY|2529.92|2529.92||
125|61533|61533 - CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING|2973.19|2973.19||
125|61531|61531 - SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING|2175.63|2175.63||
125|61530|61530 - CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA|4455.66|4455.66||
125|61526|61526 - CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM|4330.49|4330.49||
125|61524|61524 - CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST|3533.24|3533.24||
125|61522|61522 - CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS|3315.05|3315.05||
125|61521|61521 - CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL|4731.38|4731.38||
125|61520|61520 - CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM|4903.54|4903.54||
125|61519|61519 - CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA|4887.88|4887.88||
125|61518|61518 - CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA|4978.04|4978.04||
125|61517|61517 - IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT|247.3|247.3||
125|61516|61516 - CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR|3368.77|3368.77||
125|61514|61514 - CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR|3366.29|3366.29||
125|61512|61512 - CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR|5067.15|5067.15||
125|61510|61510 - CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR|4650.49|4650.49||
125|6150F|6150F - PT NOT RCVNG 1ST COURSE OF ANTI-TNF THERAPY|0.01|0.01||
125|61501|61501 - CRANIECTOMY OSTEOMYELITIS|2229.74|2229.74||
125|61500|61500 - CRANIECTOMY W/EXCISION TUMOR/LESION SKULL|2821.86|2821.86||
125|61480|61480 - CRNEC SUBOCPTL MESENCEPHAL TRCOTOMY/PEDUNCULOTMY|2672.62|2672.62||
125|61460|61460 - CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NR|3409.48|3409.48||
125|61458|61458 - CRNEC SOPL EXPL/DCMPRN CRNL NRV|3477.03|3477.03||
125|61450|61450 - CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION|2887.43|2887.43||
125|61345|61345 - OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA|2558.02|2558.02||
125|61343|61343 - CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD|4212.03|4212.03||
125|61340|61340 - SUBTEMPORAL CRANIAL DECOMPRESSION|2028.19|2028.19||
125|61333|61333 - EXPL ORBIT TRANSCRANIAL APPROACH W/RMVL LESION|3372.24|3372.24||
125|61332|61332 - EXPLORATION ORBIT TRANSCRANIAL APPROACH W/BIOPSY|3346.08|3346.08||
125|61330|61330 - DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH|2276.64|2276.64||
125|61323|61323 - CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY|5193.27|5193.27||
125|61322|61322 - CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY|4328.88|4328.88||
125|61321|61321 - CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL|3035.44|3035.44||
125|61320|61320 - CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL|2896.97|2896.97||
125|61316|61316 - INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF|430.2|430.2||
125|61315|61315 - CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL|3510.06|3510.06||
125|61314|61314 - CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL|4208.1|4208.1||
125|61313|61313 - CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL|4170.06|4170.06||
125|61312|61312 - CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL|4755.08|4755.08||
125|61305|61305 - CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL|3764.51|3764.51||
125|61304|61304 - CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL|3297.54|3297.54||
125|61253|61253 - BURR HOLE/TREPHINE INFRATENTORIAL UNI/BI|1741.04|1741.04||
125|61250|61250 - BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG|1257|1257||
125|61215|61215 - INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH|1048.43|1048.43||
125|61210|61210 - BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE|894.48|894.48||
125|61156|61156 - BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL|2504.34|2504.34||
125|61154|61154 - BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL|2164.81|2164.81||
125|61151|61151 - BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST|898.49|898.49||
125|61150|61150 - BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST|2194.12|2194.12||
125|61140|61140 - BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION|2257.36|2257.36||
125|61120|61120 - BURR HOLE VENTRICULAR PUNCTURE|919.27|919.27||
125|6110F|6110F - COUNSELING PROV RE RISKS DRIVING ALT TO DRIVING|0.01|0.01||
125|61108|61108 - TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA|1782.3|1782.3||
125|61107|61107 - TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE|1562.2|1562.2||
125|61105|61105 - TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE|968.07|968.07||
125|61070|61070 - PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX|135.43|135.43||
125|61055|61055 - CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION|287.94|287.94||
125|61050|61050 - CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX|170.71|170.71||
125|6102F|6102F - SAFETY COUNSELING DEMENTIA ORDERED|0.01|0.01||
125|61026|61026 - VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ|276.06|276.06||
125|61020|61020 - VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX|190.16|190.16||
125|6101F|6101F - SAFETY COUNSELING DEMENTIA PROVIDED|0.01|0.01||
125|6100F|6100F - VERIFY CORRECT PT SITE PXD DOCUMENTED|0.01|0.01||
125|61001|61001 - SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI SBSQ|150.05|150.05||
125|61000|61000 - SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT|174.45|174.45||
125|6090F|6090F - PATIENT SAFETY COUNSEL DISEASE STAGE APPROPRIATE|0.01|0.01||
125|6080F|6080F - PATIENT QUERIED ABOUT FALLS|0.01|0.01||
125|6070F|6070F - PATIENT QUERIED COUNSELED RE AED SIDE EFFECTS|0.01|0.01||
125|60650|60650 - LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL|1803.41|1803.41||
125|60605|60605 - EXC CAROTID BODY TUMOR W EXC CAROTID ARTERY|2313.63|2313.63||
125|60600|60600 - EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY|1945.8|1945.8||
125|60545|60545 - ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR|2252.89|2252.89||
125|60540|60540 - ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX|1918.24|1918.24||
125|60522|60522 - THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX|2384.5|2384.5||
125|60521|60521 - THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX|2005.34|2005.34||
125|60520|60520 - THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX|2031.93|2031.93||
125|60512|60512 - PARATHYROID AUTOTRANSPLANTATION ADD-ON|435.22|435.22||
125|60505|60505 - PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC|2238.53|2238.53||
125|60502|60502 - PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR|1891.57|1891.57||
125|60500|60500 - PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS|1856.45|1856.45||
125|6045F|6045F - RAD EXPOS/TIME IN LAST RPRT FLUORO PRXD DOCD|0.01|0.01||
125|6040F|6040F - USE APPROP RAD DOSE RDXN DEV/MAN TECHS DOCD|0.01|0.01||
125|6030F|6030F - ALL ELEM OF MAX STERILE BARRIER TECHNQ FLWD|0.01|0.01||
125|60300|60300 - ASPIRATION AND/OR INJECTION THYROID CYST|184.12|184.12||
125|60281|60281 - EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT|1050.65|1050.65||
125|60280|60280 - EXCISION THYROGLOSSAL DUCT CYST/SINUS|879.11|879.11||
125|60271|60271 - THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH|1717.47|1717.47||
125|60270|60270 - THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC|2139.32|2139.32||
125|60260|60260 - THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL|1408.44|1408.44||
125|60254|60254 - THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT|2772.82|2772.82||
125|60252|60252 - THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT|2079.01|2079.01||
125|60240|60240 - THYROIDECTOMY TOTAL/COMPLETE|1802.95|1802.95||
125|60225|60225 - TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC|1593.5|1593.5||
125|60220|60220 - TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY|1290.52|1290.52||
125|60212|60212 - PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC|1603.16|1603.16||
125|60210|60210 - PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY|1326.26|1326.26||
125|6020F|6020F - NOTHING BY MOUTH ORDERED|0.01|0.01||
125|60200|60200 - EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS|979.32|979.32||
125|6015F|6015F - PATIENT OK FOR PER ORAL INTAKE (FOOD/MEDICATION)|0.01|0.01||
125|6010F|6010F - DYSPHAGIA SCREENING PRIOR ORAL INTAKE|0.01|0.01||
125|60100|60100 - BIOPSY THYROID PERCUTANEOUS CORE NEEDLE|138.03|138.03||
125|6005F|6005F - RATIONALE FOR LEVEL OF CARE DOCUMENTED|0.01|0.01||
125|60000|60000 - I&D THYROGLOSSAL DUCT CYST INFECTED|153.75|153.75||
125|59871|59871 - REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA|209.28|209.28||
125|59870|59870 - UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE|533.71|533.71||
125|59866|59866 - MULTIFETAL PREGNANCY REDUCTION|361.07|361.07||
125|59857|59857 - INDUCED ABORT 1/> VAG SUPPOS DLVR FETUS HYSTOT|1057.88|1057.88||
125|59856|59856 - INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC|746.54|746.54||
125|59855|59855 - INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS|608.31|608.31||
125|59852|59852 - INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS HYSTOTM|1140.76|1140.76||
125|59851|59851 - INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS D&C|804.6|804.6||
125|59850|59850 - INDUCED ABORTION 1/> AMNIOTIC INJX W/D&C/EVACJ|721.51|721.51||
125|59841|59841 - INDUCED ABORTION DILATION & EVACUATION|576.97|576.97||
125|59840|59840 - INDUCED ABORTION DILATION AND CURETTAGE|611.88|611.88||
125|59830|59830 - TX SEPTIC ABORTION SURGICAL|738.81|738.81||
125|59821|59821 - TX MISSED ABORTION SECOND TRIMESTER SURGICAL|530.89|530.89||
125|59820|59820 - TX MISSED ABORTION FIRST TRIMESTER SURGICAL|532.84|532.84||
125|59812|59812 - TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL|457.42|457.42||
125|59622|59622 - CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA|2009.46|2009.46||
125|59620|59620 - CESAREAN DELIVERY ATTEMPTED VBAC|1873.07|1873.07||
125|59618|59618 - ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC|3590.27|3590.27||
125|59614|59614 - VAGINAL DELIVERY & POSTPARTUM CARE VBAC|1786.61|1786.61||
125|59612|59612 - VAGINAL DELIVERY AFTER CESAREAN DELIVERY|1624.83|1624.83||
125|59610|59610 - ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB|3219.79|3219.79||
125|59525|59525 - STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY|721.69|721.69||
125|59515|59515 - CESAREAN DELIVERY ONLY W/POSTPARTUM CARE|1857.25|1857.25||
125|59514|59514 - CESAREAN DELIVERY ONLY|1714.94|1714.94||
125|59510|59510 - OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM|2961.92|2961.92||
125|59430|59430 - POSTPARTUM CARE ONLY SEPARATE PROCEDURE|149.95|149.95||
125|59426|59426 - ANTEPARTUM CARE ONLY 7/> VISITS|835.14|835.14||
125|59425|59425 - ANTEPARTUM CARE ONLY 4-6 VISITS|487.12|487.12||
125|59414|59414 - DELIVERY PLACENTA SEPARATE PROCEDURE|202.03|202.03||
125|59412|59412 - EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS|273.65|273.65||
125|59410|59410 - VAGINAL DELIVERY ONLY W/POSTPARTUM CARE|1607.68|1607.68||
125|59409|59409 - VAGINAL DELIVERY ONLY|1470.98|1470.98||
125|59400|59400 - OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM|2764.5|2764.5||
125|59350|59350 - HYSTERORRHAPHY RUPTURED UTERUS|950.49|950.49||
125|59325|59325 - CERCLAGE CERVIX PREGNANCY ABDOMINAL|643.71|643.71||
125|59320|59320 - CERCLAGE CERVIX PREGNANCY VAGINAL|291.34|291.34||
125|59300|59300 - EPISIOTOMY/VAG RPR OTH/THN ATTENDING|255.68|255.68||
125|59200|59200 - INSERTION CERVICAL DILATOR SEPARATE PROCEDURE|145.51|145.51||
125|59160|59160 - CURETTAGE POSTPARTUM|392.23|392.23||
125|59151|59151 - LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY|1033.48|1033.48||
125|59150|59150 - LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY|794.38|794.38||
125|59140|59140 - TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION|984.9|984.9||
125|59136|59136 - TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER|1345.78|1345.78||
125|59135|59135 - TX ECTOPIC PREGNANCY NTRSTL REQ TOT HYST|1593.29|1593.29||
125|59130|59130 - TX ECTOPIC PREGNANCY ABDL PREGNANCY|1128.39|1128.39||
125|59121|59121 - TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY|969.03|969.03||
125|59120|59120 - TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR|1141.27|1141.27||
125|59100|59100 - HYSTEROTOMY ABDOMINAL|1093.78|1093.78||
125|59076|59076 - FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE|1236.49|1236.49||
125|59074|59074 - FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE|989.19|989.19||
125|59072|59072 - FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE|1236.49|1236.49||
125|59070|59070 - TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE|1037.73|1037.73||
125|59051|59051 - FETAL MONITR LABOR PHYS WRTTN REPRT INTERPJ ONLY|81.03|81.03||
125|59050|59050 - FETAL MONITORING LABOR PHYS WRITTEN REPORT|120.18|120.18||
125|59030|59030 - FETAL SCALP BLOOD SAMPLING|185.27|185.27||
125|59025|59025 - FETAL NONSTRESS TEST|74.1|74.1||58.85
125|59020|59020 - FETAL CONTRACTION STRESS TEST|117.28|117.28||69.38
125|59015|59015 - CHORIONIC VILLUS SAMPLING|207.31|207.31||
125|59012|59012 - CORDOCENTESIS INTRAUTERINE|380.56|380.56||
125|59001|59001 - AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID|494.6|494.6||
125|59000|59000 - AMNIOCENTESIS DIAGNOSIC|151.4|151.4||
125|58976|58976 - GAMETE ZYGOTE/EMBRYO FALLOPIAN TRANSFER ANY METH|681.78|681.78||
125|58974|58974 - EMBRYO TRANSFER INTRAUTERINE|802.5|802.5||
125|58970|58970 - FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD|1070|1070||
125|58960|58960 - LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK|1728.79|1728.79||
125|58958|58958 - RESECTION RECRT MAL W/OMENTECTOMY PEL LMPHADEC|2879.96|2879.96||
125|58957|58957 - RESECJ RECUR OVARIAN/TUBAL/PERITONEAL MALIGNANCY|2600.06|2600.06||
125|58956|58956 - BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC|1367.28|1367.28||
125|58954|58954 - BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY|6503.72|6503.72||
125|58953|58953 - BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION|5984.62|5984.62||
125|58952|58952 - RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING|2794.18|2794.18||
125|58951|58951 - RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD|2673.32|2673.32||
125|58950|58950 - RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO|1759.58|1759.58||
125|58943|58943 - OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY|1903.66|1903.66||
125|58940|58940 - OOPHORECTOMY PARTIAL/TOTAL UNI/BI|907.95|907.95||
125|58925|58925 - OVARIAN CYSTECTOMY UNI/BI|1007.39|1007.39||
125|58920|58920 - WEDGE RESCJ/BISCTJ OVARY UNI/BI|1057.94|1057.94||
125|58900|58900 - BIOPSY OVARY UNI/BI SEPARATE PROCEDURE|959.65|959.65||
125|58825|58825 - TRANSPOSITION OVARY|1168.23|1168.23||
125|58822|58822 - DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH|968.3|968.3||
125|58820|58820 - DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN|625.9|625.9||
125|58805|58805 - DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL|1012.73|1012.73||
125|58800|58800 - DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR|520.79|520.79||
125|58770|58770 - SALPINGOSTOMY|1100.02|1100.02||
125|58760|58760 - FIMBRIOPLASTY|1675.23|1675.23||
125|58752|58752 - TUBOUTERINE IMPLANTATION|1992.49|1992.49||
125|58750|58750 - TUBOTUBAL ANASTATOMOSIS|1733.07|1733.07||
125|58740|58740 - LYSIS OF ADHESIONS SALPINX/OVARY|887.32|887.32||
125|58720|58720 - SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX|1061.65|1061.65||
125|58700|58700 - SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX|967.32|967.32||
125|58674|58674 - LAPS ABLTJ UTERINE FIBROIDS W/INTRAOP US GDN|1311.82|1311.82||
125|58673|58673 - LAPAROSCOPY SALPINGOSTOMY|2248.49|2248.49||
125|58672|58672 - LAPAROSCOPY FIMBRIOPLASTY|2082.09|2082.09||
125|58671|58671 - LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS|583.19|583.19||
125|58670|58670 - LAPAROSCOPY FULGURATION OVIDUCTS|1288.32|1288.32||
125|58662|58662 - LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE|2782|2782||
125|58661|58661 - LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES|1823.32|1823.32||
125|58660|58660 - LAPAROSCOPY W/LYSIS OF ADHESIONS|1007.98|1007.98||
125|58615|58615 - OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR|697.24|697.24||
125|58611|58611 - LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG|85.86|85.86||
125|58605|58605 - LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX|509.5|509.5||
125|58600|58600 - LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI|760.49|760.49||
125|58575|58575 - LAPS TOT HYSTERECTOMY RESJ MALIGNANCY W/OMNTC|3073.07|3073.07||
125|58573|58573 - LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR|1989.17|1989.17||
125|58572|58572 - LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM|1666.43|1666.43||
125|58571|58571 - LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY|1463.09|1463.09||
125|58570|58570 - LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<|1264.36|1264.36||
125|58565|58565 - HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS|2103.81|2103.81||
125|58563|58563 - HYSTEROSCOPY ENDOMETRIAL ABLATION|2288.43|2288.43||
125|58562|58562 - HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY|865.07|865.07||
125|58561|58561 - HYSTEROSCOPY REMOVAL LEIOMYOMATA|860.32|860.32||
125|58560|58560 - HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM|609.94|609.94||
125|58559|58559 - HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS|876.78|876.78||
125|58558|58558 - HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C|464.42|464.42||
125|58555|58555 - HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE|460.15|460.15||
125|58554|58554 - LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR|2696.4|2696.4||
125|58553|58553 - LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS|2354|2354||
125|58552|58552 - LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES|2000.9|2000.9||
125|58550|58550 - LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<|2782|2782||
125|58548|58548 - LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY|3295.15|3295.15||
125|58546|58546 - LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS|2172.53|2172.53||
125|58545|58545 - LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<|1805.05|1805.05||
125|58544|58544 - LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY|1884.79|1884.79||
125|58543|58543 - LAPS SUPRACERVICAL HYSTERECTOMY >250|1740.11|1740.11||
125|58542|58542 - LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR|1710.89|1710.89||
125|58541|58541 - LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<|1545.71|1545.71||
125|58540|58540 - HYSTEROPLASTY RPR UTERINE ANOMALY|1273.81|1273.81||
125|58520|58520 - HYSTERORRHAPHY REPAIR RUPT UTERUS NONOBSTETRICAL|936.57|936.57||
125|58410|58410 - UTERINE SUSP W/WO SHORT LIGAMNTS W/SYMPATHECTOMY|1239.43|1239.43||
125|58400|58400 - UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX|982.37|982.37||
125|58356|58356 - ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR|802.49|802.49||
125|58353|58353 - ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID|2145.4|2145.4||
125|58350|58350 - CHROMOTUBATION OVIDUCT W/MATERIALS|118.24|118.24||
125|58346|58346 - INSERTION HEYMAN CAPSULES CLINICAL BRACHYTHERAPY|1236.49|1236.49||
125|58345|58345 - TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING|494.05|494.05||
125|58340|58340 - CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI|220.2|220.2||
125|58323|58323 - SPERM WASHING ARTIFICIAL INSEMINATION|29.46|29.46||
125|58322|58322 - ARTIFICIAL INSEMINATION INTRA-UTERINE|119.84|119.84||
125|58321|58321 - ARTIFICIAL INSEMINATION INTRA-CERVICAL|111.68|111.68||
125|58301|58301 - REMOVAL INTRAUTERINE DEVICE IUD|104.58|104.58||
125|58300|58300 - INSERTION INTRAUTERINE DEVICE IUD|123.94|123.94||
125|58294|58294 - VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE|2916.73|2916.73||
125|58293|58293 - VAG HYST >250 GM COLPOURTCSTOPEXY W/WO NDSC CTR|3466.8|3466.8||
125|58292|58292 - VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE|3263.41|3263.41||
125|58291|58291 - VAG HYST > 250 GM RMVL TUBE&/OVARY|3462.18|3462.18||
125|58290|58290 - VAGINAL HYSTERECTOMY UTERUS > 250 GM|3274.97|3274.97||
125|58285|58285 - VAGINAL HYSTERECTOMY RADICAL SCHAUTA OPERATION|2223.63|2223.63||
125|58280|58280 - VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE|1733.94|1733.94||
125|58275|58275 - VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY|1840.31|1840.31||
125|58270|58270 - VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE|1580.93|1580.93||
125|58267|58267 - VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY|1757.91|1757.91||
125|58263|58263 - VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL|1696.31|1696.31||
125|58262|58262 - VAG HYST 250 GM/< W/RMVL TUBE&/OVARY|1567.02|1567.02||
125|58260|58260 - VAGINAL HYSTERECTOMY UTERUS 250 GM/<|2514.5|2514.5||
125|58240|58240 - PEL EXNTJ GYNECOLOGIC MAL|4175.07|4175.07||
125|58210|58210 - RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY|2985.63|2985.63||
125|58200|58200 - TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM|2300.85|2300.85||
125|58180|58180 - SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY|1449.09|1449.09||
125|58152|58152 - TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY|1802.27|1802.27||
125|58150|58150 - TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY|2247|2247||
125|58146|58146 - MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA|2588.54|2588.54||
125|58145|58145 - MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR|1163.36|1163.36||
125|58140|58140 - MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR|1284.67|1284.67||
125|58120|58120 - DILATION & CURETTAGE DX&/THER NONOBSTETRIC|378.78|378.78||
125|58110|58110 - ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY|90.62|90.62||
125|58100|58100 - ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX|116.31|116.31||
125|57800|57800 - DILATION CERVICAL CANAL INSTRUMENTAL SPX|94.75|94.75||
125|57720|57720 - TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG|503.75|503.75||
125|57700|57700 - CERCLAGE UTERINE CERVIX NONOBSTETRICAL|476.11|476.11||
125|57558|57558 - DILATION & CURETTAGE CERVICAL STUMP|294.09|294.09||
125|57556|57556 - EXC CRV STUMP VAG APPR W/RPR NTRCL|1292.62|1292.62||
125|57555|57555 - EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR|1341.87|1341.87||
125|57550|57550 - EXCISION CERVICAL STUMP VAGINAL APPROACH|977.42|977.42||
125|57545|57545 - EXC CERVICAL STUMP ABDL APPR W/PELVIC FLOOR RPR|1195.75|1195.75||
125|57540|57540 - EXCISION CERVICAL STUMP ABDOMINAL APPROACH|1121.05|1121.05||
125|57531|57531 - RAD TRACHELECTOMY W/BI PEL LMPHADEC|2838.65|2838.65||
125|57530|57530 - TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX|574.5|574.5||
125|57522|57522 - CONIZATION CERVIX W/WO D&C RPR ELTRD EXC|449.94|449.94||
125|57520|57520 - CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER|493.54|493.54||
125|57513|57513 - CAUTERY CERVIX LASER ABLATION|425.27|425.27||
125|57511|57511 - CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT|182.7|182.7||
125|57510|57510 - CAUTERY CERVIX ELECTRO/THERMAL|181.73|181.73||
125|57505|57505 - ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C|111.83|111.83||
125|57500|57500 - BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX|138.1|138.1||
125|57461|57461 - COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX|373.31|373.31||
125|57460|57460 - COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX|336.94|336.94||
125|57456|57456 - COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE|285.74|285.74||
125|57455|57455 - COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX|300.46|300.46||
125|57454|57454 - COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE|175.21|175.21||
125|57452|57452 - COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA|118.5|118.5||
125|57426|57426 - REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC|1355.64|1355.64||
125|57425|57425 - LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX|1731.09|1731.09||
125|57423|57423 - PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH|1478.46|1478.46||
125|57421|57421 - COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX|277.34|277.34||
125|57420|57420 - COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT|184.9|184.9||
125|57415|57415 - REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL|168.04|168.04||
125|57410|57410 - PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL|149.51|149.51||
125|57400|57400 - DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL|180.02|180.02||
125|57335|57335 - VAGINOPLASTY INTERSEX STATE|1154.93|1154.93||
125|57330|57330 - CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR|1439.75|1439.75||
125|57320|57320 - CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH|1260.05|1260.05||
125|57311|57311 - CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL|1455.31|1455.31||
125|57310|57310 - CLOSURE URETHROVAGINAL FISTULA|1038.4|1038.4||
125|57308|57308 - CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ|1351.67|1351.67||
125|57307|57307 - CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST|1521.14|1521.14||
125|57305|57305 - CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH|1451.18|1451.18||
125|57300|57300 - CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR|1070.13|1070.13||
125|57296|57296 - REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR|1853.38|1853.38||
125|57295|57295 - REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP|965.03|965.03||
125|57292|57292 - CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT|1698.13|1698.13||
125|57291|57291 - CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT|1006.87|1006.87||
125|57289|57289 - PEREYRA PX W/ANTERIOR COLPORRHAPHY|1142.83|1142.83||
125|57288|57288 - SLING OPERATION STRESS INCONTINENCE|1538.27|1538.27||
125|57287|57287 - RMVL/REVJ SLING STRESS INCONTINENCE|1786.56|1786.56||
125|57285|57285 - PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH|1088.95|1088.95||
125|57284|57284 - PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR|1562.2|1562.2||
125|57283|57283 - COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH|690.9|690.9||
125|57282|57282 - COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH|1245.45|1245.45||
125|57280|57280 - COLPOPEXY ABDOMINAL APPROACH|1327.59|1327.59||
125|57270|57270 - REPAIR ENTEROCELE ABDOMINAL APPROACH SPX|1085.47|1085.47||
125|57268|57268 - REPAIR ENTEROCELE VAGINAL APPROACH SPX|920.13|920.13||
125|57267|57267 - INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE|293.42|293.42||
125|57265|57265 - CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR|1277.8|1277.8||
125|57260|57260 - CMBND ANTERPOST COLPORRAPHY W/CYSTO|1132.35|1132.35||
125|57250|57250 - POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY|805.72|805.72||
125|57240|57240 - ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO|866.67|866.67||
125|57230|57230 - PLASTIC REPAIR URETHROCELE|627.36|627.36||
125|57220|57220 - PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH|667.64|667.64||
125|57210|57210 - COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU|589.3|589.3||
125|57200|57200 - COLPORRHAPHY SUTURE INJURY VAGINA|507.78|507.78||
125|57180|57180 - INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX|151.65|151.65||
125|57170|57170 - DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS|94.14|94.14||
125|57160|57160 - FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI|78.58|78.58||
125|57156|57156 - INSERTION VAGINAL RADIATION DEVICE|319.2|319.2||
125|57155|57155 - INSERTION UTERINE TANDEM&/VAGINAL OVOIDS|1162.3|1162.3||
125|57150|57150 - IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE|64.19|64.19||
125|57135|57135 - EXCISION VAGINAL CYST/TUMOR|360.11|360.11||
125|57130|57130 - EXCISION VAGINAL SEPTUM|377.38|377.38||
125|57120|57120 - COLPOCLEISIS LE FORT TYPE|1051.6|1051.6||
125|57112|57112 - VAGNC COMPL RMVL VAG WALL TOT PEL LMPHADEC BX|2341.14|2341.14||
125|57111|57111 - VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS|1856.17|1856.17||
125|57110|57110 - VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL|1328.2|1328.2||
125|57109|57109 - VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC|2014.29|2014.29||
125|57107|57107 - VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T|1517.09|1517.09||
125|57106|57106 - VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL|522.2|522.2||
125|57105|57105 - BIOPSY VAGINAL MUCOSA EXTENSIVE|226.05|226.05||
125|57100|57100 - BIOPSY VAGINAL MUCOSA SIMPLE|107.8|107.8||
125|57065|57065 - DESTRUCTION VAGINAL LESIONS EXTENSIVE|501.74|501.74||
125|57061|57061 - DESTRUCTION VAGINAL LESIONS SIMPLE|214.83|214.83||
125|57023|57023 - I&D VAGINAL HEMATOMA NON-OBSTETRICAL|323.57|323.57||
125|57022|57022 - I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM|323.57|323.57||
125|57020|57020 - COLPOCENTESIS SEPARATE PROCEDURE|133.87|133.87||
125|57010|57010 - COLPOTOMY W/DRAINAGE PELVIC ABSCESS|559.61|559.61||
125|57000|57000 - COLPOTOMY W/EXPLORATION|375.18|375.18||
125|56821|56821 - COLPOSCOPY VULVA W/BIOPSY|277.34|277.34||
125|56820|56820 - COLPOSCOPY VULVA|184.9|184.9||
125|56810|56810 - PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX|489.88|489.88||
125|56805|56805 - CLITOROPLASTY INTERSEX STATE|1553.35|1553.35||
125|56800|56800 - PLASTIC REPAIR INTROITUS|479.24|479.24||
125|56740|56740 - EXC BARTHOLINS GLAND/CYST|446.83|446.83||
125|56700|56700 - PRTL HYMENECTOMY/REVJ HYMENAL RING|312.66|312.66||
125|56640|56640 - VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY|2899.84|2899.84||
125|56637|56637 - VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY|2980.74|2980.74||
125|56634|56634 - VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY|2683.27|2683.27||
125|56633|56633 - VULVECTOMY RADICAL COMPLETE|2139.23|2139.23||
125|56632|56632 - VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY|2740.95|2740.95||
125|56631|56631 - VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY|2368.18|2368.18||
125|56630|56630 - VULVECTOMY RADICAL PARTIAL|1742.5|1742.5||
125|56625|56625 - VULVECTOMY SIMPLE COMPLETE|1208.3|1208.3||
125|56620|56620 - VULVECTOMY SIMPLE PARTIAL|925.45|925.45||
125|56606|56606 - BIOPSY VULVA/PERINEUM EACH ADDL LESION|58.07|58.07||
125|56605|56605 - BIOPSY VULVA/PERINEUM 1 LESION SPX|109.57|109.57||
125|56515|56515 - DESTRUCTION LESIONS VULVA EXTENSIVE|447.61|447.61||
125|56501|56501 - DESTRUCTION LESIONS VULVA SIMPLE|140.44|140.44||
125|56442|56442 - HYMENOTOMY SIMPLE INCISION|106.58|106.58||
125|56441|56441 - LYSIS LABIAL ADHESIONS|192.6|192.6||
125|56440|56440 - MARSUPIALIZATION BARTHOLINS GLAND CYST|480.43|480.43||
125|56420|56420 - I&D OF BARTHOLINS GLAND ABSCESS|147.09|147.09||
125|56405|56405 - I&D VULVA/PERINEAL ABSCESS|142.62|142.62||
125|55980|55980 - INTERSEX SURG FEMALE MALE|4118.86|4118.86||
125|55970|55970 - INTERSEX SURG MALE FEMALE|7470.17|7470.17||
125|55920|55920 - PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL|740.9|740.9||
125|55876|55876 - PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT|222.44|222.44||
125|55875|55875 - TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ|1490.64|1490.64||
125|55874|55874 - TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX|5586.3|5586.3||
125|55873|55873 - CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI|2724.9|2724.9||
125|55870|55870 - ELECTROEJACULATION|252.09|252.09||
125|55866|55866 - LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT|3214.88|3214.88||
125|55865|55865 - EXPOS PROSTATE INSJ RADIOAC SBST W/BI PELV LYMPH|2719.04|2719.04||
125|55862|55862 - EXPOS PROSTATE INSJ RADIOACT SBST W/LYMPH BX|1652.34|1652.34||
125|55860|55860 - EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST|1353.2|1353.2||
125|55845|55845 - PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM|4494|4494||
125|55842|55842 - PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX|2682.99|2682.99||
125|55840|55840 - PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING|2515.55|2515.55||
125|55831|55831 - PROSTATECTOMY RETROPUBIC SUBTOTAL|1923.67|1923.67||
125|55821|55821 - PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES|2247|2247||
125|55815|55815 - PROSTATECTOMY PERINEAL RAD W/BI PELVIC LYMPH EXC|3590.29|3590.29||
125|55812|55812 - PROSTATECTOMY PERINEAL RADICAL W/LYMPH NODE BX|2961.66|2961.66||
125|55810|55810 - PROSTATECTOMY PERINEAL RADICAL|2556.58|2556.58||
125|55801|55801 - PROSTATECTOMY PERINEAL SUBTOTAL|1937.04|1937.04||
125|55725|55725 - PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED|1105.47|1105.47||
125|55720|55720 - PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE|736.79|736.79||
125|55706|55706 - BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID|613.25|613.25||
125|55705|55705 - BIOPSY PROSTATE INCISIONAL ANY APPROACH|625.91|625.91||
125|55700|55700 - PROSTATE NEEDLE BIOPSY ANY APPROACH|294.25|294.25||
125|55680|55680 - EXCISION MULLERIAN DUCT CYST|1198.43|1198.43||
125|55650|55650 - VESICULECTOMY ANY APPROACH|1508.9|1508.9||
125|55605|55605 - VESICULOTOMY COMPLICATED|1062.88|1062.88||
125|55600|55600 - VESICULOTOMY|717.21|717.21||
125|55550|55550 - LAPS LIGATION SPERMATIC VEINS VARICOCELE|858.38|858.38||
125|55540|55540 - EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR|835.11|835.11||
125|55535|55535 - EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL|798.07|798.07||
125|55530|55530 - EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX|734.89|734.89||
125|55520|55520 - EXC LESION SPERMATIC CORD SEPARATE PROCEDURE|587.5|587.5||
125|55500|55500 - EXC HYDROCELE SPRMATIC CORD UNI SPX|596|596||
125|55450|55450 - LIGATION PRQ VAS DEFERENS UNI/BI SPX|432.15|432.15||
125|55400|55400 - VASOVASOSTOMY VASOVASORRHAPHY|1147.5|1147.5||
125|55300|55300 - VASOTOMY VASOGRAMS UNI/BI|353.14|353.14||
125|55250|55250 - VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS|910.39|910.39||
125|55200|55200 - VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX|624.33|624.33||
125|55180|55180 - SCROTOPLASTY COMPLICATED|1123.86|1123.86||
125|55175|55175 - SCROTOPLASTY SIMPLE|681.54|681.54||
125|55150|55150 - RESECTION SCROTUM|858.7|858.7||
125|55120|55120 - REMOVAL FOREIGN BODY SCROTUM|423.41|423.41||
125|55110|55110 - SCROTAL EXPLORATION|590.12|590.12||
125|55100|55100 - DRAINAGE SCROTAL WALL ABSCESS|258.38|258.38||
125|55060|55060 - RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE|599.82|599.82||
125|55041|55041 - EXCISION HYDROCELE BILATERAL|1063.9|1063.9||
125|55040|55040 - EXCISION HYDROCELE UNILATERAL|749|749||
125|55000|55000 - PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED|136.89|136.89||
125|54901|54901 - EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI|1818.97|1818.97||
125|54900|54900 - EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI|1308.34|1308.34||
125|54865|54865 - EXPLORATION EPIDIDYMIS W/WO BIOPSY|540.16|540.16||
125|54861|54861 - EPIDIDYMECTOMY BILATERAL|976.7|976.7||
125|54860|54860 - EPIDIDYMECTOMY UNILATERAL|829.25|829.25||
125|54840|54840 - EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY|749|749||
125|54830|54830 - EXCISION LOCAL LESION EPIDIDYMIS|562.48|562.48||
125|54800|54800 - BIOPSY EPIDIDYMIS NEEDLE|283.48|283.48||
125|54700|54700 - I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE|336.75|336.75||
125|54692|54692 - LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS|1125.67|1125.67||
125|54690|54690 - LAPAROSCOPY SURGICAL ORCHIECTOMY|1163.06|1163.06||
125|54680|54680 - TRANSPLANTATION TESTIS TO THIGH|1225.18|1225.18||
125|54670|54670 - SUTURE/REPAIR TESTICULAR INJURY|713.86|713.86||
125|54660|54660 - INSJ TESTICULAR PROSTH SEPARATE PROCEDURE|473.71|473.71||
125|54650|54650 - ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS|1178.84|1178.84||
125|54640|54640 - ORCHIOPEXY INGUINAL OR SCROTAL APPROACH|1230.5|1230.5||
125|54620|54620 - FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE|464.58|464.58||
125|54600|54600 - RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS|1230.5|1230.5||
125|54560|54560 - EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL|1186.2|1186.2||
125|54550|54550 - EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA|818.36|818.36||
125|54535|54535 - ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL|1269.01|1269.01||
125|54530|54530 - ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH|946.42|946.42||
125|54522|54522 - ORCHIECTOMY PARTIAL|1328.94|1328.94||
125|54520|54520 - ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH|695.5|695.5||
125|54512|54512 - EXC XTRPARENCHYMAL LESION TESTIS|1167.16|1167.16||
125|54505|54505 - BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE|325.19|325.19||
125|54500|54500 - BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE|174.07|174.07||
125|54450|54450 - FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING|123.49|123.49||
125|54440|54440 - PLASTIC OPERATION PENIS INJURY|1363.75|1363.75||
125|54438|54438 - REPLANTATION PENIS COMP AMPUTATION W/URETH REP|2217.79|2217.79||
125|54437|54437 - REPAIR OF TRAUMATIC CORPOREAL TEAR(S)|1112.02|1112.02||
125|54435|54435 - CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM|723.02|723.02||
125|54430|54430 - CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI|1139.59|1139.59||
125|54420|54420 - CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI|1231.14|1231.14||
125|54417|54417 - RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD|1916.56|1916.56||
125|54416|54416 - RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI|1323.06|1323.06||
125|54415|54415 - RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT|1236.49|1236.49||
125|54411|54411 - RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL|2404.97|2404.97||
125|54410|54410 - RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS|1731.09|1731.09||
125|54408|54408 - RPR COMPONENT INFLATABLE PENILE PROSTHESIS|1483.79|1483.79||
125|54406|54406 - RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH|1557.98|1557.98||
125|54405|54405 - INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH|2211.64|2211.64||
125|54401|54401 - INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED|1573.71|1573.71||
125|54400|54400 - INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID|1336.91|1336.91||
125|54390|54390 - PLASTIC RPR PENIS EPISPADIAS W/EXSTROPHY BLADDER|2328.2|2328.2||
125|54385|54385 - PLASTIC PENIS EPISPADIAS DSTL SPHNCTR W/INCONT|1808.81|1808.81||
125|54380|54380 - PLASTIC RPR PENIS EPISPADIAS DSTL SPHNCTR|1401.42|1401.42||
125|54360|54360 - PLASTIC RPR PENIS CORRECT ANGULATION|1268.11|1268.11||
125|54352|54352 - RPR HYPOSPADIAS CRIPPLE W/DSJ & EXC & GRFS/FLAP|2651.36|2651.36||
125|54348|54348 - RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF|1832.62|1832.62||
125|54344|54344 - RPR HYPOSPADIAS COMPLCTJS MOBLJ FLAPS & URTP|1843.44|1843.44||
125|54340|54340 - RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE|1075.92|1075.92||
125|54336|54336 - 1 STG PERINEAL HYPOSPADIAS RPR W/GRF&/FLAP|2425.75|2425.75||
125|54332|54332 - 1 STAGE PROX PENILE/PENOSCROTAL HYPOSPADIAS RPR|1967.33|1967.33||
125|54328|54328 - 1 STAGE DSTL HYPOSPADIAS RPR W/EXTENSIVE DSJ|1834.78|1834.78||
125|54326|54326 - 1 STG DSTL HYPOSPADIAS RPR URTP SKN FLAPS|1671.73|1671.73||
125|54324|54324 - 1 STG DSTL HYPOSPADIAS RPR W/URTP SKIN FLAPS|1636.94|1636.94||
125|54322|54322 - 1 STG DSTL HYPOSPADIAS RPR W/SMPL MEATAL ADVMNT|1295.63|1295.63||
125|54318|54318 - URETHROPLASTY 3RD STG HYPOSPADIAS RPR RLS PENIS|1122.67|1122.67||
125|54316|54316 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR SKIN GRF|1893.12|1893.12||
125|54312|54312 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR > 3 CM|1630.67|1630.67||
125|54308|54308 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR <3 CM|1366.83|1366.83||
125|54304|54304 - PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR|1342.85|1342.85||
125|54300|54300 - PENIS STRAIGHTENING CHORDEE|1020.68|1020.68||
125|54250|54250 - NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST|129.62|129.62||123.58
125|54240|54240 - PENILE PLETHYSMOGRAPHY|191.54|191.54||91.69
125|54235|54235 - NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT|86.11|86.11||
125|54231|54231 - DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS|253.93|253.93||
125|54230|54230 - INJECTION CORPORA CAVERNOSOGRAPY|156.89|156.89||
125|54220|54220 - IRRIGATION CORPORA CAVERNOSA PRIAPISM|481.5|481.5||
125|54205|54205 - NJX PEYRONIE W/SURG EXPOS PLAQUE|789.01|789.01||
125|54200|54200 - INJECTION PEYRONIE DISEASE|110.94|110.94||
125|54164|54164 - FRENULOTOMY PENIS|174.27|174.27||
125|54163|54163 - REPAIR INCOMPLETE CIRCUMCISION|201.8|201.8||
125|54162|54162 - LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS|296.58|296.58||
125|54161|54161 - CIRCUMCISION AGE >28 DAYS|561.75|561.75||
125|54160|54160 - CIRCUMCISION NEONATE|296.39|296.39||
125|54150|54150 - CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK|444.91|444.91||
125|54135|54135 - AMPUTATION PENIS RADICAL W/LYMPH NODES|3036.92|3036.92||
125|54130|54130 - AMPUTATION PENIS RADW/BI INGUINOFEMORAL LMPHADE|2447.2|2447.2||
125|54125|54125 - AMPUTATION PENIS COMPLETE|1760.64|1760.64||
125|54120|54120 - AMPUTATION PENIS PARTIAL|986.41|986.41||
125|54115|54115 - REMOVAL FOREIGN BODY DEEP PENILE TISSUE|678.05|678.05||
125|54112|54112 - EXC PENILE PLAQUE GRAFT > 5 CM LENGTH|1612.83|1612.83||
125|54111|54111 - EXC PENILE PLAQUE GRAFT &/5 CM LENGTH|1468|1468||
125|54110|54110 - EXCISION OF PENILE PLAQUE|1005.23|1005.23||
125|54105|54105 - BIOPSY PENIS DEEP STRUCTURES|304.39|304.39||
125|54100|54100 - BIOPSY PENIS SEPARATE PROCEDURE|182.75|182.75||
125|54065|54065 - DSTRJ LESION PENIS EXTENSIVE|408.37|408.37||
125|54060|54060 - DSTRJ LESION PENIS SIMPLE SURG EXCISION|220.7|220.7||
125|54057|54057 - DSTRJ LESION PENIS SIMPLE LASER|246.81|246.81||
125|54056|54056 - DSTRJ LESION PENIS SIMPLE CRYOSURGERY|140.58|140.58||
125|54055|54055 - DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION|162.23|162.23||
125|54050|54050 - DSTRJ LESION PENIS SIMPLE CHEMICAL|112.8|112.8||
125|54015|54015 - I&D PENIS DEEP|407.01|407.01||
125|54001|54001 - SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN|247.19|247.19||
125|54000|54000 - SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN|176.19|176.19||
125|53860|53860 - TRURL RF FEMALE BLADDER NECK STRS URIN INCONT|2417.19|2417.19||
125|53855|53855 - INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT|1195.85|1195.85||
125|53852|53852 - TRURL DSTRJ PRSTATE TISS RF THERMOTH|3736.51|3736.51||
125|53850|53850 - TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH|6048.04|6048.04||
125|53665|53665 - DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES|86.79|86.79||
125|53661|53661 - DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ|77.65|77.65||
125|53660|53660 - DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI|95.13|95.13||
125|53621|53621 - DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ|171.2|171.2||
125|53620|53620 - DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST|192.6|192.6||
125|53605|53605 - DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES|118.59|118.59||
125|53601|53601 - DILAT URETHRAL STRIX DILATOR MALE SBSQ|109.54|109.54||
125|53600|53600 - DILAT URETHRAL STRIX DILATOR MALE 1ST|93.37|93.37||
125|53520|53520 - CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX|906.95|906.95||
125|53515|53515 - URTORR SUTR URETHRAL WND/INJ PROSTATOMEMBRANOUS|1615.55|1615.55||
125|53510|53510 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL|1175.08|1175.08||
125|53505|53505 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE|893.67|893.67||
125|53502|53502 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE|863.27|863.27||
125|53500|53500 - URETHROLSS TRVG SEC OPN W/CSTO|1458.37|1458.37||
125|53460|53460 - URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM|585.23|585.23||
125|53450|53450 - URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT|567.75|567.75||
125|53449|53449 - RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER|1045.38|1045.38||
125|53448|53448 - RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD|2404.97|2404.97||
125|53447|53447 - RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC|1310.19|1310.19||
125|53446|53446 - REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER|1557.98|1557.98||
125|53445|53445 - INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER|2627.5|2627.5||
125|53444|53444 - INSERTION TANDEM CUFF|1619.81|1619.81||
125|53442|53442 - RMVL/REVJ SLING MALE URINARY INCONTINENCE|1123.5|1123.5||
125|53440|53440 - SLING OPRATION CORRJ MALE URINARY INCONTINENCE|1714.43|1714.43||
125|53431|53431 - URTP W/TUBULARIZATION POST URT&/LWR BLDR|2225.69|2225.69||
125|53430|53430 - URETHROPLASTY RCNSTJ FEMALE URETHRA|1386.55|1386.55||
125|53425|53425 - URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE|1708.54|1708.54||
125|53420|53420 - URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE|1697.61|1697.61||
125|53415|53415 - URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT|2247|2247||
125|53410|53410 - URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA|1524.13|1524.13||
125|53405|53405 - URETHROPLASTY 2ND STAGE W/URINARY DIVERSION|1430.58|1430.58||
125|53400|53400 - URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX|1189.24|1189.24||
125|53275|53275 - EXCISION/FULGURATION URETHRAL PROLAPSE|422.09|422.09||
125|53270|53270 - EXCISION OR FULGURATION SKENES GLANDS|273.67|273.67||
125|53265|53265 - EXC/FULGURATION URETHRAL CARUNCLE|344.39|344.39||
125|53260|53260 - EXC/FULGURATION URETHRAL POLYP DSTL URETHRA|303.29|303.29||
125|53250|53250 - EXCISION OF BULBOURETHRAL GLAND|875.75|875.75||
125|53240|53240 - MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE|648.28|648.28||
125|53235|53235 - EXC URETHRAL DIVERTICULUM SPX MALE|1113.14|1113.14||
125|53230|53230 - EXC URETHRAL DIVERTICULUM SPX FEMALE|1209.76|1209.76||
125|53220|53220 - EXC/FULGURATION CARCINOMA URETHRA|834.2|834.2||
125|53215|53215 - URETHRECTOMY TOT W/CYSTOST MALE|1691.19|1691.19||
125|53210|53210 - URETHRECTOMY TOT W/CYSTOST FEMALE|1305.19|1305.19||
125|53200|53200 - BIOPSY URETHRA|264.33|264.33||
125|53085|53085 - DRG PERINEAL URINARY XTRVASATION COMPLIC|1069|1069||
125|53080|53080 - DRG PERINEAL URINARY XTRVASATION UNCOMP SPX|666.04|666.04||
125|53060|53060 - DRG OF SKENE'S GLAND ABSCESS OR CYST|235.49|235.49||
125|53040|53040 - DRAINAGE DEEP PERIURETHRAL ABSCESS|675.88|675.88||
125|53025|53025 - MEATOTOMY CUTTING MEATUS SPX INFANT|186.09|186.09||
125|53020|53020 - MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT|186.13|186.13||
125|53010|53010 - URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA|501.49|501.49||
125|53000|53000 - URTT/URTS XTRNL SPX PENDULOUS URETHRA|280.33|280.33||
125|52700|52700 - TRURL DRAINAGE PROSTATIC ABSCESS|696.98|696.98||
125|52649|52649 - LASER ENUCLEATION PROSTATE W/MORCELLATION|1361.31|1361.31||
125|52648|52648 - LASER VAPORIZATION OF PROSTATE FOR URINE FLOW|1414.39|1414.39||
125|52647|52647 - LASER COAGULATION OF PROSTATE FOR URINE FLOW|3174.87|3174.87||
125|52640|52640 - TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE|887.58|887.58||
125|52630|52630 - TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS|1438.5|1438.5||
125|52601|52601 - TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE|2033|2033||
125|5250F|5250F - ASTHMA DISCHARGE PLAN PRESENT|0.01|0.01||
125|52500|52500 - TRANSURETHRAL RESECTION BLADDER NECK|985.13|985.13||
125|52450|52450 - TRANSURETHRAL INCISION PROSTATE|735.57|735.57||
125|52442|52442 - CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL|1453.86|1453.86||
125|52441|52441 - CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE|1918.74|1918.74||
125|52402|52402 - CSTO W/TRURL RESCJ/INC EJACULATORY DUXS|290.17|290.17||
125|52400|52400 - CYSTO INC FULG/RESCJ URTL VALVES/FOLDS|802.55|802.55||
125|52356|52356 - CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT|693.65|693.65||
125|52355|52355 - CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR|1582.71|1582.71||
125|52354|52354 - CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION|1335.41|1335.41||
125|52353|52353 - CYSTO W/URETEROSCOPY W/LITHOTRIPSY|736.15|736.15||
125|52352|52352 - CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES|577.85|577.85||
125|52351|52351 - CYSTO W/URTROSCOPY&/PYELOSCOPY DX|530.71|530.71||
125|52346|52346 - CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE|1647.89|1647.89||
125|52345|52345 - CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX|1465.3|1465.3||
125|52344|52344 - CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE|1372.85|1372.85||
125|52343|52343 - CYSTO W/TX INTRA-RENAL STRICTURE|1285.03|1285.03||
125|52342|52342 - CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE|1222.62|1222.62||
125|52341|52341 - CYSTO W/TX URETERAL STRICTURE|1130.18|1130.18||
125|52334|52334 - CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR|575.04|575.04||
125|52332|52332 - CYSTO W/INSERT URETERAL STENT|668.75|668.75||
125|52330|52330 - CYSTO MANJ W/O RMVL URETERAL STONE|1606.49|1606.49||
125|52327|52327 - CYSTO W/SUBURTRIC NJX IMPLT MATRL|1362.63|1362.63||
125|52325|52325 - CYSTO FRAGMENTATION URETERAL STONE|912.28|912.28||
125|52320|52320 - CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS|647.84|647.84||
125|52318|52318 - LITHOLAPAXY COMP/LG > 2.5 CM|1498|1498||
125|52317|52317 - LITHOLAPAXY SMPL/SM <2.5 CM|1325.94|1325.94||
125|52315|52315 - CYSTO W/COMPLEX REMOVAL STONE & STENT|660.07|660.07||
125|52310|52310 - CYSTO W/SIMPLE REMOVAL STONE & STENT|535|535||
125|52305|52305 - CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT|559.16|559.16||
125|52301|52301 - CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI|551.02|551.02||
125|52300|52300 - CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI|570.97|570.97||
125|52290|52290 - CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI|415.35|415.35||
125|52287|52287 - CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER|495.73|495.73||
125|52285|52285 - CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME|424.69|424.69||
125|52283|52283 - CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE|350.78|350.78||
125|52282|52282 - CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT|647.02|647.02||
125|52281|52281 - CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS|374.95|374.95||
125|52277|52277 - CYSTOURETHROSCOPY W/RESECJ EXTERNAL SPHINCTER|629.97|629.97||
125|52276|52276 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE|660.32|660.32||
125|52275|52275 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE|759.26|759.26||
125|52270|52270 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE|540.15|540.15||
125|52265|52265 - CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA|604.95|604.95||
125|52260|52260 - CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH|220.3|220.3||
125|52250|52250 - CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG|521.72|521.72||
125|52240|52240 - CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE|1275.98|1275.98||
125|52235|52235 - CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM|774.15|774.15||
125|52234|52234 - CYSTO W/REMOVAL OF TUMORS SMALL|602.95|602.95||
125|52224|52224 - CYSTO W/REMOVAL OF LESIONS SMALL|1439.6|1439.6||
125|52214|52214 - CYSTO W/DESTRUCTION OF LESIONS|1522.88|1522.88||
125|52204|52204 - CYSTOURETHROSCOPY WITH BIOPSY|363.8|363.8||
125|52010|52010 - CYSTO W/EJACULATORY DUCT CATHETERIZATION|515.56|515.56||
125|5200F|5200F - CONSID NEURO EVAL APPROP SURG THXPY EPIL 3YRS|0.01|0.01||
125|52007|52007 - CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS|719.06|719.06||
125|52005|52005 - CYSTO BLADDER W/URETERAL CATHETERIZATION|363.8|363.8||
125|52001|52001 - CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS|417.2|417.2||
125|52000|52000 - CYSTOURETHROSCOPY|347.75|347.75||
125|51992|51992 - LAPAROSCOPY SLING OPERATION STRESS INCONT|1388.38|1388.38||
125|51990|51990 - LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT|1275.24|1275.24||
125|51980|51980 - CUTANEOUS VESICOSTOMY|1534.67|1534.67||
125|51960|51960 - ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS|2845.62|2845.62||
125|51940|51940 - CLOSURE EXSTROPHY BLADDER|2883.72|2883.72||
125|51925|51925 - CLSR VESICOUTERINE FISTULA W/HYSTERECTOMY|1860.07|1860.07||
125|51920|51920 - CLOSURE VESICOUTERINE FISTULA|1544.33|1544.33||
125|51900|51900 - CLSR VESICOVAGINAL FISTUL AABDL APPROACH|1852.24|1852.24||
125|51880|51880 - CLOSURE CYSTOSTOMY SEPARATE PROCEDURE|777.07|777.07||
125|51865|51865 - CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED|1792.72|1792.72||
125|51860|51860 - CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE|1605|1605||
125|51845|51845 - ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL|1307.55|1307.55||
125|51841|51841 - ANT VESICOURETHROPEXY/URETHROPEXY COMP|1819|1819||
125|51840|51840 - ANT VESICOURETHROPEXY/URETHROPEXY SMPL|1658.5|1658.5||
125|51820|51820 - CSTOURTP W/UNI/BI URTRONEOCSTOST|2241.38|2241.38||
125|51800|51800 - CSTOPLASTY/CSTOURTP PLSTC ANY|1915.2|1915.2||
125|51798|51798 - MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP|30.59|30.59||
125|51797|51797 - VOID PRESSURE STUDIES INTRAABDOMINAL|282.42|282.42||108.25
125|51792|51792 - STIMULUS EVOKED RESPONSE|266.68|266.68||87.1
125|51785|51785 - NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ|226.71|226.71||112.61
125|51784|51784 - EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL|210.65|210.65||111.02
125|51741|51741 - COMPLEX UROFLOMETRY|119.57|119.57||91.11
125|51736|51736 - SIMPLE UROFLOMETRY|67.89|67.89||53.17
125|51729|51729 - COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL|532.62|532.62||209.05
125|51728|51728 - COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES|494.49|494.49||173.55
125|51727|51727 - COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE|485.63|485.63||176.3
125|51726|51726 - BLADDER PRESSURE MEASUREMENT DURING FILLING|482.48|482.48||127.69
125|51725|51725 - SIMPLE CYSTOMETROGRAM|316.71|316.71||110.08
125|51720|51720 - BLADDER INSTILLATION ANTICARCINOGENIC AGENT|197.95|197.95||
125|51715|51715 - NDSC NJX IMPLT MATRL URT&/BLDR NCK|535|535||
125|51710|51710 - CHANGE CYSTOSTOMY TUBE COMPLICATED|191.38|191.38||
125|51705|51705 - CHANGE CYSTOSTOMY TUBE SIMPLE|126.8|126.8||
125|51703|51703 - INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED|171.6|171.6||
125|51702|51702 - INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE|160.55|160.55||
125|51701|51701 - INSJ NON-NDWELLG BLADDER CATHETER|117.75|117.75||
125|51700|51700 - BLDR IRRIGATION SMPL LAVAGE &/INSTLJ|123.05|123.05||
125|51610|51610 - NJX RETROGRADE URETHROCSTOGRAPY|473.65|473.65||
125|51605|51605 - NJX & PLACEMENT CHAIN CONTRAST&/URETHROCSTOGRAPY|412.34|412.34||
125|51600|51600 - NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY|218.65|218.65||
125|51597|51597 - PELVIC EXENTERATION COMPLETE MALIGNANCY|5017.74|5017.74||
125|51596|51596 - CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR|4863.62|4863.62||
125|51595|51595 - CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC|5136|5136||
125|51590|51590 - CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST|3976.1|3976.1||
125|51585|51585 - CYSTECTOMY W/URETEROSIGMOID BI PELV LYMPH NODES|3986.09|3986.09||
125|51580|51580 - CYSTECTOMY W/URETEROSIGMOIDOSTOMY W/NODES|3283.3|3283.3||
125|51575|51575 - CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY|3364.2|3364.2||
125|51570|51570 - CYSTECTOMY COMPLETE SEPARATE PROCEDURE|2555.43|2555.43||
125|51565|51565 - CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST|2368.12|2368.12||
125|51555|51555 - CYSTECTOMY PARTIAL COMPLICATED|2037.42|2037.42||
125|51550|51550 - CYSTECTOMY PARTIAL SIMPLE|2247|2247||
125|51535|51535 - CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE|1417.7|1417.7||
125|51530|51530 - CYSTOTOMY EXCISION BLADDER TUMOR|1454.85|1454.85||
125|51525|51525 - CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE|1735.14|1735.14||
125|51520|51520 - CYSTOTOMY SIMPLE EXCISION VESICAL NECK|1327.58|1327.58||
125|51500|51500 - EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR|1245.19|1245.19||
125|51102|51102 - ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER|362.38|362.38||
125|51101|51101 - ASPIRATION BLADDER TROCAR/INTRACATHETER|194.54|194.54||
125|51100|51100 - ASPIRATION BLADDER NEEDLE|98.91|98.91||
125|51080|51080 - DRG PRIVESICAL/PREVESICAL SPACE ABSC|750.06|750.06||
125|51065|51065 - CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO|1095.71|1095.71||
125|51060|51060 - TRANSVESICAL URETROLITHOTOMY|1466.38|1466.38||
125|51050|51050 - CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS|965.66|965.66||
125|51045|51045 - CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX|757.56|757.56||
125|51040|51040 - CYSTOSTOMY CYSTOTOMY W/DRAINAGE|651.1|651.1||
125|51030|51030 - CSTOTOMY/CSTOST CRYOSURG DSTRJ INTRAVESICAL LES|1028.2|1028.2||
125|51020|51020 - CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL|1108.41|1108.41||
125|5100F|5100F - FX RISK REF PHYS/QHP COMMJ 24 HRS IMAGING STUDY|0.01|0.01||
125|50980|50980 - NDSC URETEROTOMY RMVL FB/CALCULUS|598.48|598.48||
125|50976|50976 - URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX|989.96|989.96||
125|50974|50974 - URETERAL ENDOSCOPY VIA URETEROT W/O IMAGING W/BX|993.39|993.39||
125|50972|50972 - NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER|530.38|530.38||
125|50970|50970 - URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING|833.46|833.46||
125|50961|50961 - URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE|1164.92|1164.92||
125|50957|50957 - URETERAL ENDOSCOPY W/DEST&/INC W/WO BIOPSY|939.82|939.82||
125|50955|50955 - URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY|1017.64|1017.64||
125|50953|50953 - URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER|929.19|929.19||
125|50951|50951 - URETERAL ENDOSCOPY VIA URETEROSTOMY|492.67|492.67||
125|50948|50948 - LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT|3409.02|3409.02||
125|50947|50947 - LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT|3727.97|3727.97||
125|50945|50945 - LAPAROSCOPY URTROLITHOTOMY|1696.59|1696.59||
125|50940|50940 - DELIGATION URETER|2033|2033||
125|50930|50930 - CLOSURE URETEROCUTANEOUS FISTULA W/VISC RPR|2155.62|2155.62||
125|50920|50920 - CLOSURE URETEROCUTANEOUS FISTULA|1707.39|1707.39||
125|50900|50900 - URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE|1703.1|1703.1||
125|50860|50860 - URETEROSTOMY TRANSPLANTATION URETER SKIN|1692.49|1692.49||
125|50845|50845 - CUTANANEOUS APPENDICO-VESICOSTOMY|2139.05|2139.05||
125|50840|50840 - RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST|2489.22|2489.22||
125|50830|50830 - URINARY UNIDIVERSION|3161.5|3161.5||
125|50825|50825 - CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN|3328.92|3328.92||
125|50820|50820 - URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS|2835.5|2835.5||
125|50815|50815 - URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS|2541.87|2541.87||
125|50810|50810 - URETEROSIGMOIDOSTOMY W/SIGMOID BLADDER & COLOSTO|2480.72|2480.72||
125|50800|50800 - URETEROENTEROSTOMY ANAST URETER INTESTINE|2003.93|2003.93||
125|50785|50785 - URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP|2329.67|2329.67||
125|50783|50783 - URETERONEOCYSTOSTOMY W/URETERAL TAILORING|2174.38|2174.38||
125|50782|50782 - URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR|2100.12|2100.12||
125|50780|50780 - URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER|2247|2247||
125|50770|50770 - TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR|2274.24|2274.24||
125|50760|50760 - URETEROURETEROSTOMY|2108.66|2108.66||
125|50750|50750 - URETEROCALYCOSTOMY ANAST URETER RENAL CALYX|2230.92|2230.92||
125|50740|50740 - EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR|2100.75|2100.75||
125|50728|50728 - REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA|1347.83|1347.83||
125|50727|50727 - REVJ URINARY-CUTANEOUS ANASTAMOSIS|965.53|965.53||
125|50725|50725 - URTROLSS RETROCAVAL URTR W/REANAST|2225.25|2225.25||
125|50722|50722 - URETEROLYSIS FOR OVARIAN VEIN SYNDROME|1656.73|1656.73||
125|50715|50715 - URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS|2247|2247||
125|50706|50706 - BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I|1507.18|1507.18||
125|50705|50705 - URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I|2924.32|2924.32||
125|50700|50700 - URETEROPLASTY PLASTIC OPERATION URETER|1791.18|1791.18||
125|50695|50695 - PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH|2043.55|2043.55||
125|50694|50694 - PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH|1662.18|1662.18||
125|50693|50693 - PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT|1508.76|1508.76||
125|50690|50690 - NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG|613.48|613.48||
125|50688|50688 - CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL|111.76|111.76||
125|50686|50686 - MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH|227.01|227.01||
125|50684|50684 - INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH|580.35|580.35||
125|50660|50660 - URETERECTOMY TOT ECTOPIC URETER CMBN APPR|2117.68|2117.68||
125|50650|50650 - URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE|1905.19|1905.19||
125|50630|50630 - URTROLITHOTOMY LOWER ONE-THIRD URETER|1828.52|1828.52||
125|5062F|5062F - DOC DIRECT COMM DIAG MAMMO FNDNGS-PHONE/PERSON|0.01|0.01||
125|50620|50620 - URTROLITHOTOMY MIDDLE ONE-THIRD URETER|1728.61|1728.61||
125|50610|50610 - URTROLITHOTOMY UPPER ONE-THIRD URETER|1831.55|1831.55||
125|5060F|5060F - FINDNGS DIAG MAM TO MNGNG PRACT 3 DAYS INTERP|0.01|0.01||
125|50606|50606 - ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC|1073.05|1073.05||
125|50605|50605 - URETEROTOMY INSERTION INDWELLING STENT ALL TYPES|1421.7|1421.7||
125|50600|50600 - URTROTOMY W/EXPL/DRG SEPARATE PROCEDURE|1690.96|1690.96||
125|50593|50593 - ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY|6846.18|6846.18||
125|50592|50592 - ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY|9850.56|9850.56||
125|50590|50590 - LITHOTRIPSY XTRCORP SHOCK WAVE|1631.75|1631.75||
125|50580|50580 - RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS|961.84|961.84||
125|50576|50576 - RNL NDSC NFROT FULGURATION &/INCISION W/WO BX|1199.4|1199.4||
125|50575|50575 - RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY|1415.34|1415.34||
125|50574|50574 - RENAL NDSC NEPHROTOMY W/BIOPSY|1045.89|1045.89||
125|50572|50572 - RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER|998.31|998.31||
125|50570|50570 - RENAL NDSC NEPHROTOMY W/WO IRRIGATION|719.51|719.51||
125|50562|50562 - RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR|952.21|952.21||
125|50561|50561 - RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS|953.37|953.37||
125|50557|50557 - RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI|996.08|996.08||
125|50555|50555 - RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY|1412.91|1412.91||
125|50553|50553 - RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA|917.34|917.34||
125|50551|50551 - RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION|520.85|520.85||
125|50548|50548 - LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY|2268.01|2268.01||
125|50547|50547 - LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR|2742.28|2742.28||
125|50546|50546 - LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT|1933.07|1933.07||
125|50545|50545 - LAPAROSCOPY RADICAL NEPHRECTOMY|3344.31|3344.31||
125|50544|50544 - LAPAROSCOPY SURG PYELOPLASTY|2130.33|2130.33||
125|50543|50543 - LAPAROSCOPY SURG PARTIAL NEPHRECTOMY|2720.28|2720.28||
125|50542|50542 - LAPS ABLTJ RENAL MASS LESION W/INTRAOP US|2225.69|2225.69||
125|50541|50541 - LAPAROSCOPY SURG ABLATION RENAL CYSTS|1454.87|1454.87||
125|50540|50540 - SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI|2435.69|2435.69||
125|50526|50526 - CLSR NEPHROVISCERAL FISTULA W/VISC RPR THRC APPR|2208.45|2208.45||
125|50525|50525 - CLSR NEPHROVISCERAL FISTULA W/VISC RPR ABDL APPR|2302.3|2302.3||
125|50520|50520 - CLOSURE NEPHROCUTANEOUS/PYELOCUTANEOUS FISTULA|1967.88|1967.88||
125|5050F|5050F - TX COMMUN PROVIDERS CONTINUING CARE 1 MO DX|0.01|0.01||
125|50500|50500 - NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY|2004.75|2004.75||
125|50435|50435 - EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I|720.36|720.36||
125|50434|50434 - CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ|1266.23|1266.23||
125|50433|50433 - PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I|1618.69|1618.69||
125|50432|50432 - PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I|1185.63|1185.63||
125|50431|50431 - NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS|252.31|252.31||
125|50430|50430 - NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS|708.27|708.27||
125|50405|50405 - PYELOPLASTY COMPLICATED|2565.9|2565.9||
125|50400|50400 - PYELOPLASTY SIMPLE|2354|2354||
125|50396|50396 - MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH|160.45|160.45||
125|50395|50395 - INTRO GUIDE PELVIS&/URETER W/DILAT NFROS TRACT|522.35|522.35||
125|50391|50391 - INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB|141.48|141.48||
125|50390|50390 - ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ|247.13|247.13||
125|50389|50389 - RMVL NFROS TUBE REQ FLUORO GUIDANCE|871.63|871.63||
125|50387|50387 - RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH|1329.45|1329.45||
125|50386|50386 - REMOVE INT DWELL URETERAL STENT TRANSURETHRAL|1074.92|1074.92||
125|50385|50385 - REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL|1661.72|1661.72||
125|50384|50384 - REMOVAL INDWELLING URETERAL STENT PRQ|2594.41|2594.41||
125|50382|50382 - RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ|2774.07|2774.07||
125|50380|50380 - RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY|2386.24|2386.24||
125|50370|50370 - RMVL TRNSPLED RENAL ALLOGRAFT|1482.07|1482.07||
125|50365|50365 - RENAL ALTRNSPLJ IMPLTJ GRF W/RCP NEPHRECTOMY|4561.22|4561.22||
125|50360|50360 - RENAL ALTRNSPLJ IMPLTJ GRF W/O RCP NEPHRECTOMY|3639.07|3639.07||
125|50340|50340 - RECIPIENT NEPHRECTOMY SEPARATE PROCEDURE|1761.25|1761.25||
125|50329|50329 - BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA|185.64|185.64||
125|50328|50328 - BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA|194.31|194.31||
125|50327|50327 - BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA|221.84|221.84||
125|50325|50325 - BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT|189.92|189.92||
125|50323|50323 - BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT|207.78|207.78||
125|50320|50320 - DONOR NEPHRECTOMY OPEN LIVING DONOR|2546.17|2546.17||
125|50300|50300 - DONOR NEPHRECTOMY CADAVER DONOR UNI/BILATERAL|2632.2|2632.2||
125|50290|50290 - EXCISION PERINEPHRIC CYST|1631.75|1631.75||
125|50280|50280 - EXCISION/UNROOFING CYST KIDNEY|1717.63|1717.63||
125|50250|50250 - OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND|2477.54|2477.54||
125|50240|50240 - NEPHRECTOMY PARTIAL|3049.5|3049.5||
125|50236|50236 - NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN|3049.5|3049.5||
125|50234|50234 - NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC|2517.44|2517.44||
125|50230|50230 - NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD|2942.5|2942.5||
125|50225|50225 - NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL|2461|2461||
125|50220|50220 - NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ|1967.73|1967.73||
125|5020F|5020F - TX SUMM RPRT COMMUN PHYS&PT 1 MO COMPLETE|0.01|0.01||
125|50205|50205 - RENAL BIOPSY SURG EXPOSURE KIDNEY|993.5|993.5||
125|50200|50200 - RENAL BIOPSY PRQ TROCAR/NEEDLE|159.06|159.06||
125|5015F|5015F - DOCD CONTACT THAT FX EXISTED & PT TSTED/TXD OP|0.01|0.01||
125|50135|50135 - PYELOTOMY COMPLICATED|2327.99|2327.99||
125|50130|50130 - PYELOTOMY W/REMOVAL CALCULUS|2086.5|2086.5||
125|50125|50125 - PYELOTOMY W/DRAINAGE PYELOSTOMY|1835.72|1835.72||
125|50120|50120 - PYELOTOMY W/EXPLORATION|1818.63|1818.63||
125|5010F|5010F - DILATED MACULAR/FUNDUS XM COMMUNJ TX PHYS/QHP|0.01|0.01||
125|50100|50100 - TRNSXJ/REPOSITIONING ABERRANT RENAL VESSEL SPX|1697.82|1697.82||
125|50081|50081 - PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY > 2 CM|2755.25|2755.25||
125|50080|50080 - PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY </2 CM|1755.6|1755.6||
125|50075|50075 - NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1|2613.05|2613.05||
125|50070|50070 - NEPHROLITHOTOMY COMP CGEN KDN ABNORMALITY|2226.77|2226.77||
125|50065|50065 - NEPHROLITHOTOMY SECONDARY FOR CALCULUS|2277.69|2277.69||
125|50060|50060 - NEPHROLITHOTOMY REMOVAL STAGE 1|2300.5|2300.5||
125|5005F|5005F - COUNSEL NEW/CHANGING MOLES SELF-EXAMINATION|0.01|0.01||
125|50045|50045 - NEPHROTOMY W/EXPLORATION|1756.09|1756.09||
125|50040|50040 - NEPHROSTOMY/NEPHROTOMY W/DRAINAGE|1607.31|1607.31||
125|50020|50020 - DRAINAGE PERIRENAL/RENAL ABSCESS OPEN|1346.06|1346.06||
125|50010|50010 - RNL EXPL X NECESSITATING OTH SPEC PX|1332.42|1332.42||
125|49906|49906 - FREE OMENTAL FLAP W/MICROVASCULAR ANAST|2184.98|2184.98||
125|49905|49905 - OMENTAL FLAP INTRA-ABDOMINAL|688.2|688.2||
125|49904|49904 - OMENTAL FLAP EXTRA-ABDOMINAL|1456.8|1456.8||
125|49900|49900 - SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN|936.06|936.06||
125|49657|49657 - LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED|2197.52|2197.52||
125|49656|49656 - LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE|1524.96|1524.96||
125|49655|49655 - LAPS RPR INCISIONAL HERNIA NCRC8/STRANGULATED|1714.4|1714.4||
125|49654|49654 - LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE|1404.55|1404.55||
125|49653|49653 - LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED|1538.8|1538.8||
125|49652|49652 - LAPS REPAIR HERNIA EXCEPT INCAL/INGUN REDUCIBLE|1233.54|1233.54||
125|49651|49651 - LAPS SURG RPR RECURRENT INGUINAL HERNIA|1025.34|1025.34||
125|49650|49650 - LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA|654.18|654.18||
125|49611|49611 - RPR OMPHALOCELE GROSS TYP OPRATION 2ND STG|1108.11|1108.11||
125|49610|49610 - RPR OMPHALOCELE GROSS TYP OPRATION 1ST STG|1072.79|1072.79||
125|49606|49606 - RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH|1504.57|1504.57||
125|49605|49605 - RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH|4460.58|4460.58||
125|49600|49600 - RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE|1016.5|1016.5||
125|49590|49590 - RPR SPIGELIAN HERNIA|890.53|890.53||
125|49587|49587 - RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED|817.94|817.94||
125|49585|49585 - RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE|619.53|619.53||
125|49582|49582 - RPR UMBILICAL HERNIA < 5 YRS INCARCERATED|717.44|717.44||
125|49580|49580 - RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE|520.56|520.56||
125|49572|49572 - RPR EPIGASTRIC HERNIA INCARCERATED|733.66|733.66||
125|49570|49570 - RPR EPIGASTRIC HERNIA REDUCIBLE SPX|586.09|586.09||
125|49568|49568 - IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE|477.49|477.49||
125|49566|49566 - RPR RECRT INCAL/VNT HERNIA INCARCERATED|1316.89|1316.89||
125|49565|49565 - RPR RECRT INCAL/VNT HERNIA REDUCIBLE|1103.97|1103.97||
125|49561|49561 - RPR 1ST INCAL/VNT HERNIA INCARCERATED|1203.71|1203.71||
125|49560|49560 - REPAIR FIRST ABDOMINAL WALL HERNIA|1081.45|1081.45||
125|49557|49557 - RPR RECRT FEM HRNA INCARCERATED|1017.38|1017.38||
125|49555|49555 - RPR RECRT FEM HERNIA REDUCIBLE|979.75|979.75||
125|49553|49553 - RPR 1ST FEM HERNIA ANY AGE INCARCERATED|1122.53|1122.53||
125|49550|49550 - RPR 1ST FEM HRNA ANY AGE REDUCIBLE|757.83|757.83||
125|49540|49540 - REPAIR LUMBAR HERNIA|969.6|969.6||
125|49525|49525 - RPR INGUN HERNIA SLIDING ANY AGE|948.64|948.64||
125|49521|49521 - RPR RECRT INGUN HERNIA ANY AGE INCARCERATED|1062.01|1062.01||
125|49520|49520 - RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE|857.6|857.6||
125|49507|49507 - RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED|934.74|934.74||
125|49505|49505 - RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE|780.67|780.67||
125|49501|49501 - RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED|885.36|885.36||
125|49500|49500 - RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE|652.97|652.97||
125|49496|49496 - RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER|972.47|972.47||
125|49495|49495 - RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC|693.9|693.9||
125|49492|49492 - RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED|1583.61|1583.61||
125|49491|49491 - RPR 1ST INGUN HRNA PRETERM INFT RDC|1269.04|1269.04||
125|49465|49465 - CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE|250.01|250.01||
125|49460|49460 - OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE|1113.47|1113.47||
125|49452|49452 - REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS|1369.54|1369.54||
125|49451|49451 - REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ|1103.67|1103.67||
125|49450|49450 - REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS|1008.53|1008.53||
125|49446|49446 - CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ|1417.25|1417.25||
125|49442|49442 - INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS|1389.15|1389.15||
125|49441|49441 - INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ|1673.44|1673.44||
125|49440|49440 - INSERT GASTROSTOMY TUBE PERCUTANEOUS|1476.62|1476.62||
125|49436|49436 - DELAYED CREATION EXIT SITE EMBEDDED CATHETER|286.7|286.7||
125|49435|49435 - INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER|196.02|196.02||
125|49429|49429 - RMVL PERITONEAL-VENOUS SHUNT|773.4|773.4||
125|49428|49428 - LIGATION PERITONEAL-VENOUS SHUNT|416.87|416.87||
125|49427|49427 - INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT|96.57|96.57||
125|49426|49426 - REVIS PERITONEAL-VENOUS SHUNT|1369.05|1369.05||
125|49425|49425 - INSERTION PERITONEAL-VENOUS SHUNT|1235.27|1235.27||
125|49424|49424 - CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX|165.46|165.46||
125|49423|49423 - EXCHNG ABSC/CST DRG CATH RAD GID SPX|565.94|565.94||
125|49422|49422 - REMOVAL TUNNELED INTRAPERITONEAL CATHETER|678.04|678.04||
125|49421|49421 - INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN|643.34|643.34||
125|49419|49419 - INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT|989.19|989.19||
125|49418|49418 - INSJ INTRAPERITONEAL CATHETER W/IMG GUID|2069.51|2069.51||
125|49412|49412 - PLACEMENT INTRSTL DEV OPN W/IMG GUID 1/MLT|139.17|139.17||
125|49411|49411 - INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT|748.51|748.51||
125|49407|49407 - IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL|1007.83|1007.83||
125|49406|49406 - IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ|1237.85|1237.85||
125|49405|49405 - IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ|1238.38|1238.38||
125|49402|49402 - REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY|924.21|924.21||
125|49400|49400 - INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX|191.92|191.92||
125|49327|49327 - LAPS W/INSERTION NTRSTL DEV W/IMG GUID 1/MLT|219.85|219.85||
125|49326|49326 - LAPAROSCOPY W/OMENTOPEXY|425.5|425.5||
125|49325|49325 - LAPS W/REVISION INTRAPERITONEAL CATHETER|921.42|921.42||
125|49324|49324 - LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER|854.56|854.56||
125|49323|49323 - LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY|988.89|988.89||
125|49322|49322 - LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE|1605|1605||
125|49321|49321 - LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE|816.28|816.28||
125|49320|49320 - LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX|1112.8|1112.8||
125|49255|49255 - OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX|944.06|944.06||
125|49250|49250 - UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX|750.52|750.52||
125|49220|49220 - STAGING LAPAROTOMY HODGKINS DISEASE/LYMPHOMA|1872.51|1872.51||
125|49215|49215 - EXC PRESAC/SACROCOCCYGEAL TUMOR|2024.64|2024.64||
125|49205|49205 - EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM|2933.71|2933.71||
125|49204|49204 - EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM|2553.31|2553.31||
125|49203|49203 - EXCISION/DESTRUCTION OPEN ABDOMINAL TUMOR 5 CM/<|1991.42|1991.42||
125|49185|49185 - SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID|1436.18|1436.18||
125|49180|49180 - BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE|272.63|272.63||
125|49084|49084 - PERITONEAL LAVAGE W/WO IMAGING GUIDANCE|182.51|182.51||
125|49083|49083 - ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE|456.81|456.81||
125|49082|49082 - ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE|302.28|302.28||
125|49062|49062 - DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN|1099.42|1099.42||
125|49060|49060 - DRAINAGE OF RETROPERITONEAL ABSCESS OPEN|1158.59|1158.59||
125|49040|49040 - DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN|1180.66|1180.66||
125|49020|49020 - DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN|1396.77|1396.77||
125|49010|49010 - EXPL RETROPERITONEUM W/WO BX SPX|1269.56|1269.56||
125|49002|49002 - REOPENING RECENT LAPAROTOMY|1094.08|1094.08||
125|49000|49000 - EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX|1166.03|1166.03||
125|48556|48556 - RMVL TRANSPLANTED PANCREATIC ALLOGRAFT|1273.65|1273.65||
125|48554|48554 - TRANSPLANTATION PANCREATIC ALLOGRAFT|3174.9|3174.9||
125|48552|48552 - BKBENCH RCNSTJ CDVR PNCRS ALGRFT VEN ANAST EA|238.73|238.73||
125|48551|48551 - BKBENCH PREPJ CADAVER DONOR PANCREAS ALLOGRAFT|235.38|235.38||
125|48550|48550 - DONOR PANCREATECTOMY DUODENAL SGM TRANSPLANT|2261.38|2261.38||
125|48548|48548 - PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST|2467.97|2467.97||
125|48547|48547 - DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ|2705.82|2705.82||
125|48545|48545 - PANCREATORRHAPHY INJURY|1578.42|1578.42||
125|48540|48540 - INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y|2040.69|2040.69||
125|48520|48520 - INT ANAST PANCREATIC CYST GI TRACT DIRECT|1750.94|1750.94||
125|48510|48510 - EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN|1624.33|1624.33||
125|48500|48500 - MARSUPIALIZATION PANCREATIC CYST|1506.47|1506.47||
125|48400|48400 - INJECTION INTRAOPERATIVE PANCREATOGRAPHY|233.94|233.94||
125|48160|48160 - PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS|6252.35|6252.35||
125|48155|48155 - PANCREATECTOMY TOTAL|3091.18|3091.18||
125|48154|48154 - PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY|3746.73|3746.73||
125|48153|48153 - PNCRTECT W/PANCREATOJEJUNOSTOMY|3998.44|3998.44||
125|48152|48152 - PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY|3746.55|3746.55||
125|48150|48150 - PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY|4392.08|4392.08||
125|48148|48148 - EXCISION AMPULLA VATER|1948.34|1948.34||
125|48146|48146 - PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX|2550.15|2550.15||
125|48145|48145 - PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY|2435.22|2435.22||
125|48140|48140 - PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY|2189.48|2189.48||
125|48120|48120 - EXCISION LESION PANCREAS|1701.43|1701.43||
125|48105|48105 - RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS|2637.56|2637.56||
125|48102|48102 - BIOPSY PANCREA PERCUTANEOUS NEEDLE|517.84|517.84||
125|48100|48100 - BIOPSY PANCREAS OPEN|1244.46|1244.46||
125|48020|48020 - REMOVAL PANCREATIC CALCULUS|1582.69|1582.69||
125|48001|48001 - PLACE DRAIN PERIPANCREATIC W/CHOLECYSTOSTOMY|2281.92|2281.92||
125|48000|48000 - PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS|1679.58|1679.58||
125|47900|47900 - SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY|1655.08|1655.08||
125|47802|47802 - U-TUBE HEPATICOENTEROSTOMY|2098.75|2098.75||
125|47801|47801 - PLACEMENT CHOLEDOCHAL STENT|1176.42|1176.42||
125|47800|47800 - RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST|2158.8|2158.8||
125|47785|47785 - ANAST ROUX-EN-Y INTRAHEPATC BILIARY DUCTS & GI|2639.76|2639.76||
125|47780|47780 - ANAST ROUX-EN-Y XTRHEPATC BILIARY DUCTS & GI|2362.59|2362.59||
125|47765|47765 - ANAST INTRAHEPATC DUCTS & GI TRACT|2319.41|2319.41||
125|47760|47760 - ANAST XTRHEPATC BILIARY DUCTS & GI TRACT|2177.43|2177.43||
125|47741|47741 - CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM|2020.79|2020.79||
125|47740|47740 - CHOLECYSTOENTEROSTOMY ROUX-EN-Y|1761.88|1761.88||
125|47721|47721 - CHOLECYSTOENTEROSTOMY W/GASTROENTEROSTOMY|1828.03|1828.03||
125|47720|47720 - CHOLECYSTOENTEROSTOMY DIRECT|1516.47|1516.47||
125|47715|47715 - EXCISION CHOLEDOCHAL CYST|1589.01|1589.01||
125|47712|47712 - EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC|2416|2416||
125|47711|47711 - EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC|2124.86|2124.86||
125|47701|47701 - PORTOENETEROSTOMY|2438.51|2438.51||
125|47700|47700 - EXPL CONGENITAL ATRESIA BILE DUCTS|1551.37|1551.37||
125|47620|47620 - CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP|2009.56|2009.56||
125|47612|47612 - CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY|2314.46|2314.46||
125|47610|47610 - CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT|1656.36|1656.36||
125|47605|47605 - CHOLECYSTECTOMY W/CHOLANGIOGRAPHY|1378.43|1378.43||
125|47600|47600 - CHOLECYSTECTOMY|1282.57|1282.57||
125|47570|47570 - LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY|1438.76|1438.76||
125|47564|47564 - LAPS SURG CHOLECSTC W/EXPL COMMON DUCT|1934.77|1934.77||
125|47563|47563 - LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY|1217|1217||
125|47562|47562 - LAPAROSCOPY SURG CHOLECYSTECTOMY|1131.3|1131.3||
125|47556|47556 - BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT|560.08|560.08||
125|47555|47555 - BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT|567.16|567.16||
125|47554|47554 - BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS|667.33|667.33||
125|47553|47553 - BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE|570.45|570.45||
125|47552|47552 - BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH|440.08|440.08||
125|47550|47550 - BILIARY NDSC INTRAOPERATIVE|284.14|284.14||
125|47544|47544 - REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I|1634.4|1634.4||
125|47543|47543 - ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT|735.23|735.23||
125|47542|47542 - BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT|712.08|712.08||
125|47541|47541 - PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW|1805.96|1805.96||
125|47540|47540 - PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH|7397.38|7397.38||
125|47539|47539 - PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH|7238.85|7238.85||
125|47538|47538 - PLMT BILE DUCT STENT PRQ EXISTING ACCESS|6511.95|6511.95||
125|47537|47537 - REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I|562.22|562.22||
125|47536|47536 - EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I|1051.24|1051.24||
125|47535|47535 - CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH|1550.37|1550.37||
125|47534|47534 - PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT|2257.89|2257.89||
125|47533|47533 - PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL|1883.76|1883.76||
125|47532|47532 - NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS|1223.59|1223.59||
125|47531|47531 - NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS|483.7|483.7||
125|47490|47490 - CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT|661.06|661.06||
125|47480|47480 - CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX|1162.08|1162.08||
125|47460|47460 - TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS|1978.15|1978.15||
125|47425|47425 - CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP|1970.26|1970.26||
125|47420|47420 - CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP|1701.88|1701.88||
125|47400|47400 - HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1|2025.67|2025.67||
125|47383|47383 - ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION|10351.49|10351.49||
125|47382|47382 - ABLTJ 1/> LVR TUM PRQ RF|875.48|875.48||
125|47381|47381 - ABLTJ OPN 1/> LVR TUM CRYOSURG|1395.1|1395.1||
125|47380|47380 - ABLTJ OPN 1/> LVR TUM RF|2140|2140||
125|47371|47371 - LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG|1189.41|1189.41||
125|47370|47370 - LAPS SURG ABLTJ 1/> LVR TUM RF|1184.35|1184.35||
125|47362|47362 - MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING|1168.24|1168.24||
125|47361|47361 - MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR|3380.4|3380.4||
125|47360|47360 - MGMT LVR HEMRRG CPLX SUTR WND/INJ|1905.69|1905.69||
125|47350|47350 - MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ|1323.86|1323.86||
125|47300|47300 - MARSUPIALIZATION CST/ABSC LVR|1347.33|1347.33||
125|47147|47147 - BKBENCH RCNSTJ LVR GRF ARTL ANAST EA|407.33|407.33||
125|47146|47146 - BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA|349.13|349.13||
125|47145|47145 - BKBENCH PREPJ CADAVER DONOR WHL LVR GRF I&V VI|458.23|458.23||
125|47144|47144 - BKBENCH PREPJ CADAVER WHOLE LIVER GRF I&IV VII|445.8|445.8||
125|47143|47143 - BKBENCH PREP CADAVER DONOR|348.74|348.74||
125|47142|47142 - DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI|4291.42|4291.42||
125|47141|47141 - DONOR HEPATECTOMY LIVING DONOR SEG II III & IV|3896.13|3896.13||
125|47140|47140 - DONOR HEPATECTOMY LIVING DONOR SEG II & III|3224.47|3224.47||
125|47135|47135 - LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE|7515.5|7515.5||
125|47133|47133 - DONOR HEPATECTOMY CADAVER DONOR|2327.81|2327.81||
125|47130|47130 - HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY|3260.35|3260.35||
125|47125|47125 - HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY|3115.91|3115.91||
125|47122|47122 - HEPATECTOMY RESCJ TRISEGMENTECTOMY|3277.23|3277.23||
125|47120|47120 - HEPATECTOMY RESCJ PARTIAL LOBECTOMY|2172.11|2172.11||
125|47100|47100 - BIOPSY LIVER WEDGE|879.9|879.9||
125|47015|47015 - LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS|1076.1|1076.1||
125|47010|47010 - HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES|1124.52|1124.52||
125|47001|47001 - BX LVR NDL DONE PURPOSE TM OTH MAJOR PX|202.76|202.76||
125|47000|47000 - BIOPSY LIVER NEEDLE PERCUTANEOUS|234.57|234.57||
125|46947|46947 - HEMORRHOIDOPEXY STAPLING|337.17|337.17||
125|46946|46946 - INT HRHC BY LIGATION 2+ HROID W/O IMG GDN|279.25|279.25||
125|46945|46945 - INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN|207.64|207.64||
125|46942|46942 - CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ|155.62|155.62||
125|46940|46940 - CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST|173.86|173.86||
125|46930|46930 - DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY|326.29|326.29||
125|46924|46924 - DSTRJ LESION ANUS EXTENSIVE|447.04|447.04||
125|46922|46922 - DSTRJ LESION ANUS SIMPLE SURG EXCISION|215.62|215.62||
125|46917|46917 - DSTRJ LESION ANUS SIMPLE LASER SURG|409.83|409.83||
125|46916|46916 - DSTRJ LESION ANUS SIMPLE CRYOSURGERY|204.37|204.37||
125|46910|46910 - DSTRJ LESION ANUS SMPL ELTRDSICCATION|186.19|186.19||
125|46900|46900 - DSTRJ LESION ANUS SIMPLE CHEMICAL|208.54|208.54||
125|46762|46762 - SPHNCTROP ANAL IMPLTJ ARTIF SPHNCTR|1694.74|1694.74||
125|46761|46761 - SPHNCTROP ANAL LEVATOR MUSC IMBRCJ|1535.2|1535.2||
125|46760|46760 - SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT|1242.82|1242.82||
125|46754|46754 - RMVL THIERSCH WIRE/SUTURE ANAL CANAL|225.05|225.05||
125|46753|46753 - GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE|693.46|693.46||
125|46751|46751 - SPHNCTROP ANAL INCONTINENCE/PROLAPSE CHLD|1054.08|1054.08||
125|46750|46750 - SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT|989.78|989.78||
125|46748|46748 - RPR CLOACAL ANOMALY CMBN ABDL & SACROPRNL W/GRF|3966.36|3966.36||
125|46746|46746 - RPR CLOACAL ANOMALY CMBN ABDL&SACROPRNL|3581.99|3581.99||
125|46744|46744 - RPR CLOACAL ANOMALY SACROPERINEAL|3262.23|3262.23||
125|46742|46742 - RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL|3128.56|3128.56||
125|46740|46740 - RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR|2538.17|2538.17||
125|46735|46735 - RPR HI IMPRF ANUS W/O FISTULA CMBN APPR|2651.05|2651.05||
125|46730|46730 - RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR|2077.83|2077.83||
125|46716|46716 - RPR LW IMPERFORATE ANUS W/TRPOS FISTULA|1106.29|1106.29||
125|46715|46715 - RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK|745.51|745.51||
125|46712|46712 - RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR|3350.07|3350.07||
125|46710|46710 - RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR|1595.56|1595.56||
125|46707|46707 - REPAIR ANORECTAL FISTULA PLUG|789.49|789.49||
125|46706|46706 - REPAIR ANAL FISTULA W/FIBRIN GLUE|425.26|425.26||
125|46705|46705 - ANOPLASTY PLASTIC OPERATION STRICTURE INFANT|787.38|787.38||
125|46700|46700 - ANOPLASTY PLASTIC OPERATION STRICTURE ADULT|915.35|915.35||
125|46615|46615 - ANOSCOPY ABLATION LESION|219.14|219.14||
125|46614|46614 - ANOSCOPY CONTROL BLEEDING|226.36|226.36||
125|46612|46612 - ANOSC RMVL MULT TUMORS CAUTERY/SNARE|290.73|290.73||
125|46611|46611 - ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ|199.94|199.94||
125|46610|46610 - ANOSCOPY W/RMVL LESION CAUTERY|203.54|203.54||
125|46608|46608 - ANOSCOPY W/RMVL FOREIGN BODY|224.87|224.87||
125|46607|46607 - ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX|304.78|304.78||
125|46606|46606 - ANOSCOPY W/BX SINGLE/MULTIPLE|171.88|171.88||
125|46604|46604 - ANOSCOPY W/DILATION|387.93|387.93||
125|46601|46601 - ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT|215.8|215.8||
125|46600|46600 - ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD|78.02|78.02||
125|46505|46505 - CHEMODENERVATION INTERNAL ANAL SPHINCTER|386.07|386.07||
125|46500|46500 - INJECTION SCLEROSING SOLUTION HEMORRHOIDS|169.07|169.07||
125|46320|46320 - EXC THROMBOSED HEMORRHOID XTRNL|148.16|148.16||
125|46288|46288 - CLSR ANAL FSTL W/RCT ADVMNT FLAP|800.63|800.63||
125|46285|46285 - SURG TX ANAL FISTULA 2ND STAGE|371.81|371.81||
125|46280|46280 - TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON|769.06|769.06||
125|46275|46275 - SURG TX ANAL FISTULA INTERSPHINCTERIC|780.79|780.79||
125|46270|46270 - SURG TX ANAL FISTULA SUBQ|364.34|364.34||
125|46262|46262 - HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY|992.71|992.71||
125|46261|46261 - HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU|952.67|952.67||
125|46260|46260 - HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO|934.22|934.22||
125|46258|46258 - HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY|826.97|826.97||
125|46257|46257 - HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO|767.2|767.2||
125|46255|46255 - HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP|642.8|642.8||
125|46250|46250 - HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP|474.03|474.03||
125|46230|46230 - EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS|225.37|225.37||
125|46221|46221 - HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS|185.76|185.76||
125|46220|46220 - EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS|151.82|151.82||
125|46200|46200 - FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED|426.93|426.93||
125|46083|46083 - INCISION THROMBOSED HEMORRHOID EXTERNAL|152.77|152.77||
125|46080|46080 - SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX|301.21|301.21||
125|46070|46070 - INCISION ANAL SEPTUM INFANT|220.54|220.54||
125|46060|46060 - I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON|773.86|773.86||
125|46050|46050 - I&D PERIANAL ABSCESS SUPERFICIAL|144.19|144.19||
125|46045|46045 - I&D INTRAMURAL IM/ABSC TRANSANAL ANES|364.12|364.12||
125|46040|46040 - I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX|478.29|478.29||
125|46030|46030 - REMOVAL ANAL SETON OTHER MARKER|109.89|109.89||
125|46020|46020 - PLACEMENT SETON|213.07|213.07||
125|45990|45990 - ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX|175.42|175.42||
125|45915|45915 - RMVL FECAL IMPACTION/FB SPX UNDER ANES|301.99|301.99||
125|45910|45910 - DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL|233.42|233.42||
125|45905|45905 - DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL|154.99|154.99||
125|45900|45900 - RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE|171.23|171.23||
125|45825|45825 - CLOSURE RECTOURETHRAL FISTULA W/COLOSTOMY|2058.41|2058.41||
125|45820|45820 - CLOSURE RECTOURETHRAL FISTULA|1818.88|1818.88||
125|45805|45805 - CLSR RECTOVESICAL FISTULA W/COLOSTOMY|2141.98|2141.98||
125|45800|45800 - CLOSURE RECTOVESICAL FISTULA|1833.24|1833.24||
125|4563F|4563F - PT RECVD ASPIRIN W/IN 24 HRS PRIOR ANESTH START|0.01|0.01||
125|4562F|4562F - PATIENT DOES NOT HAVE A CORONARY ARTERY STENT|0.01|0.01||
125|4561F|4561F - PATIENT HAS A CORONARY ARTERY STENT|0.01|0.01||
125|4560F|4560F - ANESTH DID NOT INVOLVE GENERAL/NEURAXIAL ANESTH|0.01|0.01||
125|4559F|4559F - 1BODY TEMP MEAS>=35.5C IN 30-15 MINS POST ANESTH|0.01|0.01||
125|4558F|4558F - PT RCEVD 2 PROPHYLACTIC RX AGENTS PRE&INTRA-OP|0.01|0.01||
125|4557F|4557F - PT NO EXHIBIT 3+ RISK FACTORS POST-OP NAUSEA/VOM|0.01|0.01||
125|4556F|4556F - PT SHOWS 3+RISK FACTORS POST-OP NAUSEA&VOMITING|0.01|0.01||
125|45563|45563 - EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY|1989.65|1989.65||
125|45562|45562 - EXPL RPR & PRESACRAL DRG RECTAL INJURY|1502.17|1502.17||
125|45560|45560 - REPAIR RECTOCELE SEPARATE PROCEDURE|679.82|679.82||
125|4555F|4555F - PT DID NOT RECEIVE INHALATIONAL ANESTHETIC AGENT|0.01|0.01||
125|45550|45550 - PROCTOPEXY W/SIGMOID RESCJ ABDL APPR|1858.86|1858.86||
125|4554F|4554F - PT RECEIVED INHALATIONAL ANESTHETIC AGENT|0.01|0.01||
125|45541|45541 - PROCTOPEXY PERINEAL APPROACH|1633.42|1633.42||
125|45540|45540 - PROCTOPEXY ABDOMINAL APPROACH|1706.71|1706.71||
125|4553F|4553F - PT OFFERED ASSISTANCE PLANNING END LIFE ISSUES|0.01|0.01||
125|4552F|4552F - PT OFFERED REFERRAL SPEECH LANGUAGE PATHOLOGIST|0.01|0.01||
125|45520|45520 - PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE|82.91|82.91||
125|4551F|4551F - NUTRITIONAL SUPPORT OFFERED|0.01|0.01||
125|4550F|4550F - OPTIONS NONINVASIVE RESP SUPPORT DISCUSSED W/PT|0.01|0.01||
125|45505|45505 - PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE|776.82|776.82||
125|45500|45500 - PROCTOPLASTY STENOSIS|944.71|944.71||
125|4541F|4541F - TX PSEUDOBULBAR AFFECT SIALORRHEA/ALS SYMP|0.01|0.01||
125|4540F|4540F - DISEASE MODIFYING PHARMACOTHERAPY DISCUSSED|0.01|0.01||
125|45402|45402 - LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ|2476.29|2476.29||
125|45400|45400 - LAPAROSCOPY PROCTOPEXY PROLAPSE|1845.81|1845.81||
125|45398|45398 - COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)|1060.41|1060.41||
125|45397|45397 - LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR|3438.78|3438.78||
125|45395|45395 - LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY|3175.33|3175.33||
125|45393|45393 - COLONOSCOPY FLEXIBLE WITH DECOMPRESSION|426.42|426.42||
125|45392|45392 - COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL|370.35|370.35||
125|45391|45391 - COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX|293.31|293.31||
125|45390|45390 - COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION|560.1|560.1||
125|45389|45389 - COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT|488.28|488.28||
125|45388|45388 - COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES|4876.55|4876.55||
125|45386|45386 - COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT|678.51|678.51||
125|45385|45385 - COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ|834.6|834.6||
125|45384|45384 - COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS|781.1|781.1||
125|45382|45382 - COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD|784.87|784.87||
125|45381|45381 - COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST|466.97|466.97||
125|45380|45380 - COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE|652.7|652.7||
125|45379|45379 - COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)|721.79|721.79||
125|45378|45378 - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD|577.8|577.8||
125|45350|45350 - SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)|806.87|806.87||
125|45349|45349 - SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION|334.26|334.26||
125|45347|45347 - SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT|258.76|258.76||
125|45346|45346 - SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES|4634.81|4634.81||
125|45342|45342 - SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX|600.91|600.91||
125|45341|45341 - SIGMOIDOSCOPY FLX NDSC US XM|450.68|450.68||
125|45340|45340 - SIGMOIDOSCOPY FLX TNDSC BALO DILAT|318.03|318.03||
125|45338|45338 - SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ|365.81|365.81||
125|45337|45337 - SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE|361.95|361.95||
125|45335|45335 - SGMDSC FLX DIRED SBMCSL NJX ANY SBST|183.95|183.95||
125|45334|45334 - SIGMOIDOSCOPY FLX CONTROL BLEEDING|429.22|429.22||
125|45333|45333 - SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS|326.35|326.35||
125|45332|45332 - SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY|312.1|312.1||
125|45331|45331 - SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE|214|214||
125|45330|45330 - SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD|181.9|181.9||
125|45327|45327 - PROCTOSGMDSC RIGID TNDSC STENT PLMT|321.26|321.26||
125|45321|45321 - PROCTOSGMDSC RIGID DCMPRN VOLVULUS|275.61|275.61||
125|45320|45320 - PROCTOSGMDSC RIGID ABLATION LESION|352.74|352.74||
125|45317|45317 - PROCTOSGMDSC RIGID CONTROL BLEEDING|266.23|266.23||
125|45315|45315 - PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE|262.57|262.57||
125|45309|45309 - PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ|240.25|240.25||
125|45308|45308 - PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY|220.43|220.43||
125|45307|45307 - PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY|259.86|259.86||
125|45305|45305 - PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE|144.35|144.35||
125|45303|45303 - PROCTOSGMDSC RIGID W/DILATION|698.75|698.75||
125|45300|45300 - PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX|94.23|94.23||
125|4526F|4526F - NEUROPSYCHIATRIC INTERVENTION RECEIVED|0.01|0.01||
125|4525F|4525F - NEUROPSYCHIATRIC INTERVENTION ORDERED|0.01|0.01||
125|45190|45190 - DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH|745.29|745.29||
125|45172|45172 - EXC RCT TUM INCL MUSCULARIS PROPRIA|1335.43|1335.43||
125|45171|45171 - EXC RCT TUM NOT INCL MUSCULARIS PROPRIA|982.74|982.74||
125|45160|45160 - EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL|1527.69|1527.69||
125|45150|45150 - DIVISION STRICTURE RECTUM|673.22|673.22||
125|45136|45136 - EXC ILEOANAL RSVR W/ILEOSTOMY|2225.69|2225.69||
125|45135|45135 - EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH|2445.84|2445.84||
125|45130|45130 - EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH|1627.47|1627.47||
125|45126|45126 - PELVIC EXENTERATION COLORECTAL MALIGNANCY|4486.46|4486.46||
125|45123|45123 - PRCTECT PRTL W/O ANAST PRNL APPR|1638.9|1638.9||
125|45121|45121 - PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS|2524.02|2524.02||
125|45120|45120 - PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS|2817.29|2817.29||
125|45119|45119 - PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM|2807.8|2807.8||
125|45116|45116 - PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY|2082.52|2082.52||
125|45114|45114 - PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH|2754.75|2754.75||
125|45113|45113 - PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR|2820.52|2820.52||
125|45112|45112 - PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX|2693|2693||
125|45111|45111 - PRCTECT PRTL RESCJ RECTUM TABDL APPR|1969.17|1969.17||
125|45110|45110 - PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST|2853.69|2853.69||
125|4510F|4510F - PREVIOUS CARDIAC REHAB FOR QUAL CARD EVENT DONE|0.01|0.01||
125|45108|45108 - ANORECTAL MYOMECTOMY|703.72|703.72||
125|45100|45100 - BX ANORECTAL WALL ANAL APPROACH|360.06|360.06||
125|45020|45020 - I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC|504.26|504.26||
125|4500F|4500F - REFERRED TO OUTPT CARD REHABILITATION PROGRAM|0.01|0.01||
125|45005|45005 - I&D SUBMUCOSAL ABSCESS RECTUM|260.34|260.34||
125|45000|45000 - TRANSRECTAL DRAINAGE OF PELVIC ABSCESS|374.86|374.86||
125|44970|44970 - LAPAROSCOPIC APPENDECTOMY|855.12|855.12||
125|44960|44960 - APPENDEC RPTD APPENDIX ABSC/PRITONITIS|1105.04|1105.04||
125|44955|44955 - APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX|316.65|316.65||
125|44950|44950 - APPENDECTOMY|839.85|839.85||
125|44900|44900 - INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN|831.9|831.9||
125|44850|44850 - SUTURE MESENTERY SEPARATE PROCEDURE|1178.66|1178.66||
125|44820|44820 - EXCISION LESION MESENTERY SEPARATE PROCEDURE|1009.86|1009.86||
125|4481F|4481F - PT RCVNG ACE/ARB AND BETA BLOCKER < 3 MONTHS|0.01|0.01||
125|4480F|4480F - PT RCVNG ACE/ARB BETA BLOCKER TX 3 MONS/LONGER|0.01|0.01||
125|44800|44800 - EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT|1082.84|1082.84||
125|44721|44721 - BKBENCH RCNSTJ INT ALGRFT ARTL ANAST EA|407.33|407.33||
125|44720|44720 - BKBENCH RCNSTJ INT ALGRFT VEN ANAST EA|278.4|278.4||
125|44715|44715 - BKBENCH PREP CADAVER/LIVING DONOR INTESTINE|357.25|357.25||
125|4470F|4470F - IMPLANT CARDIOVERT-DEFIB (ICD) COUNSELING PROV|0.01|0.01||
125|44705|44705 - PREPARE FECAL MICROBIOTA FOR INSTILLATION|182.95|182.95||
125|44701|44701 - INTRAOPERATIVE COLONIC LAVAGE|247.3|247.3||
125|44700|44700 - EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS|1458.38|1458.38||
125|44680|44680 - INTESTINAL PLICATION SEPARATE PROCEDURE|1620.25|1620.25||
125|44661|44661 - CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ|2045.84|2045.84||
125|44660|44660 - CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ|1498.02|1498.02||
125|44650|44650 - CLSR ENTEROENTERIC/ENTEROCOLIC FSTL|1496.41|1496.41||
125|44640|44640 - CLOSURE INTESTINAL CUTANEOUS FISTULA|1289.76|1289.76||
125|44626|44626 - CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS|2038.4|2038.4||
125|44625|44625 - CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT|1529.83|1529.83||
125|44620|44620 - CLOSURE ENTEROSTOMY LG/SMALL INTESTINE|1109.59|1109.59||
125|44615|44615 - INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ|1486.74|1486.74||
125|44605|44605 - SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY|1689.32|1689.32||
125|44604|44604 - SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY|1468.04|1468.04||
125|44603|44603 - ENTERORRHAPHY MULTIPLE PERFORATIONS|1546.69|1546.69||
125|44602|44602 - ENTERORRHAPHY SINGLE PERFORATION|1223.28|1223.28||
125|4450F|4450F - SELF-CARE EDUCATION PROVIDED TO PATIENT|0.01|0.01||
125|44500|44500 - INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE|52.16|52.16||
125|44408|44408 - COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION|389.72|389.72||
125|44407|44407 - COLONOSCOPY STOMA W/US GID NDL ASPIR/BX|463.75|463.75||
125|44406|44406 - COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM|386.33|386.33||
125|44405|44405 - COLONOSCOPY STOMA W/BALLOON DILATION|831.5|831.5||
125|44404|44404 - COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION|569.54|569.54||
125|44403|44403 - COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ|511.46|511.46||
125|44402|44402 - COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT|440.18|440.18||
125|44401|44401 - COLONOSCOPY STOMA ABLATION LESION|4833.41|4833.41||
125|44394|44394 - COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE|668.45|668.45||
125|44392|44392 - COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS|706.76|706.76||
125|44391|44391 - COLONOSCOPY STOMA CONTROL BLEEDING|779.81|779.81||
125|44390|44390 - COLONOSCOPY STOMA W/RMVL FOREIGN BODY|608.51|608.51||
125|44389|44389 - COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE|637.84|637.84||
125|44388|44388 - COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX|422.65|422.65||
125|44386|44386 - NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE|433.76|433.76||
125|44385|44385 - NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX|408.56|408.56||
125|44384|44384 - ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT|257.12|257.12||
125|44382|44382 - ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE|351.37|351.37||
125|44381|44381 - ILEOSCOPY STOMA W/BALLOON DILATION|1398.47|1398.47||
125|44380|44380 - ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD|295.67|295.67||
125|44379|44379 - ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT|959.15|959.15||
125|44378|44378 - ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING|808.6|808.6||
125|44377|44377 - ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE|612.66|612.66||
125|44376|44376 - ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX|571.52|571.52||
125|44373|44373 - ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE|554.33|554.33||
125|44372|44372 - ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE|625.54|625.54||
125|44370|44370 - ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT|940.66|940.66||
125|44369|44369 - ENTEROSCOPY > 2ND PRTN ABLTJ LESION|745.02|745.02||
125|44366|44366 - ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING|726.77|726.77||
125|44365|44365 - ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY|556.52|556.52||
125|44364|44364 - ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE|634.04|634.04||
125|44363|44363 - ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY|518.14|518.14||
125|44361|44361 - ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY|523.8|523.8||
125|44360|44360 - ENDOSCOPY UPPER SMALL INTESTINE|424.62|424.62||
125|44346|44346 - REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX|1279.97|1279.97||
125|44345|44345 - REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX|1082.34|1082.34||
125|44340|44340 - REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX|503.39|503.39||
125|44322|44322 - COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX|1360.98|1360.98||
125|44320|44320 - COLOSTOMY/SKIN LEVEL CECOSTOMY|1389.93|1389.93||
125|44316|44316 - CONTINENT ILEOSTOMY KOCK PROCEDURE SPX|2023.79|2023.79||
125|44314|44314 - REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX|1347.2|1347.2||
125|44312|44312 - REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX|508.37|508.37||
125|44310|44310 - ILEOSTOMY/JEJUNOSTOMY NON-TUBE|1307.54|1307.54||
125|44300|44300 - PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN|1025.06|1025.06||
125|44227|44227 - LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS|2673.12|2673.12||
125|44213|44213 - LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY|322.06|322.06||
125|44212|44212 - LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY|1948.49|1948.49||
125|44211|44211 - LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS|2104.08|2104.08||
125|44210|44210 - LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS|1691.11|1691.11||
125|44208|44208 - LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST|1915.6|1915.6||
125|44207|44207 - LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST|1767.67|1767.67||
125|44206|44206 - LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM|1629.17|1629.17||
125|44205|44205 - LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM|2720.28|2720.28||
125|44204|44204 - LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS|2983.01|2983.01||
125|44203|44203 - LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS|1132.8|1132.8||
125|44202|44202 - LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA|2037.32|2037.32||
125|44201|44201 - LAPAROSCOPY -  JEJUNOSTOMY|1128.82|1128.82||
125|44200|44200 - LAPAROSCOPY -  ENTEROLYSIS|1416.54|1416.54||
125|44188|44188 - LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY|1912.59|1912.59||
125|44187|44187 - LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE|1735.88|1735.88||
125|44186|44186 - LAPAROSCOPY SURGICAL JEJUNOSTOMY|1087.43|1087.43||
125|44180|44180 - LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE|1414.72|1414.72||
125|44160|44160 - COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS|1882.13|1882.13||
125|44158|44158 - COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR|3285.21|3285.21||
125|44157|44157 - COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST|3201.8|3201.8||
125|44156|44156 - COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST|3127.85|3127.85||
125|44155|44155 - COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY|2742.68|2742.68||
125|44151|44151 - COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST|2594.71|2594.71||
125|44150|44150 - COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS|2616.15|2616.15||
125|44147|44147 - COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH|2439.59|2439.59||
125|44146|44146 - COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY|2620.7|2620.7||
125|44145|44145 - COLECTOMY PRTL W/COLOPROCTOSTOMY|2601.7|2601.7||
125|44144|44144 - COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA|1991.8|1991.8||
125|44143|44143 - COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT|2069.92|2069.92||
125|44141|44141 - COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY|2088.1|2088.1||
125|44140|44140 - COLECTOMY PARTIAL W/ANASTOMOSIS|2247|2247||
125|44139|44139 - MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT|232.19|232.19||
125|44137|44137 - RMVL TRNSPLED INTESTINAL ALLOGRAFT COMPL|1155.7|1155.7||
125|44136|44136 - INTESTINAL ALLOTRANSPLANTATION LIVING DONOR|3763.19|3763.19||
125|44135|44135 - INTESTINAL ALLOTRANSPLANTATION CADAVER DONOR|3763.19|3763.19||
125|44133|44133 - DONOR ENTERECTOMY OPEN LIVING DONOR|1982.6|1982.6||
125|44132|44132 - DONOR ENTERECTOMY OPEN CADAVER DONOR|2385|2385||
125|44130|44130 - ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX|1487.82|1487.82||
125|44128|44128 - ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS|1137.51|1137.51||
125|44127|44127 - ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING|2732.65|2732.65||
125|44126|44126 - ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING|2732.65|2732.65||
125|44125|44125 - ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY|1745.46|1745.46||
125|44121|44121 - ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA|627.07|627.07||
125|44120|44120 - ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST|1739.82|1739.82||
125|44111|44111 - EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE|1710.91|1710.91||
125|44110|44110 - EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM|1180.75|1180.75||
125|44100|44100 - BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS|204.61|204.61||
125|44055|44055 - CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS|1377.89|1377.89||
125|44050|44050 - RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT|1266.34|1266.34||
125|44025|44025 - COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL|1447.76|1447.76||
125|44021|44021 - ENTEROTOMY SM INT OTH/THN DUO DCMPRN|1249.98|1249.98||
125|44020|44020 - ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL|1417.15|1417.15||
125|44015|44015 - TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD|561.75|561.75||
125|44010|44010 - DUODENOTOMY EXPLORATION/BX/FOREIGN BODY REMOVAL|1155.87|1155.87||
125|4400F|4400F - REHAB THERAPY OPTIONS DISCUSSED W/PATIENT|0.01|0.01||
125|44005|44005 - ENTEROLSS FRING INTSTINAL ADHESION SPX|1592.16|1592.16||
125|43888|43888 - GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT|659.82|659.82||
125|43887|43887 - GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY|460.24|460.24||
125|43886|43886 - GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY|484.45|484.45||
125|43882|43882 - REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN|760.24|760.24||
125|43881|43881 - IMPLTJ/RPLCMT GASTRIC NSTIM ELTRDE ANTRUM OPEN|670.31|670.31||
125|43880|43880 - CLOSURE GASTROCOLIC FISTULA|1829.76|1829.76||
125|43870|43870 - CLOSURE GASTROSTOMY SURG|881.61|881.61||
125|43865|43865 - REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY|2194.47|2194.47||
125|43860|43860 - REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY|2012.98|2012.98||
125|43855|43855 - REVJ GASTRODUOL ANAST W/RCNSTJ W/VGTMY|2163.55|2163.55||
125|43850|43850 - REVJ GASTRODUOL ANAST W/RCNSTJ W/O VAGOTOMY|2017.12|2017.12||
125|43848|43848 - REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE|2194.99|2194.99||
125|43847|43847 - GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ|2603.5|2603.5||
125|43846|43846 - GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<|2595.88|2595.88||
125|43845|43845 - GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM|3285.95|3285.95||
125|43843|43843 - GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP|2312.03|2312.03||
125|43842|43842 - GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY|2051.84|2051.84||
125|43840|43840 - GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ|1300.85|1300.85||
125|43832|43832 - GASTROSTOMY OPN W/CONSTJ GSTR TUBE|1276.79|1276.79||
125|43831|43831 - GASTROSTOMY OPN NEONATAL FEEDING|820.16|820.16||
125|43830|43830 - GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX|837.01|837.01||
125|43825|43825 - GASTROJEJUNOSTOMY W/VAGOTOMY ANY TYPE|1803.08|1803.08||
125|43820|43820 - GASTROJEJUNOSTOMY W/O VAGOTOMY|1403.69|1403.69||
125|43810|43810 - GASTRODUODENOSTOMY|1369.13|1369.13||
125|43800|43800 - PYLOROPLASTY|1249.18|1249.18||
125|43775|43775 - LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY|1874.47|1874.47||
125|43774|43774 - LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT|1464.76|1464.76||
125|43773|43773 - LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE|1936.56|1936.56||
125|43772|43772 - LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE|1458.96|1458.96||
125|43771|43771 - LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE|1935.91|1935.91||
125|43770|43770 - LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE|1692.01|1692.01||
125|43761|43761 - REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO|185.13|185.13||
125|43760|43760 - CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GDNCE|122.54|122.54||
125|43757|43757 - DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN|450.65|450.65||
125|43756|43756 - DUODENAL INTUBAT W/IMAG GUIDED SINGLE SPECIMEN|317.36|317.36||
125|43755|43755 - GASTRIC INTUBATION DX & ASPIRATJ MULTIPLE SPEC|213.58|213.58||
125|43754|43754 - GASTRIC INTUBAT DX W/ASPIRATION SINGLE SPECIMEN|205.43|205.43||
125|43753|43753 - GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE|36.51|36.51||
125|43752|43752 - NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE|104|104||
125|43659|43659 - UNLISTED LAPAROSCOPIC PROCEDURE STOMACH|4969.08|4969.08||
125|43653|43653 - LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX|802.54|802.54||
125|43652|43652 - LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV|1827.05|1827.05||
125|43651|43651 - LAPS SURG TRNSXJ VAGUS NRV TRUNCAL|1249.03|1249.03||
125|43648|43648 - LAPS REVISION/RMVL GASTRIC NSTIM ELTRD ANTRUM|550.25|550.25||
125|43647|43647 - LAPS IMPLTJ/RPLCMT GASTRIC NSTIM ELTRD ANTRUM|589.42|589.42||
125|43645|43645 - LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ|1781.92|1781.92||
125|43644|43644 - LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM|1652.05|1652.05||
125|43641|43641 - VGTMY W/PYLOROPLASTY W/WO GASTROST PARIETAL CELL|1937.9|1937.9||
125|43640|43640 - VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV|1667.86|1667.86||
125|43639|43639 - REMOVE STOMACH -  PARTIAL W/VAGOTOMY|2567.74|2567.74||
125|43638|43638 - REMOVE STOMACH -  PARTIAL W/VAGOTOMY|2363.15|2363.15||
125|43635|43635 - VAGOTOMY PFRMD W/PRTL DSTL GSTRCT|525.34|525.34||
125|43634|43634 - GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH|2877.04|2877.04||
125|43633|43633 - GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ|2249.04|2249.04||
125|43632|43632 - GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY|1969.14|1969.14||
125|43631|43631 - GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY|1969.08|1969.08||
125|43622|43622 - GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYPE|3093.68|3093.68||
125|43621|43621 - GSTRCT TOT W/ROUX-EN-Y RCNSTJ|2570.41|2570.41||
125|43620|43620 - GSTRCT TOT W/ESOPHAGOENTEROSTOMY|2616.09|2616.09||
125|43611|43611 - EXC LOCAL MALIGNANT TUMOR STOMACH|1504.4|1504.4||
125|43610|43610 - EXC LOCAL ULCER/BENIGN TUMOR STOMACH|1406.35|1406.35||
125|43605|43605 - BIOPSY STOMACH LAPAROTOMY|1136.61|1136.61||
125|43520|43520 - PYLOROMYOTOMY CUTTING PYLORIC MUSC|806.78|806.78||
125|43510|43510 - GSTRT W/ESOPHGL DILAT&INSJ PRM INTRAL TUBE|1359.55|1359.55||
125|4350F|4350F - COUNSELING PROVIDED SYMP MNGMNT PALLIATION|0.01|0.01||
125|43502|43502 - GASTROTOMY W/SUTR RPR PRE-ESOPG/GASTRIC LAC|1606.07|1606.07||
125|43501|43501 - GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER|1680.49|1680.49||
125|43500|43500 - GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL|965.14|965.14||
125|43496|43496 - FREE JEJUNUM TRSF W/MICROVASC ANASTOMOSIS|3143.23|3143.23||
125|43460|43460 - ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE|354.93|354.93||
125|43453|43453 - DILATION ESOPHAGUS GUIDE WIRE|282.28|282.28||
125|43450|43450 - DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS|214|214||
125|43425|43425 - CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR|1636.24|1636.24||
125|43420|43420 - CLSR ESOPHAGOSTOMY/FSTL CRV APPR|1114.99|1114.99||
125|43415|43415 - SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR|1998.37|1998.37||
125|43410|43410 - SUTR ESOPHGL WND/INJ CRV APPR|1377.31|1377.31||
125|4340F|4340F - COUNSEL WOMEN CHILDBEARING POTENTIAL W/EPILEPSY|0.01|0.01||
125|43405|43405 - LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J|1688.32|1688.32||
125|43401|43401 - TRNSXJ ESOPH W/RPR ESOPHAGEAL VARICES|1499.28|1499.28||
125|43400|43400 - LIGATION DIRECT ESOPHAGEAL VARICES|2058.18|2058.18||
125|43361|43361 - GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT|3728.97|3728.97||
125|43360|43360 - GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH|3125.13|3125.13||
125|43352|43352 - ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR|1424.3|1424.3||
125|43351|43351 - ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR|1576.52|1576.52||
125|43341|43341 - ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR|2122.17|2122.17||
125|43340|43340 - ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR|2188.85|2188.85||
125|43338|43338 - ESOPHAGUS LENGTHENING|196.09|196.09||
125|43337|43337 - RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH|2597.78|2597.78||
125|43336|43336 - RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH|2513.9|2513.9||
125|43335|43335 - RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH|2247.93|2247.93||
125|43334|43334 - RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH|2091.88|2091.88||
125|43333|43333 - LAPT RPR PARAESOPH HIATAL HERNIA W/MESH|2109.42|2109.42||
125|43332|43332 - RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH|1935.53|1935.53||
125|43331|43331 - ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH|1967.08|1967.08||
125|43330|43330 - ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH|1851.22|1851.22||
125|43328|43328 - ESOPG/GSTR FUNDOPLASTY W/THORACOTOMY|1890.26|1890.26||
125|43327|43327 - ESOPG/GSTR FUNDOPLASTY W/LAPAROTOMY|1366.9|1366.9||
125|43325|43325 - ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH|2044.6|2044.6||
125|43320|43320 - EGST W/WO VAGOTOMY&PYLOROPLASTY TABDL/TTHRC AP|2081.86|2081.86||
125|43314|43314 - ESPHGP CGEN DFCT THRC APPR W/RPR FSTL|4216.44|4216.44||
125|43313|43313 - ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL|3709.48|3709.48||
125|43312|43312 - ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL|2798.63|2798.63||
125|43310|43310 - ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL|2728.1|2728.1||
125|4330F|4330F - EPILEPSY SPECIFIC SAFETY COUNSELING TO PATIENT|0.01|0.01||
125|43305|43305 - ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL|2074.8|2074.8||
125|43300|43300 - ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL|1680.05|1680.05||
125|4328F|4328F - PT/CAREGIVER QUERIED SLEEP DISTURBANCES|0.01|0.01||
125|43288|43288 - ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ|6247.82|6247.82||
125|43287|43287 - ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ|5990.87|5990.87||
125|43286|43286 - ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ|5239.29|5239.29||
125|43285|43285 - REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE|1028.32|1028.32||
125|43284|43284 - LAPS ESOPHGL SPHNCTR AGMNTJ PLMT DEV CRRPL|1078.18|1078.18||
125|43283|43283 - LAPS ESOPHAGEAL LENGTHENING ADDL|267.29|267.29||
125|43282|43282 - LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH|2902.69|2902.69||
125|43281|43281 - LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH|2579.75|2579.75||
125|43280|43280 - LAPS SURG ESOPG/GSTR FUNDOPLASTY|1775.95|1775.95||
125|43279|43279 - LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED|2153.25|2153.25||
125|43278|43278 - ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE|729.33|729.33||
125|43277|43277 - ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA|637.44|637.44||
125|43276|43276 - ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE|811.23|811.23||
125|43275|43275 - ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT|634.04|634.04||
125|43274|43274 - ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT|779.14|779.14||
125|43273|43273 - ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC|201.4|201.4||
125|43270|43270 - EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE|1033.39|1033.39||
125|4326F|4326F - PT/CAREGIVER QUERIED AUTONOMIC DYSFUNCJ SYMPTOMS|0.01|0.01||
125|43266|43266 - EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION|366.99|366.99||
125|43265|43265 - ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD|995.87|995.87||
125|43264|43264 - ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT|1075.88|1075.88||
125|43263|43263 - ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI|924.77|924.77||
125|43262|43262 - ERCP W/SPHINCTEROTOMY/PAPILLOTOMY|964.87|964.87||
125|43261|43261 - ERCP W/BIOPSY SINGLE/MULTIPLE|740.17|740.17||
125|43260|43260 - ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING|720.38|720.38||
125|4325F|4325F - MEDICAL & SURGICAL TREATMENT OPTION REVIEW W/P|0.01|0.01||
125|43259|43259 - EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM|509.36|509.36||
125|43257|43257 - EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD|315.81|315.81||
125|43255|43255 - EGD TRANSORAL CONTROL BLEEDING ANY METHOD|584.49|584.49||
125|43254|43254 - EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION|454.57|454.57||
125|43253|43253 - EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER|441.83|441.83||
125|43252|43252 - EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY|478.05|478.05||
125|43251|43251 - EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH|493.8|493.8||
125|43250|43250 - EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS|512.93|512.93||
125|4324F|4324F - PT QUERIED PARKINSONS MED-RELATED COMPLICATION|0.01|0.01||
125|43249|43249 - EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM|388.95|388.95||
125|43248|43248 - EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS|423.72|423.72||
125|43247|43247 - EGD FLEXIBLE FOREIGN BODY REMOVAL|455.55|455.55||
125|43246|43246 - EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE|568.11|568.11||
125|43245|43245 - EGD DILATION GASTRIC/DUODENAL STRICTURE|457.42|457.42||
125|43244|43244 - EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES|498.62|498.62||
125|43243|43243 - EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES|600.81|600.81||
125|43242|43242 - EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY|1046.97|1046.97||
125|43241|43241 - EGD INTRALUMINAL TUBE/CATHETER INSERTION|447.97|447.97||
125|43240|43240 - EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST|1458.37|1458.37||
125|43239|43239 - EGD TRANSORAL BIOPSY SINGLE/MULTIPLE|481.5|481.5||
125|43238|43238 - EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS|767.32|767.32||
125|43237|43237 - ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS|656.38|656.38||
125|43236|43236 - ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION|889.81|889.81||
125|43235|43235 - ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC|417.3|417.3||
125|43233|43233 - EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER|384.11|384.11||
125|43232|43232 - ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX|766.62|766.62||
125|43231|43231 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM|655.34|655.34||
125|4322F|4322F - CRGVR PROVIDED W/ED REFERRED ADDL RESOURCES|0.01|0.01||
125|43229|43229 - ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION|999.92|999.92||
125|43227|43227 - ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL|519.55|519.55||
125|43226|43226 - ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION|421.59|421.59||
125|43220|43220 - ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM|395.32|395.32||
125|43217|43217 - ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE|478.4|478.4||
125|43216|43216 - ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS|451.66|451.66||
125|43215|43215 - ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY|349.28|349.28||
125|43214|43214 - ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM|322.79|322.79||
125|43213|43213 - ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER|1759.93|1759.93||
125|43212|43212 - ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT|319.58|319.58||
125|43211|43211 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN|394.92|394.92||
125|43210|43210 - EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY|752.2|752.2||
125|4320F|4320F - PT COUNSEL PSYCHSOC & PHARM TX ALCOHOL DEPEND|0.01|0.01||
125|43206|43206 - ESOPHAGOSCOPY TRANSORAL W/OPTICAL ENDOMICROSCOPY|417.46|417.46||
125|43205|43205 - ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES|493.24|493.24||
125|43204|43204 - ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES|591.05|591.05||
125|43202|43202 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY|372.05|372.05||
125|43201|43201 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ|674.87|674.87||
125|43200|43200 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC|300.22|300.22||
125|43198|43198 - ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY|330.58|330.58||
125|43197|43197 - ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC|298.96|298.96||
125|43196|43196 - ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION|323.83|323.83||
125|43195|43195 - ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION|304.06|304.06||
125|43194|43194 - ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY|320.46|320.46||
125|43193|43193 - ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY|277.62|277.62||
125|43192|43192 - ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL|276.37|276.37||
125|43191|43191 - ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH|253.19|253.19||
125|43180|43180 - ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH|893.94|893.94||
125|43135|43135 - DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR|1965.76|1965.76||
125|43130|43130 - DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR|1482.15|1482.15||
125|43124|43124 - TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY|3175.94|3175.94||
125|43123|43123 - PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ|3868.35|3868.35||
125|43122|43122 - PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL|3255.61|3255.61||
125|43121|43121 - PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY|3143.84|3143.84||
125|43118|43118 - PRTL ESOPH DSTL W/WO PROX GASTRC W/COLON NTRPSTJ|4082.19|4082.19||
125|43117|43117 - PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY|3428.67|3428.67||
125|43116|43116 - PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF|4036.61|4036.61||
125|43113|43113 - TOT ESOPHG W/THORCOM W/COLON NTRPSTJ/INT RCNSTJ|3910.37|3910.37||
125|43112|43112 - TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY|3408.42|3408.42||
125|43108|43108 - TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ|3830.47|3830.47||
125|43107|43107 - TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY|3310.69|3310.69||
125|43101|43101 - EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR|1924.41|1924.41||
125|43100|43100 - EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR|1326.2|1326.2||
125|4306F|4306F - PT COUNSEL PSYCHOSOC&PHARM TX OPIOID ADDICTION|0.01|0.01||
125|4305F|4305F - PT EDUC FOOT CARE & DAILY INSPCTN FEET RCVD|0.01|0.01||
125|43045|43045 - ESOPHAGOTOMY THORACIC APPR W/RMVL FB|2059.17|2059.17||
125|43030|43030 - CRICOPHARYNGEAL MYOTOMY|1269.17|1269.17||
125|43020|43020 - ESOPHAGOTOMY CERVICAL APPR W/RMVL FB|1145.58|1145.58||
125|4301F|4301F - PT NOT RCVNG WARFARIN THXPY NONVALV AFIB/AFLUT|0.01|0.01||
125|4300F|4300F - PT RCVNG WARFARIN THXPY NONVALV AFIB OR AFLUT|0.01|0.01||
125|42972|42972 - CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ|519.71|519.71||
125|42971|42971 - CTRL NASOPHARYNGEAL HEMRRG COMP REQ HOSPIZATION|486.92|486.92||
125|42970|42970 - CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS|384.56|384.56||
125|42962|42962 - CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ|598.78|598.78||
125|42961|42961 - CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ|421.69|421.69||
125|42960|42960 - CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE|205.5|205.5||
125|42955|42955 - PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING|712.21|712.21||
125|42953|42953 - PHARYNGOESOPHAGEAL REPAIR|1396.78|1396.78||
125|42950|42950 - PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX|1261.5|1261.5||
125|4293F|4293F - PT SCRND HGH-RSK SEXUAL BEHAVIOR|0.01|0.01||
125|4290F|4290F - PATIENT SCREENED FOR INJECTION DRUG USE|0.01|0.01||
125|42900|42900 - SUTURE PHARYNX WOUND/INJURY|625.84|625.84||
125|42894|42894 - RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS|2832.57|2832.57||
125|42892|42892 - RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR|1837.67|1837.67||
125|42890|42890 - LIMITED PHARYNGECTOMY|1397.57|1397.57||
125|42870|42870 - EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX|552.83|552.83||
125|42860|42860 - EXCISION TONSIL TAGS|306.29|306.29||
125|42845|42845 - RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP|3229.3|3229.3||
125|42844|42844 - RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP|2608.84|2608.84||
125|42842|42842 - RADICAL RESECTION TONSIL W/O CLOSURE|1990.41|1990.41||
125|42836|42836 - ADENOIDECTOMY SECONDARY AGE 12/>|417.14|417.14||
125|42835|42835 - ADENOIDECTOMY SECONDARY<AGE 12|308.12|308.12||
125|42831|42831 - ADENOIDECTOMY PRIMARY AGE 12/>|382.62|382.62||
125|42830|42830 - ADENOIDECTOMY PRIMARY <AGE 12|395.9|395.9||
125|42826|42826 - TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>|586.27|586.27||
125|42825|42825 - TONSILLECTOMY PRIMARY/SECONDARY <AGE 12|543.56|543.56||
125|42821|42821 - TONSILLECTOMY & ADENOIDECTOMY AGE 12/>|610.96|610.96||
125|42820|42820 - TONSILLECTOMY & ADENOIDECTOMY <AGE 12|539.28|539.28||
125|42815|42815 - EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX|1002.44|1002.44||
125|42810|42810 - EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS|410.78|410.78||
125|4280F|4280F - PNEUMOCYS JIROVECI PNEUMO PRPHYLXS PRSCRBD 3 MON|0.01|0.01||
125|42809|42809 - REMOVAL FOREIGN BODY PHARYNX|196.16|196.16||
125|42808|42808 - EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD|324.47|324.47||
125|42806|42806 - BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION|247.21|247.21||
125|42804|42804 - BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE|195.19|195.19||
125|42800|42800 - BIOPSY OROPHARYNX|139.56|139.56||
125|4279F|4279F - PNEUMOCYSTIS JIROVECI PNEUMONIA PROPHYLAXIS RXD|0.01|0.01||
125|4276F|4276F - POTENT ANTIRETROVIRAL THERAPY PRESCRIBED|0.01|0.01||
125|4274F|4274F - FLU IMMUNO ADMIND/PREVIOUSLY RCVD|0.01|0.01||
125|42725|42725 - I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR|765.49|765.49||
125|42720|42720 - I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL|413.6|413.6||
125|4271F|4271F - PT RCVNG POT ANTI R-VIRAL THX <6 MON/NOT RCVN|0.01|0.01||
125|4270F|4270F - PT RCVNG POTENT ANTI R-VIRAL THX 6 MON OR MORE|0.01|0.01||
125|42700|42700 - I&D ABSCESS PERITONSILLAR|172.8|172.8||
125|4269F|4269F - APPROP METHOD OFFLOADING PRESCRIBED|0.01|0.01||
125|4268F|4268F - PT ED RE NEED LONG TERM COMPRESS THXPY RCVD|0.01|0.01||
125|4267F|4267F - COMPRESSION THERAPY PRESCRIBED|0.01|0.01||
125|4266F|4266F - USE WET TO DRY DRESSINGS NEITHER RXD NOR RECMD|0.01|0.01||
125|42665|42665 - LIGATION SALIVARY DUCT INTRAORAL|260.75|260.75||
125|42660|42660 - DILAT&CATHJ SALIVARY DUCT W/WO INJECTION|100.92|100.92||
125|4265F|4265F - USE OF WET TO DRY DRESSINGS PRESCRIBED RECMD|0.01|0.01||
125|42650|42650 - DILATION SALIVARY DUCT|75.11|75.11||
125|4261F|4261F - TECH OTHER THAN SURFACE CULTURE WOUND EXUD USED|0.01|0.01||
125|4260F|4260F - WOUND SURFACE CULTURE TECHNIQUE USED|0.01|0.01||
125|42600|42600 - CLOSURE SALIVARY FISTULA|784.16|784.16||
125|4256F|4256F - DURATION GEN NEUR ANESTH <60 MIN DOCD RECORD|0.01|0.01||
125|4255F|4255F - DURATION GEN NEUR ANESTH 60 MINS/> DOC RECORD|0.01|0.01||
125|42550|42550 - INJECTION PROCEDURE SIALOGRAPHY|517.66|517.66||
125|42510|42510 - PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS|1559.06|1559.06||
125|4250F|4250F - ACTV WRMNG INTRAOP FOR NORMOTHERMIA|0.01|0.01||
125|42509|42509 - PAROTID DUCT DVRJ BI W/EXC BOTH SUBMNDBLR GLANDS|1507.23|1507.23||
125|42507|42507 - PAROTID DUCT DIVERSION BILATERAL WILKE PX|952.44|952.44||
125|42505|42505 - PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP|978.46|978.46||
125|42500|42500 - PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM|635.78|635.78||
125|4248F|4248F - COUNSEL INIT BACK PAIN AGNST BED REST 4 DAYS/>|0.01|0.01||
125|4245F|4245F - PT TLK 1ST VST TO KEEP/RESUME NORMAL ACTIVITIES|0.01|0.01||
125|42450|42450 - EXISION OF SUBLINGUAL GLAND|523.93|523.93||
125|42440|42440 - EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND|933.84|933.84||
125|4242F|4242F - TLK RE SPRVSD XRCS PROG TO PTS BACK PN >12WKS|0.01|0.01||
125|42426|42426 - EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ|2914.33|2914.33||
125|42425|42425 - EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL|1420.99|1420.99||
125|42420|42420 - EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR|2289.53|2289.53||
125|42415|42415 - EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR|1976.02|1976.02||
125|42410|42410 - EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ|859.46|859.46||
125|4240F|4240F - INSTR THER XRCS-DR FLLWUP PT EPSD BACK PN >12 WK|0.01|0.01||
125|42409|42409 - MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA|413.06|413.06||
125|42408|42408 - EXC SUBLINGUAL SALIVARY CYST RANULA|486.78|486.78||
125|42405|42405 - BIOPSY SALIVARY GLAND INCISIONAL|291.06|291.06||
125|42400|42400 - BIOPSY SALIVARY GLAND NEEDLE|107.62|107.62||
125|42340|42340 - SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL|659.4|659.4||
125|42335|42335 - SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL|452.18|452.18||
125|42330|42330 - SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL|230.26|230.26||
125|42326|42326 - CREATE SALIVARY CYST DRAIN W/PROSTH|446.07|446.07||
125|42325|42325 - CREATE SALIVARY CYST DRAIN|312.44|312.44||
125|42320|42320 - DRAINAGE ABSCESS SUBMAXILLARY INTRAORAL|227.3|227.3||
125|42310|42310 - DRG ABSC SUBMAXILLARY/SUBLINGUAL INTRAORAL|156.12|156.12||
125|4230F|4230F - ANTICONVUL MED THERAPY 6 MOS/>|0.01|0.01||
125|42305|42305 - DRAINAGE ABSCESS PAROTID COMPLICATED|439.4|439.4||
125|42300|42300 - DRAINAGE ABSCESS PAROTID SIMPLE|189.07|189.07||
125|42281|42281 - INSJ PIN-RETAINED PALATAL PROSTHESIS|242.24|242.24||
125|42280|42280 - MAXILLARY IMPRESJ PALATAL PROSTHESIS|202.57|202.57||
125|42260|42260 - REPAIR NASOLABIAL FISTULA|823.87|823.87||
125|42235|42235 - REPAIR ANTERIOR PALATE W/VOMER FLAP|1242.83|1242.83||
125|42227|42227 - LENGTHENING PALATE W/ISLAND FLAP|1727.47|1727.47||
125|42226|42226 - LENGTHENING PALATE & PHARYNGEAL FLAP|1779.92|1779.92||
125|42225|42225 - PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP|1429.32|1429.32||
125|42220|42220 - PALATOPLASTY CLEFT PALATE SEC LNGTH PX|1256.38|1256.38||
125|4221F|4221F - DIURETIC MEDICATION THERAPY 6 MOS/>|0.01|0.01||
125|42215|42215 - PALATOPLASTY CLEFT PALATE MAJOR REVJ|1697.93|1697.93||
125|42210|42210 - PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE|1971.52|1971.52||
125|4220F|4220F - DIGOXIN MEDICATION THERAPY 6 MONTHS/>|0.01|0.01||
125|42205|42205 - PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE|1660.29|1660.29||
125|42200|42200 - PALATOP CL PALATE SOFT&/HARD PALATE ONLY|1637.59|1637.59||
125|42182|42182 - REPAIR LACERATION PALATE >2 CM/COMPLEX|466.09|466.09||
125|42180|42180 - REPAIR LACERATION PALATE </2 CM|295.79|295.79||
125|42160|42160 - DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM|231.66|231.66||
125|42145|42145 - PALATOPHARYNGOPLASTY|1250.64|1250.64||
125|42140|42140 - UVULECTOMY EXCISION UVULA|203.85|203.85||
125|42120|42120 - RESCJ PALATE/EXTENSIVE RESCJ LESION|936.18|936.18||
125|4210F|4210F - ACE/ARB MEDICATION THERAPY 6 MONTHS/>|0.01|0.01||
125|42107|42107 - EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE|588.96|588.96||
125|42106|42106 - EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE|345.64|345.64||
125|42104|42104 - EXC LESION PALATE UVULA W/O CLOSURE|258.8|258.8||
125|42100|42100 - BIOPSY PALATE UVULA|155.89|155.89||
125|4201F|4201F - EXTRNL BM RADIOTHXPY W/WO NODAL IRRAD AS ADJV|0.01|0.01||
125|4200F|4200F - EXTRNL BM RADIOTHXPY TO PROST W/WO NODAL IRRAD|0.01|0.01||
125|42000|42000 - DRAINAGE ABSCESS PALATE UVULA|150.63|150.63||
125|4196F|4196F - PT NOT RCVNG 1ST BIOL ANTI-RHEUM DRUG THXPY RA|0.01|0.01||
125|4195F|4195F - PT RCVNG 1ST BIOL ANTI-RHEUM DRUG THXRPY FOR RA|0.01|0.01||
125|4194F|4194F - PATIENT RCVNG >= 10 MG DAILY PREDNISONE|0.01|0.01||
125|4193F|4193F - PATIENT RCVNG <10 MG DAILY PREDNISONE|0.01|0.01||
125|4192F|4192F - PATIENT NOT RECEIVING GLUCOCORTICOID|0.01|0.01||
125|4191F|4191F - APPROP ANTICONVUL THXP MONIT TST ORDRD/DONE|0.01|0.01||
125|4190F|4190F - APPROP DIURETIC THXP MONIT TST ORDRD/DONE|0.01|0.01||
125|4189F|4189F - APPROP DIGOXIN THXP MONIT TST ORDRD/DONE|0.01|0.01||
125|4188F|4188F - APPROP ACE/ARB THXP MONIT TEST ORDRD/DONE|0.01|0.01||
125|4187F|4187F - DIS MODFY ANTI-RHEU DRUG THXPY RX/GVN|0.01|0.01||
125|41874|41874 - ALVEOLOPLASTY EACH QUADRANT SPECIFY|488.09|488.09||
125|41872|41872 - GINGIVOPLASTY EACH QUADRANT SPECIFY|534.42|534.42||
125|41870|41870 - PERIODONTAL MUCOSAL GRAFTING|531.88|531.88||
125|4186F|4186F - NO CONTIN 12MON THXPY W/PPI OR H2 H2RA RCVD|0.01|0.01||
125|4185F|4185F - NONSTOP 12MON THXPY W/PPI OR H2 H2RA RCVD|0.01|0.01||
125|41850|41850 - DESTRUCTION LESION DENTOALVEOLAR STRUCTURES|176.54|176.54||
125|41830|41830 - ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY|452.01|452.01||
125|4182F|4182F - CONFORMAL RADIATION THERAPY NOT RECEIVED|0.01|0.01||
125|41828|41828 - EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC|535.01|535.01||
125|41827|41827 - EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR|526.1|526.1||
125|41826|41826 - EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR|331.36|331.36||
125|41825|41825 - EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR|198.69|198.69||
125|41823|41823 - EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS|445.29|445.29||
125|41822|41822 - EXC FIBROUS TUBEROSITIES DENTOALVEOLAR STRUXS|295.33|295.33||
125|41821|41821 - OPRCULECTOMY EXC PRICORONAL TISSUE|93.98|93.98||
125|41820|41820 - GINGIVECTOMY EXC GINGIVA EACH QUADRANT|428.16|428.16||
125|4181F|4181F - CONFORMAL RADIATION THERAPY RECEIVED|0.01|0.01||
125|4180F|4180F - ADJVNT CHEMO RFRRD RXD/RCVD STAGE III COLON CA|0.01|0.01||
125|41806|41806 - RMVL EMBEDDED FB FROM DENTOALVEOLAR STRUXS BONE|252.85|252.85||
125|41805|41805 - RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS|163.28|163.28||
125|41800|41800 - DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS|145.71|145.71||
125|4179F|4179F - TAMOXIFEN OR AROMATASE INHIBITOR (AI) RXD|0.01|0.01||
125|4178F|4178F - ANTI-D IMMUNE GLOBULIN RCVD 26-30 WKS GESTATION|0.01|0.01||
125|4177F|4177F - COUNSEL BENEF/RISK AREDS PREV AGE RELATED AMD|0.01|0.01||
125|4176F|4176F - COUNSEL UV LITE PROTEC PREV/PROG CATARACT DEVEL|0.01|0.01||
125|4175F|4175F - CORRECT VISUAL ACUIT 20/40/> W/IN 90 DAYS SURG|0.01|0.01||
125|4174F|4174F - TLK VIS FXN & QUAL LIFE/TRXMNT FOR PT/CRGVR|0.01|0.01||
125|4172F|4172F - PATIENT NOT RECEIVING (ESA) THERAPY|0.01|0.01||
125|4171F|4171F - PATIENT RECEIVING (ESA) THERAPY|0.01|0.01||
125|4169F|4169F - PT NOT RCVG CARE IN ICU/NOT RCVG MECHL VENT|0.01|0.01||
125|4168F|4168F - PT RCVG CARE ICU & RCVNG MECH VENT 24 HRS/<|0.01|0.01||
125|4167F|4167F - HEAD-BED ELEV 30-45 DEG 1ST VENT DAY ORDERED|0.01|0.01||
125|4165F|4165F - 3D-CRT OR INTENSITY MODUL RAD THXPY RECVD|0.01|0.01||
125|4164F|4164F - ADJUVANT HORMONAL THXPY RX/ADMIN|0.01|0.01||
125|4163F|4163F - PT COUNSELING TREATMENT OPTIONS PROSTATE CANCER|0.01|0.01||
125|4159F|4159F - CONTRACEPTION COUNSEL BEFORE ANTIVIRAL TX|0.01|0.01||
125|4158F|4158F - PATIENT COUNSELED ABOUT RISKS ALCOHOL USE|0.01|0.01||
125|4157F|4157F - HEPATITIS B VACCINE SERIES PREVIOUSLY RECEIVED|0.01|0.01||
125|4155F|4155F - HEPATITIS A VACCINE SERIES PREVIOUSLY RECEIVED|0.01|0.01||
125|4153F|4153F - COMB PEGINTERF/RIBAVIRIN TX PRESCRIBED|0.01|0.01||
125|41530|41530 - SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION|1488.16|1488.16||
125|41520|41520 - FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY|396.85|396.85||
125|4151F|4151F - NO CURRENT HEPATITIS C ANTIVIRAL TREATMENT|0.01|0.01||
125|41512|41512 - TONGUE BASE SUSPENSION PERMANENT SUTURE TQ|1049.8|1049.8||
125|41510|41510 - SUTURE TONGUE LIP MICROGNATHIA|648.96|648.96||
125|4150F|4150F - CURRENT HEPATITIS C ANTIVIRAL TREATMENT|0.01|0.01||
125|41500|41500 - FIXJ TONGUE MECHANICAL OTHER/THAN SUTURE|435.15|435.15||
125|4149F|4149F - HEPATITIS B VACCCINE ADMIN OR PREVIOSLY RECVD|0.01|0.01||
125|4148F|4148F - HEPATITIS A VACCINE ADMIN OR PREVIOSLY RECVD|0.01|0.01||
125|4145F|4145F - 2+ ANTI-HYPERTENSIVE AGENTS RXD OR TAKEN|0.01|0.01||
125|4144F|4144F - ALTERNATIVE LONG-TERM CONTROL MEDICATION RXD|0.01|0.01||
125|4142F|4142F - CORTICOSTEROID SPARING THERAPY PRESCRIBED|0.01|0.01||
125|4140F|4140F - INHALED CORTICOSTEROIDS PRESCRIBED|0.01|0.01||
125|4136F|4136F - SYSTEMIC CORTICOSTEROIDS NOT PRESCRIBED|0.01|0.01||
125|4135F|4135F - SYSTEMIC CORTICOSTEROIDS PRESCRIBED|0.01|0.01||
125|4134F|4134F - ANTIHISTAMINE/DECONGESTANT NOT PRESCRIBED|0.01|0.01||
125|4133F|4133F - ANTIHISTAMINE/DECONGESTANT PRESCRIBED|0.01|0.01||
125|4132F|4132F - SYSTEMIC ANTIMICROBIAL TX NOT PRESCRIBED|0.01|0.01||
125|4131F|4131F - SYSTEMIC ANTIMICROBIAL TX PRESCRIBED|0.01|0.01||
125|4130F|4130F - ACUTE OTITIS EXTERNA TOPICAL PREPS PRESCRIBED|0.01|0.01||
125|41252|41252 - RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX|508.03|508.03||
125|41251|41251 - RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE|226.63|226.63||
125|41250|41250 - RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG|192.55|192.55||
125|4124F|4124F - ANTIBIOTIC NEITHER PRESCRIBED NOR DISPENSED|0.01|0.01||
125|4120F|4120F - ANTIBIOTIC PRESCRIBED OR DISPENSED|0.01|0.01||
125|4115F|4115F - BETA BLOCKER GIVEN W/IN 24 HRS PRIOR SURG INC|0.01|0.01||
125|41155|41155 - GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ & RAD NECK|4036.32|4036.32||
125|41153|41153 - GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ|3335.96|3335.96||
125|41150|41150 - GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ|2936.89|2936.89||
125|41145|41145 - GLSSC COMPL/TOT W/WO TRACHS W/UNI RAD NECK DSJ|3428.8|3428.8||
125|41140|41140 - GLSSC COMPL/TOT W/WOTRACHS W/O RAD NECK DSJ|2447.37|2447.37||
125|41135|41135 - GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ|2406.94|2406.94||
125|41130|41130 - GLOSSECTOMY HEMIGLOSSECTOMY|1316.27|1316.27||
125|41120|41120 - GLOSSECTOMY <ONE-HALF TONGUE|994.83|994.83||
125|41116|41116 - EXCISION LESION FLOOR MOUTH|468.34|468.34||
125|41115|41115 - EXCISION LINGUAL FRENUM FRENECTOMY|282.44|282.44||
125|41114|41114 - EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP|886.33|886.33||
125|41113|41113 - EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD|474.68|474.68||
125|41112|41112 - EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS|378.12|378.12||
125|41110|41110 - EXCISION LESION TONGUE W/O CLOSURE|193.04|193.04||
125|4110F|4110F - LIMA GRAFT USED IN 1ST ISOLATED CABG PXD|0.01|0.01||
125|41108|41108 - BIOPSY FLOOR MOUTH|139.14|139.14||
125|41105|41105 - BIOPSY TONGUE POSTERIOR ONE-THIRD|165.12|165.12||
125|41100|41100 - BIOPSY TONGUE ANTERIOR TWO-THIRDS|161.67|161.67||
125|41019|41019 - PLACEMENT NEEDLE HEAD/NECK RADIOELEMENT APPLICAT|779.43|779.43||
125|41018|41018 - XTRORAL I&D FLOOR MASTICATOR SPACE|512.42|512.42||
125|41017|41017 - XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB|397.01|397.01||
125|41016|41016 - XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT|412.96|412.96||
125|41015|41015 - XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL|378.84|378.84||
125|41010|41010 - INCISION LINGUAL FRENUM FRENOTOMY|168.44|168.44||
125|4100F|4100F - BISPHOS THXPY VENOUS ORDERED OR RECEIVED|0.01|0.01||
125|41009|41009 - INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE|432.14|432.14||
125|41008|41008 - INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE|353.51|353.51||
125|41007|41007 - INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE|403.41|403.41||
125|41006|41006 - INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD|348.45|348.45||
125|41005|41005 - INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC|174.89|174.89||
125|41000|41000 - INTRAORAL I&D TONGUE/FLOOR LINGUAL|144.14|144.14||
125|4095F|4095F - PATIENT NOT RECEIVING ERYTHORPOIETIN THERAPY|0.01|0.01||
125|4090F|4090F - PATIENT RECEIVING ERYTHROPOIETIN THERAPY|0.01|0.01||
125|4086F|4086F - ASPIRIN OR CLOPIDOGREL PRESCRIBED|0.01|0.01||
125|4084F|4084F - ASPIRIN RECVD W/IN 24 HRS PRIOR ED ARRIVAL/STAY|0.01|0.01||
125|40845|40845 - VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG|2103.42|2103.42||
125|40844|40844 - VESTIBULOPLASTY ENTIRE ARCH|1537.2|1537.2||
125|40843|40843 - VESTIBULOPLASTY POSTERIOR BILATERAL|1225.08|1225.08||
125|40842|40842 - VESTIBULOPLASTY POSTERIOR UNILATERAL|843.21|843.21||
125|40840|40840 - VESTIBULOPLASTY ANTERIOR|846.48|846.48||
125|40831|40831 - CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL|318.28|318.28||
125|40830|40830 - CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<|211.86|211.86||
125|40820|40820 - DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS|196.77|196.77||
125|40819|40819 - EXC FRENUM LABIAL/BUCCAL|254.23|254.23||
125|40818|40818 - EXC MUCOSA VESTIBULE MOUTH AS DON GRF|290.86|290.86||
125|40816|40816 - EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC|624.55|624.55||
125|40814|40814 - EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR|527.81|527.81||
125|40812|40812 - EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR|299.6|299.6||
125|40810|40810 - EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR|169.71|169.71||
125|40808|40808 - BIOPSY VESTIBULE MOUTH|137.62|137.62||
125|40806|40806 - INCISION LABIAL FRENUM FRENOTOMY|139.71|139.71||
125|40805|40805 - RMVL EMBEDDED FB VESTIBULE MOUTH COMP|441.12|441.12||
125|40804|40804 - RMVL EMBEDDED FB VESTIBULE MOUTH SMPL|175.83|175.83||
125|40801|40801 - DRG ABSC CST HMTMA VESTIBULE MOUTH COMP|434.1|434.1||
125|40800|40800 - DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL|158.01|158.01||
125|4079F|4079F - DOC REHAB SERVICES WERE CONSIDERED|0.01|0.01||
125|4077F|4077F - DOC T-PA ADMINISTRATION WAS CONSIDERED|0.01|0.01||
125|40761|40761 - PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP|2022.48|2022.48||
125|4075F|4075F - ANTICOAGULANT THERAPY PRESCRIBED AT DISCHARGE|0.01|0.01||
125|4073F|4073F - ORAL ANTIPLATELET THERAPY PRESCRBED AT DISCHARGE|0.01|0.01||
125|40720|40720 - PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL|1542.44|1542.44||
125|4070F|4070F - DEEP VEIN THROMB PROPHYL RECVD BY HOSP DAY 2|0.01|0.01||
125|40702|40702 - PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS|1607.31|1607.31||
125|40701|40701 - PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX|2279.1|2279.1||
125|40700|40700 - PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI|1572.6|1572.6||
125|4069F|4069F - VENOUS THROMBOEMBOLISM (VTE) PROPHYLAXIS RCVD|0.01|0.01||
125|4067F|4067F - PT REFERRAL ELECTROCONVULSIVE THXPY (ECT) DOCD|0.01|0.01||
125|4066F|4066F - ELECTROCONVULSIVE THERAPY (ECT) PROVIDED|0.01|0.01||
125|4065F|4065F - ANTIPSYCHOTIC PHARMACOTHERAPY PRESCRIBED|0.01|0.01||
125|40654|40654 - RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE|774.25|774.25||
125|40652|40652 - RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT|602.87|602.87||
125|40650|40650 - RPR LIP FULL THICKNESS VERMILION ONLY|476.79|476.79||
125|4064F|4064F - ANTIDEPRESSANT PHARMACOTHERAPY PRESCRIBED|0.01|0.01||
125|4063F|4063F - ANTIDEPRESSANT RXTHXY CONSIDER & NOT PRESCRIBE|0.01|0.01||
125|4062F|4062F - PATIENT REFERRAL FOR PSYCHOTHERAPY DOCUMENTED|0.01|0.01||
125|4060F|4060F - PSYCHOTHERAPY SERVICES PROVIDED|0.01|0.01||
125|4058F|4058F - PAG PROVIDED TO CAREGIVER|0.01|0.01||
125|4056F|4056F - APPROPRIATE ORAL REHYD SOLUTION RECOMMENDED|0.01|0.01||
125|4055F|4055F - PATIENT RECEIVING PERITONEAL DIALYSIS|0.01|0.01||
125|4054F|4054F - HEMODIALYSIS VIA CATHETER|0.01|0.01||
125|4053F|4053F - HEMODIALYSIS VIA FUNCTIONING AVGRAFT|0.01|0.01||
125|40530|40530 - RESCJ LIP > ONE-FOURTH W/O RCNSTJ|656.18|656.18||
125|4052F|4052F - HEMODIAL VIA FUNCTIONG AV FISTULA|0.01|0.01||
125|40527|40527 - EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP|1400.53|1400.53||
125|40525|40525 - EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP|1289.17|1289.17||
125|40520|40520 - EXC LIP V-EXC W/PRIM DIR LINR CLSR|620.39|620.39||
125|4051F|4051F - REFERRED FOR AN ARTERIO-VENOUS (AV) FISTULA|0.01|0.01||
125|40510|40510 - EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR|903.84|903.84||
125|4050F|4050F - HYPERTENSION PLAN OF CARE DOCUMENTED|0.01|0.01||
125|40500|40500 - VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT|873.48|873.48||
125|4049F|4049F - DOC ORDER GIVEN TO STOP ANTIBIO W/IN 24 HRS SURG|0.01|0.01||
125|40490|40490 - BIOPSY OF LIP|117.33|117.33||
125|4048F|4048F - DOC ANTIBIO GIVEN W/IN 1 HR PRIOR SURG/INCIS|0.01|0.01||
125|4047F|4047F - DOC ORDER ANTIBIO GIVEN W/IN 1 HR PRIOR SURG/INC|0.01|0.01||
125|4046F|4046F - DOCD ANTIBIO W/IN 4 HRS PRIOR/INTRAOP SURG INCIS|0.01|0.01||
125|4045F|4045F - APPROPRIATE EMPIRIC ANTIBIOTIC PRESCRIBED|0.01|0.01||
125|4044F|4044F - DOC ORDER VTE PROPHYL W/IN 24 HRS PRIOR SURG|0.01|0.01||
125|4043F|4043F - DOC ORDER DISCONT ANTIBIO W/IN 48 HOURS OF SURG|0.01|0.01||
125|4042F|4042F - DOC PROPHY ANTIBIO NOT GIVEN W/IN 4 HR PRIOR SUR|0.01|0.01||
125|4041F|4041F - DOC ORDER CEFAZOLIN/CEFUROXIME ANTIMICRB PROPHYL|0.01|0.01||
125|4040F|4040F - PNEUMOCOCCAL VACCINE ADMIN RCVD PRIOR|0.01|0.01||
125|4037F|4037F - INFLUENZA IMMUNIZATION ORDERED OR ADMINISTERED|0.01|0.01||
125|4035F|4035F - INFLUENZA IMMUNIZATION RECOMMENDED|0.01|0.01||
125|4033F|4033F - PULMONARY REHABILITATION RECOMMENDED|0.01|0.01||
125|4030F|4030F - LONG-TERM OXYGEN THERAPY PRESCRIBED|0.01|0.01||
125|4025F|4025F - INHALED BRONCHODILATOR PRESCRIBED|0.01|0.01||
125|4019F|4019F - DOCUMENT COUNSELING EXERCISE CALCIUM & VITAMIN|0.01|0.01||
125|4018F|4018F - THERAPEUTIC EXERCISE INVOLVED JTS INST/PRESCRIBE|0.01|0.01||
125|4017F|4017F - GI PROPHYLAXIS NSAID USE PRESCRIBED|0.01|0.01||
125|4016F|4016F - ANTI-INFLAMMATORY/ANALGESIC AGT PRESCRIBED|0.01|0.01||
125|4015F|4015F - PRSISTENT ASTHMA LONG TERM CTRL MED PRESCRIBED|0.01|0.01||
125|4014F|4014F - DSCHRG INSTRUCTIONS HRT FAILURE XCP PTS 18 YR|0.01|0.01||
125|4013F|4013F - STATIN THERAPY RXD/CURRENTLY TAKEN|0.01|0.01||
125|4012F|4012F - WARFARIN THERAPY PRESCRIBED|0.01|0.01||
125|4011F|4011F - ORAL ANTIPLATELET THERAPY PRESCRIBED|0.01|0.01||
125|4010F|4010F - ACE INHIBITOR/ARB THERAPY RXD/CURRENTLY TAKEN|0.01|0.01||
125|4008F|4008F - BETA BLOCKER THERAPY RXD/CURRENTLY BEING TAKEN|0.01|0.01||
125|4005F|4005F - PHARMACOLOGIC OSTEOPOROSIS THERAPY PRESCRIBED|0.01|0.01||
125|4004F|4004F - PT SCRND TOBACCO USE RCVD TOBACCO CESSATION TALK|0.01|0.01||
125|4003F|4003F - PT EDUCATION WRTTN/ORAL HRT FAILURE PTS PFRMD|0.01|0.01||
125|4001F|4001F - TOBACCO USE CESSATION IVNTJ PHARMACOLOGIC THER|0.01|0.01||
125|4000F|4000F - TOBACCO USE CESSATION IVNTJ COUNSELING|0.01|0.01||
125|39561|39561 - RESCJ DIAPHRAGM W/COMPLEX REPAIR|2128.21|2128.21||
125|39560|39560 - RESCJ DIAPHRAGM W/SIMPLE REPAIR|1657.08|1657.08||
125|39545|39545 - IMBRICATION DIAPHRAGM EVENTRATION|1831.86|1831.86||
125|39541|39541 - RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC|1798.99|1798.99||
125|39540|39540 - RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT|2016.12|2016.12||
125|39503|39503 - RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ|5465.89|5465.89||
125|39501|39501 - REPAIR LACERATION DIAPHRAGM ANY APPROACH|1605.8|1605.8||
125|39402|39402 - MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES|680.17|680.17||
125|39401|39401 - MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY|520.18|520.18||
125|39220|39220 - RESECTION MEDIASTINAL TUMOR|2090.35|2090.35||
125|39200|39200 - RESECTION OF MEDIASTINAL CYST|1831.72|1831.72||
125|39010|39010 - MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR|1577.42|1577.42||
125|39000|39000 - MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR|740.14|740.14||
125|38900|38900 - INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION|231.33|231.33||
125|38794|38794 - CANNULATION THORACIC DUCT|385.2|385.2||
125|38792|38792 - INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE|321.01|321.01||
125|38790|38790 - INJECTION PROCEDURE LYMPHANGIOGRAPHY|563.27|563.27||
125|38780|38780 - RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL|2595.5|2595.5||
125|38770|38770 - PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR|1747.96|1747.96||
125|38765|38765 - INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC|1931.89|1931.89||
125|38760|38760 - INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX|1053.89|1053.89||
125|38747|38747 - ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC|606.83|606.83||
125|38746|38746 - THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC|441.17|441.17||
125|38745|38745 - AXILLARY LYMPHADENECTOMY COMPLETE|1144.9|1144.9||
125|38740|38740 - AXILLARY LYMPHADENECTOMY SUPERFICIAL|786.91|786.91||
125|38724|38724 - CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ|2001.96|2001.96||
125|38720|38720 - CERVICAL LYMPHADENECTOMY|2096.8|2096.8||
125|38700|38700 - SUPRAHYOID LYMPHADENECTOMY|1157.61|1157.61||
125|38573|38573 - LAPS W/BI TOT PEL LMPHADEC & OMNTC LYMPH BX|1925.93|1925.93||
125|38572|38572 - LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1|1882.92|1882.92||
125|38571|38571 - LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY|1584.26|1584.26||
125|38570|38570 - LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT|1435.09|1435.09||
125|38564|38564 - LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC|1472.38|1472.38||
125|38562|38562 - LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC|1340.14|1340.14||
125|38555|38555 - EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ|1530.83|1530.83||
125|38550|38550 - EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ|654.86|654.86||
125|38542|38542 - DISSECTION DEEP JUGULAR NODE|660.85|660.85||
125|38530|38530 - BX/EXC LYMPH NODE OPEN INT MAMMARY NODE|665.5|665.5||
125|38525|38525 - BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE|643.27|643.27||
125|38520|38520 - BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD|524.54|524.54||
125|38510|38510 - BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE|487.46|487.46||
125|38505|38505 - BX/EXC LYMPH NODE NEEDLE SUPERFICIAL|203.3|203.3||
125|38500|38500 - BX/EXC LYMPH NODE OPEN SUPERFICIAL|348.95|348.95||
125|38382|38382 - SUTR&/LIG THORACIC DUCT ABDOMINAL APPROACH|1371.41|1371.41||
125|38381|38381 - SUTR&/LIG THORACIC DUCT THORACIC APPROACH|1682.61|1682.61||
125|38380|38380 - SUTR&/LIG THORACIC DUCT CERVICAL APPROACH|975.24|975.24||
125|38308|38308 - LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS|484.32|484.32||
125|38305|38305 - DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV|468.75|468.75||
125|38300|38300 - DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL|243.89|243.89||
125|38243|38243 - TRNSPLJ HEMATOPOIETIC CELL BOOST|178.32|178.32||
125|38242|38242 - ALLOGENEIC LYMPHOCYTE INFUSIONS|441.16|441.16||
125|38241|38241 - TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR|586.58|586.58||
125|38240|38240 - TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR|584.98|584.98||
125|38232|38232 - BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS|329.7|329.7||
125|38230|38230 - BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC|927.89|927.89||
125|38222|38222 - DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS|264.88|264.88||
125|38221|38221 - DIAGNOSTIC BONE MARROW BIOPSIES|288.95|288.95||
125|38220|38220 - DIAGNOSTIC BONE MARROW ASPIRATIONS|267.55|267.55||
125|38215|38215 - TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM|147.92|147.92||
125|38214|38214 - TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ|124.8|124.8||
125|38213|38213 - TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ|147.92|147.92||
125|38212|38212 - TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL|147.92|147.92||
125|38211|38211 - TRNSPL PREPJ HEMATOP PROGEN TUM CELL DEPLJ|147.92|147.92||
125|38210|38210 - TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL|147.92|147.92||
125|38209|38209 - TRNSP PREP HMATOP PROG THAW PREV HRV WSH PER DNR|136.36|136.36||
125|38208|38208 - TRNSPL PREP HEMATOP PROGEN THAW PREV HRV PER DNR|154.85|154.85||
125|38207|38207 - TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR|143.29|143.29||
125|38206|38206 - BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL|387.37|387.37||
125|38205|38205 - BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC|387.37|387.37||
125|38204|38204 - MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ|174.98|174.98||
125|38200|38200 - INJECTION PROCEDURE SPLENOPORTOGRAPY|304.96|304.96||
125|38120|38120 - LAPAROSCOPIC SURGICAL SPLENECTOMY|1665.11|1665.11||
125|38115|38115 - RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT|1565.06|1565.06||
125|38102|38102 - SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX|622.34|622.34||
125|38101|38101 - SPLENECTOMY TOTAL EN BLOC W/OTHER PROCEDURE|1377.09|1377.09||
125|38100|38100 - SPLENECTOMY TOTAL SEPARATE PROCEDURE|1439.15|1439.15||
125|37790|37790 - PENILE VENOUS OCCLUSIVE PROCEDURE|924.49|924.49||
125|37788|37788 - PENILE REVASCULARIZATION ARTERY W/WO VEIN GRAFT|2408.52|2408.52||
125|37785|37785 - LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG|579.04|579.04||
125|37780|37780 - LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX|302.07|302.07||
125|3776F|3776F - ADENOMA(S)/NEOPLASM NOT DETECTED SCRNG CLNSCPY|0.01|0.01||
125|37766|37766 - STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS|1171.58|1171.58||
125|37765|37765 - STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS|963.35|963.35||
125|37761|37761 - LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG|907.08|907.08||
125|37760|37760 - LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG|1143.83|1143.83||
125|3775F|3775F - ADENOMA(S)/NEOPLASM DETECTED SCRNG CLNSCPY|0.01|0.01||
125|37735|37735 - LIGJ & DIVJ RADICAL STRIP LONG/SHORT SAPHENOUS|1472.44|1472.44||
125|37730|37730 - REMOVAL OF LEG VEINS|1042.17|1042.17||
125|37722|37722 - LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW|946.67|946.67||
125|37720|37720 - REMOVAL OF LEG VEIN|683.2|683.2||
125|37718|37718 - LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN|794.06|794.06||
125|37700|37700 - LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ|473.21|473.21||
125|37660|37660 - LIGATION OF COMMON ILIAC VEIN|1270.38|1270.38||
125|37650|37650 - LIGATION OF FEMORAL VEIN|661.42|661.42||
125|3763F|3763F - PATIENT IS NOT DYSARTHRIC|0.01|0.01||
125|3762F|3762F - PATIENT IS DYSARTHRIC|0.01|0.01||
125|3761F|3761F - PT WO/DYSPHAG/WT LOSS/IMPAIRED NUTRITION|0.01|0.01||
125|37619|37619 - INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I|2889.04|2889.04||
125|37618|37618 - LIGATION MAJOR ARTERY EXTREMITY|809.44|809.44||
125|37617|37617 - LIGATION MAJOR ARTERY ABDOMEN|1364|1364||
125|37616|37616 - LIGATION MAJOR ARTERY CHEST|1397.36|1397.36||
125|37615|37615 - LIGATION MAJOR ARTERY NECK|770.3|770.3||
125|3760F|3760F - PT W/DYSPHAG/WT LOSS/IMPAIRED NUTRITION|0.01|0.01||
125|37609|37609 - LIGATION/BIOPSY TEMPORAL ARTERY|314.04|314.04||
125|37607|37607 - LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA|586.63|586.63||
125|37606|37606 - LIG INT/COMMON CAROTID ART W/GRADUAL OCCLUSION|869.39|869.39||
125|37605|37605 - LIGATION INTERNAL/COMMON CAROTID ARTERY|853.58|853.58||
125|37600|37600 - LIGATION EXTERNAL CAROTID ARTERY|747.74|747.74||
125|3759F|3759F - PT SCRND DYSPHAGIA WT LOSS IMPAIRED NUTRITION|0.01|0.01||
125|3758F|3758F - PULM FUNC TESTING/PEAK COUGH EXPIRATORY FLOW|0.01|0.01||
125|3757F|3757F - NO PSEUDOBULBAR AFFECT/SIALORRHEA/ALS SYMP|0.01|0.01||
125|3756F|3756F - PT HAS PSEUDOBULBAR AFFECT/SIALORRHEA/ALS SYMP|0.01|0.01||
125|37565|37565 - LIGATION INTERNAL JUGULAR VEIN|754.21|754.21||
125|3755F|3755F - COGNITIVE&BEHAVIORAL IMPAIRMENT SCRNG PERFORMED|0.01|0.01||
125|3754F|3754F - SCREENING TSTS DIABETES MELLITUS RVWD RQSTD ORD|0.01|0.01||
125|3753F|3753F - PT HAS CLINICAL SYMP&SIGNS NEUROPATHY W/CAUSE|0.01|0.01||
125|3752F|3752F - ELECTRODIAG STUDIES DSP NOT DOCD RVWD W/IN 6 MON|0.01|0.01||
125|3751F|3751F - ELECTRODIAG STUDIES DSP DOCD RVWD W/IN 6 MONTHS|0.01|0.01||
125|3750F|3750F - PT NOT RCVNG CORTICOSTERIDS>/=10MG/DAY 60/> DAYS|0.01|0.01||
125|37500|37500 - VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX|1509.21|1509.21||
125|3725F|3725F - SCREENING FOR DEPRESSION PERFORMED|0.01|0.01||
125|37253|37253 - INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL|320.83|320.83||
125|37252|37252 - INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL|2062.94|2062.94||
125|37249|37249 - TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN|970.81|970.81||
125|37248|37248 - TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN|2262.7|2262.7||
125|37247|37247 - TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART|1317.76|1317.76||
125|37246|37246 - TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART|3249.75|3249.75||
125|37244|37244 - VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE|10207.16|10207.16||
125|37243|37243 - VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT|10739.28|10739.28||
125|37242|37242 - VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I|11024.8|11024.8||
125|37241|37241 - VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I|7145.33|7145.33||
125|37239|37239 - OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL|3039.07|3039.07||
125|37238|37238 - OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST|6272.88|6272.88||
125|37237|37237 - OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL|3651.95|3651.95||
125|37236|37236 - OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL|5818.73|5818.73||
125|37235|37235 - REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL|6209.81|6209.81||
125|37234|37234 - REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL|5860.63|5860.63||
125|37233|37233 - REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL|2198.28|2198.28||
125|37232|37232 - REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL|1805.63|1805.63||
125|37231|37231 - REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL|20055.81|20055.81||
125|37230|37230 - REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL|12402.69|12402.69||
125|37229|37229 - REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL|16194.98|16194.98||
125|37228|37228 - REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI|8035.36|8035.36||
125|37227|37227 - REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL|22186.08|22186.08||
125|37226|37226 - REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL|13417.25|13417.25||
125|37225|37225 - REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL|16405.56|16405.56||
125|37224|37224 - REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI|5624.67|5624.67||
125|37223|37223 - REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL|3836.79|3836.79||
125|37222|37222 - REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL|1315.87|1315.87||
125|37221|37221 - REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY|6864.19|6864.19||
125|37220|37220 - REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL|4638.26|4638.26||
125|37218|37218 - TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE|1366.54|1366.54||
125|37217|37217 - TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE|1829.82|1829.82||
125|37216|37216 - TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ|1084.93|1084.93||
125|37215|37215 - TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ|1126.5|1126.5||
125|37214|37214 - CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL|206.34|206.34||
125|37213|37213 - THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX|393.29|393.29||
125|37212|37212 - THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX|569.31|569.31||
125|37211|37211 - THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX|650.76|650.76||
125|3720F|3720F - COGNITIVE IMPAIRMENT/DYSFUNCTION ASSESSED|0.01|0.01||
125|37200|37200 - TRANSCATHETER BIOPSY|517.83|517.83||
125|37197|37197 - PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING|2215.54|2215.54||
125|37195|37195 - THROMBOLYSIS CEREBRAL IV INFUSION|518.04|518.04||
125|37193|37193 - RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I|2341.56|2341.56||
125|37192|37192 - REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I|2082.31|2082.31||
125|37191|37191 - INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I|3868.94|3868.94||
125|37188|37188 - PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX|4407.93|4407.93||
125|37187|37187 - PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN|5119.67|5119.67||
125|37186|37186 - SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL|3547.24|3547.24||
125|37185|37185 - PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ|1725.61|1725.61||
125|37184|37184 - PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST|5267.31|5267.31||
125|37183|37183 - REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT|450.45|450.45||
125|37182|37182 - INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT|969.79|969.79||
125|37181|37181 - VENOUS ANASTOMOSIS OPEN SPLENORENAL DISTAL|2816.33|2816.33||
125|37180|37180 - VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL|2651.32|2651.32||
125|37160|37160 - VENOUS ANASTOMOSIS OPEN CAVAL-MESENTERIC|2688.21|2688.21||
125|37145|37145 - VENOUS ANASTOMOSIS OPEN RENOPORTAL|2718.11|2718.11||
125|37140|37140 - VENOUS ANASTOMOSIS OPEN PORTOCAVAL|2702.09|2702.09||
125|3700F|3700F - PSYCHIATRIC DISORDERS/DISTURBANCES ASSESSED|0.01|0.01||
125|36909|36909 - DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I|2974.02|2974.02||
125|36908|36908 - STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR|4080.7|4080.7||
125|36907|36907 - TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I|1150.55|1150.55||
125|36906|36906 - PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT|10258.99|10258.99||
125|36905|36905 - PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP|3500.51|3500.51||
125|36904|36904 - PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH|2764.45|2764.45||
125|36903|36903 - INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT|8437.37|8437.37||
125|36902|36902 - INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP|1899.75|1899.75||
125|36901|36901 - INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I|920.56|920.56||
125|36861|36861 - XTRNL CANNULA DECLTNG SPX W/BALO CATH|392.02|392.02||
125|36860|36860 - XTRNL CANNULA DECLTNG SPX W/O BALO CATH|360.71|360.71||
125|36838|36838 - DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS|2967.58|2967.58||
125|36835|36835 - INSERTION THOMAS SHUNT SEPARATE PROCEDURE|1148.62|1148.62||
125|36833|36833 - REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF|1357.87|1357.87||
125|36832|36832 - REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF|1131.81|1131.81||
125|36831|36831 - THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF|642.04|642.04||
125|36830|36830 - CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF|1373.61|1373.61||
125|36825|36825 - CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF|1519.49|1519.49||
125|36823|36823 - INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL|1301.21|1301.21||
125|36821|36821 - ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT|1088.99|1088.99||
125|36820|36820 - ARVEN ANAST OPN F/ARM VEIN TRPOS|1755.82|1755.82||
125|36819|36819 - ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS|1341.15|1341.15||
125|36818|36818 - ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS|756.45|756.45||
125|36815|36815 - INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR|424.54|424.54||
125|36810|36810 - INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL|667.41|667.41||
125|36800|36800 - INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN|293.92|293.92||
125|36680|36680 - PLACEMENT NEEDLE INTRAOSSEOUS INFUSION|136.2|136.2||
125|36660|36660 - CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY|143.98|143.98||
125|36640|36640 - ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN|297.93|297.93||
125|36625|36625 - ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN|179.51|179.51||
125|36620|36620 - ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ|139.19|139.19||
125|36600|36600 - ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX|40.39|40.39||
125|36598|36598 - CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT|274.7|274.7||
125|36597|36597 - RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE|331.28|331.28||
125|36596|36596 - MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN|372.1|372.1||
125|36595|36595 - MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS|1855.89|1855.89||
125|36593|36593 - DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH|47.68|47.68||
125|36592|36592 - COLLECT BLOOD FROM CATHETER VENOUS NOS|40.2|40.2||
125|36591|36591 - COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE|35.97|35.97||
125|36590|36590 - RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ|650.85|650.85||
125|36589|36589 - RMVL TUN CVC W/O SUBQ PORT/PMP|435.76|435.76||
125|36585|36585 - RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT|2472.98|2472.98||
125|36584|36584 - COMPLETE REPLACEMENT PICC RS&I|732.93|732.93||
125|36583|36583 - RPLCMT COMPL TUN CTR VAD W/SUBQ PMP|2720.28|2720.28||
125|36582|36582 - RPLCMT COMPL TUN CTR VAD W/SUBQ PORT|2720.28|2720.28||
125|36581|36581 - RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP|1236.49|1236.49||
125|36580|36580 - RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP|741.06|741.06||
125|36578|36578 - RPLCMT CATH CTR VAD SUBQ PORT/PMP|1236.49|1236.49||
125|36576|36576 - RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT|619.4|619.4||
125|36575|36575 - RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP|432.59|432.59||
125|36571|36571 - INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>|2637.51|2637.51||
125|36570|36570 - INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR|2634.38|2634.38||
125|36569|36569 - INSERTION PICC W/O IMG GDN 5 YR/>|825.03|825.03||
125|36568|36568 - INSERTION PICC W/O IMG GDN < 5 YR|844.49|844.49||
125|36566|36566 - INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT|2215.4|2215.4||
125|36565|36565 - INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP|2124.97|2124.97||
125|36563|36563 - INSJ TUNNELED CTR VAD W/SUBQ PUMP|3092.39|3092.39||
125|36561|36561 - INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>|3175.6|3175.6||
125|36560|36560 - INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR|2673.04|2673.04||
125|36558|36558 - INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>|2325.76|2325.76||
125|36557|36557 - INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR|963|963||
125|36556|36556 - INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>|743.56|743.56||
125|36555|36555 - INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y|765.66|765.66||
125|36522|36522 - PHOTOPHERESIS EXTRACORPOREAL|1230.53|1230.53||
125|36516|36516 - THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION|3058.68|3058.68||
125|36515|36515 - THER APHERESIS W/XTRCORP IMMUNODSPTJ& PLSM RENFJ|2444.94|2444.94||
125|36514|36514 - THERAPEUTIC APHERESIS PLASMA PHERESIS|680.63|680.63||
125|36513|36513 - THERAPEUTIC APHERESIS PLATELETS|420.64|420.64||
125|36512|36512 - THERAPEUTIC APHERESIS RED BLOOD CELLS|420.64|420.64||
125|36511|36511 - THERAPEUTIC APHERESIS WHITE BLOOD CELLS|420.64|420.64||
125|36510|36510 - CATHJ UMBILICAL VEIN DX/THER NB|187.24|187.24||
125|3650F|3650F - ELECTROENCEPHALOGRAM ORDERED RVWD OR REQ|0.01|0.01||
125|36500|36500 - VEN CATHJ SLCTV ORGAN BLD SAMPLING|298.75|298.75||
125|36483|36483 - ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN|229.08|229.08||
125|36482|36482 - ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN|3196.22|3196.22||
125|36481|36481 - PRQ PORTAL VEIN CATHETERIZATION ANY METHOD|763.86|763.86||
125|36479|36479 - ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS|646.01|646.01||
125|36478|36478 - ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN|2938.79|2938.79||
125|36476|36476 - ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS|693.95|693.95||
125|36475|36475 - ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN|3557.08|3557.08||
125|36474|36474 - ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS|429.11|429.11||
125|36473|36473 - ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN|2286.76|2286.76||
125|36471|36471 - INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS|292.15|292.15||
125|36470|36470 - INJECTION SCLEROSANT SINGLE INCMPTNT VEIN|232.64|232.64||
125|36468|36468 - INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK|81.87|81.87||
125|36466|36466 - NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS|2510.67|2510.67||
125|36465|36465 - NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN|2399.03|2399.03||
125|36460|36460 - TRANSFUSION INTRAUTERINE FETAL|837.96|837.96||
125|36456|36456 - PRTL EXCHANGE TRANSFUSE BLOOD/PLSM/CRYST NEWBORN|179.41|179.41||
125|36455|36455 - EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN|289.1|289.1||
125|36450|36450 - EXCHNG TRANSFUSION BLOOD NEWBORN|252.74|252.74||
125|36440|36440 - PUSH TRANSFUSION BLOOD 2 YR/UNDER|121.62|121.62||
125|36430|36430 - TRANSFUSION BLOOD/BLOOD COMPONENTS|63.22|63.22||
125|36425|36425 - VENIPUNCTURE CUTDOWN AGE 1 YR/>|73.18|73.18||
125|36420|36420 - VENIPUNCTURE CUTDOWN UNDER AGE 1 YR|153.58|153.58||
125|36416|36416 - COLLECTION CAPILLARY BLOOD SPECIMEN|3.1|3.1||
125|36415|36415 - COLLECTION VENOUS BLOOD VENIPUNCTURE|5.94|5.94||
125|36410|36410 - VNPNXR 3 YEARS/> PHYS/QHP SKILL|24.54|24.54||
125|36406|36406 - VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN|22.47|22.47||
125|36405|36405 - VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN|50.88|50.88||
125|36400|36400 - VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN|26.6|26.6||
125|36262|36262 - REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP|536.08|536.08||
125|36261|36261 - REVJ IMPLANTED INTRA-ARTERIAL INFUSION PUMP|597.76|597.76||
125|36260|36260 - INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM|1110.67|1110.67||
125|36254|36254 - SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I|3295.91|3295.91||
125|36253|36253 - SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I|3355.96|3355.96||
125|36252|36252 - SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL|2292.73|2292.73||
125|36251|36251 - SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN|2108.6|2108.6||
125|36248|36248 - SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH|188.58|188.58||
125|36247|36247 - SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH|2044.61|2044.61||
125|36246|36246 - SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH|1300.51|1300.51||
125|36245|36245 - SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH|1350.01|1350.01||
125|36228|36228 - SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT|2018.35|2018.35||
125|36227|36227 - SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC|403.21|403.21||
125|36226|36226 - SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY|2843.49|2843.49||
125|36225|36225 - SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY|2228.13|2228.13||
125|36224|36224 - SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART|2931.46|2931.46||
125|36223|36223 - SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART|2313.18|2313.18||
125|36222|36222 - SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART|1851.7|1851.7||
125|36221|36221 - NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART|1567.03|1567.03||
125|36218|36218 - SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH|226.13|226.13||
125|36217|36217 - SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH|2255.91|2255.91||
125|36216|36216 - SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH|1268.25|1268.25||
125|36215|36215 - SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH|1168.64|1168.64||
125|36200|36200 - INTRODUCTION CATHETER AORTA|722.74|722.74||
125|36160|36160 - INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR|594.1|594.1||
125|36140|36140 - INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY|544.5|544.5||
125|36120|36120 - INTRO NEEDLE/INTRACATH RETROGRADE BRACHIAL ART|470.07|470.07||
125|36100|36100 - INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY|564.72|564.72||
125|36015|36015 - SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART|997.15|997.15||
125|36014|36014 - SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY|849.51|849.51||
125|36013|36013 - INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY|875.14|875.14||
125|36012|36012 - SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC|829.49|829.49||
125|36011|36011 - SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH|1133.29|1133.29||
125|36010|36010 - INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA|796.25|796.25||
125|36005|36005 - NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH|342.4|342.4||
125|36002|36002 - INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM|296.75|296.75||
125|36000|36000 - INTRODUCTION NEEDLE/INTRACATHETER VEIN|40.66|40.66||
125|35907|35907 - EXCISION INFECTED GRAFT ABDOMEN|2113.26|2113.26||
125|35905|35905 - EXCISION INFECTED GRAFT THORAX|1907.74|1907.74||
125|35903|35903 - EXCISION INFECTED GRAFT EXTREMITY|1097.12|1097.12||
125|35901|35901 - EXCISION INFECTED NECK GRAFT|1045.8|1045.8||
125|35884|35884 - REVISION FEMORAL ANAST OPEN W/AUTOG GRAFT|3132|3132||
125|35883|35883 - REVISION FEMORAL ANAST OPEN NONAUTOG GRAFT|2948.28|2948.28||
125|35881|35881 - REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS|2532.98|2532.98||
125|35879|35879 - REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP|2404.94|2404.94||
125|35876|35876 - THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF|1458.35|1458.35||
125|35875|35875 - THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL|1177.87|1177.87||
125|35870|35870 - RPR GRF-ENTERIC FSTL|2907.83|2907.83||
125|35860|35860 - EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR|824.03|824.03||
125|35840|35840 - EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD|1125.74|1125.74||
125|35820|35820 - EXPL PO HEMRRG THROMBOSIS/INFCTJ CH|1388.59|1388.59||
125|35800|35800 - EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK|855.18|855.18||
125|35761|35761 - EXPL N/FLWD SURG RPR W/WO LYSIS OTHER ARTERY|744.99|744.99||
125|35741|35741 - EXPL N/FLWD SURG RPR W/WO LYSIS POPLITEAL ARTERY|719.03|719.03||
125|3573F|3573F - PT NOT POTENT RISK FRACTURE WEIGHT-BEARING SITE|0.01|0.01||
125|3572F|3572F - PT POTENTIAL RISK FRACTURE WEIGHT-BEARING SITE|0.01|0.01||
125|35721|35721 - EXPL N/FLWD SURG RPR W/WO LYSIS FEMORAL ARTERY|734.64|734.64||
125|3570F|3570F - REPORT BONE SCINTIGRAPHY W/X-RAY SAME REGION|0.01|0.01||
125|35701|35701 - EXPLORATION N/FLWD SURG NECK ARTERY|832.18|832.18||
125|35700|35700 - ROPRTJ > 1 MO AFTER ORIGINAL OPRATION|551.92|551.92||
125|35697|35697 - RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART|774.62|774.62||
125|35695|35695 - TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART|2007.56|2007.56||
125|35694|35694 - TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART|1901.39|1901.39||
125|35693|35693 - TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART|1866.2|1866.2||
125|35691|35691 - TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART|2339.74|2339.74||
125|35686|35686 - CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO|766.62|766.62||
125|35685|35685 - PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT|741.9|741.9||
125|35683|35683 - BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION|650.99|650.99||
125|35682|35682 - BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS|568.81|568.81||
125|35681|35681 - BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN|1200.54|1200.54||
125|35671|35671 - BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART|2661.28|2661.28||
125|35666|35666 - BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL|2655.57|2655.57||
125|35665|35665 - BYP OTH/THN VEIN ILIOFEMORAL|2456.67|2456.67||
125|35663|35663 - BYP OTH/THN VEIN ILIOILIAC|2376.71|2376.71||
125|35661|35661 - BYP OTH/THN VEIN FEMORAL-FEMORAL|1895.5|1895.5||
125|35656|35656 - BYP OTH/THN VEIN FEMORAL-POPLITEAL|2350.26|2350.26||
125|35654|35654 - BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL|3268.5|3268.5||
125|35650|35650 - BYP OTH/THN VEIN AXILLARY-AXILLARY|2315.32|2315.32||
125|35647|35647 - BYP OTH/THN VEIN AORTOFEMORAL|3536.37|3536.37||
125|35646|35646 - BYP OTH/THN VEIN AORTOBIFEMORAL|3329.3|3329.3||
125|35645|35645 - BYP OTH/THN VEIN SUBCLAVIAN-VERTEBRAL|2283.27|2283.27||
125|35642|35642 - BYP OTH/THN VEIN CAROTID-VERTEBRAL|2282.96|2282.96||
125|35638|35638 - BYP OTH/THN VEIN AORTOBI-ILIAC|3428.92|3428.92||
125|35637|35637 - BYP OTH/THN VEIN AORTOILIAC|3375.35|3375.35||
125|35636|35636 - BYP OTH/THN VEIN SPLENORENAL|2512.55|2512.55||
125|35634|35634 - BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL|3000.21|3000.21||
125|35633|35633 - BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC|3393.17|3393.17||
125|35632|35632 - BYPASS GRAFT W/OTHER THAN VEIN ILIO-CELIAC|3066.5|3066.5||
125|35631|35631 - BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL|2761.56|2761.56||
125|35626|35626 - BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE|2822.92|2822.92||
125|35623|35623 - BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL|2171.04|2171.04||
125|35621|35621 - BYP OTH/THN VEIN AXILLARY-FEMORAL|2288.45|2288.45||
125|35616|35616 - BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY|2323.14|2323.14||
125|35612|35612 - BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN|2321.05|2321.05||
125|35606|35606 - BYP OTH/THN VEIN CAROTID-SUBCLAVIAN|2433.18|2433.18||
125|35601|35601 - BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID|2448.43|2448.43||
125|35600|35600 - HARVEST UPPER EXTREMITY ARTERY 1 SEGMENT CABG|1272.6|1272.6||
125|35587|35587 - IN-SITU VEIN BYP POP-TIBL PRONEAL|2716.43|2716.43||
125|35585|35585 - IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART|3185.92|3185.92||
125|35583|35583 - IN-SITU VEIN BYPASS FEMORAL-POPLITEAL|2641.57|2641.57||
125|35572|35572 - HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX|1211.07|1211.07||
125|35571|35571 - BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL|2902.24|2902.24||
125|35570|35570 - BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL|2574.01|2574.01||
125|35566|35566 - BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL|3019|3019||
125|35565|35565 - BYPASS W/VEIN ILIOFEMORAL|2440.18|2440.18||
125|35563|35563 - BYPASS W/VEIN ILIOILIAC|2104.07|2104.07||
125|35560|35560 - BYPASS W/VEIN AORTORENAL|2996.6|2996.6||
125|3555F|3555F - PT HAD INR MEASUREMENT PERFORMED|0.01|0.01||
125|35558|35558 - BYPASS W/VEIN FEMORAL-FEMORAL|2276.94|2276.94||
125|35556|35556 - BYPASS W/VEIN FEMORAL-POPLITEAL|2544.19|2544.19||
125|35540|35540 - BYPASS W/VEIN AORTOBIFEMORAL|5039.21|5039.21||
125|35539|35539 - BYPASS W/VEIN AORTOFEMORAL|4519.24|4519.24||
125|35538|35538 - BYPASS W/VEIN AORTOBI-ILIAC|4623.65|4623.65||
125|35537|35537 - BYPASS W/VEIN AORTOILIAC|4137.87|4137.87||
125|35536|35536 - BYPASS W/VEIN SPLENORENAL|2945.76|2945.76||
125|35535|35535 - BYPASS W/VEIN HEPATORENAL|3230.76|3230.76||
125|35533|35533 - BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL|3189.69|3189.69||
125|35531|35531 - BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC|3068.62|3068.62||
125|3552F|3552F - HIGH RISK FOR THROMBOEMBOLISM|0.01|0.01||
125|35526|35526 - BYPASS W/VEIN AORTOSUBCLAV/CAROTID/INNOMINATE|2455.03|2455.03||
125|35525|35525 - BYPASS W/VEIN BRACHIAL-BRACHIAL|3582.36|3582.36||
125|35523|35523 - BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL|2156.49|2156.49||
125|35522|35522 - BYPASS W/VEIN AXILLARY-BRACHIAL|3582.36|3582.36||
125|35521|35521 - BYPASS W/VEIN AXILLARY-FEMORAL|2380.94|2380.94||
125|3551F|3551F - INTERMEDIATE RISK FOR THROMBOEMBOLISM|0.01|0.01||
125|35518|35518 - BYPASS W/VEIN AXILLARY-AXILLARY|2594.18|2594.18||
125|35516|35516 - BYPASS W/VEIN SUBCLAVIAN-AXILLARY|2403.24|2403.24||
125|35515|35515 - BYPASS W/VEIN SUBCLAVIAN-VERTEBRAL|2444.62|2444.62||
125|35512|35512 - BYPASS W/VEIN SUBCLAVIAN-BRACHIAL|3880.5|3880.5||
125|35511|35511 - BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN|2194.62|2194.62||
125|35510|35510 - BYPASS W/VEIN CAROTID-BRACHIAL|1377.43|1377.43||
125|3550F|3550F - LOW RISK FOR THROMBOEMBOLISM|0.01|0.01||
125|35509|35509 - BYPASS W/VEIN CAROTID-CONTRALATERAL CAROTID|2565.4|2565.4||
125|35508|35508 - BYPASS W/VEIN CAROTID-VERTEBRAL|2678.86|2678.86||
125|35506|35506 - BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID|2582.2|2582.2||
125|35501|35501 - BYPASS W/VEIN COMMON-IPSILATERAL CAROTID|2575.09|2575.09||
125|35500|35500 - HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX|1211.07|1211.07||
125|35494|35494 - ATHERECTOMY -  PERCUTANEOUS|1397.45|1397.45||
125|35400|35400 - ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ|789.04|789.04||
125|35390|35390 - ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO|262.05|262.05||
125|35372|35372 - TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL|1720.28|1720.28||
125|35371|35371 - TEAEC W/WO PATCH GRAFT COMMON FEMORAL|1701.82|1701.82||
125|35363|35363 - TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL|3040.23|3040.23||
125|35361|35361 - TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC|2754.79|2754.79||
125|35355|35355 - TEAEC W/WO PATCH GRAFT ILIOFEMORAL|2224.02|2224.02||
125|35351|35351 - TEAEC W/WO PATCH GRAFT ILIAC|2270.28|2270.28||
125|35341|35341 - TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL|2529.28|2529.28||
125|35331|35331 - TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA|2528.97|2528.97||
125|35321|35321 - TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL|1985.42|1985.42||
125|35311|35311 - TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC|2749.91|2749.91||
125|35306|35306 - TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART|890.27|890.27||
125|35305|35305 - TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL|2363.84|2363.84||
125|35304|35304 - TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY|2460|2460||
125|35303|35303 - TEAEC W/GRAFT POPLITEAL ARTERY|2363.84|2363.84||
125|35302|35302 - TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY|2150.83|2150.83||
125|35301|35301 - TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC|2165.95|2165.95||
125|35286|35286 - RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY|2157.39|2157.39||
125|35281|35281 - RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL|2520.57|2520.57||
125|35276|35276 - RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP|2396.38|2396.38||
125|35271|35271 - RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP|3114.04|3114.04||
125|35266|35266 - RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY|1462.69|1462.69||
125|35261|35261 - REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK|2193.2|2193.2||
125|35256|35256 - REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY|2159.75|2159.75||
125|35251|35251 - REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL|2347.55|2347.55||
125|35246|35246 - RPR BLOOD VESSEL VEIN GRF INTRATHORACIC W/O BYP|2700.54|2700.54||
125|35241|35241 - RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP|3198.9|3198.9||
125|35236|35236 - REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY|2119.04|2119.04||
125|35231|35231 - REPAIR BLOOD VESSEL W/VEIN GRAFT NECK|2232.84|2232.84||
125|35226|35226 - RPR BLOOD VESSEL DIRECT LOWER EXTREMITY|1578.07|1578.07||
125|35221|35221 - RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL|2408.54|2408.54||
125|35216|35216 - RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS|2500.6|2500.6||
125|35211|35211 - RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS|2945.84|2945.84||
125|3520F|3520F - CLOSTRIDIUM DIFFICILE TESTING PERFORMED|0.01|0.01||
125|35207|35207 - REPAIR BLOOD VESSEL DIRECT HAND FINGER|1640.07|1640.07||
125|35206|35206 - REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY|1587.06|1587.06||
125|35201|35201 - REPAIR BLOOD VESSEL DIRECT NECK|1946.44|1946.44||
125|35190|35190 - RPR/TRAUMATIC AV FISTULA EXTREMITIES|2026.53|2026.53||
125|35189|35189 - RPR/TRAUMATIC AV FISTULA THORAX & ABDOMEN|2142.95|2142.95||
125|35188|35188 - RPR/TRAUMATIC AV FISTULA HEAD & NECK|1993.43|1993.43||
125|35184|35184 - RPR CONGENITAL AV FISTULA EXTREMITIES|1974.27|1974.27||
125|35182|35182 - RPR CONGENITAL AV FISTULA THORAX & ABDOMEN|2073.91|2073.91||
125|35180|35180 - REPAIR CONGENITAL AV FISTULA HEAD & NECK|1935.65|1935.65||
125|3517F|3517F - HBV STATUS ASSESSED W/ RESULTS IN 1 YR|0.01|0.01||
125|3515F|3515F - PATIENT HAS DOCUMENTED IMMUNITY TO HEPATITIS C|0.01|0.01||
125|35152|35152 - DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY|2048.08|2048.08||
125|35151|35151 - DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY|2279.56|2279.56||
125|3514F|3514F - HEPATITIS C SCREENING DOCUMENTED AS PERFORMED|0.01|0.01||
125|35142|35142 - DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART|2266.21|2266.21||
125|35141|35141 - DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY|1957.3|1957.3||
125|3513F|3513F - HEPATITIS B SCREENING DOCUMENTED AS PERFORMED|0.01|0.01||
125|35132|35132 - DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY|2603.76|2603.76||
125|35131|35131 - DIR RPR ANEURYSM & GRAFT ILIAC ARTERY|2343.61|2343.61||
125|3512F|3512F - SYPHILIS SCREENING DOCUMENTED AS DONE|0.01|0.01||
125|35122|35122 - DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN|2961.88|2961.88||
125|35121|35121 - DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC|2726.81|2726.81||
125|3511F|3511F - CHLAMYDIA/GONORRHEA TSTS DOCD AS DONE|0.01|0.01||
125|35112|35112 - DIR RPR RUPTD ANEURYSM SPLENIC ARTERY|1987.81|1987.81||
125|35111|35111 - DIR RPR ANEURYSM SPLENIC ARTERY|2052.82|2052.82||
125|3510F|3510F - DOCJ TB SCREEN PERFORMED & RESULTS INTERPRET|0.01|0.01||
125|35103|35103 - DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS|3468.75|3468.75||
125|35102|35102 - DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS|3341.61|3341.61||
125|35092|35092 - DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS|3955.47|3955.47||
125|35091|35091 - DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS|3678.39|3678.39||
125|35082|35082 - DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA|3762.12|3762.12||
125|35081|35081 - DIR RPR ANEURYSM ABDOMINAL AORTA|3161.05|3161.05||
125|35045|35045 - DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY|2461.75|2461.75||
125|3503F|3503F - HIV RNA VIRAL LOAD NOT <LIMITS OF QUANTIF|0.01|0.01||
125|3502F|3502F - HIV RNA VIRAL LOAD <LIMITS OF QUANTIF|0.01|0.01||
125|35022|35022 - DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN|2615.91|2615.91||
125|35021|35021 - DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY|2601.35|2601.35||
125|35013|35013 - DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS|2226.36|2226.36||
125|35011|35011 - DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION|1969.17|1969.17||
125|3500F|3500F - CD4+CELL CNT/CD4+CELL % DOCD AS DONE|0.01|0.01||
125|35005|35005 - DIR RPR ANEURYSM VERTEBRAL ARTERY|2356.21|2356.21||
125|35002|35002 - DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY|2540.78|2540.78||
125|35001|35001 - DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY|2621.45|2621.45||
125|3498F|3498F - CD4+ CELL PERCENTAGE >= 15% HIV|0.01|0.01||
125|3497F|3497F - CD4+ CELL PERCENTAGE <15% HIV|0.01|0.01||
125|3496F|3496F - CD4+ CELL COUNT >= 500 CELLS/MM|0.01|0.01||
125|3495F|3495F - CD4+ CELL COUNT 200-499 CELLS/MM (HIV)|0.01|0.01||
125|3494F|3494F - CD4+ CELL COUNT <200 CELLS/MM|0.01|0.01||
125|3493F|3493F - NO HIST NADIR CD4+ CELL CNT <350&AIDS CONDITION|0.01|0.01||
125|3492F|3492F - HISTORY OF NADIR CD4+ CELL COUNT <350 CELLS/MM3|0.01|0.01||
125|3491F|3491F - HIV INDETERMINATE INFANTS BORN OF HIV MOTHERS|0.01|0.01||
125|3490F|3490F - HISTORY OF AIDS-DEFINING CONDITION|0.01|0.01||
125|34900|34900 - EVASC RPR ILIAC ART ILIO-ILIAC PROSTHESIS|1008.94|1008.94||
125|34848|34848 - VISCER AND INFRARENAL ABDOM AORTA 4+ PROSTHESIS|2695.81|2695.81||
125|34847|34847 - VISCER AND INFRARENAL ABDOM AORTA 3 PROSTHESIS|2472.17|2472.17||
125|34846|34846 - VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS|2243.89|2243.89||
125|34845|34845 - VISCER AND INFRARENAL ABDOM AORTA 1 PROSTHESIS|2001.34|2001.34||
125|34844|34844 - ENDOVASC VISCER AORTA REPR FENEST 4+ ENDOGRAFT|2286.7|2286.7||
125|34843|34843 - ENDOVASC VISCER AORTA REPAIR FENEST 3 ENDOGRAFT|2062.99|2062.99||
125|34842|34842 - ENDOVASC VISCER AORTA REPAIR FENEST 2 ENDOGRAFT|1846.91|1846.91||
125|34841|34841 - ENDOVASC VISCER AORTA REPAIR FENEST 1 ENDOGRAFT|1591.81|1591.81||
125|34834|34834 - OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI|1063.15|1063.15||
125|34833|34833 - OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP|1532.33|1532.33||
125|34832|34832 - OPN RPR ARYSM RPR ARTL TRMA AORTO-BIFEM PROSTH|4347.37|4347.37||
125|34831|34831 - OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH|4347.37|4347.37||
125|34830|34830 - OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH|3952.15|3952.15||
125|34826|34826 - PLMT XTN PROSTH EVASC RPR ARYSM/DSJ EA VSL|1021.83|1021.83||
125|34825|34825 - PLMT XTN PROSTH EVASC RPR ARYSM/DSJ 1ST VSL|3321.01|3321.01||
125|34820|34820 - OPN ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI|2262.66|2262.66||
125|34813|34813 - PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR|1184.62|1184.62||
125|34812|34812 - OPN FEM ART EXPOS DLVR EVASC PROSTH UNI|1453.74|1453.74||
125|34808|34808 - EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE|890.27|890.27||
125|34806|34806 - TCAT PLACEMENT PHYSIOLOGIC SENSOR ANEURYSMAL SAC|123.88|123.88||
125|34805|34805 - EVASC RPR AAA AORTO-UNIILIAC/AORTO-UNIFEM PROSTH|5785.45|5785.45||
125|34804|34804 - EVASC RPR AAA W/UNIBDY BFRC PROSTH|6047.75|6047.75||
125|34803|34803 - EVASC RPR AAA W/MDLR BFRC PROSTH 2 LIMBS|1416.33|1416.33||
125|34802|34802 - EVASC RPR AAA W/MDLR BFRC PROSTH 1 LIMB|2359.4|2359.4||
125|34800|34800 - EVASC RPR AAA W/AORTO-AORTIC TUBE PROSTH|5509.73|5509.73||
125|3476F|3476F - DISEASE PROGNOSIS RA ASSESSED GOOD PROG DOCD|0.01|0.01||
125|3475F|3475F - DISEASE PROGNOSIS RA ASSESSED POOR PROG DOCD|0.01|0.01||
125|3472F|3472F - RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY HIGH|0.01|0.01||
125|3471F|3471F - RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY MOD|0.01|0.01||
125|34716|34716 - OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ|631.38|631.38||
125|34715|34715 - OPN AX/SUBCLA ART EXPOS DLVR EVASC PROSTH UNI|509.64|509.64||
125|34714|34714 - OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH|455.75|455.75||
125|34713|34713 - PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT|217.31|217.31||
125|34712|34712 - TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I|1143.62|1143.62||
125|34711|34711 - DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL|505.58|505.58||
125|34710|34710 - DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL|1347.77|1347.77||
125|3470F|3470F - RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY LOW|0.01|0.01||
125|34709|34709 - PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR|547.53|547.53||
125|34708|34708 - EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT|3120.16|3120.16||
125|34707|34707 - EVASC RPR DPLMNT ILIO-ILIAC NDGFT|1936.31|1936.31||
125|34706|34706 - EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT|3883.39|3883.39||
125|34705|34705 - EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT|2577.67|2577.67||
125|34704|34704 - EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT|3897.74|3897.74||
125|34703|34703 - EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT|2341.22|2341.22||
125|34702|34702 - EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT|3102.26|3102.26||
125|34701|34701 - EVASC RPR DPLMNT AORTO-AORTIC NDGFT|2074.97|2074.97||
125|3455F|3455F - TB SCRNG DONE INTRPD </6 MOS START RA THXPY|0.01|0.01||
125|34530|34530 - SAPHENOPOPLITEAL VEIN ANASTOMOSIS|1698.58|1698.58||
125|3452F|3452F - DYSPNEA NOT SCREENED|0.01|0.01||
125|34520|34520 - CROSS-OVER VEIN GRAFT VENOUS SYSTEM|1481.27|1481.27||
125|3451F|3451F - DYSPNEA SCRND MOD-SEVERE DYSPNEA|0.01|0.01||
125|34510|34510 - VENOUS VALVE TRANSPOSITION ANY VEIN DONOR|1413.31|1413.31||
125|3450F|3450F - DYSPNEA SCRND NO-MILD DYSPNEA|0.01|0.01||
125|34502|34502 - RECONSTRUCTION VENA CAVA ANY METHOD|3071.14|3071.14||
125|34501|34501 - VALVULOPLASTY FEMORAL VEIN|1166.75|1166.75||
125|34490|34490 - THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN|1144.74|1144.74||
125|34471|34471 - THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC|1090.57|1090.57||
125|34451|34451 - THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN ABDL&LEG|1972.81|1972.81||
125|34421|34421 - THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC|1272.98|1272.98||
125|34401|34401 - THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC|1568.37|1568.37||
125|34203|34203 - EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC|1706.03|1706.03||
125|34201|34201 - EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART|1200.54|1200.54||
125|34151|34151 - EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART|2063.16|2063.16||
125|34111|34111 - EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC|1599.52|1599.52||
125|34101|34101 - EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART|1210.97|1210.97||
125|34051|34051 - EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY|1666.86|1666.86||
125|34001|34001 - EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART|1514.08|1514.08||
125|33993|33993 - REPOSITION VAD W/IMAGING DIFFERENT SESSION|295.29|295.29||
125|33992|33992 - REMOVAL PERCUTANEOUS VAD DIFFERENT SESSION|337.93|337.93||
125|33991|33991 - INSJ PERQ VAD TRNSPTAL W/IMAGE ART&VENOUS ACCESS|1060.4|1060.4||
125|33990|33990 - INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY|718.8|718.8||
125|33989|33989 - RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS|840.18|840.18||
125|33988|33988 - INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS|1322.55|1322.55||
125|33987|33987 - ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS|354.8|354.8||
125|33986|33986 - ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER|882.71|882.71||
125|33985|33985 - ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH-5 YRS|874.54|874.54||
125|33984|33984 - ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER|481.62|481.62||
125|33983|33983 - RPLCMT VAD PMP IMPLTBL ICORP 1 VNTR W/BYPASS|3905.46|3905.46||
125|33982|33982 - PLCMT VAD PMP IMPLTBL ICORP 1 VENTR W/O BYPASS|3326.19|3326.19||
125|33981|33981 - RPLCMT XTRCORP VAD 1/BIVENTR PUMP 1/EA PUMP|1415.75|1415.75||
125|33980|33980 - RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC|3507.51|3507.51||
125|33979|33979 - INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC|3919.69|3919.69||
125|33978|33978 - REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR|2434.9|2434.9||
125|33977|33977 - REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE|2094.85|2094.85||
125|33976|33976 - INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR|3089.56|3089.56||
125|33975|33975 - INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE|2425.91|2425.91||
125|33974|33974 - RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA|1285.52|1285.52||
125|33973|33973 - INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA|1163.79|1163.79||
125|33971|33971 - RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF|1216|1216||
125|33970|33970 - INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN|1123.34|1123.34||
125|33969|33969 - ECMO/ECLS RMVL OF PERPH CANNULA OPEN BIRTH-5 YRS|464.35|464.35||
125|33968|33968 - REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ|56.66|56.66||
125|33967|33967 - INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ|482.24|482.24||
125|33966|33966 - ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER|400.25|400.25||
125|33965|33965 - ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS|313.51|313.51||
125|33964|33964 - ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER|840.18|840.18||
125|33963|33963 - ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH-5YRS|795.91|795.91||
125|33962|33962 - ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER|398.99|398.99||
125|3395F|3395F - QUANT NON-HER2 IHC EVAL OF BRST CANCER PERFORMED|0.01|0.01||
125|33959|33959 - ECMO/ECLS REPOS PERPH CANNULA OPEN BIRTH-5 YRS|397.93|397.93||
125|33958|33958 - ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER|314.04|314.04||
125|33957|33957 - ECMO/ECLS REPOS PERIPH CANNULA PERQ BIRTH-5 YRS|313.51|313.51||
125|33956|33956 - ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER|1407.8|1407.8||
125|33955|33955 - ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH-5 YRS|1412.36|1412.36||
125|33954|33954 - ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN|807.76|807.76||
125|33953|33953 - ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS OPEN|805.84|805.84||
125|33952|33952 - ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ|722.5|722.5||
125|33951|33951 - ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS PERQ|720.67|720.67||
125|3394F|3394F - QUANT HER2 IHC EVAL OF BRST CANCER ASCO/CAP|0.01|0.01||
125|33949|33949 - ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL|390.35|390.35||
125|33948|33948 - ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS|401.89|401.89||
125|33947|33947 - ECMO/ECLS INITIATION VENO-ARTERIAL|580.79|580.79||
125|33946|33946 - ECMO/ECLS INITIATION VENO-VENOUS|520.48|520.48||
125|33945|33945 - HEART TRANSPLANT W/WO RECIPIENT CARDIECTOMY|2696.4|2696.4||
125|33944|33944 - BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT|317.05|317.05||
125|33940|33940 - DONOR CARDIECTOMY|1712|1712||
125|33935|33935 - HEART-LUNG TRNSPL W/RECIPIENT CARDIECTOMY-PNUMEC|3829.53|3829.53||
125|33933|33933 - BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT|400.37|400.37||
125|33930|33930 - DONOR CARDIECTOMY-PNEUMONECTOMY|2104.95|2104.95||
125|33927|33927 - IMPLTJ TOTAL RPLCMT HEART SYS W/RCP CARDIECTOMY|4301.33|4301.33||
125|33926|33926 - RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/BYPASS|5548.86|5548.86||
125|33925|33925 - RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS|4044|4044||
125|33924|33924 - LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART|689.6|689.6||
125|33922|33922 - TRANSECTION PULMONARY ARTERY W/CARD BYPASS|2999.76|2999.76||
125|33920|33920 - RPR PULMONARY ATRESIA W/CONSTJ/RPLCMT CONDUIT|4768.23|4768.23||
125|33919|33919 - REPAIR PULMONARY ATRESIA W/BYPASS|4916.36|4916.36||
125|33918|33918 - REPAIR PULMONARY ATRESIA|3831.8|3831.8||
125|33917|33917 - RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT|3926.48|3926.48||
125|33916|33916 - PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS|3074.29|3074.29||
125|33915|33915 - PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS|2334.14|2334.14||
125|33910|33910 - PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS|3103.95|3103.95||
125|3390F|3390F - AJCC COLON CANCER STAGE IV DOCD|0.01|0.01||
125|33891|33891 - BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC|2172.86|2172.86||
125|3388F|3388F - AJCC COLON CANCER STAGE III DOCD|0.01|0.01||
125|33889|33889 - OPN SUBCLA CRTD ART TRPOS NCK INC ULAT|1694.84|1694.84||
125|33886|33886 - PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA|2018.07|2018.07||
125|33884|33884 - PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN|845.39|845.39||
125|33883|33883 - PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN|2327.81|2327.81||
125|33881|33881 - EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN|3161.05|3161.05||
125|33880|33880 - EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH|3665.43|3665.43||
125|33877|33877 - RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS|5042.86|5042.86||
125|33875|33875 - DESCENDING THORACIC AORTA GRAFT W/WO BYPASS|3949.51|3949.51||
125|33870|33870 - TRANSVERSE ARCH GRAFT W/CARDIOPULMONARY BYPASS|6149.31|6149.31||
125|3386F|3386F - AJCC COLON CANCER STAGE II|0.01|0.01||
125|33864|33864 - ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL|5418.84|5418.84||
125|33863|33863 - AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT|4868.23|4868.23||
125|33860|33860 - ASCENDING AORTA GRF W/CARD BYP & VALVE SSP|4639.51|4639.51||
125|33853|33853 - RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/BYPASS|4572.46|4572.46||
125|33852|33852 - RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/O BYPASS|4303.67|4303.67||
125|33851|33851 - EXC COARCJ AORTA W/L SUBCLAV ART/PROSTC GUSSET|3928.41|3928.41||
125|3384F|3384F - AJCC COLON CANCER STAGE I|0.01|0.01||
125|33845|33845 - EXCISION COARCTATION AORTA W/WO PDA W/GRAFT|3394.11|3394.11||
125|33840|33840 - EXC COARCJ AORTA W/WO PDA W/DIRECT ANASTOMOSIS|2937.92|2937.92||
125|3382F|3382F - AJCC COLON CANCER STAGE 0|0.01|0.01||
125|33824|33824 - RPR PATENT DUXUS ARTERIOSUS DIV 18 YR & OLDER|2677.3|2677.3||
125|33822|33822 - RPR PATENT DUXUS ARTERIOSUS DIV UNDER 18 YR|2330.65|2330.65||
125|33820|33820 - REPAIR PATENT DUCTUS ARTERIOSUS LIGATION|2140.74|2140.74||
125|33814|33814 - OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/BYPASS|3826.04|3826.04||
125|33813|33813 - OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/O BYPASS|2933.11|2933.11||
125|3380F|3380F - AJCC BREAST CANCER STAGE IV|0.01|0.01||
125|33803|33803 - DIVISION ABERRANT VESSEL W/REANASTOMOSIS|2666.46|2666.46||
125|33802|33802 - DIVISION ABERRANT VESSEL VASCULAR RING|2343.84|2343.84||
125|33800|33800 - AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX|2055.04|2055.04||
125|3378F|3378F - AJCC BREAST CANCER STAGE III|0.01|0.01||
125|33788|33788 - REIMPLANTATION ANOMALOUS PULMONARY ARTERY|3391.65|3391.65||
125|33786|33786 - TOTAL REPAIR TRUNCUS ARTERIOSUS|5001.46|5001.46||
125|33783|33783 - A-ROOT TLCJ VSD PULM STNS RPR W/RIMPLTJ C OSTIA|5880.67|5880.67||
125|33782|33782 - A-ROOT TLCJ VSD PULM STNS RPR W/O C OST RIMPLTJ|5443.53|5443.53||
125|33781|33781 - RPR TGV AORTIC P-ART RCNSTJ RPR SBPULMC OBSTRCJ|5795.25|5795.25||
125|33780|33780 - RPR TGV AORTIC P-ART RCNSTJ W/CLSR V-SEPTL DFCT|6315.27|6315.27||
125|33779|33779 - RPR TGV AORTIC PULM ART RCNSTJ W/RMVL PULM BAND|6187|6187||
125|33778|33778 - RPR TRPOS GRT VESSEL AORTIC PULMONARY ART RCNSTJ|5689.02|5689.02||
125|33777|33777 - RPR TRPOS GRT VSL ATR BAFFLE W/BYP SBPULM OBSTRC|5240.25|5240.25||
125|33776|33776 - RPR TRPOS GRT VSL ATR BAFFLE W/CLSR V-SEPTL DFCT|5398.88|5398.88||
125|33775|33775 - RPR TRPOS GREAT VSLS ATR BAFFLE W/RMVL PULM BAND|5098.31|5098.31||
125|33774|33774 - RPR TRPOS GREAT VSLS ATRIAL BAFFLE PX W/BYPASS|4682.82|4682.82||
125|33771|33771 - RPR TRPOS GREAT VSLS W/ENLGMNT V-SEPTL DFCT|5058.62|5058.62||
125|33770|33770 - RPR TRPOS GREAT VSLS W/O ENLGMNT V-SEPTL DFCT|4942.31|4942.31||
125|3376F|3376F - AJCC BREAST CANCER STAGE II|0.01|0.01||
125|33768|33768 - ANASTOMOSIS CAVOPULMARY 2ND SUPRIOR VENA CAVA|950.57|950.57||
125|33767|33767 - SHUNT SUPERIOR VENA CAVA PULM ARTERY BOTH LUNGS|3059.3|3059.3||
125|33766|33766 - SHUNT SUPERIOR VENA CAVA PULMONARY ART 1 LUNG|2785.55|2785.55||
125|33764|33764 - SHUNT CENTRAL W/PROSTHETIC GRAFT|2978.43|2978.43||
125|33762|33762 - SHUNT DESCENDING AORTA PULMONARY ARTERY|2756.78|2756.78||
125|33755|33755 - SHUNT ASCENDING AORTA PULMONARY ARTERY|2743.99|2743.99||
125|33750|33750 - SHUNT SUBCLAVIAN PULMONARY ARTERY|2751.07|2751.07||
125|3374F|3374F - AJCC BREAST CANCER STAGE I T1C|0.01|0.01||
125|33737|33737 - ATRIAL SEPTECT/SEPTOST OPN HRT W/INFL OCCLUSION|3099.64|3099.64||
125|33736|33736 - ATRIAL SEPTECTOMY/SEPTOSTOMY OPEN HEART W/BYPASS|3372.37|3372.37||
125|33735|33735 - ATRIAL SEPTECTOMY/SEPTOSTOMY CLOSED HEART|2942.54|2942.54||
125|33732|33732 - RPR COR TRIATM/SUPVALVR RING RESCJ L ATRIAL MEMB|4071.59|4071.59||
125|33730|33730 - COMPLETE RPR ANOMALOUS PULMONARY VENOUS RETURN|4447.97|4447.97||
125|3372F|3372F - AJCC BREAST CANCER STAGE I T1MIC T1A/T1B|0.01|0.01||
125|33726|33726 - REPAIR PULMONARY VENOUS STENOSIS|4447.39|4447.39||
125|33724|33724 - REPAIR ISOLATED PARTIAL PULM VENOUS RETURN|3373|3373||
125|33722|33722 - CLOSURE AORTICO-LEFT VENTRICULAR TUNNEL|4036.43|4036.43||
125|33720|33720 - RPR SINUS VALSALVA ANEURYSM|3983.33|3983.33||
125|33710|33710 - RPR SINUS VALSALVA FISTULA W/RPR V-SEPTAL DEFECT|4490.28|4490.28||
125|3370F|3370F - AJCC BREAST CANCER STAGE 0 DOCUMENTED|0.01|0.01||
125|33702|33702 - RPR SINUS VALSALVA FISTULA|3760.75|3760.75||
125|33697|33697 - COMPL RPR T-FALLOT W/PULM ATRESIA|4743.98|4743.98||
125|33694|33694 - COMPL RPR T-FALLOT W/O PULM ATRESIA TANULR PATCH|4856.32|4856.32||
125|33692|33692 - COMPL RPR TETRALOGY FALLOT W/O PULM ATRESIA|4641.15|4641.15||
125|33690|33690 - BANDING PULMONARY ARTERY|2358.42|2358.42||
125|33688|33688 - CLSR V-SEPTAL DFCT W/RMVL P-ART BAND W/WO GUSSET|4304.93|4304.93||
125|33684|33684 - CLSR V-SEPTL DFCT W/PULM VLVT/INFUND RESCJ|4244.45|4244.45||
125|33681|33681 - CLSR 1 VENTRICULAR SEPTAL DEFECT W/WO PATCH|3942.34|3942.34||
125|33677|33677 - CLOSURE MULTIPLE VSD W/REMOVAL ARTERY BAND|4661.81|4661.81||
125|33676|33676 - CLOSURE MULTIPLE VSD W/RESECTION|4484.27|4484.27||
125|33675|33675 - CLOSURE MULTIPLE VENTRICULAR SEPTAL DEFECTS|4346.02|4346.02||
125|33670|33670 - RPR COMPL AV CANAL W/WO PROSTC VALVE|4887.5|4887.5||
125|33665|33665 - RPR INTRM/TRANSJ AV CANAL W/WO AV VALVE RPR|4101.38|4101.38||
125|33660|33660 - RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR|3881.59|3881.59||
125|33647|33647 - RPR ATRIAL & VENTRIC SEPTAL DFCT DIR/PATCH CLS|4442.24|4442.24||
125|33645|33645 - DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG|3428.07|3428.07||
125|33641|33641 - RPR ATRIAL SEPTAL DFCT SECUNDUM W/BYP W/WO PATCH|3079.33|3079.33||
125|33622|33622 - RECONSTRUCTION COMPLEX CARDIAC ANOMALY|5785.83|5785.83||
125|33621|33621 - TRANSTHORACIC CATHETER INSERTION FOR STENT PLMT|1560.69|1560.69||
125|33620|33620 - APPLICATION RIGHT & LEFT PULMONARY ARTERY BAND|2778.74|2778.74||
125|33619|33619 - RPR 1 VNTRC W/O/F OBSTRCJ&AORTIC ARCH HYPOPLAS|5326.44|5326.44||
125|33617|33617 - RPR COMPLEX CARDIAC ANOMALY MODIFIED FONTAN PX|4992.19|4992.19||
125|33615|33615 - RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX|4490.03|4490.03||
125|33612|33612 - RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ|4956.79|4956.79||
125|33611|33611 - RPR 2 OUTLET R VNTRC W/INTRAVENTR TUNNEL RPR|4949.15|4949.15||
125|33610|33610 - RPR CAR ANOMAL SURG ENLGMENT VENTR SEPTL DFCT|4730.07|4730.07||
125|33608|33608 - RPR CAR ANOMAL XCP PULM ATRESIA VENTR SEPTL DFCT|4795.3|4795.3||
125|33606|33606 - ANAST PULMONARY ART AORTA DAMUS-KAYE-STANSEL PX|3906.07|3906.07||
125|33602|33602 - CLOSURE SEMILUNAR VALVE AORTIC/PULM SUTURE/PATCH|4025.15|4025.15||
125|33600|33600 - CLOSURE ATRIOVENTRICULAR VALVE SUTURE/PATCH|4184.95|4184.95||
125|33572|33572 - CORONARY ENDARTERCOMY OPEN ANY METHOD|1145.19|1145.19||
125|3354F|3354F - CLIN SIGN DEP SYMP BY STAND DEP ASSESS TOOL|0.01|0.01||
125|33548|33548 - SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD|6230.77|6230.77||
125|33545|33545 - RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT|4912.44|4912.44||
125|33542|33542 - MYOCARDIAL RESECTION|4093.75|4093.75||
125|3353F|3353F - MILD TO MOD DEP SYMP BY STAND DEP ASSESS TOOL|0.01|0.01||
125|33536|33536 - CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS|5146.16|5146.16||
125|33535|33535 - CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS|4670.02|4670.02||
125|33534|33534 - CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS|4237.47|4237.47||
125|33533|33533 - CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT|3778.44|3778.44||
125|33530|33530 - ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ|1055.56|1055.56||
125|3352F|3352F - NO SIGNIF DEP SYMP CAT BY STAND DEP ASSESS TOOL|0.01|0.01||
125|33523|33523 - CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN|2091.85|2091.85||
125|33522|33522 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN|1745.97|1745.97||
125|33521|33521 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN|1400.63|1400.63||
125|3351F|3351F - NEG DEP SYMP CAT USING STAND DEP ASSESS TOOL|0.01|0.01||
125|33519|33519 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN|1053.95|1053.95||
125|33518|33518 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN|709.94|709.94||
125|33517|33517 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN|364.6|364.6||
125|33516|33516 - CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT|5451.38|5451.38||
125|33514|33514 - CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS|5102.56|5102.56||
125|33513|33513 - CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS|4705.59|4705.59||
125|33512|33512 - CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS|4357.84|4357.84||
125|33511|33511 - CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS|4013.3|4013.3||
125|33510|33510 - CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT|3667.42|3667.42||
125|3350F|3350F - MAMMO ASSESSMENT CAT BIOPSY PROVEN MALIG DOCD|0.01|0.01||
125|33508|33508 - NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG|78.6|78.6||
125|33507|33507 - RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ|4452.02|4452.02||
125|33506|33506 - RPR ANOM CORONARY ART FROM PULM ART TO AORTA|4146.25|4146.25||
125|33505|33505 - RPR ANOM CORON ART W/CONSTJ INTRAPULM ART TUNNEL|4151.05|4151.05||
125|33504|33504 - RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP|3882.22|3882.22||
125|33503|33503 - RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT|3140.41|3140.41||
125|33502|33502 - RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION|2239.17|2239.17||
125|33501|33501 - RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/O BYPASS|2315.37|2315.37||
125|33500|33500 - RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS|3730.26|3730.26||
125|33496|33496 - RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS|4153.84|4153.84||
125|33478|33478 - OUTFLOW TRACT AGMNTJ W/WO COMMISSUR/INFUND RESCJ|3928.14|3928.14||
125|33477|33477 - TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH|2299.44|2299.44||
125|33476|33476 - R VENTRIC RESCJ INFUND STEN W/WO COMMISSUROTOMY|3660.36|3660.36||
125|33475|33475 - REPLACEMENT PULMONARY VALVE|4310.08|4310.08||
125|33474|33474 - VALVOTOMY PULMONARY VALVE OPEN HEART W/BYPASS|3490.69|3490.69||
125|33471|33471 - VALVOTOMY PULM VALVE CLSD HEART VIA PULM ARTERY|3300.88|3300.88||
125|33470|33470 - VALVOTOMY PULMONARY VALVE CLSD HEART TRANSVENTR|2697.86|2697.86||
125|33468|33468 - TRICUSPID VALVE RPSG&PLCTJ EBSTEIN ANOMALY|4420.53|4420.53||
125|33465|33465 - REPLACEMENT TRICUSPID VALVE W/CARD BYPASS|4143.77|4143.77||
125|33464|33464 - VALVULOPLASTY TRICUSPID VALVE W/RING INSERTION|4089.36|4089.36||
125|33463|33463 - VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION|3954.59|3954.59||
125|33460|33460 - VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP|3500.37|3500.37||
125|3345F|3345F - MAMMO ASSESSMENT CAT HIGH CHANCE MALIG DOCD|0.01|0.01||
125|3344F|3344F - MAMMO ASSESSMENT CAT SUSPICIOUS DOCD|0.01|0.01||
125|3343F|3343F - MAMMO ASSESSMENT CAT PROB BENIGN DOCD|0.01|0.01||
125|33430|33430 - REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP|4501.76|4501.76||
125|3342F|3342F - MAMMO ASSESSMENT CAT BENIGN DOCD|0.01|0.01||
125|33427|33427 - VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING|3982.32|3982.32||
125|33426|33426 - VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING|4114.9|4114.9||
125|33425|33425 - VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS|3953.5|3953.5||
125|33422|33422 - VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS|3738.89|3738.89||
125|33420|33420 - VALVOTOMY MITRAL VALVE CLOSED HEART|2720.57|2720.57||
125|3341F|3341F - MAMMO ASSESSMENT CAT NEGATIVE DOCD|0.01|0.01||
125|33419|33419 - TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS|716.68|716.68||
125|33418|33418 - TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS|3023.55|3023.55||
125|33417|33417 - AORTOPLASTY SUPRAVALVULAR STENOSIS|3967.85|3967.85||
125|33416|33416 - VENTRICULOMYOTOMY-MYECTOMY|3970.83|3970.83||
125|33415|33415 - RESECTION/INCISION SUBVALVULAR TISSUE|3609.89|3609.89||
125|33414|33414 - RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC|4335.22|4335.22||
125|33413|33413 - REPLACEMENT AORTIC&PULMON VALVES ROSS PROCEDUR|5347.71|5347.71||
125|33412|33412 - REPLACEMENT AORTIC VALVE KONNO PROCEDURE|4820.15|4820.15||
125|33411|33411 - RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS|4723.15|4723.15||
125|33410|33410 - RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE|3317.04|3317.04||
125|3340F|3340F - MAMMO ASSESSMENT CAT INCOMP ADDTNL IMAGE DOCD|0.01|0.01||
125|33406|33406 - RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND|4513.5|4513.5||
125|33405|33405 - RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT|4136.89|4136.89||
125|33404|33404 - CONSTRUCTION APICAL-AORTIC CONDUIT|4329.72|4329.72||
125|33391|33391 - VALVULOPLASTY AORTIC VALVE OPEN CARD BYP COMPLEX|3770.37|3770.37||
125|33390|33390 - VALVULOPLASTY AORTIC VALVE OPEN CARD BYP SIMPLE|3177.77|3177.77||
125|33369|33369 - REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH|1669.2|1669.2||
125|33368|33368 - REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH|1264.33|1264.33||
125|33367|33367 - REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH|1061.96|1061.96||
125|33366|33366 - TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE|3250.38|3250.38||
125|33365|33365 - REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH|3004.77|3004.77||
125|33364|33364 - REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH|2731.72|2731.72||
125|33363|33363 - REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH|2593.69|2593.69||
125|33362|33362 - REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH|2500.52|2500.52||
125|33361|33361 - REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH|2289.58|2289.58||
125|33340|33340 - PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT|1332.69|1332.69||
125|33335|33335 - INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS|3539.85|3539.85||
125|33330|33330 - INSJ GRAFT AORTA/GREAT VESSEL W/O SHUNT/BYPASS|2558.19|2558.19||
125|33322|33322 - SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS|2872.2|2872.2||
125|33321|33321 - SUTR RPR AORTA/GREAT VESSEL W/SHUNT BYPASS|2638.08|2638.08||
125|33320|33320 - SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP|1970.59|1970.59||
125|3331F|3331F - IMAGING STUDY NOT ORDERED|0.01|0.01||
125|33315|33315 - CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP|2917.23|2917.23||
125|33310|33310 - CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP|2031.66|2031.66||
125|3330F|3330F - IMAGING STUDY ORDERED|0.01|0.01||
125|33305|33305 - REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS|2745.62|2745.62||
125|33300|33300 - REPAIR CARDIAC WOUND W/O BYPASS|1930.5|1930.5||
125|3328F|3328F - PERFORMANCE STATUS DOCD RVWD 2 WKS PRIOR SURG|0.01|0.01||
125|33284|33284 - RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER|449.44|449.44||
125|33282|33282 - IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER|577.84|577.84||
125|33273|33273 - REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB|670.73|670.73||
125|33272|33272 - RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE|580.12|580.12||
125|33271|33271 - INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE|762.45|762.45||
125|33270|33270 - INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD|946.12|946.12||
125|33266|33266 - NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS|3309.93|3309.93||
125|33265|33265 - NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS|2414.53|2414.53||
125|33264|33264 - RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD|672.49|672.49||
125|33263|33263 - RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD|645.58|645.58||
125|33262|33262 - RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD|618.37|618.37||
125|33261|33261 - OPRATIVE ABLTJ VENTR ARRHYTHMOGENIC FOC W/BYPASS|2514.94|2514.94||
125|3325F|3325F - PREOP ASSES 12 MOS PRIOR CATARACT SURG W/IO LENS|0.01|0.01||
125|33259|33259 - ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS|1404.91|1404.91||
125|33258|33258 - ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP|1095.31|1095.31||
125|33257|33257 - ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE|967.49|967.49||
125|33256|33256 - ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS|3661.66|3661.66||
125|33255|33255 - ABLATION & RCNSTJ ATRIA EXTNSV W/O BYPASS|3062.17|3062.17||
125|33254|33254 - ABLATION & RECONSTRUCTION ATRIA LIMITED|2541.61|2541.61||
125|33251|33251 - ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS|2667.64|2667.64||
125|33250|33250 - ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/O BYPASS|2060.24|2060.24||
125|3324F|3324F - MRI CT SCAN ORDERED REVIEWED/REQUESTED|0.01|0.01||
125|33249|33249 - INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR|2008.39|2008.39||
125|33244|33244 - RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ|1207.23|1207.23||
125|33243|33243 - RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM|2102.82|2102.82||
125|33241|33241 - REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY|352.03|352.03||
125|33240|33240 - INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD|873.92|873.92||
125|3323F|3323F - CLIN TUMOR NODE METASTASES STAGE DOCD PRIOR SURG|0.01|0.01||
125|33238|33238 - RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY|1909.56|1909.56||
125|33237|33237 - RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY|1767.16|1767.16||
125|33236|33236 - RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS|1538.32|1538.32||
125|33235|33235 - RMVL TRANSVNS PM ELTRD DUAL LEAD SYS|883.82|883.82||
125|33234|33234 - RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR|765.85|765.85||
125|33233|33233 - REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY|358.45|358.45||
125|33231|33231 - INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS|667.04|667.04||
125|33230|33230 - INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS|635.19|635.19||
125|3322F|3322F - MELANOMA THAN AJCC STAGE 0|0.01|0.01||
125|33229|33229 - REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD|621.42|621.42||
125|33228|33228 - REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS|587.55|587.55||
125|33227|33227 - REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD|560.98|560.98||
125|33226|33226 - RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD|1409.83|1409.83||
125|33225|33225 - INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN|945.64|945.64||
125|33224|33224 - INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN|1063.93|1063.93||
125|33223|33223 - RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR|829.25|829.25||
125|33222|33222 - RELOCATION OF SKIN POCKET FOR PACEMAKER|715.3|715.3||
125|33221|33221 - INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS|597.23|597.23||
125|33220|33220 - RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB|633.44|633.44||
125|3321F|3321F - AJCC CANCER STAGE 0 OR IA MELANOMA|0.01|0.01||
125|33218|33218 - RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB|664.47|664.47||
125|33217|33217 - INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB|674.64|674.64||
125|33216|33216 - INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB|650.54|650.54||
125|33215|33215 - RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE|641.68|641.68||
125|33214|33214 - UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS|898.27|898.27||
125|33213|33213 - INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS|795.28|795.28||
125|33212|33212 - INS PM PLS GEN W/EXIST SINGLE LEAD|734.02|734.02||
125|33211|33211 - INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX|565.61|565.61||
125|33210|33210 - INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH|404.61|404.61||
125|3320F|3320F - 0 DX IMG ORDER CHEST XRAY CT US MRI PET/NUC MED|0.01|0.01||
125|33208|33208 - INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT|1091.03|1091.03||
125|33207|33207 - INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR|1125.37|1125.37||
125|33206|33206 - INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL|958.72|958.72||
125|33203|33203 - INSERTION EPICARDIAL ELECTRODE ENDOSCOPIC|1944.71|1944.71||
125|33202|33202 - INSERTION EPICARDIAL ELECTRODE OPEN|1899.74|1899.74||
125|3319F|3319F - 1 DX IMG ORDER CHEST XRAY CT US MRI PET/NUC MED|0.01|0.01||
125|3318F|3318F - PATH REPRT MALIGNANCY DOCD & RVWD INITIA RAD|0.01|0.01||
125|3317F|3317F - PATH REPRT MALIGNANCY DOCD & RVWD INITIATE CHE|0.01|0.01||
125|3316F|3316F - ESTROGEN/PROGEST RECEPTOR NEGATIVE BREAST CANCER|0.01|0.01||
125|3315F|3315F - ESTROGEN/PROGEST RECEPTOR POSITIVE BREAST CANCER|0.01|0.01||
125|33141|33141 - TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX|1236.15|1236.15||
125|33140|33140 - TRANSMYOCARDIAL LASER REVASCULAR THORACOTOMY SPX|2447.04|2447.04||
125|33130|33130 - RESECTION EXTERNAL CARDIAC TUMOR|2352.28|2352.28||
125|33120|33120 - EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP|3622.25|3622.25||
125|33050|33050 - RESECTION PERICARDIAL CYST/TUMOR|1604.25|1604.25||
125|33031|33031 - PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS|3096.7|3096.7||
125|33030|33030 - PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS|2773.81|2773.81||
125|33025|33025 - CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX|1728.85|1728.85||
125|33020|33020 - PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY|1690.04|1690.04||
125|3301F|3301F - CANCER STAGE DOCD METASTATIC & REVIEWED|0.01|0.01||
125|33015|33015 - TUBE PERICARDIOSTOMY|573.23|573.23||
125|33011|33011 - PERICARDIOCENTESIS SUBSEQUENT|186.64|186.64||
125|33010|33010 - PERICARDIOCENTESIS INITIAL|233.91|233.91||
125|3300F|3300F - AJCC STAGE DOCUMENTED & REVIEWED|0.01|0.01||
125|32998|32998 - ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY|3184.5|3184.5||
125|32997|32997 - TOTAL LUNG LAVAGE UNILATERAL|396.01|396.01||
125|32994|32994 - ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION|9306.66|9306.66||
125|32960|32960 - PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR|156.51|156.51||
125|3294F|3294F - GBS SCRNING DOCD DONE DURING WK 35-37 GESTATION|0.01|0.01||
125|32940|32940 - PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX|1764.37|1764.37||
125|3293F|3293F - ABO AND RH BLOOD TYPING DOCUMENTED AS PERFORMED|0.01|0.01||
125|3292F|3292F - HIV TSTNG ASK/DOCD/RVWD AT 1ST/2ND PRENATAL VST|0.01|0.01||
125|3291F|3291F - PATIENT IS D (RH) POSITIVE OR SENSITIZED|0.01|0.01||
125|3290F|3290F - PATIENT IS D (RH) NEGATIVE AND UNSENSITIZED|0.01|0.01||
125|32906|32906 - THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL|2561.92|2561.92||
125|32905|32905 - THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL|1980.1|1980.1||
125|32900|32900 - RESECTION RIBS EXTRAPLEURAL ALL STAGES|1686.43|1686.43||
125|3288F|3288F - FALLS RISK ASSESSMENT DOCUMENTED|0.01|0.01||
125|3285F|3285F - IOP REDUCED <15% PRE-INTERVENTION LEVEL|0.01|0.01||
125|32856|32856 - BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT BI|336.59|336.59||
125|32855|32855 - BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT UNI|274.46|274.46||
125|32854|32854 - LUNG TRANSPLANT 2 W/CARDIOPULMONARY BYPASS|4801.84|4801.84||
125|32853|32853 - LUNG TRANSPLANT 2 W/O CARDIOPULMONARY BYPASS|4500.78|4500.78||
125|32852|32852 - LUNG TRANSPLANT 1 W/CARDIOPULMONARY BYPASS|3908.68|3908.68||
125|32851|32851 - LUNG TRANSPLANT 1 W/O CARDIOPULMONARY BYPASS|3605.09|3605.09||
125|32850|32850 - DONOR PNEUMONECTOMY FROM CADAVER DONOR|1180.89|1180.89||
125|3284F|3284F - INTRAOCULAR PRESS REDUCED >/EQUAL 15%|0.01|0.01||
125|32820|32820 - MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC|2572|2572||
125|3281F|3281F - HEMOGLOBIN LEVEL <11 G/DL|0.01|0.01||
125|32815|32815 - OPEN CLOSURE MAJOR BRONCHIAL FISTULA|2528.5|2528.5||
125|32810|32810 - CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA|1098.12|1098.12||
125|3280F|3280F - HEMOGLOBIN LEVEL 11 G/DL-12.9 G/DL|0.01|0.01||
125|32800|32800 - REPAIR LUNG HERNIA THROUGH CHEST WALL|1554.07|1554.07||
125|3279F|3279F - HEMOGLOBIN LEVEL>/EQUAL 13 G/DL|0.01|0.01||
125|3278F|3278F - SERUM LEVELS CALCUM PHOSPH PARATHYR & LIPID PR|0.01|0.01||
125|3274F|3274F - PROST CANCER RSK RECUR NOT DETER/LOW/INTERMED/HI|0.01|0.01||
125|3273F|3273F - HIGH RISK OF RECURRENCE PROSTATE CANCER|0.01|0.01||
125|3272F|3272F - INTERMED RISK OF RECURRENCE PROSTATE CANCER|0.01|0.01||
125|3271F|3271F - LOW RISK OF RECURRENCE PROSTATE CANCER|0.01|0.01||
125|3270F|3270F - BONE SCAN NOT PRIOR INITIAT TX/DX PROSTATE CA|0.01|0.01||
125|32701|32701 - THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE|360|360||
125|3269F|3269F - BONE SCAN PRIOR INITIAT TX/DX PROSTATE CANCER|0.01|0.01||
125|3268F|3268F - PSA & TUMOR STAGE&GLEASON SCORE PRIOR INIT|0.01|0.01||
125|3267F|3267F - PATH RPRT INCLUDES PT & PN CAT GLEASON|0.01|0.01||
125|32674|32674 - THORCOSCPY W/MEDIASTINL & REGIONL LYMPHDENECTOMY|362.66|362.66||
125|32673|32673 - THORACOSCOPY RESEXN THYMUS UNI/BILATERAL|2031.75|2031.75||
125|32672|32672 - THORACOSCOPY W/RESEXN-PLICAJ EMPHYSEMA LUNG UNIL|2554.94|2554.94||
125|32671|32671 - THORACOSCOPY W/PNEUMONECTOMY|2980.83|2980.83||
125|32670|32670 - THORACOSCOPY W/BILOBECTOMY|2679.87|2679.87||
125|3266F|3266F - HEPATITIS C GENOTYPE PRIOR ANTIVIRAL TREATMENT|0.01|0.01||
125|32669|32669 - THORACOSCOPY W/SEGMENTECTOMY|2243.29|2243.29||
125|32668|32668 - THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN|264.32|264.32||
125|32667|32667 - THORACOSCOPY W/THERA WEDGE RESEXN ADDL IPSILATRL|264.32|264.32||
125|32666|32666 - THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT|1445.08|1445.08||
125|32665|32665 - THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE|1810.23|1810.23||
125|32664|32664 - THORACOSCOPY W/THORACIC SYMPATHECTOMY|1716.3|1716.3||
125|32663|32663 - THORACOSCOPY W/LOBECTOMY SINGLE LOBE|2205.22|2205.22||
125|32662|32662 - THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS|1967.79|1967.79||
125|32661|32661 - THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS|1676.33|1676.33||
125|3265F|3265F - RNA TESTING FOR HEP C VIREMIA ORDERED/DOCD|0.01|0.01||
125|32659|32659 - THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC|1730.44|1730.44||
125|32658|32658 - THORACOSCOPY W/RMVL CLOT/FB FROM PERICARDIAL SAC|1734.78|1734.78||
125|32656|32656 - THORACOSCOPY W/PARIETAL PLEURECTOMY|1637.87|1637.87||
125|32655|32655 - THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX|1741.63|1741.63||
125|32654|32654 - THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE|1583.48|1583.48||
125|32653|32653 - THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT|1589.35|1589.35||
125|32652|32652 - THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS|2004.1|2004.1||
125|32651|32651 - THORACOSCOPY W/PARTIAL PULMONARY DECORTICATION|1468.8|1468.8||
125|32650|32650 - THORACOSCOPY W/PLEURODESIS|1353.71|1353.71||
125|3260F|3260F - TUMOR/NODES/HISTO GRADE DOCUMENTED|0.01|0.01||
125|32609|32609 - THORACOSCOPY WITH BIOPSYIES OF PLEURA|431.12|431.12||
125|32608|32608 - THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL|632.11|632.11||
125|32607|32607 - THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL|515.18|515.18||
125|32606|32606 - THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX|722.79|722.79||
125|32604|32604 - THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX|805.21|805.21||
125|32601|32601 - THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX|540.75|540.75||
125|32562|32562 - INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY|134.96|134.96||
125|32561|32561 - INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY|150.09|150.09||
125|32560|32560 - INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS|380.31|380.31||
125|32557|32557 - PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING|788.17|788.17||
125|32556|32556 - PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING|856.34|856.34||
125|32555|32555 - THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING|451.14|451.14||
125|32554|32554 - THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING|317.64|317.64||
125|32553|32553 - PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT|808.64|808.64||
125|32552|32552 - RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF|295.62|295.62||
125|32551|32551 - TUBE THORACOSTOMY INCLUDES WATER SEAL|262.63|262.63||
125|32550|32550 - INSERTION INDWELLING TUNNELED PLEURAL CATHETER|1095.08|1095.08||
125|32540|32540 - EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY|1914.68|1914.68||
125|32525|32525 - REMOVE LUNG -  RECONSTRUCT CHEST WALL|3467.38|3467.38||
125|32522|32522 - REMOVE LUNG -  RECONSTRUCT CHEST WALL|3229|3229||
125|32520|32520 - REMOVE LUNG -  RESECT CHEST WALL|2904.29|2904.29||
125|3250F|3250F - NONPRIM ANATOMIC LOCATION OF SPECIMEN SITE|0.01|0.01||
125|32507|32507 - THORACOTOMY W/DX WEDGE RESEXN & ANTOM LUNG RESE|263.8|263.8||
125|32506|32506 - THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL|263.8|263.8||
125|32505|32505 - THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL|1546.74|1546.74||
125|32504|32504 - RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ|4131.77|4131.77||
125|32503|32503 - RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ|3621.77|3621.77||
125|32501|32501 - RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY|614.63|614.63||
125|32491|32491 - RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG|2200.31|2200.31||
125|32488|32488 - RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC|2913.42|2913.42||
125|32486|32486 - RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY|2749.56|2749.56||
125|32484|32484 - RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY|2400.34|2400.34||
125|32482|32482 - RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC|2365.17|2365.17||
125|32480|32480 - RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT|2384.23|2384.23||
125|32445|32445 - REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL|2996.22|2996.22||
125|32442|32442 - REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA|2980.5|2980.5||
125|32440|32440 - REMOVAL OF LUNG PNEUMONECTOMY|2815.8|2815.8||
125|32405|32405 - BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE|261.18|261.18||
125|32400|32400 - BIOPSY PLEURA PERCUTANEOUS NEEDLE|192.21|192.21||
125|32320|32320 - DECORTICATION & PARIETAL PLEURECTOMY|2636.58|2636.58||
125|32310|32310 - PLEURECTOMY PARIETAL SEPARATE PROCEDURE|1832.87|1832.87||
125|3230F|3230F - HEARING TEST 6 MOS PRIOR TO EAR TUBE INSERTION|0.01|0.01||
125|32225|32225 - DECORTICATION PULMONARY PARTIAL SEPARATE PROC|1563.05|1563.05||
125|32220|32220 - DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE|2272.09|2272.09||
125|32215|32215 - PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX|1640.34|1640.34||
125|3220F|3220F - HEP C QUANT RNA TEST 12 WKS AFTER ANTIVIRAL TX|0.01|0.01||
125|32200|32200 - PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST|1429.84|1429.84||
125|3218F|3218F - HEP C RNA TEST 6 MOS BEFORE ANTIVIRAL TX|0.01|0.01||
125|3216F|3216F - DOCUMENTED IMMUNITY HEPATITIS B|0.01|0.01||
125|32160|32160 - THORACOTOMY W/CARDIAC MASSAGE|1604.72|1604.72||
125|3215F|3215F - DOCUMENTED IMMUNITY HEPATITIS A|0.01|0.01||
125|32151|32151 - THORCOM W/RMVL IPUL FB|1735.22|1735.22||
125|32150|32150 - THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP|1530.55|1530.55||
125|32141|32141 - THORACOTOMY W/RESECTION BULLAE|1914.29|1914.29||
125|32140|32140 - THORCOM W/REMOVAL OF CYST|1751.01|1751.01||
125|32124|32124 - THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS|1656.56|1656.56||
125|32120|32120 - THORACOTOMY POSTOPERATIVE COMPLICATIONS|1553.73|1553.73||
125|32110|32110 - THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR|1709.25|1709.25||
125|3210F|3210F - GROUP A STREP TEST PERFORMED|0.01|0.01||
125|32100|32100 - THORACOTOMY WITH EXPLORATION|1475.06|1475.06||
125|32098|32098 - THORACOTOMY W/BIOPSY OF PLEURA|1267.85|1267.85||
125|32097|32097 - THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL|1337.2|1337.2||
125|32096|32096 - THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL|1338.36|1338.36||
125|32036|32036 - THORACOSTOMY OPEN FLAP DRAINAGE EMPYEMA|1143.48|1143.48||
125|32035|32035 - THORACOSTOMY W/RIB RESECTION EMPYEMA|1023.07|1023.07||
125|3200F|3200F - BARIUM SWALLOW TEST NOT ORDERED|0.01|0.01||
125|31830|31830 - REVISION TRACHEOSTOMY SCAR|547.22|547.22||
125|31825|31825 - SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR|801.78|801.78||
125|31820|31820 - SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR|574.22|574.22||
125|31805|31805 - SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC|1664.01|1664.01||
125|31800|31800 - SUTURE TRACHEAL WOUND/INJURY CERVICAL|1167.46|1167.46||
125|31786|31786 - EXCISION TRACHEAL TUMOR/CARCINOMA THORACIC|2980.82|2980.82||
125|31785|31785 - EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL|2374.47|2374.47||
125|31781|31781 - EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC|2835.01|2835.01||
125|31780|31780 - EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA|2625.48|2625.48||
125|31775|31775 - BRONCHOPLASTY EXCISION STENOSIS & ANASTOMOSIS|2801.53|2801.53||
125|31770|31770 - BRONCHOPLASTY GRAFT REPAIR|2728.06|2728.06||
125|31766|31766 - CARINAL RECONSTRUCTION|2971.82|2971.82||
125|31760|31760 - TRACHEOPLASTY INTRATHORACIC|2209.5|2209.5||
125|31755|31755 - TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG|2042.17|2042.17||
125|31750|31750 - TRACHEOPLASTY CERVICAL|1564.59|1564.59||
125|31730|31730 - TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER|292.75|292.75||
125|31725|31725 - CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX|195.51|195.51||
125|31720|31720 - CATHETER ASPIRATION NASOTRACHEAL SPX|109.3|109.3||
125|31717|31717 - CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY|386.52|386.52||
125|3170F|3170F - FLOW CYTOMETRY W/DIAG/PRIOR INITIATING TREATMENT|0.01|0.01||
125|31661|31661 - BRONCHOSCOPIC THERMOPLASTY 2/> LOBES|342.85|342.85||
125|31660|31660 - BRONCHOSCOPIC THERMOPLASTY ONE LOBE|323.77|323.77||
125|31654|31654 - BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES|198.37|198.37||
125|31653|31653 - BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX|1351.76|1351.76||
125|31652|31652 - BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX|1277.06|1277.06||
125|31651|31651 - BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE|123.47|123.47||
125|31649|31649 - BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL|112.52|112.52||
125|31648|31648 - BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL|322.84|322.84||
125|31647|31647 - BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE|352.88|352.88||
125|31646|31646 - BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ|481.14|481.14||
125|31645|31645 - BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST|409.01|409.01||
125|31643|31643 - BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL|330.63|330.63||
125|31641|31641 - BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC|1006.11|1006.11||
125|31640|31640 - BRONCHOSCOPY W/EXCISION TUMOR|814.23|814.23||
125|31638|31638 - BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS|276.96|276.96||
125|31637|31637 - BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED|89.2|89.2||
125|31636|31636 - BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS|249.46|249.46||
125|31635|31635 - BRONCHOSCOPY W/REMOVAL FOREIGN BODY|657.27|657.27||
125|31634|31634 - BRONCHOSCOPY BALLOON OCCLUSION|2699.02|2699.02||
125|31633|31633 - BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE|330.5|330.5||
125|31632|31632 - BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE|330.5|330.5||
125|31631|31631 - BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT|661.54|661.54||
125|31630|31630 - BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX|512.33|512.33||
125|31629|31629 - BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON|682.17|682.17||
125|31628|31628 - BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE|522.96|522.96||
125|31627|31627 - BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION|2119.36|2119.36||
125|31626|31626 - BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT|1300.17|1300.17||
125|31625|31625 - BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES|441.26|441.26||
125|31624|31624 - BRNCHSC W/BRNCL ALVEOLAR LAVAGE|437.61|437.61||
125|31623|31623 - BRNCHSC BRUSHING/PROTECTED BRUSHINGS|378.78|378.78||
125|31622|31622 - BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX|642|642||
125|31615|31615 - TRACHEOBRNCHSC THRU EST TRACHS INC|345.71|345.71||
125|31614|31614 - TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION|1047.7|1047.7||
125|31613|31613 - TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION|550.05|550.05||
125|31612|31612 - TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX|168.2|168.2||
125|31611|31611 - CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH|1001.46|1001.46||
125|31610|31610 - TRACHEOSTOMY FENESTRATION W/SKIN FLAPS|1133.95|1133.95||
125|3160F|3160F - DOC IRON STORES PRIOR START EPO THERAPY|0.01|0.01||
125|31605|31605 - TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE|609.58|609.58||
125|31603|31603 - TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL|701.68|701.68||
125|31601|31601 - TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX|646.72|646.72||
125|31600|31600 - TRACHEOSTOMY PLANNED SEPARATE PROCEDURE|576.55|576.55||
125|31595|31595 - SECTION RECURRENT LARYNGEAL NERVE THER UNI SPX|1649.33|1649.33||
125|31592|31592 - CRICOTRACHEAL RESECTION|2724.54|2724.54||
125|31591|31591 - LARYNGOPLASTY MEDIALIZATION UNLIATERAL|1658.61|1658.61||
125|31590|31590 - LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE|1443.53|1443.53||
125|31587|31587 - LARYNGOPLASTY CRICOID SPLIT W/O GRAFT PLACEMENT|1504.68|1504.68||
125|31586|31586 - TREAT LARYNX FX -  W/MANIP REDUCTION|799.93|799.93||
125|31585|31585 - TREAT LARYNX FRACTURE|477.08|477.08||
125|31584|31584 - LARYNGOPLASTY W/OPEN REDUCTION FRACTURE W/TRACHS|2069.04|2069.04||
125|31580|31580 - LARYNGOPLASTY LARYN WEB W/KEEL STENT INSERTION|1905.67|1905.67||
125|31579|31579 - LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY|294.25|294.25||
125|31578|31578 - LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER|648.93|648.93||
125|31577|31577 - LARYNGOSCOPY FLX RMVL FOREIGN BODY(S)|569.78|569.78||
125|31576|31576 - LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES)|497.38|497.38||
125|31575|31575 - LARYNGOSCOPY FLEXIBLE DIAGNOSTIC|225.77|225.77||
125|31574|31574 - LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI|1537.16|1537.16||
125|31573|31573 - LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI|411.93|411.93||
125|31572|31572 - LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI|760.77|760.77||
125|31571|31571 - LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE|887.93|887.93||
125|31570|31570 - LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC|697.65|697.65||
125|31561|31561 - LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE|1674.34|1674.34||
125|31560|31560 - LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY|1118.91|1118.91||
125|3155F|3155F - CYTOGEN TEST DONE MARROW DIAG OR PRIOR TXMNT|0.01|0.01||
125|31554|31554 - LARYNGOPLASTY LARYNGEAL STEN W/STENT 12 YRS >|2650.77|2650.77||
125|31553|31553 - LARYNGOPLASTY LARYNGEAL STEN W/STENT < 12 YRS|2545.13|2545.13||
125|31552|31552 - LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >|2318.9|2318.9||
125|31551|31551 - LARYNGOPLASTY LARYNGEAL STEN W/O STENT < 12 YRS|2317.68|2317.68||
125|31546|31546 - LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD GRAFT|602.86|602.86||
125|31545|31545 - LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP|394.07|394.07||
125|31541|31541 - LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP|573.25|573.25||
125|31540|31540 - LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT|622.39|622.39||
125|31536|31536 - LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE|549.89|549.89||
125|31535|31535 - LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY|435.76|435.76||
125|31531|31531 - LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE|749.25|749.25||
125|31530|31530 - LARYNGOSCOPY W/FOREIGN BODY REMOVAL|505.05|505.05||
125|31529|31529 - LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ|412.81|412.81||
125|31528|31528 - LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN|456.01|456.01||
125|31527|31527 - LARYNGOSCOPY W/WO TRACHEOSCOPY INSERT OBTURATOR|689.58|689.58||
125|31526|31526 - LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE|617.08|617.08||
125|31525|31525 - LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN|376.43|376.43||
125|31520|31520 - LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN|263.22|263.22||
125|31515|31515 - LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION|205.09|205.09||
125|31513|31513 - LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION|544.56|544.56||
125|31512|31512 - LARYNGOSCOPY INDIRECT W/REMOVAL LESION|470.7|470.7||
125|31511|31511 - LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY|406.29|406.29||
125|31510|31510 - LARYNGOSCOPY INDIRECT W/BIOPSY|328.85|328.85||
125|3150F|3150F - FORCEPS ESOPHAGEAL BIOPSY PERFORMED|0.01|0.01||
125|31505|31505 - LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX|186.15|186.15||
125|31502|31502 - TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT|145.58|145.58||
125|31500|31500 - INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE|241.31|241.31||
125|3142F|3142F - BARIUM SWALLOW TEST ORDERED|0.01|0.01||
125|31420|31420 - EPIGLOTTIDECTOMY|1467|1467||
125|3141F|3141F - UPPER GI ENDO REPORT SHOW NO SUSPECT BARRETT'S|0.01|0.01||
125|3140F|3140F - UPPER GI ENDO REPORT SHOWS POSS BARRETT'S ESOPH|0.01|0.01||
125|31400|31400 - ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH|1398.8|1398.8||
125|31395|31395 - PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/RCNSTJ|4584.89|4584.89||
125|31390|31390 - PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/O RCNSTJ|3758.89|3758.89||
125|31382|31382 - PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL|2493.15|2493.15||
125|31380|31380 - PARTIAL LARYNGECTOMY HEMILARYNG ANTEROVERTICAL|2529.15|2529.15||
125|31375|31375 - PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL|2446.29|2446.29||
125|31370|31370 - PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL|2815|2815||
125|31368|31368 - LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ|3898.91|3898.91||
125|31367|31367 - LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ|2682.19|2682.19||
125|31365|31365 - LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION|3875.87|3875.87||
125|31360|31360 - LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION|2653.65|2653.65||
125|3132F|3132F - DOC REFERAL FOR UPPER GI ENDOSCOPY|0.01|0.01||
125|31320|31320 - LARYNGOTOMY THYROTOMY LARYNGOFISSURE DX|752.17|752.17||
125|3130F|3130F - UPPER GI ENDOSCOPY PERFORMED|0.01|0.01||
125|31300|31300 - LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY|1740.01|1740.01||
125|31298|31298 - NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS|5827.56|5827.56||
125|31297|31297 - NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS|3007.43|3007.43||
125|31296|31296 - NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS|3072.08|3072.08||
125|31295|31295 - NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS|3030.48|3030.48||
125|31294|31294 - NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN|1661.95|1661.95||
125|31293|31293 - NASAL/SINUS NDSC SURG MEDIAL&INF ORB WALL DCMPRN|1693.06|1693.06||
125|31292|31292 - NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN|1527.32|1527.32||
125|31291|31291 - NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID|1846.4|1846.4||
125|31290|31290 - NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID|1793.33|1793.33||
125|31288|31288 - NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS|639.06|639.06||
125|31287|31287 - NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY|547.04|547.04||
125|31276|31276 - NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS|930.63|930.63||
125|3126F|3126F - ESOPH BX RPRT W/DYSPLAS INFO AND APPROP GRADING|0.01|0.01||
125|31267|31267 - NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS|946.55|946.55||
125|31259|31259 - NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL|778.57|778.57||
125|31257|31257 - NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY|734.28|734.28||
125|31256|31256 - NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY|517.53|517.53||
125|31255|31255 - NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY|2058.14|2058.14||
125|31254|31254 - NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY|925.46|925.46||
125|31253|31253 - NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL|825.2|825.2||
125|31241|31241 - NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY|736.69|736.69||
125|31240|31240 - NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION|361.66|361.66||
125|31239|31239 - NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY|1295.16|1295.16||
125|31238|31238 - NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG|552.46|552.46||
125|31237|31237 - NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX|343.13|343.13||
125|31235|31235 - NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY|680.89|680.89||
125|31233|31233 - NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY|457.85|457.85||
125|31231|31231 - NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX|169.03|169.03||
125|31230|31230 - MAXILLECTOMY W/ORBITAL EXENTERATION|3020.91|3020.91||
125|31225|31225 - MAXILLECTOMY W/O ORBITAL EXENTERATION|2551.99|2551.99||
125|3120F|3120F - 12-LEAD ECG PERFORMED|0.01|0.01||
125|31205|31205 - ETHMOIDECTOMY EXTRANASAL TOTAL|1420.22|1420.22||
125|31201|31201 - ETHMOIDECTOMY INTRANASAL TOTAL|1040.74|1040.74||
125|31200|31200 - ETHMOIDECTOMY INTRANASAL ANTERIOR|724.74|724.74||
125|3119F|3119F - NO EVAL LEVEL OF ACTIVITY OR CLINICAL SYMPTOMS|0.01|0.01||
125|3118F|3118F - NEW YORK HEART ASSOCIATION (NYHA) CLASS DOCD|0.01|0.01||
125|3117F|3117F - HF DISEASE SPECIFIC ASSESSMENT TOOL COMPLETED|0.01|0.01||
125|3115F|3115F - QUANT RESULTS EVAL CURR LEVEL ACTIVITY CLIN SYMP|0.01|0.01||
125|3112F|3112F - CT/MRI BRAIN DONE 24 HRS AFTER HOSP ARRIVAL|0.01|0.01||
125|3111F|3111F - CT OR MRI BRAIN DONE W/IN 24 HRS HOSP ARRIVAL|0.01|0.01||
125|3110F|3110F - CT/MRI HMRHG/MASS LESION/ACUTE INFRC DOC|0.01|0.01||
125|31090|31090 - SINUSOT UNI 3/> PARANSL SINUSES|2111.28|2111.28||
125|31087|31087 - SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC|1847.96|1847.96||
125|31086|31086 - SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC|1850.73|1850.73||
125|31085|31085 - SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC|2065.34|2065.34||
125|31084|31084 - SINUSOT FRNT OBLIT W/OSTPL FLAP BROW INC|2011.19|2011.19||
125|31081|31081 - SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC|1640.65|1640.65||
125|31080|31080 - SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC|1554.21|1554.21||
125|31075|31075 - SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL|1620.12|1620.12||
125|31070|31070 - SINUSOTOMY FRONTAL EXTERNAL SIMPLE|840.65|840.65||
125|31051|31051 - SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP|1421.08|1421.08||
125|31050|31050 - SINUSOTOMY SPHENOID W/WO BIOPSY|1238.53|1238.53||
125|31040|31040 - PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH|1748.4|1748.4||
125|31032|31032 - SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS|1285.43|1285.43||
125|31030|31030 - SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS|936.54|936.54||
125|31020|31020 - SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL|450.63|450.63||
125|3100F|3100F - CAROTID IMAGNG REPORT DIR/INDIR MEAS VESSEL DIAM|0.01|0.01||
125|31002|31002 - LAVAGE CANNULATION SPHENOID SINUS|200|200||
125|31000|31000 - LAVAGE CANNULATION MAXILLARY SINUS|153.45|153.45||
125|3096F|3096F - CENTRAL DUAL ENERGY ABSORPTIOMETRY ORDERED|0.01|0.01||
125|3095F|3095F - CENTRAL DUAL ENERGY ABSORPTIOMETRY DOCD|0.01|0.01||
125|3093F|3093F - DOC NEW DIAG DX INIT/RECURRENT EPISODE OF MDD|0.01|0.01||
125|30930|30930 - FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC|153.92|153.92||
125|3092F|3092F - MAJOR DEPRESSIVE DISORDER REMISSION|0.01|0.01||
125|30920|30920 - LIGATION ARTERIES INT MAXILLARY TRANSANTRAL|1417.69|1417.69||
125|3091F|3091F - MAJOR DESPRESV DISORDER SEVERE W/PSYCHOT FEATURE|0.01|0.01||
125|30915|30915 - LIGATION ARTERIES ETHMOIDAL|922.85|922.85||
125|3090F|3090F - MDD SEVERE WITHOUT PSYCHOTIC FEATURES|0.01|0.01||
125|30906|30906 - CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ|246.98|246.98||
125|30905|30905 - CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST|251.72|251.72||
125|30903|30903 - CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX|176.02|176.02||
125|30901|30901 - CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE|133.56|133.56||
125|3089F|3089F - MAJOR DEPRESSIVE DISORDER MODERATE|0.01|0.01||
125|3088F|3088F - MAJOR DEPRESSIVE DISORDER MILD|0.01|0.01||
125|3085F|3085F - SUICIDE RISK ASSESSED|0.01|0.01||
125|3084F|3084F - KT/V >/= 1.7|0.01|0.01||
125|3083F|3083F - KT/V EQUAL/>1.2 & <1.7|0.01|0.01||
125|3082F|3082F - KT/V <1.2 (CLEARANCE OF UREA (KT)/VOLUME (V))|0.01|0.01||
125|3080F|3080F - MOST RECENT DIASTOL BLOOD PRES >/EQUAL 90 MM HG|0.01|0.01||
125|30802|30802 - ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL|253.86|253.86||
125|30801|30801 - ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC|195.44|195.44||
125|3079F|3079F - MOST RECENT DIASTOLIC BLOOD PRESSURE 80-89 MM HG|0.01|0.01||
125|3078F|3078F - MOST RECENT DIASTOLIC BLOOD PRESSURE < 80 MM HG|0.01|0.01||
125|3077F|3077F - MOST RECENT SYSTOLIC BLOOD PRES>/EQUAL 140 MM HG|0.01|0.01||
125|3075F|3075F - MOST RECENT SYSTOLIC BLOOD PRESS 130-139MM HG|0.01|0.01||
125|3074F|3074F - MOST RECENT SYSTOLIC BLOOD PRESSURE <130 MM HG|0.01|0.01||
125|3073F|3073F - DOCUMENTED LENGTH CORNEAL POWER & LENS POWER|0.01|0.01||
125|3072F|3072F - LOW RISK FOR RETINOPATHY|0.01|0.01||
125|3066F|3066F - DOCUMENTATION OF TREATMENT FOR NEPHROPATHY|0.01|0.01||
125|30630|30630 - REPAIR NASAL SEPTAL PERFORATIONS|968.79|968.79||
125|3062F|3062F - POSITIVE MACROALBUMINURIA TEST RESULT DOC&REV|0.01|0.01||
125|30620|30620 - SEPTAL/OTHER INTRANASAL DERMATOPLASTY|1095.48|1095.48||
125|3061F|3061F - NEGATIVE MICROALBUMINURIA TEST RESULT DOC&REV|0.01|0.01||
125|3060F|3060F - POSITIVE MICROALBUMINURIA TEST RESULT DOC&REV|0.01|0.01||
125|30600|30600 - REPAIR FISTULA ORONASAL|866.79|866.79||
125|30580|30580 - REPAIR FISTULA OROMAXILLARY|973.48|973.48||
125|3056F|3056F - LVEF GREATER THAN 35%|0.01|0.01||
125|30560|30560 - LYSIS INTRANASAL SYNECHIA|229.85|229.85||
125|3055F|3055F - LVEF LESS THAN OR EQUAL TO 35%|0.01|0.01||
125|30545|30545 - REPAIR CHOANAL ATRESIA TRANSPALATINE|1818.07|1818.07||
125|30540|30540 - REPAIR CHOANAL ATRESIA INTRANASAL|1065.4|1065.4||
125|30520|30520 - SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF|1327.87|1327.87||
125|3050F|3050F - MOST RECENT LDL-C >/EQUAL 130 MG/DL|0.01|0.01||
125|3049F|3049F - MOST RECENT LDL-C 100-129 MG/DL|0.01|0.01||
125|3048F|3048F - MOST RECENT LDL-C <100 MG/DL|0.01|0.01||
125|3046F|3046F - MOST RECENT HEMOGLOBIN A1C LEVEL >9.0%|0.01|0.01||
125|30465|30465 - REPAIR NASAL VESTIBULAR STENOSIS|3519.06|3519.06||
125|30462|30462 - RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT|2427.38|2427.38||
125|30460|30460 - RHINP DFRM W/COLUM LNGTH TIP ONLY|1026.53|1026.53||
125|3045F|3045F - MOST RECENT HEMOGLOBIN A1C LEVEL GT 7.0-9.0 %|0.01|0.01||
125|30450|30450 - RHINOPLASTY SECONDARY MAJOR REVISION|1854.32|1854.32||
125|3044F|3044F - MOST RECENT HEMOGLOBIN A1C LEVEL < 7.0%|0.01|0.01||
125|30435|30435 - RHINOPLASTY SECONDARY INTERMEDIATE REVISION|1347.3|1347.3||
125|30430|30430 - RHINOPLASTY SECONDARY MINOR REVISION|894.72|894.72||
125|3042F|3042F - FUNCTJL EXPIR VOLUME >/EQUAL 40% PREDICTED VALUE|0.01|0.01||
125|30420|30420 - RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR|2475.48|2475.48||
125|30410|30410 - RHINP PRIM COMPLETE XTRNL PARTS|1771.94|1771.94||
125|3040F|3040F - FUNCTIONAL EXPIRATORY VOLUME < 40%|0.01|0.01||
125|30400|30400 - RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI|1393.87|1393.87||
125|3038F|3038F - PULMONARY FUNC TEST WITHIN 12 MON PRIOR SURG|0.01|0.01||
125|3037F|3037F - OXYGEN SATURATION >88%/PAO2 >55 MM HG|0.01|0.01||
125|3035F|3035F - OXYGEN SATUR </EQUAL 88%/PAO2 </EQUAL 55 MM|0.01|0.01||
125|30320|30320 - RMVL FOREIGN BODY INTRANASAL LATERAL RHINOTOMY|583.14|583.14||
125|30310|30310 - REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES|228.71|228.71||
125|30300|30300 - REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE|217.07|217.07||
125|3028F|3028F - OXYGEN SATURATION RESULTS DOCUMENTED & REVIEWE|0.01|0.01||
125|3027F|3027F - SPIROMETRY TEST RESULTS FEV/FVC >/=70% W/O COPD|0.01|0.01||
125|3025F|3025F - SPIROMETRY TEST RESULTS FEV/FVC <70% W/COPD|0.01|0.01||
125|3023F|3023F - SPIROMETRY RESULTS DOCUMENTED AND REVIEWED|0.01|0.01||
125|3022F|3022F - LEFT VENTRICULAR EJECTION FRACTION >/EQUAL 40%|0.01|0.01||
125|30220|30220 - INSERTION NASAL SEPTAL PROSTHESIS BUTTON|266.38|266.38||
125|3021F|3021F - LEFT VENTRICULAR EJECTION FRACTION <40%|0.01|0.01||
125|30210|30210 - DISPLACEMENT THERAPY PROETZ TYPE|124.28|124.28||
125|3020F|3020F - LEFT VENTRICULAR FUNCTION ASSESSMENT DOCUMENTED|0.01|0.01||
125|30200|30200 - INJECTION TURBINATE THERAPEUTIC|94.41|94.41||
125|3019F|3019F - LVEF ASSESSMENT PLANNED POST DISCHARGE|0.01|0.01||
125|3018F|3018F - PRE-PRX RISK ASSESS DEPTH&QUAL BOWEL PREP|0.01|0.01||
125|3017F|3017F - COLORECTAL CANCER SCREENING RESULTS DOC&REV|0.01|0.01||
125|3016F|3016F - PT SCRND UNHLTHY OH USE BY SYSTMTC SCRNG METHD|0.01|0.01||
125|30160|30160 - RHINECTOMY TOTAL|1131.62|1131.62||
125|3015F|3015F - CERVICAL CANCER SCREENING RESULTS DOCD & RVWD|0.01|0.01||
125|30150|30150 - RHINECTOMY PARTIAL|866.56|866.56||
125|3014F|3014F - SCREENING MAMMOGRAPHY RESULTS DOC&REV|0.01|0.01||
125|30140|30140 - SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL|1247.62|1247.62||
125|30130|30130 - EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE|385.62|385.62||
125|30125|30125 - EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG|1181.28|1181.28||
125|30124|30124 - EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS|312.1|312.1||
125|30120|30120 - EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA|941.67|941.67||
125|3011F|3011F - LIPID PANEL RESULTS DOCUMENTED & REVIEWED|0.01|0.01||
125|30118|30118 - EXCISION/DESTRUCTION INTRANASAL LESION XTRNL|1072.34|1072.34||
125|30117|30117 - EXCISION/DESTRUCTION INTRANASAL LESION INT APPR|608.28|608.28||
125|30115|30115 - EXCISION NASAL POLYP EXTENSIVE|471.74|471.74||
125|30110|30110 - EXCISION NASAL POLYP SIMPLE|190.18|190.18||
125|30100|30100 - BIOPSY INTRANASAL|113.27|113.27||
125|3008F|3008F - BODY MASS INDEX DOCUMENTED|0.01|0.01||
125|3006F|3006F - CHEST X-RAY RESULTS DOCUMENTED & REVIEWED|0.01|0.01||
125|30020|30020 - DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM|180.31|180.31||
125|30000|30000 - DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH|211|211||
125|29916|29916 - ARTHROSCOPY HIP W/LABRAL REPAIR|1653.03|1653.03||
125|29915|29915 - ARTHROSCOPY HIP W/ACETABULOPLASTY|1643.33|1643.33||
125|29914|29914 - ARTHROSCOPY HIP W/FEMOROPLASTY|1603.82|1603.82||
125|29907|29907 - ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS|1432.67|1432.67||
125|29906|29906 - ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT|1134.37|1134.37||
125|29905|29905 - ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY|895.82|895.82||
125|29904|29904 - ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY|1040.93|1040.93||
125|29902|29902 - ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM|1051.02|1051.02||
125|29901|29901 - ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT|741.9|741.9||
125|29900|29900 - ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY|618.25|618.25||
125|29899|29899 - ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS|3076.21|3076.21||
125|29898|29898 - ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE|1739.61|1739.61||
125|29897|29897 - ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED|1093.09|1093.09||
125|29895|29895 - ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL|1289.13|1289.13||
125|29894|29894 - ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY|1304.37|1304.37||
125|29893|29893 - ENDOSCOPIC PLANTAR FASCIOTOMY|646.32|646.32||
125|29892|29892 - ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX|1075.4|1075.4||
125|29891|29891 - ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT|1123.5|1123.5||
125|29889|29889 - ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ|2176.85|2176.85||
125|29888|29888 - ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ|2365.22|2365.22||
125|29887|29887 - ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ|2507.14|2507.14||
125|29886|29886 - ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION|978.25|978.25||
125|29885|29885 - ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG|1177.3|1177.3||
125|29884|29884 - ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX|1089.69|1089.69||
125|29883|29883 - ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL|1959.42|1959.42||
125|29882|29882 - ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL|1285.62|1285.62||
125|29881|29881 - ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG|1541.22|1541.22||
125|29880|29880 - ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING|1475.1|1475.1||
125|29879|29879 - ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX|1244.78|1244.78||
125|29877|29877 - ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG|1277.95|1277.95||
125|29876|29876 - ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS|1363.84|1363.84||
125|29875|29875 - ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX|974.84|974.84||
125|29874|29874 - ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY|1055.37|1055.37||
125|29873|29873 - ARTHROSCOPY KNEE LATERAL RELEASE|1027.2|1027.2||
125|29871|29871 - ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE|904.52|904.52||
125|29870|29870 - ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX|719.63|719.63||
125|29868|29868 - ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT|1726.69|1726.69||
125|29867|29867 - ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT|1270.28|1270.28||
125|29866|29866 - ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST|1062.01|1062.01||
125|29863|29863 - ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY|1607.76|1607.76||
125|29862|29862 - ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG|1907.22|1907.22||
125|29861|29861 - ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB|1353.49|1353.49||
125|29860|29860 - ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX|865.69|865.69||
125|29856|29856 - ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR|1568.59|1568.59||
125|29855|29855 - ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR|1488.36|1488.36||
125|29851|29851 - ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ|1456.38|1456.38||
125|29850|29850 - ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ|1199.32|1199.32||
125|29848|29848 - NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM|977.11|977.11||
125|29847|29847 - ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY|1342.22|1342.22||
125|29846|29846 - ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT|1153.1|1153.1||
125|29845|29845 - ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE|1137.59|1137.59||
125|29844|29844 - ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL|933.19|933.19||
125|29843|29843 - ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE|919.63|919.63||
125|29840|29840 - ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX|759.63|759.63||
125|29838|29838 - ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE|1607.09|1607.09||
125|29837|29837 - ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED|1186.18|1186.18||
125|29836|29836 - ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE|1357.71|1357.71||
125|29835|29835 - ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL|1159.28|1159.28||
125|29834|29834 - ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB|1172.53|1172.53||
125|29830|29830 - ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX|755.67|755.67||
125|29828|29828 - ARTHROSCOPY SHOULDER BICEPS TENODESIS|1482.78|1482.78||
125|29827|29827 - ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR|2778.06|2778.06||
125|29826|29826 - ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE|1928.14|1928.14||
125|29825|29825 - ARTHROSCOPY SHOULDER AHESIOLYSIS W/WO MANIPJ|1190.06|1190.06||
125|29824|29824 - ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY|1236.49|1236.49||
125|29823|29823 - ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE|1220.87|1220.87||
125|29822|29822 - ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED|1127.68|1127.68||
125|29821|29821 - ARTHROSCOPY SHOULDER SURG SYNOVECTOMY COMPLETE|1342.21|1342.21||
125|29820|29820 - ARTHROSCOPY SHOULDER SURG SYNOVECTOMY PARTIAL|1176.79|1176.79||
125|29819|29819 - ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB|1215.83|1215.83||
125|29807|29807 - ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION|2022.3|2022.3||
125|29806|29806 - ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY|2559.55|2559.55||
125|29805|29805 - ARTHROSCOPY SHOULDER DX W/WO SYNOVIAL BIOPSY SPX|989.19|989.19||
125|29804|29804 - ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL|1337.5|1337.5||
125|29800|29800 - ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX|800.53|800.53||
125|29750|29750 - WEDGING CLUBFOOT CAST|98.44|98.44||
125|29740|29740 - WEDGING CAST EXCEPT CLUBFOOT CASTS|93.21|93.21||
125|29730|29730 - WINDOWING CAST|64.08|64.08||
125|29720|29720 - REPAIR SPICA BODY CAST/JACKET|73.37|73.37||
125|29710|29710 - RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET|116.5|116.5||
125|29705|29705 - REMOVAL/BIVALVING FULL ARM/FULL LEG CAST|76.95|76.95||
125|29700|29700 - REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST|57.68|57.68||
125|29584|29584 - APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING|120.86|120.86||
125|29583|29583 - APPL MLTLAYR COMPRES SYSTEM UPPER & LOWER ARM|50.74|50.74||
125|29582|29582 - APPL MLTLAYR COMPRES THGH LEG ANKLE FT WHEN DONE|80.93|80.93||
125|29581|29581 - APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT|131.43|131.43||
125|29580|29580 - STRAPPING UNNA BOOT|74.31|74.31||
125|29550|29550 - STRAPPING TOES|36.43|36.43||
125|29540|29540 - STRAPPING ANKLE &/FOOT|51.63|51.63||
125|29530|29530 - STRAPPING KNEE|61.79|61.79||
125|29520|29520 - STRAPPING HIP|65.51|65.51||
125|29515|29515 - APPLICATION SHORT LEG SPLINT CALF FOOT|97.73|97.73||
125|29505|29505 - APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES|113.98|113.98||
125|29450|29450 - APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG|147.5|147.5||
125|29445|29445 - APPLICATION RIGID TOTAL CONTACT LEG CAST|244.17|244.17||
125|29440|29440 - ADDING WALKER PREVIOUSLY APPLIED CAST|51.72|51.72||
125|29435|29435 - APPLICATION PATELLAR TENDON BEARING CAST|172.95|172.95||
125|29425|29425 - APPLICATION SHORT LEG CAST WALKING/AMBULATORY|166.91|166.91||
125|29405|29405 - APPLICATION SHORT LEG CAST BELOW KNEE-TOE|139.6|139.6||
125|29365|29365 - APPLICATION CYLINDER CAST THIGH ANKLE|137.01|137.01||
125|29358|29358 - APPLICATION LONG LEG CAST BRACE|243.9|243.9||
125|29355|29355 - APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE|178.17|178.17||
125|29345|29345 - APPLICATION LONG LEG CAST THIGH-TOE|213.03|213.03||
125|29325|29325 - APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS|324.54|324.54||
125|29305|29305 - APPLICATION HIP SPICA CAST 1 LEG|281.83|281.83||
125|29280|29280 - STRAPPING HAND/FINGER|52.63|52.63||
125|29260|29260 - STRAPPING ELBOW/WRIST|56.14|56.14||
125|29240|29240 - STRAPPING SHOULDER|69.75|69.75||
125|29200|29200 - STRAPPING THORAX|64.94|64.94||
125|29131|29131 - APPLICATION FINGER SPLINT DYNAMIC|69.54|69.54||
125|29130|29130 - APPLICATION FINGER SPLINT STATIC|47.93|47.93||
125|29126|29126 - APPLICATION SHORT ARM SPLINT DYNAMIC|106.7|106.7||
125|29125|29125 - APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC|81.32|81.32||
125|29105|29105 - APPLICATION LONG ARM SPLINT SHOULDER HAND|119.09|119.09||
125|29086|29086 - APPLICATION CAST FINGER|74.19|74.19||
125|29085|29085 - APPLICATION CAST HAND & LOWER FOREARM GAUNTLET|91.28|91.28||
125|29075|29075 - APPLICATION CAST ELBOW FINGER SHORT ARM|120.47|120.47||
125|29065|29065 - APPLICATION CAST SHOULDER HAND LONG ARM|144.44|144.44||
125|29058|29058 - APPLICATION CAST PLASTER VELPEAU|132.17|132.17||
125|29055|29055 - APPLICATION CAST SHOULDER SPICA|232.09|232.09||
125|29049|29049 - APPLICATION CAST FIGURE-OF-8|101.53|101.53||
125|29046|29046 - APPLICATION BODY CAST SHOULDER HIPS BOTH THIGHS|294.57|294.57||
125|29044|29044 - APPLICATION BODY CAST SHOULDER HIPS W/ONE THIGH|295.07|295.07||
125|29040|29040 - APPLICATION BODY CAST SHOULDER HIPS HEAD MINERVA|293.51|293.51||
125|29035|29035 - APPLICATION BODY CAST SHOULDER HIPS|242.85|242.85||
125|29015|29015 - APPLICATION RISSER JACKET LOCALIZER BODY W/HEAD|366.95|366.95||
125|29010|29010 - APPLICATION RISSER JACKET LOCALIZER BODY ONLY|336.28|336.28||
125|29000|29000 - APPLICATION HALO TYPE BODY CAST|356.15|356.15||
125|28890|28890 - ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA|531.26|531.26||
125|28825|28825 - AMPUTATION TOE INTERPHALANGEAL JOINT|414.75|414.75||
125|28820|28820 - AMPUTATION TOE METATARSOPHALANGEAL JOINT|500.63|500.63||
125|28810|28810 - AMPUTATION METATARSAL W/TOE SINGLE|682.66|682.66||
125|28805|28805 - AMPUTATION FOOT TRANSMETARSAL|1048.29|1048.29||
125|28800|28800 - AMPUTATION FOOT MIDTARSAL|999.38|999.38||
125|28760|28760 - ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK|786.35|786.35||
125|28755|28755 - ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT|543.56|543.56||
125|28750|28750 - ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT|791.07|791.07||
125|28740|28740 - ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT|898.85|898.85||
125|28737|28737 - ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR|1231.3|1231.3||
125|28735|28735 - ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT|1381.08|1381.08||
125|28730|28730 - ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS|1323.86|1323.86||
125|28725|28725 - ARTHRODESIS SUBTALAR|1412.13|1412.13||
125|28715|28715 - ARTHRODESIS TRIPLE|1707.99|1707.99||
125|28705|28705 - ARTHRODESIS PANTALAR|2048.3|2048.3||
125|28675|28675 - OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION|469.78|469.78||
125|28666|28666 - PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ|354.44|354.44||
125|28665|28665 - CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES|176.46|176.46||
125|28660|28660 - CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES|111.45|111.45||
125|28645|28645 - OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION|484.72|484.72||
125|28636|28636 - PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ|347.33|347.33||
125|28635|28635 - CLTX METATARSOPHLNGL JT DISLC REQ ANES|210.81|210.81||
125|28630|28630 - CLTX METATARSOPHLNGL JT DISLC W/O ANES|157.41|157.41||
125|28615|28615 - OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION|1001.99|1001.99||
125|28606|28606 - PRQ SKEL FIXJ TARS JT DISLC W/MANJ|601.36|601.36||
125|28605|28605 - CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES|307.45|307.45||
125|28600|28600 - CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES|203.77|203.77||
125|28585|28585 - OPEN TREATMENT TALOTARSAL JOINT DISLOCATION|889.35|889.35||
125|28576|28576 - PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ|553.74|553.74||
125|28575|28575 - CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES|337.55|337.55||
125|28570|28570 - CLOSED TX TALOTARSAL JOINT DISLC W/O ANES|216.74|216.74||
125|28555|28555 - OPEN TREATMENT TARSAL BONE DISLOCATION|883.43|883.43||
125|28546|28546 - PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ|429.92|429.92||
125|28545|28545 - CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES|251.04|251.04||
125|28540|28540 - CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES|194.79|194.79||
125|28531|28531 - OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION|511.97|511.97||
125|28530|28530 - CLOSED TREATMENT SESAMOID FRACTURE|163.12|163.12||
125|28525|28525 - OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE|505.28|505.28||
125|28515|28515 - CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ|153.94|153.94||
125|28510|28510 - CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ|136.1|136.1||
125|28505|28505 - OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES|520.64|520.64||
125|28496|28496 - PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ|454.29|454.29||
125|28495|28495 - CLTX FX GRT TOE PHLX/PHLG W/MANJ|183.29|183.29||
125|28490|28490 - CLTX FX GRT TOE PHLX/PHLG W/O MANJ|128.38|128.38||
125|28485|28485 - OPEN TREATMENT METATARSAL FRACTURE EACH|857.52|857.52||
125|28476|28476 - PRQ SKEL FIXJ METAR FX W/MANJ|495.15|495.15||
125|28475|28475 - CLTX METAR FX W/MANJ|313.39|313.39||
125|28470|28470 - CLOSED TX METATARSAL FRACTURE W/O MANIPULATION|296.03|296.03||
125|28465|28465 - OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA|982.67|982.67||
125|28456|28456 - PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ|422|422||
125|28455|28455 - TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ|356.74|356.74||
125|28450|28450 - TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ|274.39|274.39||
125|28446|28446 - OPEN OSTEOCHONDRAL AUTOGRAFT TALUS|2006.95|2006.95||
125|28445|28445 - OPEN TREATMENT TALUS FRACTURE|1319.93|1319.93||
125|28436|28436 - PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ|556.84|556.84||
125|28435|28435 - CLOSED TX TALUS FRACTURE W/MANIPULATION|460.38|460.38||
125|28430|28430 - CLOSED TX TALUS FRACTURE W/O MANIPULATION|300.1|300.1||
125|28420|28420 - OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT|1987.59|1987.59||
125|28415|28415 - OPEN TREATMENT CALCANEAL FRACTURE|1482.77|1482.77||
125|28406|28406 - PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ|714.4|714.4||
125|28405|28405 - CLOSED TX CALCANEAL FRACTURE W/MANIPULATION|594.32|594.32||
125|28400|28400 - CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION|355.49|355.49||
125|28360|28360 - RECONSTRUCTION CLEFT FOOT|1444|1444||
125|28345|28345 - RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB|761.57|761.57||
125|28344|28344 - RECONSTRUCTION TOE POLYDACTYLY|473.61|473.61||
125|28341|28341 - RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION|901.88|901.88||
125|28340|28340 - RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION|757.74|757.74||
125|28322|28322 - RPR NON/MALUNION METARSAL W/WO BONE GRAFT|883.83|883.83||
125|28320|28320 - REPAIR NONUNION/MALUNION TARSAL BONES|916.52|916.52||
125|28315|28315 - SESAMOIDECTOMY FIRST TOE SPX|575.39|575.39||
125|28313|28313 - RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY|460.05|460.05||
125|28312|28312 - OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE|539.11|539.11||
125|28310|28310 - OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE|603.74|603.74||
125|28309|28309 - OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT|958.81|958.81||
125|28308|28308 - OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA|689.08|689.08||
125|28307|28307 - OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE|904.15|904.15||
125|28306|28306 - OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR|663.4|663.4||
125|28305|28305 - OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT|1205.99|1205.99||
125|28304|28304 - OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS|979.52|979.52||
125|28302|28302 - OSTEOTOMY TALUS|1226.22|1226.22||
125|28300|28300 - OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION|1105.58|1105.58||
125|28299|28299 - CORRJ HALLUX VALGUS W/SESMDC W/2 OSTEOT|1249.49|1249.49||
125|28298|28298 - CORRJ HALLUX VALGUS W/SESMDC W/PROX PHLNX OSTEOT|1028.54|1028.54||
125|28297|28297 - CORRJ HALLUX VALGUS W/SESMDC W/1METAR MEDIAL CNF|1137.14|1137.14||
125|28296|28296 - CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT|1496.83|1496.83||
125|28295|28295 - CORRJ HALLUX VALGUS W/SESMDC W/PROX METAR OSTEOT|1493.52|1493.52||
125|28292|28292 - CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL|870.71|870.71||
125|28291|28291 - HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/IMPLT|1161.83|1161.83||
125|28289|28289 - HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT|968.4|968.4||
125|28288|28288 - OSTC PRTL EXOSTC/CONDYLC METAR HEAD|594.06|594.06||
125|28286|28286 - CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE|525.91|525.91||
125|28285|28285 - CORRECTION HAMMERTOE|656.93|656.93||
125|28280|28280 - SYNDACTYLIZATION TOES|498.36|498.36||
125|28272|28272 - CAPSULOTOMY IPHAL JOINT EACH JOINT SPX|381.19|381.19||
125|28270|28270 - CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX|477.22|477.22||
125|28264|28264 - CAPSULOTOMY MIDTARSAL|1279.79|1279.79||
125|28262|28262 - CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH|1684.44|1684.44||
125|28261|28261 - CAPSULOTOMY MIDFOOT W/TENDON LENGTHENING|1072.96|1072.96||
125|28260|28260 - CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX|822.64|822.64||
125|28250|28250 - DIVISION PLANTAR FASCIA & MUSCLE SPX|659.66|659.66||
125|28240|28240 - TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC|423.24|423.24||
125|28238|28238 - RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR|997.78|997.78||
125|28234|28234 - TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON|333.16|333.16||
125|28232|28232 - TX OPEN TENDON FLEXOR TOE 1 TENDON SPX|355.31|355.31||
125|28230|28230 - TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX|429.6|429.6||
125|28226|28226 - TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON|456.25|456.25||
125|28225|28225 - TENOLYSIS EXTENSOR FOOT SINGLE TENDON|367.11|367.11||
125|28222|28222 - TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS|709.71|709.71||
125|28220|28220 - TENOLYSIS FLEXOR FOOT SINGLE TENDON|557.53|557.53||
125|28210|28210 - RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON|623.75|623.75||
125|28208|28208 - REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON|460.9|460.9||
125|28202|28202 - RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON|833.79|833.79||
125|28200|28200 - RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON|614.72|614.72||
125|28193|28193 - REMOVAL FOREIGN BODY FOOT COMPLICATED|616.06|616.06||
125|28192|28192 - REMOVAL FOREIGN BODY FOOT DEEP|460.77|460.77||
125|28190|28190 - REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS|209.35|209.35||
125|28175|28175 - RADICAL RESECTION TUMOR PHALANX OR TOE|654.26|654.26||
125|28173|28173 - RADICAL RESECTION TUMOR METATARSAL|871.91|871.91||
125|28171|28171 - RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS|1047.52|1047.52||
125|28160|28160 - HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE|505.58|505.58||
125|28153|28153 - RESECTION CONDYLE DISTAL END PHALANX EACH TOE|517.08|517.08||
125|28150|28150 - PHALANGECTOMY TOE EACH TOE|479.36|479.36||
125|28140|28140 - METATARSECTOMY|753.55|753.55||
125|28130|28130 - TALECTOMY ASTRAGALECTOMY|1051.82|1051.82||
125|28126|28126 - RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH|464.77|464.77||
125|28124|28124 - PARTICAL EXCISION BONE PHALANX TOE|598.67|598.67||
125|28122|28122 - PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS|788.56|788.56||
125|28120|28120 - PARTIAL EXCISION BONE TALUS/CALCANEUS|675.7|675.7||
125|28119|28119 - OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS|725.19|725.19||
125|28118|28118 - OSTECTOMY CALCANEUS|737.76|737.76||
125|28116|28116 - OSTECTOMY TARSAL COALITION|835.4|835.4||
125|28114|28114 - OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC|1261.68|1261.68||
125|28113|28113 - OSTECTOMY COMPLETE 5TH METATARSAL HEAD|578.34|578.34||
125|28112|28112 - OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4|546.5|546.5||
125|28111|28111 - OSTECTOMY COMPLETE 1ST METATARSAL HEAD|725.47|725.47||
125|28110|28110 - OSTECTOMY PRTL 5TH METAR HEAD SPX|489.26|489.26||
125|28108|28108 - EXC/CURTG CST/B9 TUM PHALANGES FOOT|562.55|562.55||
125|28107|28107 - EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT|717.58|717.58||
125|28106|28106 - EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT|851.42|851.42||
125|28104|28104 - EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL|640.4|640.4||
125|28103|28103 - EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT|772.69|772.69||
125|28102|28102 - EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT|1002.59|1002.59||
125|28100|28100 - EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS|706.74|706.74||
125|28092|28092 - EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA|391.49|391.49||
125|28090|28090 - EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT|508.69|508.69||
125|28088|28088 - SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR|490.06|490.06||
125|28086|28086 - SYNOVECTOMY TENDON SHEATH FOOT FLEXOR|520.56|520.56||
125|28080|28080 - EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH|486.05|486.05||
125|28072|28072 - SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH|468.6|468.6||
125|28070|28070 - SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX|639.33|639.33||
125|28062|28062 - FASCIOTOMY PLANTAR FASCIA RADICAL SPX|1112.04|1112.04||
125|28060|28060 - FASCIECTOMY PLANTAR FASCIA PARTIAL SPX|608.56|608.56||
125|28055|28055 - NEURECTOMY INTRINSIC MUSCULATURE OF FOOT|616.51|616.51||
125|28054|28054 - ARTHRTOMY W/BX INTERPHALANGEAL JOINT|397.24|397.24||
125|28052|28052 - ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT|528.05|528.05||
125|28050|28050 - ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT|528.58|528.58||
125|28047|28047 - RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/>|1728.5|1728.5||
125|28046|28046 - RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM|2036.52|2036.52||
125|28045|28045 - EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM|556.03|556.03||
125|28043|28043 - EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM|367.88|367.88||
125|28041|28041 - EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>|742.97|742.97||
125|28039|28039 - EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>|807.91|807.91||
125|28035|28035 - RELEASE TARSAL TUNNEL|726|726||
125|28024|28024 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT|463.31|463.31||
125|28022|28022 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT|503.17|503.17||
125|28020|28020 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT|649.49|649.49||
125|28011|28011 - TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON|388.84|388.84||
125|28010|28010 - TENOTOMY PERCUTANEOUS TOE SINGLE TENDON|425.33|425.33||
125|28008|28008 - FASCIOTOMY FOOT&/TOE|459.3|459.3||
125|28005|28005 - INCISION BONE CORTEX FOOT|850.08|850.08||
125|28003|28003 - I&D BELOW FASCIA FOOT MULTIPLE AREAS|797.34|797.34||
125|28002|28002 - I&D BELOW FASCIA FOOT 1 BURSAL SPACE|457.87|457.87||
125|28001|28001 - INCISION&DRAINAGE BURSA FOOT|330.52|330.52||
125|27894|27894 - DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS|940.7|940.7||
125|27893|27893 - DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV|724.76|724.76||
125|27892|27892 - DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE|727.4|727.4||
125|27889|27889 - ANKLE DISARTICULATION|1218.76|1218.76||
125|27888|27888 - AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV|1252.37|1252.37||
125|27886|27886 - AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION|1172.21|1172.21||
125|27884|27884 - AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV|652.03|652.03||
125|27882|27882 - AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR|1073.41|1073.41||
125|27881|27881 - AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST|1465.2|1465.2||
125|27880|27880 - AMPUTATION LEG THROUGH TIBIA&FIBULA|1435.62|1435.62||
125|27871|27871 - ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL|1230.26|1230.26||
125|27870|27870 - ARTHRODESIS ANKLE OPEN|1858.11|1858.11||
125|27860|27860 - MANIPULATION ANKLE UNDER GENERAL ANESTHESIA|233.06|233.06||
125|27848|27848 - OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ|1445.11|1445.11||
125|27846|27846 - OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ|1236.18|1236.18||
125|27842|27842 - CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ|486.43|486.43||
125|27840|27840 - CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA|348.15|348.15||
125|27832|27832 - OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB|849.38|849.38||
125|27831|27831 - CLTX PROX TIBFIB JT DISLC REQ ANES|439.13|439.13||
125|27830|27830 - CLTX PROX TIBFIB JT DISLC W/O ANES|369.22|369.22||
125|27829|27829 - OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION|885.02|885.02||
125|27828|27828 - OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA|1838.94|1838.94||
125|27827|27827 - OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY|1948.99|1948.99||
125|27826|27826 - OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA|1448.54|1448.54||
125|27825|27825 - CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ|761.73|761.73||
125|27824|27824 - CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ|413.75|413.75||
125|27823|27823 - OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP|1937.5|1937.5||
125|27822|27822 - OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP|1606.88|1606.88||
125|27818|27818 - CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION|876.74|876.74||
125|27816|27816 - CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION|398.45|398.45||
125|27814|27814 - OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE|1568.06|1568.06||
125|27810|27810 - CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ|759.91|759.91||
125|27808|27808 - CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ|415.01|415.01||
125|27792|27792 - OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS|1011.71|1011.71||
125|27788|27788 - CLTX DSTL FIBULAR FX LAT MALLS W/MANJ|458.55|458.55||
125|27786|27786 - CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ|460.1|460.1||
125|27784|27784 - OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE|856.61|856.61||
125|27781|27781 - CLTX PROX FIBULA/SHFT FX W/MANJ|440.51|440.51||
125|27780|27780 - CLTX PROX FIBULA/SHFT FX W/O MANJ|296.4|296.4||
125|27769|27769 - OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE|1191.6|1191.6||
125|27768|27768 - CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ|709.03|709.03||
125|27767|27767 - CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ|445.1|445.1||
125|27766|27766 - OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE|1088.55|1088.55||
125|27762|27762 - CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ|506.5|506.5||
125|27760|27760 - CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION|380.92|380.92||
125|27759|27759 - TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA|2077.69|2077.69||
125|27758|27758 - OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE|1775.02|1775.02||
125|27756|27756 - PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE|1080.61|1080.61||
125|27752|27752 - CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ|800.18|800.18||
125|27750|27750 - CLTX TIBIAL SHAFT FX W/O MANIPULATION|498.77|498.77||
125|27745|27745 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA|1459.27|1459.27||
125|27742|27742 - ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR|1836.95|1836.95||
125|27740|27740 - ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA|1546.49|1546.49||
125|27734|27734 - ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA|1217.68|1217.68||
125|27732|27732 - ARREST EPIPHYSEAL OPEN DISTAL FIBULA|696.3|696.3||
125|27730|27730 - ARREST EPIPHYSEAL OPEN DISTAL TIBIA|962.02|962.02||
125|27727|27727 - REPAIR CONGENITAL PSEUDARTHROSIS TIBIA|1858.1|1858.1||
125|27726|27726 - REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION|1574.01|1574.01||
125|27725|27725 - RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH|2156.8|2156.8||
125|27724|27724 - RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT|2135.42|2135.42||
125|27722|27722 - REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT|1691.17|1691.17||
125|27720|27720 - REPAIR NONUNION/MALUNION TIBIA W/O GRAFT|1877.39|1877.39||
125|27715|27715 - OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN|2193.91|2193.91||
125|27712|27712 - OSTEOT MLT W/RELIGNMT IMED ROD|1759.93|1759.93||
125|27709|27709 - OSTEOTOMY TIBIA & FIBULA|1687.21|1687.21||
125|27707|27707 - OSTEOTOMY FIBULA|655.78|655.78||
125|27705|27705 - OSTEOTOMY TIBIA|1423.47|1423.47||
125|27704|27704 - REMOVAL ANKLE IMPLANT|977.91|977.91||
125|27703|27703 - ARTHROPLASTY ANKLE REVISION TOTAL ANKLE|2339.27|2339.27||
125|27702|27702 - ARTHROPLASTY ANKLE W/IMPLANT|2666.91|2666.91||
125|27700|27700 - ARTHROPLASTY ANKLE|1755.26|1755.26||
125|27698|27698 - REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL|1508|1508||
125|27696|27696 - RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS|1272.27|1272.27||
125|27695|27695 - RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL|1026.45|1026.45||
125|27692|27692 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN|228.03|228.03||
125|27691|27691 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP|1136.88|1136.88||
125|27690|27690 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC|958.68|958.68||
125|27687|27687 - GASTROCNEMIUS RECESSION|784.4|784.4||
125|27686|27686 - LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA|889.97|889.97||
125|27685|27685 - LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX|694.99|694.99||
125|27681|27681 - TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN|770.57|770.57||
125|27680|27680 - TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH|612.99|612.99||
125|27676|27676 - REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT|847.5|847.5||
125|27675|27675 - RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY|771.26|771.26||
125|27665|27665 - RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH|677|677||
125|27664|27664 - RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH|613.12|613.12||
125|27659|27659 - RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH|813.96|813.96||
125|27658|27658 - REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH|640.56|640.56||
125|27656|27656 - REPAIR FASCIAL DEFECT LEG|608.76|608.76||
125|27654|27654 - REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT|1465.63|1465.63||
125|27652|27652 - RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT|1310.97|1310.97||
125|27650|27650 - REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON|1233.31|1233.31||
125|27648|27648 - INJECTION ANKLE ARTHROGRAPHY|377.4|377.4||
125|27647|27647 - RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS|1453.72|1453.72||
125|27646|27646 - RADICAL RESECTION TUMOR BONE FIBULA|1499.88|1499.88||
125|27645|27645 - RADICAL RESECTION OF TUMOR TIBIA|1632.96|1632.96||
125|27641|27641 - PARTIAL EXCISION BONE FIBULA|1109.32|1109.32||
125|27640|27640 - PARTIAL EXCISION BONE TIBIA|1387.23|1387.23||
125|27638|27638 - EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT|1331.72|1331.72||
125|27637|27637 - EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT|1298.46|1298.46||
125|27635|27635 - EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA|1092.44|1092.44||
125|27634|27634 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>|1116.21|1116.21||
125|27632|27632 - EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>|677.25|677.25||
125|27630|27630 - EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK|539.09|539.09||
125|27626|27626 - ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY|1347.4|1347.4||
125|27625|27625 - ARTHROTOMY W/SYNOVECTOMY ANKLE|1247.93|1247.93||
125|27620|27620 - ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB|901.19|901.19||
125|27619|27619 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM|760|760||
125|27618|27618 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM|551.94|551.94||
125|27616|27616 - RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>|2093.52|2093.52||
125|27615|27615 - RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM|2252.07|2252.07||
125|27614|27614 - BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP|567.1|567.1||
125|27613|27613 - BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL|228.26|228.26||
125|27612|27612 - ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH|1002.93|1002.93||
125|27610|27610 - ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB|1023.54|1023.54||
125|27607|27607 - INCISION LEG/ANKLE|966.34|966.34||
125|27606|27606 - TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES|548.64|548.64||
125|27605|27605 - TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES|407.11|407.11||
125|27604|27604 - INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA|508.64|508.64||
125|27603|27603 - INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA|601.96|601.96||
125|27602|27602 - DCMPRN FASCT LEG ANT&/LAT&PST CMPRT|742.77|742.77||
125|27601|27601 - DCMPRN FASCT LEG POST COMPARTMENT ONLY|579.09|579.09||
125|27600|27600 - DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY|588.06|588.06||
125|27598|27598 - DISARTICULATION KNEE|1379.45|1379.45||
125|27596|27596 - AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION|1214.72|1214.72||
125|27594|27594 - AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION|605.04|605.04||
125|27592|27592 - AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR|1393.01|1393.01||
125|27591|27591 - AMP THI THRU FEMUR LVL IMMT FITG TQ W/1ST CST|1683.96|1683.96||
125|27590|27590 - AMPUTATION THIGH THROUGH FEMUR ANY LEVEL|1484.96|1484.96||
125|27580|27580 - ARTHRODESIS KNEE ANY TECHNIQUE|2187.49|2187.49||
125|27570|27570 - MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA|279.77|279.77||
125|27566|27566 - OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY|1622.19|1622.19||
125|27562|27562 - CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA|561.82|561.82||
125|27560|27560 - CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA|369.3|369.3||
125|27558|27558 - OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION|2354.76|2354.76||
125|27557|27557 - OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR|2099.55|2099.55||
125|27556|27556 - OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR|1739.86|1739.86||
125|27552|27552 - CLOSED TX KNEE DISLOCATION W/ANESTHESIA|763.61|763.61||
125|27550|27550 - CLOSED TX KNEE DISLOCATION W/O ANESTHESIA|587.52|587.52||
125|27540|27540 - OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE|1603.11|1603.11||
125|27538|27538 - CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN|563.37|563.37||
125|27536|27536 - OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ|1718.58|1718.58||
125|27535|27535 - OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR|1522.28|1522.28||
125|27532|27532 - CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ|721.9|721.9||
125|27530|27530 - CLTX TIBIAL FX PROXIMAL W/O MANIPULATION|473.8|473.8||
125|27524|27524 - OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR|1363.83|1363.83||
125|27520|27520 - CLOSED TX PATELLAR FRACTURE W/O MANIPULATION|426.75|426.75||
125|27519|27519 - OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION|1763.79|1763.79||
125|27517|27517 - CLTX DSTL FEM EPIPHYSL SEP W/MANJ W/WO SKIN/SKEL|968.96|968.96||
125|27516|27516 - CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ|649|649||
125|27514|27514 - OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE|2178.27|2178.27||
125|27513|27513 - OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN|2572.65|2572.65||
125|27511|27511 - OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN|2090.62|2090.62||
125|27510|27510 - CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ|987.55|987.55||
125|27509|27509 - PRQ SKELETAL FIXJ FEMORAL FX DISTAL END|846.4|846.4||
125|27508|27508 - CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ|676.17|676.17||
125|27507|27507 - OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE|2116.14|2116.14||
125|27506|27506 - OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW|2578.57|2578.57||
125|27503|27503 - CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ|1098.28|1098.28||
125|27502|27502 - CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ|1293.28|1293.28||
125|27501|27501 - CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ|816.72|816.72||
125|27500|27500 - CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION|735.94|735.94||
125|27499|27499 - DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE|1033.07|1033.07||
125|27498|27498 - DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS|872.42|872.42||
125|27497|27497 - DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE|796.23|796.23||
125|27496|27496 - DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT|632.08|632.08||
125|27495|27495 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR|1986.57|1986.57||
125|27488|27488 - RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER|2251.3|2251.3||
125|27487|27487 - REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE|3846.07|3846.07||
125|27486|27486 - REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT|2899.87|2899.87||
125|27485|27485 - ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA|1171.07|1171.07||
125|27479|27479 - ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB|1921.43|1921.43||
125|27477|27477 - ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL|1622.46|1622.46||
125|27475|27475 - ARREST EPIPHYSEAL DISTAL FEMUR|1308.85|1308.85||
125|27472|27472 - RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE|2574.35|2574.35||
125|27470|27470 - RPR NON/MAL FEMUR DSTL H/N W/O GRF|2214.4|2214.4||
125|27468|27468 - OSTPL FEMUR CMBN LNGTH&SHRT W/FEMORAL SGM TRNSFR|2817.53|2817.53||
125|27466|27466 - OSTEOPLASTY FEMUR LENGTHENING|2420.66|2420.66||
125|27465|27465 - OSTEOPLASTY FEMUR SHORTENING EXCLUDING 64876|1979.52|1979.52||
125|27457|27457 - OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL|1907.16|1907.16||
125|27455|27455 - OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL|1537.94|1537.94||
125|27454|27454 - OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT|2163.35|2163.35||
125|27450|27450 - OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION|2029.89|2029.89||
125|27448|27448 - OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION|1627.65|1627.65||
125|27447|27447 - ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS|3855.15|3855.15||
125|27446|27446 - ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT|2392.79|2392.79||
125|27445|27445 - ARTHROPLASTY KNEE HINGE PROSTHESIS|2702.22|2702.22||
125|27443|27443 - ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL|1876.64|1876.64||
125|27442|27442 - ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE|1736.42|1736.42||
125|27441|27441 - ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT|1415.65|1415.65||
125|27440|27440 - ARTHROPLASTY KNEE TIBIAL PLATEAU|1513.22|1513.22||
125|27438|27438 - ARTHROPLASTY PATELLA W/PROSTHESIS|1550.43|1550.43||
125|27437|27437 - ARTHROPLASTY PATELLA W/O PROSTHESIS|1254.84|1254.84||
125|27435|27435 - CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE|1106.39|1106.39||
125|27430|27430 - QUADRICEPSPLASTY|1300.83|1300.83||
125|27429|27429 - LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR|2226.97|2226.97||
125|27428|27428 - LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR|2190.16|2190.16||
125|27427|27427 - LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR|1873.43|1873.43||
125|27425|27425 - LATERAL RETINACULAR RELEASE OPEN|906.18|906.18||
125|27424|27424 - RCNSTJ DISLC PATELLA W/PATELLECTOMY|1534.88|1534.88||
125|27422|27422 - RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL|1547.78|1547.78||
125|27420|27420 - RCNSTJ DISLOCATING PATELLA|1573.92|1573.92||
125|27418|27418 - ANTERIOR TIBIAL TUBERCLEPLASTY|1805.11|1805.11||
125|27416|27416 - OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY|1605.6|1605.6||
125|27415|27415 - OSTEOCHONDRAL ALLOGRAFT KNEE OPEN|1368.24|1368.24||
125|27412|27412 - AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE|1640.92|1640.92||
125|27409|27409 - RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE|1945.44|1945.44||
125|27407|27407 - REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT|1514.67|1514.67||
125|27405|27405 - RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL|1407.18|1407.18||
125|27403|27403 - ARTHROTOMY W/MENISCUS REPAIR KNEE|1320.74|1320.74||
125|27400|27400 - TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR|1088.56|1088.56||
125|27397|27397 - TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN|1263.08|1263.08||
125|27396|27396 - TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON|1024.6|1024.6||
125|27395|27395 - LENGTHENING HAMSTRING TENDON MULTIPLE BILATERAL|1480.26|1480.26||
125|27394|27394 - LENGTHENING HAMSTRING TENDON MULTIPLE 1 LEG|1030.99|1030.99||
125|27393|27393 - LENGTHENING HAMSTRING TENDON SINGLE|671.96|671.96||
125|27392|27392 - TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI|1138.78|1138.78||
125|27391|27391 - TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG|740.17|740.17||
125|27390|27390 - TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON|587.86|587.86||
125|27386|27386 - SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ|1628.89|1628.89||
125|27385|27385 - SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY|1187.23|1187.23||
125|27381|27381 - SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF|1549.32|1549.32||
125|27380|27380 - SUTURE INFRAPATELLAR TENDON PRIMARY|947.6|947.6||
125|27372|27372 - REMOVAL FOREIGN BODY DEEP THIGH/KNEE|595.57|595.57||
125|27370|27370 - INJECTION KNEE ARTHROGRAPHY|469|469||
125|27365|27365 - RADICAL RESECTION TUMOR FEMOR OR KNEE|2142.13|2142.13||
125|27364|27364 - RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>|2583|2583||
125|27360|27360 - PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA|1257.05|1257.05||
125|27358|27358 - EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION|1144.86|1144.86||
125|27357|27357 - EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT|1466.95|1466.95||
125|27356|27356 - EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT|1239.49|1239.49||
125|27355|27355 - EXCISION/CURETTAGE CYST/TUMOR FEMUR|1084.78|1084.78||
125|27350|27350 - PATELLECTOMY/HEMIPATELLECTOMY|1231.93|1231.93||
125|27347|27347 - EXCISION LESION MENISCUS/CAPSULE KNEE|930.9|930.9||
125|27345|27345 - EXCISION SYNOVIAL CYST POPLITEAL SPACE|816.21|816.21||
125|27340|27340 - EXCISION PREPATELLAR BURSA|517.55|517.55||
125|27339|27339 - EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>|1235.52|1235.52||
125|27337|27337 - EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>|685.24|685.24||
125|27335|27335 - ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA|1517.04|1517.04||
125|27334|27334 - ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR|1465.43|1465.43||
125|27333|27333 - ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT|1426.24|1426.24||
125|27332|27332 - ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT|1359.5|1359.5||
125|27331|27331 - ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB|1054.16|1054.16||
125|27330|27330 - ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY|898.13|898.13||
125|27329|27329 - RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM|2395.8|2395.8||
125|27328|27328 - EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM|630.51|630.51||
125|27327|27327 - EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM|491.04|491.04||
125|27326|27326 - NEURECTOMY POPLITEAL|778.87|778.87||
125|27325|27325 - NEURECTOMY HAMSTRING MUSCLE|826.32|826.32||
125|27324|27324 - BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP|474.54|474.54||
125|27323|27323 - BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL|227.4|227.4||
125|27310|27310 - ARTHRT KNE W/EXPL DRG/RMVL FB|1260.37|1260.37||
125|27307|27307 - TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON|525.61|525.61||
125|27306|27306 - TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX|395.04|395.04||
125|27305|27305 - FASCIOTOMY ILIOTIBIAL OPEN|591.06|591.06||
125|27303|27303 - INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE|834.49|834.49||
125|27301|27301 - I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION|662.09|662.09||
125|27295|27295 - DISARTICULATION HIP|2803.37|2803.37||
125|27290|27290 - INTERPELVIABDOMINAL AMPUTATION|3259.04|3259.04||
125|27286|27286 - ARTHRD HIP JT W/OBTG GRF W/SUBTRCHNTRIC OSTEOT|2230.03|2230.03||
125|27284|27284 - ARTHRODESIS HIP JOINT W/OBTAINING GRAFT|2172.23|2172.23||
125|27282|27282 - ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT|1743.16|1743.16||
125|27280|27280 - ARTHRODESIS SACROILIAC JOINT W/OBTAINING GRAFT|1557.29|1557.29||
125|27279|27279 - ARTHRODESIS SACROILIAC JOINT PERCUTANEOUS|1134.11|1134.11||
125|27275|27275 - MANIPULATION HIP JOINT GENERAL ANESTHESIA|304.66|304.66||
125|27269|27269 - OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD|2043.12|2043.12||
125|27268|27268 - CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ|875.29|875.29||
125|27267|27267 - CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ|698.31|698.31||
125|27266|27266 - CLTX POST HIP ARTHRP DISLC REQ ANES|768.81|768.81||
125|27265|27265 - CLTX POST HIP ARTHRP DISLC W/O ANES|643.38|643.38||
125|27259|27259 - OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM SHRT|2301.22|2301.22||
125|27258|27258 - OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM|1935.28|1935.28||
125|27257|27257 - TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES|868.42|868.42||
125|27256|27256 - TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES|829.71|829.71||
125|27254|27254 - OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD|2259.62|2259.62||
125|27253|27253 - OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ|1601.5|1601.5||
125|27252|27252 - CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA|973.14|973.14||
125|27250|27250 - CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA|540.57|540.57||
125|27248|27248 - OPEN TREATMENT GREATER TROCHANTERIC FRACTURE|1277.01|1277.01||
125|27246|27246 - CLTX GREATER TROCHANTERIC FX W/O MANJ|478.27|478.27||
125|27245|27245 - TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW|2592.78|2592.78||
125|27244|27244 - TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT|2558.76|2558.76||
125|27240|27240 - CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ|1197.97|1197.97||
125|27238|27238 - CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ|700.09|700.09||
125|27236|27236 - OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT|2578.63|2578.63||
125|27235|27235 - PRQ SKEL FIXJ FEMORAL FX PROX END NECK|1872.29|1872.29||
125|27232|27232 - CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ|1111.26|1111.26||
125|27230|27230 - CLTX FEM FX PROX END NCK W/O MANJ|525.02|525.02||
125|27228|27228 - OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT|3098.94|3098.94||
125|27227|27227 - OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT|2303.14|2303.14||
125|27226|27226 - OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ|2151.3|2151.3||
125|27222|27222 - CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ|1073.37|1073.37||
125|27220|27220 - CLTX ACETABULUM HIP/SOCKT FX W/O MANJ|577.92|577.92||
125|27218|27218 - OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD|2107.51|2107.51||
125|27217|27217 - OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR|2043.55|2043.55||
125|27216|27216 - PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS|1062.34|1062.34||
125|27215|27215 - OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD|1548.26|1548.26||
125|27202|27202 - OPEN TREATMENT COCCYGEAL FRACTURE|941.38|941.38||
125|27200|27200 - CLOSED TREATMENT COCCYGEAL FRACTURE|217.99|217.99||
125|27198|27198 - CLSD TX PELVIC RING FX W/MANIPULATION W/ANES|492.31|492.31||
125|27197|27197 - CLSD TX PELVIC RING FX W/O MANIPULATION|194.02|194.02||
125|27187|27187 - PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR|2665.47|2665.47||
125|27185|27185 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR|847.84|847.84||
125|27181|27181 - OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ|2228.88|2228.88||
125|27179|27179 - OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX|1664.41|1664.41||
125|27178|27178 - OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN|2017.42|2017.42||
125|27177|27177 - OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT|2197.6|2197.6||
125|27176|27176 - TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU|1719.53|1719.53||
125|27175|27175 - TX SLP FEMORAL EPIPHYSIS TRCJ W/O REDUCTION|931.06|931.06||
125|27170|27170 - B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA|2428.91|2428.91||
125|27165|27165 - OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL|2380.69|2380.69||
125|27161|27161 - OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE|1954.53|1954.53||
125|27158|27158 - OSTEOTOMY PELVIS BILATERAL|2693.71|2693.71||
125|27156|27156 - OSTEOT ILIAC ACTBLR/INNOMINATE BONE OSTEOT RDCTJ|2750.55|2750.55||
125|27151|27151 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT|2529.13|2529.13||
125|27147|27147 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ|2447.52|2447.52||
125|27146|27146 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE|1829.72|1829.72||
125|27140|27140 - OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX|1291.84|1291.84||
125|27138|27138 - REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT|3275.57|3275.57||
125|27137|27137 - REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT|3226.8|3226.8||
125|27134|27134 - REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT|4227.73|4227.73||
125|27132|27132 - CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT|3999.99|3999.99||
125|27130|27130 - ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT|3923.24|3923.24||
125|27125|27125 - HEMIARTHROPLASTY HIP PARTIAL|2389.77|2389.77||
125|27122|27122 - ACETABULOPLASTY RESECTION FEMORAL HEAD|2190.97|2190.97||
125|27120|27120 - ACETABULOPLASTY|2553.94|2553.94||
125|27111|27111 - TRANSFER ILIOPSOAS FEMORAL NECK|1623.18|1623.18||
125|27110|27110 - TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR|1907.79|1907.79||
125|27105|27105 - TR PARASPI MUSC HIP FASC/TDN XTN GRF|1463.57|1463.57||
125|27100|27100 - TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF|1460.36|1460.36||
125|27098|27098 - TRANSFER ADDUCTOR ISCHIUM|1304.61|1304.61||
125|27097|27097 - RELEASE/RECESSION HAMSTRING PROXIMAL|1211.05|1211.05||
125|27096|27096 - INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA|599.24|599.24||
125|27095|27095 - INJECTION HIP ARTHROGRAPHY W/ANESTHESIA|447.93|447.93||
125|27093|27093 - INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA|491.24|491.24||
125|27091|27091 - RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA|3074.53|3074.53||
125|27090|27090 - REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE|1226.04|1226.04||
125|27087|27087 - REMOVAL FOREIGN BODY PELVIS/HIP DEEP|687.77|687.77||
125|27086|27086 - RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS|247.57|247.57||
125|27080|27080 - COCCYGECTOMY PRIMARY|723.45|723.45||
125|27078|27078 - RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR|1358.74|1358.74||
125|27077|27077 - RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL|3331.79|3331.79||
125|27076|27076 - RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC|2691.22|2691.22||
125|27075|27075 - RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL|2319.37|2319.37||
125|27071|27071 - PARTIAL EXCISION DEEP PELVIS|1284.48|1284.48||
125|27070|27070 - PARTIAL EXCISION SUPERFICIAL PELVIS|1014.5|1014.5||
125|27067|27067 - EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC|1568.01|1568.01||
125|27066|27066 - EXCISION BONE CYST/BENIGN TUMOR DEEP|1299.79|1299.79||
125|27065|27065 - EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL|688.06|688.06||
125|27062|27062 - EXCISION TROCHANTERIC BURSA/CALCIFICATION|587.47|587.47||
125|27060|27060 - EXCISION ISCHIAL BURSA|582.35|582.35||
125|27059|27059 - RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5 CM/>|3012.75|3012.75||
125|27057|27057 - DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI|1663.38|1663.38||
125|27054|27054 - ARTHROTOMY W/SYNOVECTOMY HIP JOINT|1720.28|1720.28||
125|27052|27052 - ARTHROTOMY W/BIOPSY HIP JOINT|1221|1221||
125|27050|27050 - ARTHROTOMY W/BIOPSY SACROILIAC JOINT|634.24|634.24||
125|27049|27049 - RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM|2247.77|2247.77||
125|27048|27048 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM|1001.56|1001.56||
125|27047|27047 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM|595.16|595.16||
125|27045|27045 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>|1223.93|1223.93||
125|27043|27043 - EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>|770.97|770.97||
125|27041|27041 - BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM|689.04|689.04||
125|27040|27040 - BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL|314.01|314.01||
125|27036|27036 - CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC|1418.6|1418.6||
125|27035|27035 - DNRVTJ HIP JT INTRAPEL/XTRPEL INTRA-ARTCLR BRNCH|1861.6|1861.6||
125|27033|27033 - ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY|1634.11|1634.11||
125|27030|27030 - ARTHROTOMY HIP W/DRAINAGE|1619.83|1619.83||
125|27027|27027 - DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI|1437.94|1437.94||
125|27025|27025 - FASCIOTOMY HIP/THIGH ANY TYPE|1132.15|1132.15||
125|27006|27006 - TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX|835.89|835.89||
125|27005|27005 - TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE|779.85|779.85||
125|27003|27003 - TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY|770.46|770.46||
125|27001|27001 - TENOTOMY ADDUCTOR HIP OPEN|589.42|589.42||
125|27000|27000 - TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX|453.94|453.94||
125|26992|26992 - INCISION BONE CORTEX PELVIS&/HIP JOINT|1502.54|1502.54||
125|26991|26991 - I&D PELVIS/HIP JOINT AREA INFECTED BURSA|711.91|711.91||
125|26990|26990 - I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA|778.25|778.25||
125|26952|26952 - AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP|721.34|721.34||
125|26951|26951 - AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR|628.91|628.91||
125|26910|26910 - AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER|841.7|841.7||
125|26863|26863 - ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT|417.89|417.89||
125|26862|26862 - ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT|860.98|860.98||
125|26861|26861 - ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT|264.84|264.84||
125|26860|26860 - ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ|669.61|669.61||
125|26852|26852 - ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT|1019.45|1019.45||
125|26850|26850 - ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ|836.56|836.56||
125|26844|26844 - ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT|1085.68|1085.68||
125|26843|26843 - ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH|908.65|908.65||
125|26842|26842 - ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT|1108.28|1108.28||
125|26841|26841 - ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ|910.74|910.74||
125|26820|26820 - FUSION OPPOSITION THUMB W/AUTOGENOUS GRAFT|1044.05|1044.05||
125|26785|26785 - OPEN TX INTERPHALANGEAL JOINT DISLOCATION|476.51|476.51||
125|26776|26776 - PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ|441.55|441.55||
125|26775|26775 - CLTX IPHAL JT DISLC W/MANJ REQ ANES|376.05|376.05||
125|26770|26770 - CLTX IPHAL JT DISLC W/MANJ W/O ANES|256.12|256.12||
125|26765|26765 - OPEN TX DISTAL PHALANGEAL FRACTURE EACH|464.54|464.54||
125|26756|26756 - PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA|416.07|416.07||
125|26755|26755 - CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA|312.35|312.35||
125|26750|26750 - CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA|179.77|179.77||
125|26746|26746 - OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA|712.73|712.73||
125|26742|26742 - CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ|389.78|389.78||
125|26740|26740 - CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ|222.99|222.99||
125|26735|26735 - OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA|619.39|619.39||
125|26727|26727 - PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T|468.15|468.15||
125|26725|26725 - CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA|369.81|369.81||
125|26720|26720 - CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA|195.65|195.65||
125|26715|26715 - OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION|671.33|671.33||
125|26706|26706 - PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ|528.92|528.92||
125|26705|26705 - CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES|404.67|404.67||
125|26700|26700 - CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES|328.68|328.68||
125|26686|26686 - OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ|949.18|949.18||
125|26685|26685 - OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB|745.49|745.49||
125|26676|26676 - PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT|551.12|551.12||
125|26675|26675 - CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES|471.37|471.37||
125|26670|26670 - CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES|337.62|337.62||
125|26665|26665 - OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB|1025.32|1025.32||
125|26650|26650 - PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB|614.32|614.32||
125|26645|26645 - CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ|417.86|417.86||
125|26641|26641 - CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ|368.82|368.82||
125|26615|26615 - OPEN TX METACARPAL FRACTURE SINGLE EA BONE|711.77|711.77||
125|26608|26608 - PRQ SKELETAL FIXJ METACARPAL FX EACH BONE|711.1|711.1||
125|26607|26607 - CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE|567.53|567.53||
125|26605|26605 - CLTX METACARPAL FX W/MANIPULATION EACH BONE|387.32|387.32||
125|26600|26600 - CLTX METACARPAL FX W/O MANIPULATION EACH BONE|272.14|272.14||
125|26596|26596 - EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES|996.75|996.75||
125|26593|26593 - RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE|651.17|651.17||
125|26591|26591 - REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE|518.98|518.98||
125|26590|26590 - REPAIR MACRODACTYLIA EACH DIGIT|1987.67|1987.67||
125|26587|26587 - RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE|957.86|957.86||
125|26580|26580 - REPAIR CLEFT HAND|1867.22|1867.22||
125|26568|26568 - OSTEOPLASTY LENGTHENING METACARPAL/PHALANX|1234.71|1234.71||
125|26567|26567 - OSTEOTOMY PHALANX FINGER EACH|808.05|808.05||
125|26565|26565 - OSTEOTOMY METACARPAL EACH|860.87|860.87||
125|26562|26562 - REPAIR SYNDACTYLY EACH SPACE COMPLEX|2177.23|2177.23||
125|26561|26561 - REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT|1312.59|1312.59||
125|26560|26560 - REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS|833.2|833.2||
125|26556|26556 - TRANSFER FREE TOE JOINT W/MVASC ANASTOMOSIS|5185.47|5185.47||
125|26555|26555 - TR FNGR AXH POS W/O MVASC ANAST|1879.78|1879.78||
125|26554|26554 - TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 2|6075.29|6075.29||
125|26553|26553 - TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 1|5088.16|5088.16||
125|26551|26551 - TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND|5155.81|5155.81||
125|26550|26550 - POLLICIZATION DIGIT|2675.67|2675.67||
125|26548|26548 - RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL|960.26|960.26||
125|26546|26546 - RPR NON-UNION MTCRPL/PHALANX|1122.44|1122.44||
125|26545|26545 - RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT|884.56|884.56||
125|26542|26542 - RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS|1145.25|1145.25||
125|26541|26541 - RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF|1165.68|1165.68||
125|26540|26540 - RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT|940.36|940.36||
125|26536|26536 - ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA|965.9|965.9||
125|26535|26535 - ARTHROPLASTY INTERPHALANGEAL JOINT EACH|694.36|694.36||
125|26531|26531 - ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT|1046.26|1046.26||
125|26530|26530 - ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH|846.68|846.68||
125|26525|26525 - CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH|768.22|768.22||
125|26520|26520 - CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH|762.33|762.33||
125|26518|26518 - CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS|1128.35|1128.35||
125|26517|26517 - CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS|1055.84|1055.84||
125|26516|26516 - CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT|816.7|816.7||
125|26510|26510 - CROSS INTRINSIC TRANSFER EACH TENDON|1166.52|1166.52||
125|26508|26508 - RELEASE THENAR MUSCLE|751.8|751.8||
125|26502|26502 - RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX|832.95|832.95||
125|26500|26500 - RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX|700.02|700.02||
125|26499|26499 - CORRECTION CLAW FINGER OTHER METHODS|882.61|882.61||
125|26498|26498 - TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS|1723.78|1723.78||
125|26497|26497 - TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR|1300.64|1300.64||
125|26496|26496 - OPPONENSPLASTY OTHER METHODS|1413.58|1413.58||
125|26494|26494 - OPPONENSPLASTY HYPOTHENAR MUSC TR|1135.29|1135.29||
125|26492|26492 - OPPONENSPLASTY TDN TR W/GRF EA TDN|1280.66|1280.66||
125|26490|26490 - OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN|1086.98|1086.98||
125|26489|26489 - TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH|1096.49|1096.49||
125|26485|26485 - TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH|1035.12|1035.12||
125|26483|26483 - TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT|1140.99|1140.99||
125|26480|26480 - TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN|923.4|923.4||
125|26479|26479 - SHORTENING TENDON FLEXOR HAND/FINGER EACH|739.81|739.81||
125|26478|26478 - LENGTHENING TENDON FLEXOR HAND/FINGER EACH|707.03|707.03||
125|26477|26477 - SHORTENING TENDON EXTENSOR HAND/FINGER EACH|643.95|643.95||
125|26476|26476 - LENGTHENING TENDON EXTENSOR HAND/FINGER EACH|640.22|640.22||
125|26474|26474 - TENODESIS DISTAL JOINT EACH|665.6|665.6||
125|26471|26471 - TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH|771.43|771.43||
125|26460|26460 - TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON|418.83|418.83||
125|26455|26455 - TENOTOMY FLEXOR FINGER OPEN EACH TENDON|433.95|433.95||
125|26450|26450 - TENOTOMY FLEXOR PALM OPEN EACH TENDON|437.24|437.24||
125|26449|26449 - TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA|901.71|901.71||
125|26445|26445 - TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH|692.9|692.9||
125|26442|26442 - TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO|960.45|960.45||
125|26440|26440 - TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON|733.98|733.98||
125|26437|26437 - REALIGNMENT EXTENSOR TENDON HAND EACH TENDON|695.62|695.62||
125|26434|26434 - REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT|740.68|740.68||
125|26433|26433 - REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF|612.8|612.8||
125|26432|26432 - CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING|563.19|563.19||
125|26428|26428 - RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER|980.42|980.42||
125|26426|26426 - RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR|864.28|864.28||
125|26420|26420 - REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH|816.24|816.24||
125|26418|26418 - REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH|653.67|653.67||
125|26416|26416 - RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD|1130.77|1130.77||
125|26415|26415 - EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA|979.7|979.7||
125|26412|26412 - REPAIR EXTENSOR TENDON HAND W/GRAFT EACH|784.22|784.22||
125|26410|26410 - REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH|659.45|659.45||
125|26392|26392 - RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD|1185.23|1185.23||
125|26390|26390 - EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F|1048.9|1048.9||
125|26373|26373 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA|1126.83|1126.83||
125|26372|26372 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA|1226.38|1226.38||
125|26370|26370 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN|1112.32|1112.32||
125|26358|26358 - RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON|1510.78|1510.78||
125|26357|26357 - RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON|1404.71|1404.71||
125|26356|26356 - RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON|1296.42|1296.42||
125|26352|26352 - RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON|1155.73|1155.73||
125|26350|26350 - RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON|875.67|875.67||
125|26341|26341 - MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD|156.95|156.95||
125|26340|26340 - MANIPULATION FINGER JOINT UNDER ANES EACH JOINT|308.25|308.25||
125|26320|26320 - REMOVAL IMPLANT FROM FINGER/HAND|467.64|467.64||
125|26262|26262 - RADICAL RESECTION TUMOR DISTAL PHALANX FINGER|857.97|857.97||
125|26260|26260 - RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER|936.24|936.24||
125|26250|26250 - RADICAL RESECTION TUMOR METACARPAL|868.88|868.88||
125|26236|26236 - PARTIAL EXCISION DISTAL PHALANX FINGER|559.29|559.29||
125|26235|26235 - PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER|593.97|593.97||
125|26230|26230 - PARTIAL EXCISION BONE METACARPAL|654.31|654.31||
125|26215|26215 - EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT|864.39|864.39||
125|26210|26210 - EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER|644.49|644.49||
125|26205|26205 - EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT|915.2|915.2||
125|26200|26200 - EXCISION/CURETTAGE CYST/TUMOR METACARPAL|706.56|706.56||
125|26185|26185 - SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE|586.64|586.64||
125|26180|26180 - EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH|518.55|518.55||
125|26170|26170 - EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH|463.92|463.92||
125|26160|26160 - EXC LESION TDN SHTH/JT CAPSL HAND/FNGR|588.95|588.95||
125|26145|26145 - SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN|811.86|811.86||
125|26140|26140 - SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT|733.93|733.93||
125|26135|26135 - SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD|841.21|841.21||
125|26130|26130 - SYNOVECTOMY CARPOMETACARPAL JOINT|728.58|728.58||
125|26125|26125 - FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR|537.78|537.78||
125|26123|26123 - FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR|1536.5|1536.5||
125|26121|26121 - FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT|1141.29|1141.29||
125|26118|26118 - RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>|1716.46|1716.46||
125|26117|26117 - RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM|1540.2|1540.2||
125|26116|26116 - EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM|594.13|594.13||
125|26115|26115 - EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM|650.88|650.88||
125|26113|26113 - EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>|888.5|888.5||
125|26111|26111 - EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>|676.96|676.96||
125|26110|26110 - ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH|411|411||
125|26105|26105 - ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH|485.81|485.81||
125|26100|26100 - ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH|493.22|493.22||
125|26080|26080 - ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA|478.7|478.7||
125|26075|26075 - ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA|517.26|517.26||
125|26070|26070 - ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT|503.72|503.72||
125|26060|26060 - TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT|280.64|280.64||
125|26055|26055 - TENDON SHEATH INCISION|639.15|639.15||
125|26045|26045 - FASCIOTOMY PALMAR OPEN PARTIAL|611.64|611.64||
125|26040|26040 - FASCIOTOMY PALMAR PERCUTANEOUS|394.78|394.78||
125|26037|26037 - DECOMPRESSIVE FASCIOTOMY HAND|716.89|716.89||
125|26035|26035 - DECOMPRESSION FINGERS&/HAND INJECTION INJURY|1103.65|1103.65||
125|26034|26034 - INCISION BONE CORTEX HAND/FINGER|621.02|621.02||
125|26030|26030 - DRAINAGE OF PALMAR BURSA MULTIPLE BURSA|1008.03|1008.03||
125|26025|26025 - DRAINAGE OF PALMAR BURSA SINGLE BURSA|589.75|589.75||
125|26020|26020 - DRAINAGE TENDON SHEATH DIGIT&/PALM EACH|551.81|551.81||
125|26011|26011 - DRAINAGE FINGER ABSCESS COMPLICATED|422.47|422.47||
125|26010|26010 - DRAINAGE FINGER ABSCESS SIMPLE|270.05|270.05||
125|25931|25931 - TRANSMETACARPAL AMPUTATION RE-AMPUTATION|942.99|942.99||
125|25929|25929 - TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ|688.36|688.36||
125|25927|25927 - TRANSMETACARPAL AMPUTATION|1042.25|1042.25||
125|25924|25924 - DISARTICULATION THRU WRIST RE-AMPUTATION|1026.59|1026.59||
125|25922|25922 - DISARTICULATION THRU WRIST SEC CLOSURE/SCAR REVJ|730.03|730.03||
125|25920|25920 - DISARTICULATION THROUGH WRIST|1021.21|1021.21||
125|25915|25915 - KRUKENBERG PROCEDURE|1863.8|1863.8||
125|25909|25909 - AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION|1021.38|1021.38||
125|25907|25907 - AMP F/ARM THRU RADIUS&ULNA SEC CLOSURE/SCAR RE|792.69|792.69||
125|25905|25905 - AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR|1082.95|1082.95||
125|25900|25900 - AMPUTATION FOREARM THROUGH RADIUS & ULNA|1056.11|1056.11||
125|25830|25830 - ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE|1348.97|1348.97||
125|25825|25825 - ARTHRODESIS WRIST LIMITED W/AUTOGRAFT|1492.82|1492.82||
125|25820|25820 - ARTHRODESIS WRIST LIMITED W/O BONE GRAFT|1149.24|1149.24||
125|25810|25810 - ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT|1555.91|1555.91||
125|25805|25805 - ARTHRODESIS WRIST W/SLIDING GRAFT|1562.77|1562.77||
125|25800|25800 - ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT|1329.3|1329.3||
125|25695|25695 - OPEN TREATMENT LUNATE DISLOCATION|989.32|989.32||
125|25690|25690 - CLOSED TX LUNATE DISLOCATION W/MANIPULATION|608.87|608.87||
125|25685|25685 - OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC|1192.38|1192.38||
125|25680|25680 - CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ|594.29|594.29||
125|25676|25676 - OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC|879.27|879.27||
125|25675|25675 - CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ|443.66|443.66||
125|25671|25671 - PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION|791.35|791.35||
125|25670|25670 - OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES|911.37|911.37||
125|25660|25660 - CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ|454.7|454.7||
125|25652|25652 - OPEN TREATMENT ULNAR STYLOID FRACTURE|1088.12|1088.12||
125|25651|25651 - PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE|865.54|865.54||
125|25650|25650 - CLOSED TREATMENT ULNAR STYLOID FRACTURE|584.99|584.99||
125|25645|25645 - OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA|797.72|797.72||
125|25635|25635 - CLTX CARPAL BONE FX W/MANJ EACH BONE|462.86|462.86||
125|25630|25630 - CLTX CARPAL BONE FX W/O MANJ EACH BONE|309.44|309.44||
125|25628|25628 - OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE|931.48|931.48||
125|25624|25624 - CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ|541.96|541.96||
125|25622|25622 - CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ|372.25|372.25||
125|25609|25609 - OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG|1716.26|1716.26||
125|25608|25608 - OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG|1344.18|1344.18||
125|25607|25607 - OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP|1171.97|1171.97||
125|25606|25606 - PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP|873.33|873.33||
125|25605|25605 - CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF|800.93|800.93||
125|25600|25600 - CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ|378.82|378.82||
125|25575|25575 - OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA|1415.77|1415.77||
125|25574|25574 - OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA|1289.39|1289.39||
125|25565|25565 - CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ|720.22|720.22||
125|25560|25560 - CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN|363.68|363.68||
125|25545|25545 - OPEN TREATMENT OF ULNAR SHAFT FRACTURE|1057.59|1057.59||
125|25535|25535 - CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION|558.64|558.64||
125|25530|25530 - CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION|350.01|350.01||
125|25526|25526 - OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE|1719.45|1719.45||
125|25525|25525 - OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE|1314.73|1314.73||
125|25520|25520 - CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT|636.3|636.3||
125|25515|25515 - OPEN TREATMENT RADIAL SHAFT FRACTURE|1129.95|1129.95||
125|25505|25505 - CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION|566.02|566.02||
125|25500|25500 - CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION|329.91|329.91||
125|25492|25492 - PROPH TX N/P/PLTWR W/WO METHYLMECRYLATE RAD&UL|1402.57|1402.57||
125|25491|25491 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE ULNA|1149.11|1149.11||
125|25490|25490 - PROPH TX N/P/PLTWR W/WO METHYLACRYLATE RADIUS|1120.28|1120.28||
125|25455|25455 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA|1067.49|1067.49||
125|25450|25450 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U|823.28|823.28||
125|25449|25449 - REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT|1297.25|1297.25||
125|25447|25447 - ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS|1448.1|1448.1||
125|25446|25446 - ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS|2409.7|2409.7||
125|25445|25445 - ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM|1559.61|1559.61||
125|25444|25444 - ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE|1581.74|1581.74||
125|25443|25443 - ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL|1433.5|1433.5||
125|25442|25442 - ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA|1362.07|1362.07||
125|25441|25441 - ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS|1588.76|1588.76||
125|25440|25440 - RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC|1370.03|1370.03||
125|25431|25431 - REPAIR NONUNION CARPAL BONE EACH BONE|1854.74|1854.74||
125|25430|25430 - INSERTION VASCULAR PEDICLE CARPAL BONE|686.55|686.55||
125|25426|25426 - REPAIR DEFECT W/AUTOGRAFT RADIUS&ULNA|1828.22|1828.22||
125|25425|25425 - REPAIR DEFECT W/AUTOGRAFT RADIUS/ULNA|1611.26|1611.26||
125|25420|25420 - RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT|2017.69|2017.69||
125|25415|25415 - RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF|1682.72|1682.72||
125|25405|25405 - RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT|1956.22|1956.22||
125|25400|25400 - RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT|1602.35|1602.35||
125|25394|25394 - OSTEOPLASTY CARPAL BONE SHORTENING|1236.49|1236.49||
125|25393|25393 - OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAF|1722.46|1722.46||
125|25392|25392 - OSTEOPLASTY RADIUS & ULNA SHORTENING|1520.16|1520.16||
125|25391|25391 - OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT|1429.19|1429.19||
125|25390|25390 - OSTEOPLASTY RADIUS/ULNA SHORTENING|1200.08|1200.08||
125|25375|25375 - MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA|1760.74|1760.74||
125|25370|25370 - MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA|1479.11|1479.11||
125|25365|25365 - OSTEOTOMY RADIUS & ULNA|1546.88|1546.88||
125|25360|25360 - OSTEOTOMY ULNA|1071.89|1071.89||
125|25355|25355 - OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD|1325.42|1325.42||
125|25350|25350 - OSTEOTOMY RADIUS DISTAL THIRD|1131.24|1131.24||
125|25337|25337 - RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ|1381.52|1381.52||
125|25335|25335 - CENTRALIZATION WRST ULNA|1952.57|1952.57||
125|25332|25332 - ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ|1532.24|1532.24||
125|25320|25320 - CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS|1408.58|1408.58||
125|25316|25316 - FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFE|1613.26|1613.26||
125|25315|25315 - FLEXOR ORIGIN SLIDE FOREARM &/WRIST|1194.92|1194.92||
125|25312|25312 - TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR|1166.36|1166.36||
125|25310|25310 - TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN|1237.7|1237.7||
125|25301|25301 - TENODESIS WRIST EXTENSORS FINGERS|1010.02|1010.02||
125|25300|25300 - TENODESIS WRIST FLEXORS FINGERS|1115.55|1115.55||
125|25295|25295 - TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA|749.45|749.45||
125|25290|25290 - TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA|794.76|794.76||
125|25280|25280 - LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN|794.18|794.18||
125|25275|25275 - RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT|1236.49|1236.49||
125|25274|25274 - RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN|964.68|964.68||
125|25272|25272 - RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU|795.47|795.47||
125|25270|25270 - RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN|723.28|723.28||
125|25265|25265 - RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA|1080.28|1080.28||
125|25263|25263 - RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS|889.03|889.03||
125|25260|25260 - RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU|851.01|851.01||
125|25259|25259 - MANIPULATION WRIST UNDER ANESTHESIA|379.74|379.74||
125|25251|25251 - REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST|1013.5|1013.5||
125|25250|25250 - REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE|694.5|694.5||
125|25248|25248 - EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST|541.46|541.46||
125|25246|25246 - INJECTION WRIST ARTHROGRAPHY|419.11|419.11||
125|25240|25240 - EXCISION DISTAL ULNA PARTIAL/COMPLETE|717.56|717.56||
125|25230|25230 - RADICAL STYLOIDECTOMY SEPARATE PROCEDURE|696.25|696.25||
125|25215|25215 - CARPECTOMY ALL BONES PROXIMAL ROW|1091.9|1091.9||
125|25210|25210 - CARPECTOMY 1 BONE|789.01|789.01||
125|25170|25170 - RADICAL RESECTION TUMOR RADIUS OR ULNA|1432.07|1432.07||
125|25151|25151 - PARTIAL EXCISION BONE RADIUS|886.69|886.69||
125|25150|25150 - PARTIAL EXCISION BONE ULNA|880.65|880.65||
125|25145|25145 - SEQUESTRECTOMY FOREARM &/WRIST|1126.44|1126.44||
125|25136|25136 - EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT|857.78|857.78||
125|25135|25135 - EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT|916.18|916.18||
125|25130|25130 - EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES|733|733||
125|25126|25126 - EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT|1037.41|1037.41||
125|25125|25125 - EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT|1026.47|1026.47||
125|25120|25120 - EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA|869.15|869.15||
125|25119|25119 - SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA|938.64|938.64||
125|25118|25118 - SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT|859|859||
125|25116|25116 - RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS|1105.76|1105.76||
125|25115|25115 - RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS|1116.91|1116.91||
125|25112|25112 - EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT|586.88|586.88||
125|25111|25111 - EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY|532.89|532.89||
125|25110|25110 - EXCISION LESION TENDON SHEATH FOREARM&/WRIST|436.97|436.97||
125|25109|25109 - EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA|757.92|757.92||
125|25107|25107 - ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE|832.92|832.92||
125|25105|25105 - ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY|934.71|934.71||
125|25101|25101 - ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB|815.9|815.9||
125|25100|25100 - ARTHROTOMY WRIST JOINT WITH BIOPSY|592.34|592.34||
125|25085|25085 - CAPSULOTOMY WRIST|774.74|774.74||
125|25078|25078 - RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>|1916.18|1916.18||
125|25077|25077 - RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM|1532.03|1532.03||
125|25076|25076 - EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM|578.78|578.78||
125|25075|25075 - EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM|385.7|385.7||
125|25073|25073 - EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>|866.51|866.51||
125|25071|25071 - EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>|694.12|694.12||
125|25066|25066 - BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP|445.02|445.02||
125|25065|25065 - BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL|202.12|202.12||
125|25040|25040 - ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB|969.99|969.99||
125|25035|25035 - INCISION DEEP BONE CORTEX FOREARM&/WRIST|871.9|871.9||
125|25031|25031 - INCISION & DRAINAGE FOREARM&/WRIST BURSA|481.79|481.79||
125|25028|25028 - I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA|534.49|534.49||
125|25025|25025 - DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT|1446.7|1446.7||
125|25024|25024 - DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB|1112.84|1112.84||
125|25023|25023 - DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT|1137.08|1137.08||
125|25020|25020 - DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT|694.67|694.67||
125|25001|25001 - INCISION FLEXOR TENDON SHEATH WRIST|717.17|717.17||
125|25000|25000 - INCISION EXTENSOR TENDON SHEATH WRIST|580.43|580.43||
125|24940|24940 - CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE|1743.05|1743.05||
125|24935|24935 - STUMP ELONGATION UPPER EXTREMITY|1776.87|1776.87||
125|24931|24931 - AMPUTATION ARM THRU HUMERUS W/IMPLANT|1468.84|1468.84||
125|24930|24930 - AMPUTATION ARM THRU HUMERUS RE-AMPUTATION|1177.82|1177.82||
125|24925|24925 - AMP ARM THRU HUMERUS SECONDARY CLSR/SCAR REVJ|733.59|733.59||
125|24920|24920 - AMPUTATION ARM THRU HUMERUS OPEN CIRCULAR|1109.32|1109.32||
125|24900|24900 - AMPUTATION ARM THRU HUMERUS W/PRIMARY CLOSURE|1140.87|1140.87||
125|24802|24802 - ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT|1887.73|1887.73||
125|24800|24800 - ARTHRODESIS ELBOW JOINT LOCAL|1552.17|1552.17||
125|24685|24685 - OPEN TREATMENT ULNAR FRACTURE PROXIMAL END|1167.38|1167.38||
125|24675|24675 - CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ|467.12|467.12||
125|24670|24670 - CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ|274.89|274.89||
125|24666|24666 - OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC|1186.03|1186.03||
125|24665|24665 - OPEN TX RADIAL HEAD/NECK FRACTURE|962.13|962.13||
125|24655|24655 - CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION|442.88|442.88||
125|24650|24650 - CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION|308.56|308.56||
125|24640|24640 - CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ|177.98|177.98||
125|24635|24635 - OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW|1467.41|1467.41||
125|24620|24620 - CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ|595.65|595.65||
125|24615|24615 - OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION|1145.05|1145.05||
125|24605|24605 - TREATMENT CLOSED ELBOW DISLOCATION REQ ANES|517.76|517.76||
125|24600|24600 - TREATMENT CLOSED ELBOW DISLOCATION W/O ANES|455|455||
125|24587|24587 - OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR|2108.4|2108.4||
125|24586|24586 - OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO|1838.99|1838.99||
125|24582|24582 - PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ|886.82|886.82||
125|24579|24579 - OPEN TREATMENT HUMERAL CONDYLAR FRACTURE|1238.47|1238.47||
125|24577|24577 - CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ|553.95|553.95||
125|24576|24576 - CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ|307.79|307.79||
125|24575|24575 - OPEN TX HUMERAL EPICONDYLAR FRACTURE|1139.09|1139.09||
125|24566|24566 - PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ|855.4|855.4||
125|24565|24565 - CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ|527.23|527.23||
125|24560|24560 - CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ|401.89|401.89||
125|24546|24546 - OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN|1554.91|1554.91||
125|24545|24545 - OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN|1469.23|1469.23||
125|24538|24538 - PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX|1146.07|1146.07||
125|24535|24535 - CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ|698.86|698.86||
125|24530|24530 - CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ|451.7|451.7||
125|24516|24516 - TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE|1525.79|1525.79||
125|24515|24515 - OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE|1519.83|1519.83||
125|24505|24505 - CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ|619.31|619.31||
125|24500|24500 - CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION|412.28|412.28||
125|24498|24498 - PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT|1576.86|1576.86||
125|24495|24495 - DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL|1087.91|1087.91||
125|24470|24470 - HEMIEPIPHYSEAL ARREST|1311.56|1311.56||
125|24435|24435 - REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT|2051.77|2051.77||
125|24430|24430 - REPAIR NON/MALUNION HUMERUS W/O GRAFT|1875.1|1875.1||
125|24420|24420 - OSTEOPLASTY HUMERUS|1695.2|1695.2||
125|24410|24410 - MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT|1961.56|1961.56||
125|24400|24400 - OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION|1519.64|1519.64||
125|24371|24371 - REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT|2960.99|2960.99||
125|24370|24370 - REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT|2534.23|2534.23||
125|24366|24366 - ARTHROPLASTY RADIAL HEAD W/IMPLANT|1256.04|1256.04||
125|24365|24365 - ARTHROPLASTY RADIAL HEAD|1089.3|1089.3||
125|24363|24363 - ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM|2990.94|2990.94||
125|24362|24362 - ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ|2045.23|2045.23||
125|24361|24361 - ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT|2055.8|2055.8||
125|24360|24360 - ARTHROPLASTY ELBOW W/MEMBRANE|2047.87|2047.87||
125|24359|24359 - TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR|1071.63|1071.63||
125|24358|24358 - TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN|845.01|845.01||
125|24357|24357 - TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS|676.29|676.29||
125|24346|24346 - RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF|2015.48|2015.48||
125|24345|24345 - REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW|1681.63|1681.63||
125|24344|24344 - RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT|2015.48|2015.48||
125|24343|24343 - REPAIR LATERAL COLLATERAL LIGAMENT ELBOW|1681.63|1681.63||
125|24342|24342 - RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF|1475.34|1475.34||
125|24341|24341 - REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA|1025.36|1025.36||
125|24340|24340 - TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE|1002.99|1002.99||
125|24332|24332 - TENOLYSIS TRICEPS|1063.39|1063.39||
125|24331|24331 - FLEXOR-PLASTY ELBOW W/EXTENSOR ADVANCEMENT|1495.07|1495.07||
125|24330|24330 - FLEXOR-PLASTY ELBOW|1239.85|1239.85||
125|24320|24320 - TENOPLASTY ELBOW TO SHOULDER SINGLE|1437.92|1437.92||
125|24310|24310 - TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON|565.09|565.09||
125|24305|24305 - TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON|685.28|685.28||
125|24301|24301 - MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE|1268.56|1268.56||
125|24300|24300 - MANIPULATION ELBOW UNDER ANESTHESIA|754.35|754.35||
125|24220|24220 - INJECTION ELBOW ARTHROGRAPHY|423.14|423.14||
125|24201|24201 - REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP|561.22|561.22||
125|24200|24200 - RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS|200.77|200.77||
125|24164|24164 - PROSTHESIS REMOVAL RADIAL HEAD|769.37|769.37||
125|24160|24160 - PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS|840.59|840.59||
125|24155|24155 - RESECTION ELBOW JOINT ARTHRECTOMY|1528.44|1528.44||
125|24152|24152 - RADICAL RESECTION TUMOR RADIAL HEAD/NECK|1649.32|1649.32||
125|24150|24150 - RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS|1759.62|1759.62||
125|24149|24149 - RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT|1646.93|1646.93||
125|24147|24147 - PARTIAL EXCISION BONE OLECRANON PROCESS|975.7|975.7||
125|24145|24145 - PARTIAL EXCISION BONE RADIAL HEAD/NECK|893.58|893.58||
125|24140|24140 - PARTIAL EXCISION BONE HUMERUS|1245.23|1245.23||
125|24138|24138 - SEQUESTRECTOMY OLECRANON PROCESS|1049.91|1049.91||
125|24136|24136 - SEQUESTRECTOMY RADIAL HEAD OR NECK|1110.06|1110.06||
125|24134|24134 - SEQUESTRECTOMY SHAFT/DISTAL HUMERUS|1194.62|1194.62||
125|24130|24130 - EXCISION RADIAL HEAD|878.73|878.73||
125|24126|24126 - EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT|1043.85|1043.85||
125|24125|24125 - EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/AGRFT|967.92|967.92||
125|24120|24120 - EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN|867.59|867.59||
125|24116|24116 - EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT|1326.66|1326.66||
125|24115|24115 - EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT|1225.25|1225.25||
125|24110|24110 - EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS|1024.39|1024.39||
125|24105|24105 - EXCISION OLECRANON BURSA|507.84|507.84||
125|24102|24102 - ARTHROTOMY ELBOW W/SYNOVECTOMY|1370.03|1370.03||
125|24101|24101 - ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB|998.59|998.59||
125|24100|24100 - ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY|644.86|644.86||
125|24079|24079 - RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5CM/>|2189.84|2189.84||
125|24077|24077 - RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM|1753.02|1753.02||
125|24076|24076 - EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM|682.51|682.51||
125|24075|24075 - EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM|442.58|442.58||
125|24073|24073 - EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>|1136.62|1136.62||
125|24071|24071 - EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>|665.01|665.01||
125|24066|24066 - BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP|560.02|560.02||
125|24065|24065 - BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL|205.81|205.81||
125|24006|24006 - ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX|1009.72|1009.72||
125|24000|24000 - ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB|977.33|977.33||
125|23935|23935 - INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW|756.82|756.82||
125|23931|23931 - INCISION&DRAINAGE UPPER ARM/ELBOW BURSA|294.14|294.14||
125|23930|23930 - I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA|361.32|361.32||
125|23921|23921 - DISRTCJ SHOULDER SECONDARY CLSR/SCAR REVISION|563.98|563.98||
125|23920|23920 - DISARTICULATION SHOULDER|2146.73|2146.73||
125|23900|23900 - INTERTHORACOSCAPULAR AMPUTATION|2701.72|2701.72||
125|23802|23802 - ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT|2164.12|2164.12||
125|23800|23800 - ARTHRODESIS GLENOHUMERAL JOINT|2094.77|2094.77||
125|23700|23700 - MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS|368.95|368.95||
125|23680|23680 - OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE|1678.37|1678.37||
125|23675|23675 - CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ|551.01|551.01||
125|23670|23670 - OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX|1208.83|1208.83||
125|23665|23665 - CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ|442.82|442.82||
125|23660|23660 - OPEN TX ACUTE SHOULDER DISLOCATION|1167.41|1167.41||
125|23655|23655 - CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES|498.48|498.48||
125|23650|23650 - CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES|376.28|376.28||
125|23630|23630 - OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE|1036.54|1036.54||
125|23625|23625 - CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION|417.74|417.74||
125|23620|23620 - CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ|305.92|305.92||
125|23616|23616 - OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT|2546.18|2546.18||
125|23615|23615 - OPEN TREATMENT PROXIMAL HUMERAL FRACTURE|1296.44|1296.44||
125|23605|23605 - CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ|602.43|602.43||
125|23600|23600 - CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION|407.74|407.74||
125|23585|23585 - OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD|1219.91|1219.91||
125|23575|23575 - CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION|391.38|391.38||
125|23570|23570 - CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION|237.17|237.17||
125|23552|23552 - OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF|1236.96|1236.96||
125|23550|23550 - OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC|1194.85|1194.85||
125|23545|23545 - CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION|327.1|327.1||
125|23540|23540 - CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION|255.4|255.4||
125|23532|23532 - OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF|1114.68|1114.68||
125|23530|23530 - OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC|1016.13|1016.13||
125|23525|23525 - CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION|351.37|351.37||
125|23520|23520 - CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION|228.15|228.15||
125|23515|23515 - OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION|981.91|981.91||
125|23505|23505 - CLSD TX CLAVICULAR FRACTURE W/MANIPULATION|370.12|370.12||
125|23500|23500 - CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION|256.9|256.9||
125|23491|23491 - PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS|1670.22|1670.22||
125|23490|23490 - PROPH TX W/WO METHYLMETHACRYLATE CLAVICLE|1307.43|1307.43||
125|23485|23485 - OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL|1513.57|1513.57||
125|23480|23480 - OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION|1160.01|1160.01||
125|23474|23474 - REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT|2885.56|2885.56||
125|23473|23473 - REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT|2670.54|2670.54||
125|23472|23472 - ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER|3174.05|3174.05||
125|23470|23470 - ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY|2280.17|2280.17||
125|23466|23466 - CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS|2172.96|2172.96||
125|23465|23465 - CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK|1969.41|1969.41||
125|23462|23462 - CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR|2054.59|2054.59||
125|23460|23460 - CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK|2132.54|2132.54||
125|23455|23455 - CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR|2151.87|2151.87||
125|23450|23450 - CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON|1820.78|1820.78||
125|23440|23440 - RESECTION/TRANSPLANTATION LONG TENDON BICEPS|1261.75|1261.75||
125|23430|23430 - TENODESIS LONG TENDON BICEPS|1253|1253||
125|23420|23420 - RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC|2131.47|2131.47||
125|23415|23415 - CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY|1134.49|1134.49||
125|23412|23412 - OPEN REPAIR OF ROTATOR CUFF CHRONIC|1919.07|1919.07||
125|23410|23410 - OPEN REPAIR OF ROTATOR CUFF ACUTE|1580.15|1580.15||
125|23406|23406 - TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION|1309.08|1309.08||
125|23405|23405 - TENOTOMY SHOULDER AREA 1 TENDON|943.84|943.84||
125|23400|23400 - SCAPULOPEXY|1965.69|1965.69||
125|23397|23397 - MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE|1722.17|1722.17||
125|23395|23395 - MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE|1977.57|1977.57||
125|23350|23350 - INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG|179.43|179.43||
125|23335|23335 - PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT|2099.15|2099.15||
125|23334|23334 - PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT|1759.8|1759.8||
125|23333|23333 - REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM|752.95|752.95||
125|23330|23330 - REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS|215.65|215.65||
125|23220|23220 - RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS|1881.48|1881.48||
125|23210|23210 - RADICAL RESECTION TUMOR SCAPULA|1693.8|1693.8||
125|23200|23200 - RADICAL RESECTION TUMOR CLAVICLE|1311.5|1311.5||
125|23195|23195 - RESECTION HUMERAL HEAD|1413.88|1413.88||
125|23190|23190 - OSTECTOMY SCAPULA PARTIAL|845.29|845.29||
125|23184|23184 - PARTIAL EXCISION BONE PROXIMAL HUMERUS|1083.03|1083.03||
125|23182|23182 - PARTIAL EXCISION BONE SCAPULA|826.14|826.14||
125|23180|23180 - PARTIAL EXCISION BONE CLAVICLE|910.25|910.25||
125|23174|23174 - SEQUESTRECTOMY HUMERAL HEAD SURGERY NECK|1360.54|1360.54||
125|23172|23172 - SEQUESTRECTOMY SCAPULA|881.72|881.72||
125|23170|23170 - SEQUESTRECTOMY CLAVICLE|731.94|731.94||
125|23156|23156 - EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT|1191.3|1191.3||
125|23155|23155 - EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT|1384.16|1384.16||
125|23150|23150 - EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS|1054.82|1054.82||
125|23146|23146 - EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT|829.19|829.19||
125|23145|23145 - EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/AGRFT|1088.26|1088.26||
125|23140|23140 - EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA|709.72|709.72||
125|23130|23130 - PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE|1033.08|1033.08||
125|23125|23125 - CLAVICULECTOMY TOTAL|1416.36|1416.36||
125|23120|23120 - CLAVICULECTOMY PARTIAL|979.37|979.37||
125|23107|23107 - ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB|1144.66|1144.66||
125|23106|23106 - ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX|932.18|932.18||
125|23105|23105 - ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY|1424.13|1424.13||
125|23101|23101 - ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG|856.85|856.85||
125|23100|23100 - ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY|913.34|913.34||
125|23078|23078 - RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5 CM/>|2371.58|2371.58||
125|23077|23077 - RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM|2916.42|2916.42||
125|23076|23076 - EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM|713.16|713.16||
125|23075|23075 - EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM|298.63|298.63||
125|23073|23073 - EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>|1138.41|1138.41||
125|23071|23071 - EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>|687.44|687.44||
125|23066|23066 - BIOPSY SOFT TISSUE SHOULDER DEEP|466.5|466.5||
125|23065|23065 - BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL|197.29|197.29||
125|23044|23044 - ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB|794.28|794.28||
125|23040|23040 - ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB|1168.73|1168.73||
125|23035|23035 - INCISION BONE CORTEX SHOULDER AREA|905.12|905.12||
125|23031|23031 - I&D SHOULDER INFECTED BURSA|409.46|409.46||
125|23030|23030 - I&D SHOULDER DEEP ABSCESS/HEMATOMA|423.75|423.75||
125|23020|23020 - CAPSULAR CONTRACTURE RELEASE|1111.73|1111.73||
125|23000|23000 - REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN|579.09|579.09||
125|22905|22905 - RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>|2207.69|2207.69||
125|22904|22904 - RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM|1735.77|1735.77||
125|22903|22903 - EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>|721.36|721.36||
125|22902|22902 - EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM|699.51|699.51||
125|22901|22901 - EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>|1097.32|1097.32||
125|22900|22900 - EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM|597.6|597.6||
125|22870|22870 - INSJ STABLJ DEV W/O DCMPRN LUMBAR SECOND LEVEL|228.18|228.18||
125|22869|22869 - INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE LEVEL|868.24|868.24||
125|22868|22868 - INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL|396.76|396.76||
125|22867|22867 - INSJ STABLJ DEV W/DCMPRN LUMBAR SINGLE LEVEL|1536|1536||
125|22865|22865 - RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR|3315.32|3315.32||
125|22864|22864 - RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL|3503.82|3503.82||
125|22862|22862 - REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR|3405.15|3405.15||
125|22861|22861 - REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC CRV|3931.56|3931.56||
125|22859|22859 - INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD|543.43|543.43||
125|22858|22858 - TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL|863.23|863.23||
125|22857|22857 - TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC LMBR|2790.73|2790.73||
125|22856|22856 - TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV|2727.14|2727.14||
125|22855|22855 - REMOVAL ANTERIOR INSTRUMENTATION|2030.87|2030.87||
125|22854|22854 - INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD|543.43|543.43||
125|22853|22853 - INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD|420.07|420.07||
125|22852|22852 - REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION|1371.63|1371.63||
125|22850|22850 - REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION|1341.19|1341.19||
125|22849|22849 - REINSERTION SPINAL FIXATION DEVICE|1780.08|1780.08||
125|22848|22848 - PELVIC FIXATION OTHER THAN SACRUM|802.94|802.94||
125|22847|22847 - ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS|2014.9|2014.9||
125|22846|22846 - ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS|1461.98|1461.98||
125|22845|22845 - ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS|1011.74|1011.74||
125|22844|22844 - POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE|2122.2|2122.2||
125|22843|22843 - POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG|1842.53|1842.53||
125|22842|22842 - POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG|1204.65|1204.65||
125|22841|22841 - INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS|732.74|732.74||
125|22840|22840 - POSTERIOR NON-SEGMENTAL INSTRUMENTATION|1143.48|1143.48||
125|22830|22830 - EXPLORATION SPINAL FUSION|2043.91|2043.91||
125|22819|22819 - KYPHECTOMY 3 OR MORE SEGMENTS|3735.58|3735.58||
125|22818|22818 - KYPHECTOMY SINGLE OR TWO SEGMENTS|5784.48|5784.48||
125|22812|22812 - ARTHRODESIS ANTERIOR SPINAL DFRM 8/> VRT SEG|4102.81|4102.81||
125|22810|22810 - ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SEG|3651.15|3651.15||
125|22808|22808 - ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SEG|3190.98|3190.98||
125|22804|22804 - ARTHRODESIS POSTERIOR SPINAL DFRM 13/> VRT SEG|4684.95|4684.95||
125|22802|22802 - ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SEG|4287|4287||
125|22800|22800 - ARTHRODESIS POSTERIOR SPINAL DFRM UP 6 VRT SEG|2952.88|2952.88||
125|22634|22634 - ARTHDSIS POST/POSTERLATRL/POSTINTRBDYADL SPC/SEG|838.08|838.08||
125|22633|22633 - ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR|3088.75|3088.75||
125|22632|22632 - ARTHRODESIS POSTERIOR INTERBODY EA ADDL|820.34|820.34||
125|22630|22630 - ARTHRODESIS POSTERIOR INTERBODY LUMBAR|2908.09|2908.09||
125|22614|22614 - ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL|926.08|926.08||
125|22612|22612 - ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR|2849.14|2849.14||
125|22610|22610 - ARTHRODESIS POSTERIOR/POSTEROLATERAL THORACIC|2318.09|2318.09||
125|22600|22600 - ARTHRODESIS PST/PSTLAT CERVICAL BELW C2 SGM|2936.12|2936.12||
125|22595|22595 - ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2|3393.33|3393.33||
125|22590|22590 - ARTHRODESIS POSTERIOR CRANIOCERVICAL|3581.24|3581.24||
125|22586|22586 - ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5-S1|3359.02|3359.02||
125|22585|22585 - ARTHRODESIS ANTERIOR INTERBODY EA ADDL NTRSPC|811.89|811.89||
125|22558|22558 - ARTHRODESIS ANTERIOR INTERBODY LUMBAR|3543.36|3543.36||
125|22556|22556 - ARTHRD ANT MIN DISCECTOMY INTERBODY THORACIC|3250.05|3250.05||
125|22554|22554 - ARTHRD ANT MIN DISCECT INTERBODY CERV BELOW C2|3308.51|3308.51||
125|22552|22552 - ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC|673.39|673.39||
125|22551|22551 - ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2|2851.98|2851.98||
125|22548|22548 - ARTHRD ANT TRANSORL/XTRORAL C1-C2 W/WO EXC ODNTD|3455.12|3455.12||
125|22534|22534 - ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR|1766.13|1766.13||
125|22533|22533 - ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR|4328.88|4328.88||
125|22532|22532 - ARTHRODESIS LATERAL EXTRACAVITARY THORACIC|4624.71|4624.71||
125|22527|22527 - PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL|2382.04|2382.04||
125|22526|22526 - PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LEVEL|2948.26|2948.26||
125|22515|22515 - PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH|6501.89|6501.89||
125|22514|22514 - PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR|10750.27|10750.27||
125|22513|22513 - PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION|10806.05|10806.05||
125|22512|22512 - VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL|1463.35|1463.35||
125|22511|22511 - PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL|2551.85|2551.85||
125|22510|22510 - PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC|2588.13|2588.13||
125|22505|22505 - MANIPULATION SPINE REQUIRING ANESTHESIA|199.69|199.69||
125|22328|22328 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA|667.52|667.52||
125|22327|22327 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH|2437.93|2437.93||
125|22326|22326 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR|2473.86|2473.86||
125|22325|22325 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM|2126.3|2126.3||
125|22319|22319 - OPTX&/RDCTJ ODNTD FX&/DISLC ANT W/INT FIXJ|4157.37|4157.37||
125|22318|22318 - OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT|3573.01|3573.01||
125|22315|22315 - CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ|908.76|908.76||
125|22310|22310 - CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING|396.97|396.97||
125|22226|22226 - OSTEOT SPI W/DSKC ANT APPR 1 VRT SGM EA VRT SGM|917.02|917.02||
125|22224|22224 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM LMBR|3228.3|3228.3||
125|22222|22222 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM THRC|3144.82|3144.82||
125|22220|22220 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM CRV|3284.86|3284.86||
125|22216|22216 - OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM|892.01|892.01||
125|22214|22214 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR|3170.44|3170.44||
125|22212|22212 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC|3241.62|3241.62||
125|22210|22210 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV|3278.48|3278.48||
125|22208|22208 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM|1002.38|1002.38||
125|22207|22207 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR|4001.52|4001.52||
125|22206|22206 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC|4068.14|4068.14||
125|22116|22116 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA|335.54|335.54||
125|22114|22114 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR|1332.92|1332.92||
125|22112|22112 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC|1425.79|1425.79||
125|22110|22110 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV|1418.88|1418.88||
125|22103|22103 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA|302.88|302.88||
125|22102|22102 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR|909.05|909.05||
125|22101|22101 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC|1001|1001||
125|22100|22100 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV|980.88|980.88||
125|22015|22015 - I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC|1317.57|1317.57||
125|22010|22010 - I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR|1328.68|1328.68||
125|21936|21936 - RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>|2341.98|2341.98||
125|21935|21935 - RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM|1695.7|1695.7||
125|21933|21933 - EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>|1213.86|1213.86||
125|21932|21932 - EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM|1087.18|1087.18||
125|21931|21931 - EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>|772.03|772.03||
125|21930|21930 - EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM|550.52|550.52||
125|21925|21925 - BIOPSY SOFT TISSUE BACK/FLANK DEEP|495.08|495.08||
125|21920|21920 - BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL|206.72|206.72||
125|21825|21825 - OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION|1029.34|1029.34||
125|21820|21820 - CLOSED TREATMENT STERNUM FRACTURE|212.14|212.14||
125|21813|21813 - OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS|1659.65|1659.65||
125|21812|21812 - OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS|1215.54|1215.54||
125|21811|21811 - OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS|998.88|998.88||
125|21750|21750 - CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX|1096.19|1096.19||
125|21743|21743 - REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC|3092.39|3092.39||
125|21742|21742 - REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC|2350.49|2350.49||
125|21740|21740 - REPAIR PECTUS EXCAVATUM/CARINATUM OPEN|1735.81|1735.81||
125|21725|21725 - DIVISION STERNOCLEIDOMASTOID OPEN W/CAST|887.52|887.52||
125|21720|21720 - DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST|759.06|759.06||
125|21705|21705 - DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB|1158.15|1158.15||
125|21700|21700 - DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB|876.44|876.44||
125|21685|21685 - HYOID MYOTOMY & SUSPENSION|1608.6|1608.6||
125|21632|21632 - RADICAL RESECTION STERNUM W/MEDSTNL LMPHADEC|2646.44|2646.44||
125|21630|21630 - RADICAL RESECTION STERNUM|2100.36|2100.36||
125|21627|21627 - STERNAL DEBRIDEMENT|1470.74|1470.74||
125|21620|21620 - OSTECTOMY STERNUM PARTIAL|1193.95|1193.95||
125|21616|21616 - EXCISION 1ST &/CERVICAL RIB W/SYMPATHECTOMY|1539.33|1539.33||
125|21615|21615 - EXCISION 1ST &/CERVICAL RIB|1503.69|1503.69||
125|21610|21610 - COSTOTRANSVERSECTOMY SEPARATE PROCEDURE|1087.78|1087.78||
125|21600|21600 - EXCISION RIB PARTIAL|810.95|810.95||
125|21558|21558 - RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>|2212.46|2212.46||
125|21557|21557 - RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM|2572.85|2572.85||
125|21556|21556 - EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM|587.43|587.43||
125|21555|21555 - EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM|394.21|394.21||
125|21554|21554 - EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>|1200.2|1200.2||
125|21552|21552 - EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>|732.2|732.2||
125|21550|21550 - BIOPSY SOFT TISSUE NECK/THORAX|218.24|218.24||
125|21510|21510 - INCISION DEEP OPENING BONE CORTEX THORAX|554.6|554.6||
125|21502|21502 - I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI|701.18|701.18||
125|21501|21501 - I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX|420.68|420.68||
125|21497|21497 - INTERDENTAL WIRING OTHER THAN FRACTURE|743.83|743.83||
125|21494|21494 - TREAT HYOID BONE FX -  W/MANIPULATION|676.1|676.1||
125|21493|21493 - TREAT HYOID BONE FX -  W/O MANIPUL|156.51|156.51||
125|21490|21490 - OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION|1442.38|1442.38||
125|21485|21485 - CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ|474.96|474.96||
125|21480|21480 - CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ|149.62|149.62||
125|21470|21470 - OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION|2106.3|2106.3||
125|21465|21465 - OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE|1987.25|1987.25||
125|21462|21462 - OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION|1433.03|1433.03||
125|21461|21461 - OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION|1382.92|1382.92||
125|21454|21454 - OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION|1362.45|1362.45||
125|21453|21453 - CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION|1153.49|1153.49||
125|21452|21452 - PERCUTANEOUS TX MANDIBULAR FX W/EXTERNAL FIXJ|874.45|874.45||
125|21451|21451 - CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION|1112.53|1112.53||
125|21450|21450 - CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION|838.82|838.82||
125|21445|21445 - OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX|923.08|923.08||
125|21440|21440 - CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX|603.95|603.95||
125|21436|21436 - OPTX CRNFCL SEP LFT III TYP COMP INT FIXJ W/BONE|3155.91|3155.91||
125|21435|21435 - OPEN TX CRANIOFACIAL SEP COMP W/INT&/XTRNL FIX|2733.79|2733.79||
125|21433|21433 - OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR|2858.77|2858.77||
125|21432|21432 - OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ|1448.34|1448.34||
125|21431|21431 - CLOSED TX CRANIOFACIAL SEPARATION|930.3|930.3||
125|21423|21423 - OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR|1473.72|1473.72||
125|21422|21422 - OPEN TREATMENT PALATAL/MAXILLARY FRACTURE|1261.14|1261.14||
125|21421|21421 - CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT|870.49|870.49||
125|21408|21408 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT|1564.94|1564.94||
125|21407|21407 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT|1053.42|1053.42||
125|21406|21406 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT|1118.14|1118.14||
125|21401|21401 - CLOSED TX FX ORBIT EXCEPT BLOWOUT W/MANIPULATION|432.85|432.85||
125|21400|21400 - CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION|253.77|253.77||
125|21395|21395 - OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF|1727.45|1727.45||
125|21390|21390 - OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC|1436.96|1436.96||
125|21387|21387 - OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR|1782.12|1782.12||
125|21386|21386 - OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL|1596.89|1596.89||
125|21385|21385 - OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL|1281.32|1281.32||
125|21366|21366 - OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT|2187.28|2187.28||
125|21365|21365 - OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG|1872.5|1872.5||
125|21360|21360 - OPEN TX DEPRESSED MALAR FRACTURE|977.1|977.1||
125|21356|21356 - OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE|649.49|649.49||
125|21355|21355 - PERCUTANEOUS TX MALAR AREA FRACTURE|394.35|394.35||
125|21348|21348 - OPTX NASOMAX CPLX FX LEFT II TYPE W/BONE GRAFT|2202.42|2202.42||
125|21347|21347 - OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN|1537.06|1537.06||
125|21346|21346 - OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ|1722.82|1722.82||
125|21345|21345 - CLOSED TX NASOMAXILLARY COMPLEX FRACTURE|1481.55|1481.55||
125|21344|21344 - OPEN TX COMPLICATED FRONTAL SINUS FRACTURE|1909.95|1909.95||
125|21343|21343 - OPEN TX DEPRESSED FRONTAL SINUS FRACTURE|1573.7|1573.7||
125|21340|21340 - PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE|1459.04|1459.04||
125|21339|21339 - OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION|1076.02|1076.02||
125|21338|21338 - OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION|872.68|872.68||
125|21337|21337 - CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION|367.28|367.28||
125|21336|21336 - OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION|631.57|631.57||
125|21335|21335 - OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM|1196.26|1196.26||
125|21330|21330 - OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI|913.17|913.17||
125|21325|21325 - OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED|581.64|581.64||
125|21320|21320 - CLOSED TREATMENT NASAL FRACTURE W/STABILIZATION|342.4|342.4||
125|21315|21315 - CLOSED TX NASAL FRACTURE W/O STABILIZATION|225.24|225.24||
125|21310|21310 - CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION|150.31|150.31||
125|21296|21296 - REDUCTION MASSETER MUSCLE & BONE INTRAORAL|1163.34|1163.34||
125|21295|21295 - REDUCTION MASSETER MUSCLE & BONE EXTRAORAL|754.64|754.64||
125|21282|21282 - LATERAL CANTHOPEXY|810.46|810.46||
125|21280|21280 - MEDIAL CANTHOPEXY SEPARATE PROCEDURE|1033.81|1033.81||
125|21275|21275 - SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ|3386.14|3386.14||
125|21270|21270 - MALAR AUGMENTATION PROSTHETIC MATERIAL|1627.01|1627.01||
125|21268|21268 - ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC|5931.97|5931.97||
125|21267|21267 - ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL|5073.2|5073.2||
125|21263|21263 - PERIORBITAL OSTEOTOMIES W/BONE GRAFTS W/FOREHEAD|5961.58|5961.58||
125|21261|21261 - PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA & XTR|4116.92|4116.92||
125|21260|21260 - PERIORBITAL OSTEOTOMIES BONE GRAFTS EXTRACRANIAL|3265.52|3265.52||
125|21256|21256 - RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS|3644.46|3644.46||
125|21255|21255 - RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG|2616.93|2616.93||
125|21249|21249 - RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE|4023.1|4023.1||
125|21248|21248 - RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL|2652.24|2652.24||
125|21247|21247 - RCNSTJ MNDBLR CONDYLE W/BONE CARTLG AUTOGRAFTS|3021.39|3021.39||
125|21246|21246 - RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE|2965.12|2965.12||
125|21245|21245 - RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL|2906.78|2906.78||
125|21244|21244 - RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE|2712.54|2712.54||
125|21243|21243 - ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT|3132.09|3132.09||
125|21242|21242 - ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT|2556.35|2556.35||
125|21240|21240 - ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT|2354|2354||
125|21235|21235 - GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR|1002.32|1002.32||
125|21230|21230 - GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR|1435.67|1435.67||
125|21215|21215 - GRAFT BONE MANDIBLE|1993.31|1993.31||
125|21210|21210 - GRAFT BONE NASAL/MAXILLARY/MALAR AREAS|1827.17|1827.17||
125|21209|21209 - OSTEOPLASTY FACIAL BONES REDUCTION|1086.32|1086.32||
125|21208|21208 - OSTEOPLASTY FACIAL BONES AUGMENTATION|1549.71|1549.71||
125|21206|21206 - OSTEOTOMY MAXILLA SEGMENTAL|2752.77|2752.77||
125|21199|21199 - OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT|4606.49|4606.49||
125|21198|21198 - OSTEOTOMY MANDIBLE SEGMENTAL|1927.41|1927.41||
125|21196|21196 - RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI|2568|2568||
125|21195|21195 - RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD|1956.5|1956.5||
125|21194|21194 - RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT|3331.33|3331.33||
125|21193|21193 - RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF|2930.56|2930.56||
125|21188|21188 - RCNSTJ MDFC OTH/THN LEFORT OSTEOT & BONE GRAFTS|3287.09|3287.09||
125|21184|21184 - RCNSTJ ORBIT/FHD/NASETHMD EXC BONE TUM GRF>80SQ|5233.93|5233.93||
125|21183|21183 - RCNSTJ ORBIT/FHD/NASETHMD EXC BONE GRF>40 <80|4832.75|4832.75||
125|21182|21182 - RCNSTJ ORBIT/FHD/NASETHMD EXCBONE TUM GRF<40SQCM|4422.14|4422.14||
125|21181|21181 - RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC|1304.55|1304.55||
125|21180|21180 - RCNSTJ FOREHEAD &/ SUPRAORBITAL RIMS W/AUTOGRAFT|3779.34|3779.34||
125|21179|21179 - RCNSTJ FOREHEAD &/ SUPRAORB RIMS W/ALGRF/PROSTC|3354.44|3354.44||
125|21175|21175 - RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD|4438.31|4438.31||
125|21172|21172 - RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD|3218.46|3218.46||
125|21160|21160 - RCNSTJ MIDFACE LEFORT III W/FHD W/LEFORT I|6798.38|6798.38||
125|21159|21159 - RCNSTJ MIDFACE LEFORT III W/FHD W/O LEFORT I|6018.32|6018.32||
125|21155|21155 - RCNSTJ MIDFACE LEFORT III W/LEFORT I|4902.49|4902.49||
125|21154|21154 - RCNSTJ MIDFACE LEFORT III W/O LEFORT I|4338.45|4338.45||
125|21151|21151 - RCNSTJ MIDFACE LEFORT II W/BONE GRAFTS|3988.59|3988.59||
125|21150|21150 - RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION|3458.27|3458.27||
125|21147|21147 - RCNSTJ MIDFACE LEFORT I 3/> PIECE W/BONE GRAFTS|3405.9|3405.9||
125|21146|21146 - RCNSTJ MIDFACE LEFORT I 2 PIECES W/BONE GRAFTS|3179.98|3179.98||
125|21145|21145 - RCNSTJ MIDFACE LEFORT I 1 PIECE W/BONE GRAFTS|2919.79|2919.79||
125|21143|21143 - RCNSTJ MIDFACE LEFORT I 3/> PIECE W/O BONE GRAFT|3068.09|3068.09||
125|21142|21142 - RCNSTJ MIDFACE LEFORT I 2 PIECES W/O BONE GRAFT|2958.07|2958.07||
125|21141|21141 - RCNSTJ MIDFACE LEFORT I 1 PIECE W/O BONE GRAFT|2830.82|2830.82||
125|21139|21139 - RDCTJ FHD CNTRG & SETBACK ANT FRONTAL SINUS WALL|2222.79|2222.79||
125|21138|21138 - RDCTJ FHD CNTRG & PROSTHETIC MATRL/BONE GRAFT|1991.57|1991.57||
125|21137|21137 - REDUCTION FOREHEAD CONTOURING ONLY|1541.02|1541.02||
125|21127|21127 - AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL|2040.4|2040.4||
125|21125|21125 - AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL|2434.96|2434.96||
125|21123|21123 - GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS|1930.26|1930.26||
125|21122|21122 - GENIOPLASTY 2/> SLIDING OSTEOTOMIES|1603.15|1603.15||
125|21121|21121 - GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE|1283.59|1283.59||
125|21120|21120 - GENIOPLASTY AUGMENTATION|857.81|857.81||
125|21116|21116 - INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY|256.8|256.8||
125|21110|21110 - APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC|617.39|617.39||
125|21100|21100 - APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX|596.8|596.8||
125|21088|21088 - IMPRESSION & PREPARATION FACIAL PROSTHESIS|1129.24|1129.24||
125|21087|21087 - IMPRESSION & PREPARATION NASAL PROSTHESIS|2933.51|2933.51||
125|21086|21086 - IMPRESSION & PREPARATION AURICULAR PROSTHESIS|3005.22|3005.22||
125|21085|21085 - IMPRESSION & PREPARATION ORAL SURGICAL SPLINT|1179.53|1179.53||
125|21084|21084 - IMPRESSION & PREPARATION SPEECH AID PROSTHESIS|2715.85|2715.85||
125|21083|21083 - IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS|2327.76|2327.76||
125|21082|21082 - IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES|2456.54|2456.54||
125|21081|21081 - IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES|2758.5|2758.5||
125|21080|21080 - IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES|3026.7|3026.7||
125|21079|21079 - IMPRESSION & PREPARATION INTERIM OBTURATOR PROST|2694.91|2694.91||
125|21077|21077 - IMPRESSION & PREPARATION ORBITAL PROSTHESIS|4687.6|4687.6||
125|21076|21076 - IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES|1863.94|1863.94||
125|21073|21073 - MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA|608.23|608.23||
125|21070|21070 - CORONOIDECTOMY SEPARATE PROCEDURE|1396.32|1396.32||
125|21060|21060 - MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX|1913.84|1913.84||
125|21050|21050 - CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX|2107.46|2107.46||
125|21049|21049 - EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC|3758.01|3758.01||
125|21048|21048 - EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT|3413.64|3413.64||
125|21047|21047 - EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB|3758.01|3758.01||
125|21046|21046 - EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT|3413.64|3413.64||
125|21045|21045 - EXCISION MALIGNANT TUMOR MANDIBLE RADICAL|2320.73|2320.73||
125|21044|21044 - EXCISION MALIGNANT TUMOR MANDIBLE|1438.04|1438.04||
125|21040|21040 - EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT|481.5|481.5||
125|21034|21034 - EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA|1496.87|1496.87||
125|21032|21032 - EXCISION MAXILLARY TORUS PALATINUS|508.76|508.76||
125|21031|21031 - EXCISION TORUS MANDIBULARIS|386.69|386.69||
125|21030|21030 - EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG|876.6|876.6||
125|21029|21029 - REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE|1274.47|1274.47||
125|21026|21026 - EXCISION FACIAL BONE|1086.99|1086.99||
125|21025|21025 - EXCISION BONE MANDIBLE|1212.98|1212.98||
125|21016|21016 - RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>|1656.37|1656.37||
125|21015|21015 - RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM|722.79|722.79||
125|21014|21014 - EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>|848.51|848.51||
125|21013|21013 - EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM|824.67|824.67||
125|21012|21012 - EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>|550.22|550.22||
125|21011|21011 - EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM|546.02|546.02||
125|21010|21010 - ARTHROTOMY TEMPOROMANDIBULAR JOINT|1506.84|1506.84||
125|20985|20985 - CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS|244.65|244.65||
125|20983|20983 - ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD|9050.28|9050.28||
125|20982|20982 - ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE|4239.56|4239.56||
125|20979|20979 - LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE|243.49|243.49||
125|20975|20975 - ELECTRICAL STIMULATION BONE HEALING INVASIVE|579.04|579.04||
125|20974|20974 - ELECTRICAL STIMULATION BONE HEALING NONINVASIVE|270.51|270.51||
125|20973|20973 - FR OSTQ FLAP W/MVASC ANAST GRT TOE W/WEB SPACE|5017.47|5017.47||
125|20972|20972 - FREE OSTQ FLAP W/MVASC ANASTOMOSIS METATARSAL|4691.1|4691.1||
125|20970|20970 - FREE OSTQ FLAP W/MVASC ANASTOMOSIS ILIAC CREST|4700.51|4700.51||
125|20969|20969 - FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE|4762.5|4762.5||
125|20962|20962 - BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR|3376.19|3376.19||
125|20957|20957 - BONE GRAFT MICROVASCULAR ANAST METATARSAL|3969.9|3969.9||
125|20956|20956 - BONE GRAFT MICROVASCULAR ANAST ILIAC CREST|3859.58|3859.58||
125|20955|20955 - BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA|3980.79|3980.79||
125|20950|20950 - MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME|303.17|303.17||
125|20939|20939 - BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY|111.15|111.15||
125|20938|20938 - AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC|478.32|478.32||
125|20937|20937 - AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION|419.71|419.71||
125|20936|20936 - AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION|533.76|533.76||
125|20931|20931 - ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL|272.85|272.85||
125|20930|20930 - ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED|231.42|231.42||
125|20926|20926 - TISSUE GRAFTS OTHER|513.87|513.87||
125|20924|20924 - TENDON GRAFT FROM A DISTANCE|852.92|852.92||
125|20922|20922 - FASCIA LATA GRAFT INCISION & AREA EXPOSURE|605.88|605.88||
125|20920|20920 - FASCIA LATA GRAFT BY STRIPPER|489.31|489.31||
125|20912|20912 - CARTILAGE GRAFT NASAL SEPTUM|642.57|642.57||
125|20910|20910 - CARTILAGE GRAFT COSTOCHONDRAL|489.11|489.11||
125|20902|20902 - BONE GRAFT ANY DONOR AREA MAJOR/LARGE|861.17|861.17||
125|20900|20900 - BONE GRAFT ANY DONOR AREA MINOR/SMALL|563.41|563.41||
125|20838|20838 - REPLANTATION FOOT COMPLETE AMPUTATION|4536.54|4536.54||
125|20827|20827 - RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION|2953.76|2953.76||
125|20824|20824 - RPLJ THMB CARP/MTCRPL JT MP JT COMPL AMPUTATION|3444.99|3444.99||
125|20822|20822 - RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP|2440.67|2440.67||
125|20816|20816 - RPLJ DGT EXCEPT THMB MTCARPHLNGL JT COMPL AMP|3461|3461||
125|20808|20808 - REPLANTATION HAND COMPLETE AMPUTATION|6850.58|6850.58||
125|20805|20805 - REPLANTATION FOREARM COMPLETE AMPUTATION|5477.48|5477.48||
125|20802|20802 - REPLANTATION ARM COMPLETE AMPUTATION|4451|4451||
125|20697|20697 - XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT|3189.21|3189.21||
125|20696|20696 - XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ|1967.13|1967.13||
125|20694|20694 - REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES|477.18|477.18||
125|20693|20693 - ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES|612.95|612.95||
125|20692|20692 - APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM|803.87|803.87||
125|20690|20690 - APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM|525.08|525.08||
125|20680|20680 - REMOVAL IMPLANT DEEP|489.97|489.97||
125|20670|20670 - REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE|493.87|493.87||
125|20665|20665 - REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL|137.07|137.07||
125|20664|20664 - APPL HALO 6/> PINS THIN SKULL OSTEOLOGY|957.52|957.52||
125|20663|20663 - APPLICATION HALO FEMORAL INCLUDING REMOVAL|508.6|508.6||
125|20662|20662 - APPLICATION HALO PELVIC INCLUDING REMOVAL|643|643||
125|20661|20661 - APPLICATION HALO CRANIAL INCLUDING REMOVAL|724.39|724.39||
125|20660|20660 - APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX|366.66|366.66||
125|20650|20650 - INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX|236.02|236.02||
125|20615|20615 - ASPIRATION & INJECTION TREATMENT BONE CYST|225.82|225.82||
125|20612|20612 - ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ|96.34|96.34||
125|20611|20611 - ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US|144.16|144.16||
125|20610|20610 - ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US|86.19|86.19||
125|2060F|2060F - PT INTRVWD BY EVAL CLINICIAN </DATE DIAG MDD|0.01|0.01||
125|20606|20606 - ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US|127.43|127.43||
125|20605|20605 - ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US|91.54|91.54||
125|20604|20604 - ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT|114.44|114.44||
125|20600|20600 - ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US|74.37|74.37||
125|20555|20555 - PLACEMENT NEEDLES MUSCLE SUBSEQUENT RADIOELEMENT|537.64|537.64||
125|20553|20553 - INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES|62.55|62.55||
125|20552|20552 - INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES|111.29|111.29||
125|20551|20551 - INJECTION SINGLE TENDON ORIGIN/INSERTION|85.64|85.64||
125|20550|20550 - INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS|85.12|85.12||
125|20527|20527 - INJECTION ENZYME PALMAR FASCIAL CORD|134.9|134.9||
125|20526|20526 - INJECTION THERAPEUTIC CARPAL TUNNEL|122.02|122.02||
125|20525|20525 - RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP|487.61|487.61||
125|20520|20520 - REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE|193.99|193.99||
125|2050F|2050F - WOUND CHARACTERISTICS DOCD PRIOR DEBRIDEMENT|0.01|0.01||
125|20501|20501 - INJECTION SINUS TRACT DIAGNOSTIC|139.86|139.86||
125|20500|20500 - INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC|263.24|263.24||
125|2044F|2044F - DOC MNTL HLTH ASSES PRIOR INTVN BACK PAIN 6WKS|0.01|0.01||
125|2040F|2040F - PHYS EXAM ON DATE OF INIT VST FOR LBP DONE|0.01|0.01||
125|2035F|2035F - TYMPANIC MEMBRANE MOBILITY ASSESS|0.01|0.01||
125|2031F|2031F - HYDRATION STATUS DOCUMENTED DEHYDRATED|0.01|0.01||
125|2030F|2030F - HYDRATION STATUS DOCD NORMALLY HYDRATED|0.01|0.01||
125|2029F|2029F - COMPLETE PHYSICAL SKIN EXAM PERFORMED|0.01|0.01||
125|2028F|2028F - FOOT EXAMINATION PERFORMED|0.01|0.01||
125|2027F|2027F - OPTIC NERVE HEAD EVALUATION PERFORMED|0.01|0.01||
125|2026F|2026F - EYE IMG VALID MATCH DX 7 STND FLD W/EVC RTNOPTHY|0.01|0.01||
125|20251|20251 - BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL|1058.39|1058.39||
125|20250|20250 - BIOPSY VERTEBRAL BODY OPEN THORACIC|1011.64|1011.64||
125|2024F|2024F - 7 STANDARD FLD RETINAL PHOTO W/EVC RTNOPTHY|0.01|0.01||
125|20245|20245 - BIOPSY BONE OPEN DEEP|598.24|598.24||
125|20240|20240 - BIOPSY BONE OPEN SUPERFICIAL|332.96|332.96||
125|2022F|2022F - DILATED RETINAL EXAM W/EVIDENCE OF RETINOPATHY|0.01|0.01||
125|20225|20225 - BIOPSY BONE TROCAR/NEEDLE DEEP|958.91|958.91||
125|20220|20220 - BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL|221.96|221.96||
125|2021F|2021F - DILATED MACULAR OR FUNDUS EXAM PERFORMED|0.01|0.01||
125|2020F|2020F - DILATED FUNDUS EVALUATION PERFORMED|0.01|0.01||
125|20206|20206 - BIOPSY MUSCLE PERCUTANEOUS NEEDLE|275.36|275.36||
125|20205|20205 - BIOPSY MUSCLE DEEP|303.97|303.97||
125|20200|20200 - BIOPSY MUSCLE SUPERFICIAL|175.8|175.8||
125|2019F|2019F - DILATED MACULAR EXAM PERFORMED|0.01|0.01||
125|2018F|2018F - HYDRATION STATUS ASSESSED|0.01|0.01||
125|2016F|2016F - ASTHMA RISK ASSESSED|0.01|0.01||
125|2015F|2015F - ASTHMA IMPAIRMENT ASSESSED|0.01|0.01||
125|20150|20150 - EXCISION EPIPHYSEAL BAR|1503.92|1503.92||
125|2014F|2014F - MENTAL STATUS ASSESSED|0.01|0.01||
125|2010F|2010F - VITAL SIGNS RECORDED|0.01|0.01||
125|20103|20103 - EXPLORATION PENETRATING WOUND SPX EXTREMITY|639.41|639.41||
125|20102|20102 - EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK|448.86|448.86||
125|20101|20101 - EXPLORATION PENETRATING WOUND SPX CHEST|753.07|753.07||
125|20100|20100 - EXPLORATION PENETRATING WOUND SPX NECK|1010.76|1010.76||
125|2004F|2004F - INITIAL EXAMINATION INVOLVED JOINTS|0.01|0.01||
125|2002F|2002F - CLINICAL SIGNS VOLUME OVERLOAD ASSESSED|0.01|0.01||
125|2001F|2001F - WEIGHT RECORDED|0.01|0.01||
125|2000F|2000F - BLOOD PRESSURE MEASURED|0.01|0.01||
125|20005|20005 - I&D SOFT TISSUE ABSCESS SUBFASC|344.52|344.52||
125|19396|19396 - PREPARATION MOULAGE CUSTOM BREAST IMPLANT|303.31|303.31||
125|19380|19380 - REVISION RECONSTRUCTED BREAST|1391|1391||
125|19371|19371 - PERIPROSTHETIC CAPSULECTOMY BREAST|1170.58|1170.58||
125|19370|19370 - OPEN PERIPROSTHETIC CAPSULOTOMY BREAST|1118.75|1118.75||
125|19369|19369 - BREAST RECONSTRUCTION TRAM FLAP DOUBLE PEDICLE|3373.44|3373.44||
125|19368|19368 - BREAST RECONSTRUCTION TRAM 1 PEDCL MVASC ANAST|4228.24|4228.24||
125|19367|19367 - BREAST RECONSTRUCTION TRAM FLAP 1 PEDICLE|3098.99|3098.99||
125|19366|19366 - BREAST RECONSTRUCTION OTHER TECHNIQUE|2141.93|2141.93||
125|19364|19364 - BREAST RECONSTRUCTION FREE FLAP|3582.75|3582.75||
125|19361|19361 - BRST RCNSTJ W/LATSMS D/SI FLAP WO PRSTHC IMPL|2916.82|2916.82||
125|19357|19357 - BRST RCNSTJ IMMT/DLYD W/TISS EXPANDER SBSQ XPNSJ|2168.89|2168.89||
125|19355|19355 - CORRECTION INVERTED NIPPLES|794.65|794.65||
125|19350|19350 - NIPPLE/AREOLA RECONSTRUCTION|1177|1177||
125|19342|19342 - DLYD INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ|1691.07|1691.07||
125|19340|19340 - IMMT INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ|1007.14|1007.14||
125|19330|19330 - REMOVAL MAMMARY IMPLANT MATERIAL|769.86|769.86||
125|19328|19328 - REMOVAL INTACT MAMMARY IMPLANT|604.95|604.95||
125|19325|19325 - MAMMAPLASTY AUGMENTATION W/PROSTHETIC IMPLANT|1182.31|1182.31||
125|19324|19324 - MAMMAPLASTY AUGMENTATION W/O PROSTHETIC IMPLANT|792.68|792.68||
125|19318|19318 - REDUCTION MAMMAPLASTY|2884.71|2884.71||
125|19316|19316 - MASTOPEXY|1526.3|1526.3||
125|19307|19307 - MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN|2046.78|2046.78||
125|19306|19306 - MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES|1939.51|1939.51||
125|19305|19305 - MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES|1720.35|1720.35||
125|19304|19304 - MASTECTOMY SUBCUTANEOUS|926.81|926.81||
125|19303|19303 - MASTECTOMY SIMPLE COMPLETE|1795.28|1795.28||
125|19302|19302 - MASTECTOMY PARTIAL W/AXILLARY LYMPHADENECTOMY|1974.59|1974.59||
125|19301|19301 - MASTECTOMY PARTIAL|909.23|909.23||
125|19300|19300 - MASTECTOMY GYNECOMASTIA|615.74|615.74||
125|19298|19298 - PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST|1768.01|1768.01||
125|19297|19297 - PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST|99.3|99.3||
125|19296|19296 - PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST|4645.92|4645.92||
125|19294|19294 - PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY|272.49|272.49||
125|19288|19288 - PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID|1050.05|1050.05||
125|19287|19287 - PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID|1306.22|1306.22||
125|19286|19286 - PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE|685.94|685.94||
125|19285|19285 - PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG|788.85|788.85||
125|19284|19284 - PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC|313.74|313.74||
125|19283|19283 - PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE|421.24|421.24||
125|19282|19282 - PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE|256.89|256.89||
125|19281|19281 - PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE|373.99|373.99||
125|19272|19272 - EXC CHEST TUMOR W/RCNSTJ W/MEDSTNL LMPHADEC|2568.6|2568.6||
125|19271|19271 - EXC CHEST TUMOR W/RCNSTJ W/O MEDSTNL LMPHADEC|2412.02|2412.02||
125|19260|19260 - EXCISION CHEST WALL TUMOR INCLUDING RIBS|1492.44|1492.44||
125|19126|19126 - EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL|261.41|261.41||
125|19125|19125 - EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES|749.73|749.73||
125|19120|19120 - EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION|696.04|696.04||
125|19112|19112 - EXCISION LACTIFEROUS DUCT FISTULA|477.66|477.66||
125|19110|19110 - NIPPLE EXPLORATION|642.27|642.27||
125|19105|19105 - ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA|2714.19|2714.19||
125|19101|19101 - BIOPSY BREAST OPEN INCISIONAL|392.96|392.96||
125|19100|19100 - BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX|138.03|138.03||
125|19086|19086 - BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID|1231.53|1231.53||
125|19085|19085 - BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID|1529.25|1529.25||
125|19084|19084 - BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID|831.66|831.66||
125|19083|19083 - BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID|1028.79|1028.79||
125|19082|19082 - BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID|866.83|866.83||
125|19081|19081 - BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID|1058.72|1058.72||
125|19030|19030 - INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM|184.25|184.25||
125|19020|19020 - MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP|387.99|387.99||
125|19001|19001 - PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST|50.12|50.12||
125|19000|19000 - PUNCTURE ASPIRATION CYST BREAST|108.02|108.02||
125|17380|17380 - ELECTROLYSIS EPILATION EACH 30 MINUTES|56.93|56.93||
125|17360|17360 - CHEMICAL EXFOLIATION ACNE|111.84|111.84||
125|17340|17340 - CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE|47.83|47.83||
125|17315|17315 - MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE|73.54|73.54||
125|17314|17314 - MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE|411.97|411.97||
125|17313|17313 - MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS|676.65|676.65||
125|17312|17312 - MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE|444.83|444.83||
125|17311|17311 - MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS|742.06|742.06||
125|17286|17286 - DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM|552.12|552.12||
125|17284|17284 - DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM|415.96|415.96||
125|17283|17283 - DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM|349.36|349.36||
125|17282|17282 - DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM|284.62|284.62||
125|17281|17281 - DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM|235.67|235.67||
125|17280|17280 - DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<|174.68|174.68||
125|17276|17276 - DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM|418.9|418.9||
125|17274|17274 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM|359.25|359.25||
125|17273|17273 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM|287.3|287.3||
125|17272|17272 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM|245.03|245.03||
125|17271|17271 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM|201.43|201.43||
125|17270|17270 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>|165.58|165.58||
125|17266|17266 - DESTRUCTION MAL LESION TRUNK/ARM/LEG > 4.0 CM|347.48|347.48||
125|17264|17264 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM|281.41|281.41||
125|17263|17263 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM|250.65|250.65||
125|17262|17262 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM|211.06|211.06||
125|17261|17261 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM|159.16|159.16||
125|17260|17260 - DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<|127.6|127.6||
125|17250|17250 - CHEMICAL CAUTERIZATION OF GRANULATION TISSUE|65.87|65.87||
125|17111|17111 - DESTRUCTION BENIGN LESIONS 15/>|99|99||
125|17110|17110 - DESTRUCTION BENIGN LESIONS UP TO 14|86.25|86.25||
125|17108|17108 - DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM|1391.27|1391.27||
125|17107|17107 - DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM|809.19|809.19||
125|17106|17106 - DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM|411.95|411.95||
125|17004|17004 - DESTRUCTION PREMALIGNANT LESION 15/>|267.54|267.54||
125|17003|17003 - DESTRUCTION PREMALIGNANT LESION 2-14 EA|20.37|20.37||
125|17000|17000 - DESTRUCTION PREMALIGNANT LESION 1ST|71.68|71.68||
125|16036|16036 - ESCHAROTOMY EACH ADDITIONAL INCISION|286.59|286.59||
125|16035|16035 - ESCHAROTOMY FIRST INCISION|523.8|523.8||
125|16030|16030 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE|176.59|176.59||
125|16025|16025 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM|148.77|148.77||
125|16020|16020 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL|81.72|81.72||
125|16015|16015 - BURN TREATMENT W/ANESTH -  MED/LARGE|267.54|267.54||
125|16010|16010 - BURN TREATMENT W/ANESTH -  SMALL|77.08|77.08||
125|16000|16000 - INITIAL TX 1ST DEGREE BURN LOCAL TX|80.3|80.3||
125|15958|15958 - EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC|1930.32|1930.32||
125|15956|15956 - EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN|1872.54|1872.54||
125|15953|15953 - EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY|1337.54|1337.54||
125|15952|15952 - EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE|1123.54|1123.54||
125|15951|15951 - EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY|1123.54|1123.54||
125|15950|15950 - EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR|642.04|642.04||
125|15946|15946 - EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN|2300.54|2300.54||
125|15945|15945 - EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY|1444.54|1444.54||
125|15944|15944 - EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE|1288.32|1288.32||
125|15941|15941 - EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT|1177.04|1177.04||
125|15940|15940 - EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE|802.54|802.54||
125|15937|15937 - EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC|1673.52|1673.52||
125|15936|15936 - EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR|1522.34|1522.34||
125|15935|15935 - EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY|1721.1|1721.1||
125|15934|15934 - EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR|1335.36|1335.36||
125|15933|15933 - EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY|1182.35|1182.35||
125|15931|15931 - EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE|741.24|741.24||
125|15922|15922 - EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR|1005.27|1005.27||
125|15920|15920 - EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR|685.87|685.87||
125|15879|15879 - SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY|284.49|284.49||
125|15878|15878 - SUCTION ASSISTED LIPECTOMY UPPER EXTREMITY|284.49|284.49||
125|15877|15877 - SUCTION ASSISTED LIPECTOMY TRUNK|284.49|284.49||
125|15876|15876 - SUCTION ASSISTED LIPECTOMY HEAD & NECK|284.49|284.49||
125|15860|15860 - IV INJECTION TEST VASCULAR FLOW FLAP/GRAFT|194.23|194.23||
125|15852|15852 - DRESSING CHANGE UNDER ANESTHESIA|104.21|104.21||
125|15851|15851 - REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON|103.15|103.15||
125|15850|15850 - REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON|89.38|89.38||
125|15847|15847 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN|584.11|584.11||
125|15845|15845 - GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR|2064.92|2064.92||
125|15842|15842 - GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG|3410.03|3410.03||
125|15841|15841 - GRAFT FACIAL NERVE PARALYSIS FREE MUSCLE GRAFT|2484.86|2484.86||
125|15840|15840 - GRAFT FACIAL NERVE PARALYSIS FREE FASCIAL GRAFT|1948.98|1948.98||
125|15839|15839 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA|741.63|741.63||
125|15838|15838 - EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD|831.72|831.72||
125|15837|15837 - EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND|949.43|949.43||
125|15836|15836 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM|1217.25|1217.25||
125|15835|15835 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK|1307.17|1307.17||
125|15834|15834 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP|1286.02|1286.02||
125|15833|15833 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG|1244.12|1244.12||
125|15832|15832 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH|1350.27|1350.27||
125|15830|15830 - EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY|1853.83|1853.83||
125|15829|15829 - RHYTIDECTOMY SMAS FLAP|6204.69|6204.69||
125|15828|15828 - RHYTIDECTOMY CHEEK CHIN & NECK|3743.18|3743.18||
125|15826|15826 - RHYTIDECTOMY GLABELLAR FROWN LINES|1219.18|1219.18||
125|15825|15825 - RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING|2421.35|2421.35||
125|15824|15824 - RHYTIDECTOMY FOREHEAD|1262.84|1262.84||
125|15823|15823 - BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN|929.83|929.83||
125|15822|15822 - BLEPHAROPLASTY UPPER EYELID|641.46|641.46||
125|15821|15821 - BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD|794.48|794.48||
125|15820|15820 - BLEPHAROPLASTY LOWER EYELID|718.5|718.5||
125|15819|15819 - CERVICOPLASTY|1007.02|1007.02||
125|15811|15811 - SALABRASION -  OVER 20 SQ CM|953.41|953.41||
125|15810|15810 - SALABRASION -  20 SQ CM OR LESS|699.23|699.23||
125|15793|15793 - CHEMICAL PEEL NONFACIAL DERMAL|384.09|384.09||
125|15792|15792 - CHEMICAL PEEL NONFACIAL EPIDERMAL|334.1|334.1||
125|15789|15789 - CHEMICAL PEEL FACIAL DERMAL|886.31|886.31||
125|15788|15788 - CHEMICAL PEEL FACIAL EPIDERMAL|663.84|663.84||
125|15787|15787 - ABRASION EACH ADDITIONAL 4 LESIONS OR LESS|53.93|53.93||
125|15786|15786 - ABRASION 1 LESION|207.23|207.23||
125|15783|15783 - DERMABRASION SUPERFICIAL ANY SITE|430.24|430.24||
125|15782|15782 - DERMABRASION REGIONAL OTHER THAN FACE|540.38|540.38||
125|15781|15781 - DERMABRASION SEGMENTAL FACE|486.27|486.27||
125|15780|15780 - DERMABRASION TOTAL FACE|892.44|892.44||
125|15777|15777 - IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT|357.87|357.87||
125|15776|15776 - PUNCH GRAFT HAIR TRANSPLANT >15 PUNCH GRAFTS|516.29|516.29||
125|15775|15775 - PUNCH GRAFT HAIR TRANSPLANT 1-15 PUNCH GRAFTS|361.09|361.09||
125|15770|15770 - GRAFT DERMA-FAT-FASCIA|1097.3|1097.3||
125|15760|15760 - GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA|1047.67|1047.67||
125|15758|15758 - FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS|4811.13|4811.13||
125|15757|15757 - FREE SKIN FLAP W/MICROVASCULAR ANASTOMOSIS|4517.19|4517.19||
125|15756|15756 - FREE MUSCLE/MYOCUTANEOUS FLAP W/MVASC ANAST|3856.32|3856.32||
125|15750|15750 - FLAP NEUROVASCULAR PEDICLE|1543.81|1543.81||
125|15740|15740 - FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY|1383.72|1383.72||
125|15738|15738 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR|1762.05|1762.05||
125|15736|15736 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR|1949.68|1949.68||
125|15734|15734 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK|2310.13|2310.13||
125|15733|15733 - MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL|1706.33|1706.33||
125|15732|15732 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP HEAD&NC|2003.31|2003.31||
125|15731|15731 - FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE|1391.88|1391.88||
125|15730|15730 - MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES|2432.37|2432.37||
125|15650|15650 - TRANSFER ANY PEDICLE FLAP ANY LOCATION|689.12|689.12||
125|15630|15630 - DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS|584.66|584.66||
125|15620|15620 - DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F|491.96|491.96||
125|15610|15610 - DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS|438.82|438.82||
125|15600|15600 - DELAY FLAP/SECTIONING FLAP TRUNK|384.81|384.81||
125|15576|15576 - FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL|858.04|858.04||
125|15574|15574 - FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F|934.75|934.75||
125|15572|15572 - FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS|896.11|896.11||
125|15570|15570 - FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK|914.29|914.29||
125|15351|15351 - APPLY SKIN ALLOGRAFT EA ADD 100 CM|93.13|93.13||
125|15350|15350 - APPLY SKIN ALLOGRAFT UP TO 100 CM|422.12|422.12||
125|15343|15343 - APPLY SKIN SUB/NEODRM ADD 25 SQ CM|91.67|91.67||
125|15342|15342 - APPLY BILAM SKIN SUB/NEODRM 25 SQCM|469.17|469.17||
125|15278|15278 - SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM ADL 100SQ CM|136.15|136.15||
125|15277|15277 - SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM 1ST 100SQ CM|526.73|526.73||
125|15276|15276 - SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM|55.79|55.79||
125|15275|15275 - SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM|237.41|237.41||
125|15274|15274 - APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM|113.56|113.56||
125|15273|15273 - APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM|480.52|480.52||
125|15272|15272 - APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC|43.62|43.62||
125|15271|15271 - APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25|223.62|223.62||
125|15261|15261 - FTH/GFT FREE W/DIR CLSR N/E/E/L EA 20 SQ CM/<|346.41|346.41||
125|15260|15260 - FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<|1102.37|1102.37||
125|15241|15241 - FTH/GT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA20CM/<|289.7|289.7||
125|15240|15240 - FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<|995.93|995.93||
125|15221|15221 - FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<|202.76|202.76||
125|15220|15220 - FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<|821.22|821.22||
125|15201|15201 - FTH/GFT FR W/DIR CLSR TRNK EA ADDL 20 CM/<|215.6|215.6||
125|15200|15200 - FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<|779.5|779.5||
125|15157|15157 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT EA 100 EA|305.61|305.61||
125|15156|15156 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM|275.85|275.85||
125|15155|15155 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<|1134.86|1134.86||
125|15152|15152 - CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA|258.63|258.63||
125|15151|15151 - CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM|210.31|210.31||
125|15150|15150 - CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<|1116.62|1116.62||
125|15136|15136 - DERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA|153.12|153.12||
125|15135|15135 - DERMAL AUTOGRAFT F/S/N/H/F/G/M/D GT 1ST 100|1315.34|1315.34||
125|15131|15131 - DERMAL AUTOGRAFT TRUNK/ARM/LEG EA 100 CM/EA|162|162||
125|15130|15130 - DERMAL AUTOGRAFT TRUNK/ARM/LEG 1ST 100 CM|1064.83|1064.83||
125|15121|15121 - SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %|381.72|381.72||
125|15120|15120 - SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %|1037.36|1037.36||
125|15116|15116 - EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM|260.88|260.88||
125|15115|15115 - EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<|1294.68|1294.68||
125|15111|15111 - EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD|198.44|198.44||
125|15110|15110 - EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD|1346.77|1346.77||
125|15101|15101 - SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD|215.34|215.34||
125|15100|15100 - SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD|865.47|865.47||
125|1505F|1505F - PATIENT DOES NOT HAVE RESPIRATORY INSUFFICIENCY|0.01|0.01||
125|15050|15050 - PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM|443.03|443.03||
125|1504F|1504F - PATIENT HAS RESPIRATORY INSUFFICIENCY|0.01|0.01||
125|15040|15040 - HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<|394.88|394.88||
125|1503F|1503F - PT QUERIED RE SYMP RESPIRATORY INSUFFICIENCY|0.01|0.01||
125|1502F|1502F - PT QUERIED RE PAIN W/FUNC USING RELIABLE INSTRM|0.01|0.01||
125|1501F|1501F - NOT INITIAL EVALUATION FOR CONDITION|0.01|0.01||
125|1500F|1500F - SYMP&SIGN DISTAL SYMM POLYNEUROPATHY REVWD&DOCD|0.01|0.01||
125|15005|15005 - PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT|137.11|137.11||
125|15004|15004 - PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT|434.99|434.99||
125|15003|15003 - PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT|80.68|80.68||
125|15002|15002 - PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT|359.95|359.95||
125|1494F|1494F - COGNITION ASSESSED AND REVIEWED|0.01|0.01||
125|1493F|1493F - DEMENTIA SEVERITY CLASSIFIED SEVERE|0.01|0.01||
125|1491F|1491F - DEMENTIA SEVERITY CLASSIFIED MODERATE|0.01|0.01||
125|1490F|1490F - DEMENTIA SEVERITY CLASSIFIED MILD|0.01|0.01||
125|1461F|1461F - NO QUAL CARD EVENT/DIAG IN PREVIOUS 12 MONTHS|0.01|0.01||
125|1460F|1460F - QUALIFYING CARD EVENT/DIAGNOSIS PRIOR 12 MONTHS|0.01|0.01||
125|1451F|1451F - SYMPTOMS SHOW CLIN IMPRTNT DROP SINCE ASSESSMENT|0.01|0.01||
125|1450F|1450F - SYMPTOMS IMPROVED/CONSIST W/TXMNT GOAL ASSESSMNT|0.01|0.01||
125|14350|14350 - FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE|911.69|911.69||
125|14302|14302 - ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM|365.3|365.3||
125|14301|14301 - ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM|1715.18|1715.18||
125|14061|14061 - ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM|1417.22|1417.22||
125|14060|14060 - ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<|1072.13|1072.13||
125|14041|14041 - ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM|1209.9|1209.9||
125|14040|14040 - ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<|1047.52|1047.52||
125|14021|14021 - ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM|1025.6|1025.6||
125|14020|14020 - ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<|696.11|696.11||
125|1400F|1400F - PARKINSON DISEASE DIAGNOSIS REVIEWED|0.01|0.01||
125|14001|14001 - ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM|836.74|836.74||
125|14000|14000 - ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<|571.56|571.56||
125|13160|13160 - SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC|900.55|900.55||
125|13153|13153 - REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<|289.86|289.86||
125|13152|13152 - REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM|730.54|730.54||
125|13151|13151 - REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM|448.06|448.06||
125|13133|13133 - REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<|236.54|236.54||
125|13132|13132 - REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM|585.91|585.91||
125|13131|13131 - REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM|369.15|369.15||
125|13122|13122 - REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<|161.43|161.43||
125|13121|13121 - REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM|443.25|443.25||
125|13120|13120 - REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM|299.6|299.6||
125|13102|13102 - REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<|123.66|123.66||
125|13101|13101 - REPAIR COMPLEX TRUNK 2.6-7.5 CM|379.58|379.58||
125|13100|13100 - REPAIR COMPLEX TRUNK 1.1-2.5 CM|281.94|281.94||
125|1220F|1220F - PATIENT SCREENED DEPRESSION|0.01|0.01||
125|1205F|1205F - ETIOLOGY OF EPILEPSY SYNDROME RVWD & DOCD|0.01|0.01||
125|12057|12057 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM|719.58|719.58||
125|12056|12056 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM|635.85|635.85||
125|12055|12055 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM|486.32|486.32||
125|12054|12054 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM|428|428||
125|12053|12053 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM|308.7|308.7||
125|12052|12052 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM|285.82|285.82||
125|12051|12051 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<|225.24|225.24||
125|12047|12047 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM|562.82|562.82||
125|12046|12046 - RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM|459.57|459.57||
125|12045|12045 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM|350.99|350.99||
125|12044|12044 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM|293.37|293.37||
125|12042|12042 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM|235.14|235.14||
125|12041|12041 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<|198.56|198.56||
125|12037|12037 - REPAIR INTERMEDIATE S/A/T/E >30.0 CM|506.38|506.38||
125|12036|12036 - REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM|443.47|443.47||
125|12035|12035 - REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM|339.72|339.72||
125|12034|12034 - REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM|296.59|296.59||
125|12032|12032 - REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM|273.05|273.05||
125|12031|12031 - REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<|185.91|185.91||
125|12021|12021 - TX SUPERFICIAL WOUND DEHISCENCE W/PACKING|171.26|171.26||
125|12020|12020 - TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE|260.02|260.02||
125|12018|12018 - SIMPLE REPAIR F/E/E/N/L/M >30.0 CM|675.44|675.44||
125|12017|12017 - SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM|513.07|513.07||
125|12016|12016 - SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM|351.53|351.53||
125|12015|12015 - SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM|280.67|280.67||
125|12014|12014 - SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM|217.16|217.16||
125|12013|12013 - SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM|178.2|178.2||
125|12011|12011 - SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<|178.08|178.08||
125|1200F|1200F - SEIZURE TYPE FREQUENCY DOCUMENTED|0.01|0.01||
125|12007|12007 - SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM|381.72|381.72||
125|12006|12006 - SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM|323.66|323.66||
125|12005|12005 - SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM|268.76|268.76||
125|12004|12004 - SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM|212.12|212.12||
125|12002|12002 - SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM|180.56|180.56||
125|12001|12001 - SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<|178.56|178.56||
125|11983|11983 - RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT|228.57|228.57||
125|11982|11982 - REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT|204.02|204.02||
125|11981|11981 - INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT|204.02|204.02||
125|11980|11980 - SUBCUTANEOUS HORMONE PELLET IMPLANTATION|150.3|150.3||
125|11976|11976 - REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES|163.91|163.91||
125|11971|11971 - REMOVAL TISS EXPANDER W/O INSERTION PROSTHESIS|423.94|423.94||
125|11970|11970 - REPLACEMENT TISS EXPANDER PERMANENT PROSTHESIS|1038.44|1038.44||
125|11960|11960 - INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ|855.86|855.86||
125|11954|11954 - SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC|171.68|171.68||
125|11952|11952 - SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC|215.02|215.02||
125|11951|11951 - SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC|178.26|178.26||
125|11950|11950 - SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<|150.56|150.56||
125|11922|11922 - TATTOOING INCL MICROPIGMENTATION EA 20.0 CM|157.69|157.69||
125|11921|11921 - TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM|644.47|644.47||
125|11920|11920 - TATTOOING INCL MICROPIGMENTATION 6.0 CM/<|360.17|360.17||
125|11901|11901 - INJECTION INTRALESIONAL >7 LESIONS|66.63|66.63||
125|11900|11900 - INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS|47.88|47.88||
125|1183F|1183F - NEUROPSYCHIATRIC SYMPTOMS ABSENT|0.01|0.01||
125|1182F|1182F - NEUROPSYCHIATRIC SYMPTOMS ONE OR MORE PRESENT|0.01|0.01||
125|1181F|1181F - NEUROPSYCHIATRIC SYMPTS ASSESSED RESULTS REVIEWD|0.01|0.01||
125|1180F|1180F - THROMBOEMBOLIC RISK ASSESSED|0.01|0.01||
125|11772|11772 - EXCISION PILONIDAL CYST/SINUS COMPLICATED|753.82|753.82||
125|11771|11771 - EXCISION PILONIDAL CYST/SINUS EXTENSIVE|653.77|653.77||
125|11770|11770 - EXCISION PILONIDAL CYST/SINUS SIMPLE|341.33|341.33||
125|11765|11765 - WEDGE EXCISION SKIN NAIL FOLD|94.78|94.78||
125|11762|11762 - RECONSTRUCTION NAIL BED W/GRAFT|337.85|337.85||
125|11760|11760 - REPAIR NAIL BED|167.58|167.58||
125|1175F|1175F - FUNCTIONAL STATUS DEMENTIA ASSESS RESULTS RVWD|0.01|0.01||
125|11755|11755 - BIOPSY NAIL UNIT SEPARATE PROCEDURE|145.52|145.52||
125|11750|11750 - EXCISION NAIL MATRIX PERMANENT REMOVAL|252.51|252.51||
125|11740|11740 - EVACUATION SUBUNGUAL HEMATOMA|53.03|53.03||
125|11732|11732 - AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL|45.42|45.42||
125|11730|11730 - AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1|111.27|111.27||
125|11721|11721 - DEBRIDEMENT NAIL ANY METHOD 6/>|68.47|68.47||
125|11720|11720 - DEBRIDEMENT NAIL ANY METHOD 1-5|37.5|37.5||
125|11719|11719 - TRIMMING NONDYSTROPHIC NAILS ANY NUMBER|32.92|32.92||
125|1170F|1170F - FUNCTIONAL STATUS ASSESSED|0.01|0.01||
125|11646|11646 - EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM|652.7|652.7||
125|11644|11644 - EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM|504.77|504.77||
125|11643|11643 - EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM|407.94|407.94||
125|11642|11642 - EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM|344.54|344.54||
125|11641|11641 - EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM|286.76|286.76||
125|11640|11640 - EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<|204.1|204.1||
125|11626|11626 - EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM|493|493||
125|11624|11624 - EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM|415.7|415.7||
125|11623|11623 - EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM|345.61|345.61||
125|11622|11622 - EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM|286.49|286.49||
125|11621|11621 - EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM|237.27|237.27||
125|11620|11620 - EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<|173.34|173.34||
125|1160F|1160F - RVW ALL MEDS BY RXNG PRCTIONR OR CLIN RPH DOCD|0.01|0.01||
125|11606|11606 - EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM|561.75|561.75||
125|11604|11604 - EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM|338.12|338.12||
125|11603|11603 - EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM|300.14|300.14||
125|11602|11602 - EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM|247.97|247.97||
125|11601|11601 - EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM|211.32|211.32||
125|11600|11600 - EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<|164.68|164.68||
125|1159F|1159F - MEDICATION LIST DOCUMENTED IN MEDICAL RECORD|0.01|0.01||
125|1158F|1158F - ADVNC CARE PLANNING TLK DOCD IN MED RCRD|0.01|0.01||
125|1157F|1157F - ADVNC CARE PLAN OR EQV LGL DOC IN MED RCRD|0.01|0.01||
125|1153F|1153F - DOC ADVANCED DISEASE DX CARE GOALS W/O COMFORT|0.01|0.01||
125|1152F|1152F - DOC ADVANCED DISEASE DX CARE GOALS COMFORT|0.01|0.01||
125|1151F|1151F - DOC PT W/O SUBSTANTIAL RISK DEATH WITHIN 1 YEAR|0.01|0.01||
125|1150F|1150F - DOC PT W/SUBSTANTIAL RISK DEATH WITHIN 1 YEAR|0.01|0.01||
125|11471|11471 - EXCISION H/P/P/U COMPLEX REPAIR|453.68|453.68||
125|11470|11470 - EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR|394.56|394.56||
125|11463|11463 - EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR|423.67|423.67||
125|11462|11462 - EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR|319.4|319.4||
125|11451|11451 - EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR|443.25|443.25||
125|11450|11450 - EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR|353.1|353.1||
125|11446|11446 - EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM|400.45|400.45||
125|11444|11444 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM|310.57|310.57||
125|11443|11443 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM|254.13|254.13||
125|11442|11442 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM|214|214||
125|11441|11441 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM|158.99|158.99||
125|11440|11440 - EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<|124.8|124.8||
125|11426|11426 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM|362.73|362.73||
125|11424|11424 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM|255.2|255.2||
125|11423|11423 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM|222.83|222.83||
125|11422|11422 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM|185.82|185.82||
125|11421|11421 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM|144.04|144.04||
125|11420|11420 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<|106.6|106.6||
125|11406|11406 - EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM|303.61|303.61||
125|11404|11404 - EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM|228.98|228.98||
125|11403|11403 - EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM|197.95|197.95||
125|11402|11402 - EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM|171.98|171.98||
125|11401|11401 - EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM|135.4|135.4||
125|11400|11400 - EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<|108.38|108.38||
125|1137F|1137F - EPISODE BACK PAIN LASTING >12 WKS|0.01|0.01||
125|1136F|1136F - EPISODE BACK PAIN LASTING 12 WEEKS/<|0.01|0.01||
125|1135F|1135F - EPISODE BACK PAIN LASTING >SIX WEEKS|0.01|0.01||
125|1134F|1134F - EPISODE BACK PAIN LASTING SIX WEEKS/<|0.01|0.01||
125|11313|11313 - SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM|195.81|195.81||
125|11312|11312 - SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM|147.12|147.12||
125|11311|11311 - SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM|121.18|121.18||
125|11310|11310 - SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<|91.48|91.48||
125|1130F|1130F - BK PAIN & FXN ASSESSED CERTAIN ASPECTS OF CARE|0.01|0.01||
125|11308|11308 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM|178.42|178.42||
125|11307|11307 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM|132.41|132.41||
125|11306|11306 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM|108.6|108.6||
125|11305|11305 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<|75.97|75.97||
125|11303|11303 - SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM|165.85|165.85||
125|11302|11302 - SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM|123.58|123.58||
125|11301|11301 - SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM|97.1|97.1||
125|11300|11300 - SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<|67.95|67.95||
125|1128F|1128F - SUBS EPISODE FOR CONDITION|0.01|0.01||
125|1127F|1127F - NEW EPISODE FOR CONDITION|0.01|0.01||
125|1126F|1126F - PAIN SEVERITY QUANTIFIED NO PAIN PRESENT|0.01|0.01||
125|1125F|1125F - PAIN SEVERITY QUANTIFIED PAIN PRESENT|0.01|0.01||
125|1124F|1124F - ADV CARE PLN/ NO ALT DCSN MKR DOCD OR REFUSAL|0.01|0.01||
125|1123F|1123F - ADV CARE PLN TLKD & ALT DCSN MAKER DOCD|0.01|0.01||
125|1121F|1121F - SUBSEQUENT EVALUATION CONDITION|0.01|0.01||
125|11201|11201 - REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10|29.35|29.35||
125|11200|11200 - REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15|74.9|74.9||
125|1119F|1119F - INITIAL EVALUATION FOR CONDITION|0.01|0.01||
125|1118F|1118F - GERD SYMPTOMS ASSESSED AFTER 12 MONTHS THERAPY|0.01|0.01||
125|1116F|1116F - AURICULAR/PERIAURICULAR PAIN ASSESSED|0.01|0.01||
125|1111F|1111F - DISCHRG MEDS RECONCILED W/CURRENT MED LIST|0.01|0.01||
125|1110F|1110F - PT DISCHARGE INPT FACILITY WITHIN LAST 60 DAYS|0.01|0.01||
125|11102|11102 - TANGENTIAL BIOPSY SKIN SINGLE LESION|114.67|114.67||
125|11101|11101 - BIOPSY SKIN SUBQ&/MUCOUS MEMBRANE EA ADDL LESN|43.34|43.34||
125|11100|11100 - BX SKIN SUBCUTANEOUS&/MUCOUS MEMBRANE 1 LESION|88.5|88.5||
125|11057|11057 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4|67.84|67.84||
125|11056|11056 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4|50.36|50.36||
125|11055|11055 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1|92.92|92.92||
125|11047|11047 - DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM|200.78|200.78||
125|11046|11046 - DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM|118.19|118.19||
125|11045|11045 - DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM|66.03|66.03||
125|11044|11044 - DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<|402.61|402.61||
125|11043|11043 - DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<|271.93|271.93||
125|11042|11042 - DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<|118.81|118.81||
125|1101F|1101F - PT FALLS ASSESS DOCD W/O FALL/INJURY PAST YEAR|0.01|0.01||
125|11012|11012 - DBRDMT FX&/DISLC SUBQ T/M/F BONE|918.89|918.89||
125|11011|11011 - DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC|660.47|660.47||
125|11010|11010 - DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS|754.4|754.4||
125|1100F|1100F - PT FALLS ASSESS DOCD 2/> FALLS/FALL W/INJURY/YR|0.01|0.01||
125|11008|11008 - REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION|298.89|298.89||
125|11006|11006 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL|734.94|734.94||
125|11005|11005 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL|794.03|794.03||
125|11004|11004 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR|583.8|583.8||
125|11001|11001 - DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF|38.03|38.03||
125|11000|11000 - DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF|73.3|73.3||
125|1091F|1091F - URINE INCONTINENCE CHARACTERIZED|0.01|0.01||
125|1090F|1090F - PRESENCE/ABSENCE URINARY INCONTINENCE ASSESSED|0.01|0.01||
125|1071F|1071F - ALARM SYMPTOMS ASSESSED 1/> PRESENT|0.01|0.01||
125|1070F|1070F - ALARM SYMPTOMS ASSESSED NONE PRESENT|0.01|0.01||
125|1066F|1066F - ISCHEMIC STROKE SYMP ONSET >/=3 HRS PRIOR ARRIVA|0.01|0.01||
125|1065F|1065F - ISCHEMIC STROKE SYMP ONSET <3 HRS PRIOR ARRIVAL|0.01|0.01||
125|1061F|1061F - DOC ABSENCE PERM&PERSISTENT&PAROXYSM ATRIAL FIB|0.01|0.01||
125|1060F|1060F - DOC PERM/PERSISTENT/PAROXYSMAL ATRIAL FIB|0.01|0.01||
125|1055F|1055F - VISUAL FUNCTIONAL STATUS ASSESSED|0.01|0.01||
125|1052F|1052F - TYPE ANATOMIC LOCATION AND ACTIVITY ALL ASSESSED|0.01|0.01||
125|1050F|1050F - HISTORY NEW OR CHANGING MOLES|0.01|0.01||
125|1040F|1040F - DSM-5 CRITERIA MDD DOCD AT THE INITIAL EVAL|0.01|0.01||
125|1039F|1039F - INTERMITTENT ASTHMA|0.01|0.01||
125|1038F|1038F - PERSISTENT ASTHMA MILD MODERATE OR SEVERE ASTHMA|0.01|0.01||
125|1036F|1036F - CURRENT TOBACCO NON-USER CAD CAP COPD PV DM|0.01|0.01||
125|1035F|1035F - CURRENT SMOKELESS TOBACCO USER|0.01|0.01||
125|1034F|1034F - CURRENT TOBACCO SMOKER|0.01|0.01||
125|1033F|1033F - TOBACCO NON-SMOKER & NO 2NDHAND SMOKE EXPOSURE|0.01|0.01||
125|1032F|1032F - CURRENT SMOKER/EXPOSED TO SECONDHAND SMOKE|0.01|0.01||
125|1031F|1031F - SMOKING & 2ND HAND SMOKE IN THE HOME ASSESSED|0.01|0.01||
125|1030F|1030F - INFLUENZA IMMUNIZATION STATUS ASSESSED|0.01|0.01||
125|1026F|1026F - CO-MORBID CONDITIONS ASSESSED|0.01|0.01||
125|1022F|1022F - PNEUMOCOCCUS IMMUNIZATION STATUS ASSESSED|0.01|0.01||
125|1019F|1019F - DYSPNEA ASSESSED PRESENT|0.01|0.01||
125|1018F|1018F - DYSPNEA ASSESSED NOT PRESENT|0.01|0.01||
125|10180|10180 - INCISION & DRAINAGE COMPLEX PO WOUND INFECTION|210.75|210.75||
125|10160|10160 - PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST|111.37|111.37||
125|1015F|1015F - COPD SYMPTOMS ASSESSED/TOOL COMPLETED|0.01|0.01||
125|10140|10140 - I&D HEMATOMA SEROMA/FLUID COLLECTION|132.79|132.79||
125|1012F|1012F - ANGINA ABSENT|0.01|0.01||
125|10121|10121 - INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL|247.15|247.15||
125|10120|10120 - INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE|131.78|131.78||
125|1011F|1011F - ANGINA PRESENT|0.01|0.01||
125|1010F|1010F - SEVERITY OF ANGINA ASSESSED BY LEVEL OF ACTIVITY|0.01|0.01||
125|1008F|1008F - GI&RENAL PRESCRIBED/OTC NSAID RISK FACTORS ASSES|0.01|0.01||
125|10081|10081 - INCISION & DRAINAGE PILONIDAL CYST COMPLICATED|254.7|254.7||
125|10080|10080 - INCISION & DRAINAGE PILONIDAL CYST SIMPLE|162.63|162.63||
125|1007F|1007F - ANTI-INFLAMMATORY/ANALGESIC SYMPTOM RELIEF ASSES|0.01|0.01||
125|1006F|1006F - OSTEOARTHRITIS SYMPTOMS&FUNCJAL STATUS ASSES|0.01|0.01||
125|10061|10061 - INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE|299.65|299.65||
125|10060|10060 - INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE|108.51|108.51||
125|1005F|1005F - ASTHMA SYMPTOMS EVALUATED|0.01|0.01||
125|1004F|1004F - CLINICAL SYMPTOMS VOL OVERLOAD ASSESSED|0.01|0.01||
125|10040|10040 - ACNE SURGERY|86.34|86.34||
125|1003F|1003F - LEVEL ACTIVITY ASSESSED|0.01|0.01||
125|10036|10036 - PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE|686.26|686.26||
125|10035|10035 - PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE|787.81|787.81||
125|10030|10030 - IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE|865.01|865.01||
125|1002F|1002F - ANGINAL SYMPTOMS & LEVEL ACTIVITY ASSESSED|0.01|0.01||
125|10022|10022 - FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE|219.4|219.4||154.56
125|10021|10021 - FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION|198|198||
125|1000F|1000F - TOBACCO USE ASSESSED|0.01|0.01||
125|0584F|0584F - TRANSFER OF CARE CHECKLIST NOT USED|0.01|0.01||
125|0583F|0583F - TRANSFER OF CARE CHECKLIST USED|0.01|0.01||
125|0582F|0582F - PT NOT TRANSFERRED FROM ANESTHETIZING TO CC UNIT|0.01|0.01||
125|0581F|0581F - PT TRANSFERRED FROM ANESTHETIZING TO CC UNIT|0.01|0.01||
125|0580F|0580F - MULTIDISCIPLINARY CARE PLAN DEVELOPED/UPDATED|0.01|0.01||
125|0575F|0575F - HIV RNA CONTROL PLAN OF CARE DOCD|0.01|0.01||
125|0557F|0557F - PLAN OF CARE TO MANAGE ANGINAL SYMPTOMS DOCD|0.01|0.01||
125|0556F|0556F - PLAN OF CARE TO ACHIEVE LIPID CONTROL DOCUMENTED|0.01|0.01||
125|0555F|0555F - SYMPTOM MANAGEMENT PLAN OF CARE DOCUMENTED|0.01|0.01||
125|0551F|0551F - CYTOPATH REPORT NONGYN SPCMN DOCD NON-ROUTINE|0.01|0.01||
125|0550F|0550F - CYTOPATH REPORT ON NONGYN SPECIMEN 2 WKNG DAYS|0.01|0.01||
125|0545F|0545F - PLAN FOR FOLLOW-UP CARE FOR MDD DOCD|0.01|0.01||
125|0540F|0540F - GLUCORTICOID MANAGEMENT PLAN DOCUMENTED|0.01|0.01||
125|0535F|0535F - DYSPNEA MANAGEMENT PLAN DOCUMENTED|0.01|0.01||
125|0529F|0529F - INTRVL 3/> YRS PTS LAST COLONOSCOPY DOCD|0.01|0.01||
125|0528F|0528F - RCMND FLLW-UP 2ND CLNSCPY 10/> YRS DOCD RPRT|0.01|0.01||
125|0526F|0526F - SUBSEQUENT VISIT FOR EPISODE|0.01|0.01||
125|0525F|0525F - INITIAL VISIT FOR EPISODE|0.01|0.01||
125|0521F|0521F - PLAN OF CARE TO ADDRESS PAIN DOCUMENTED|0.01|0.01||
125|0520F|0520F - RAD DOSE LIMTS EST PRIOR3D RAD FOR MIN 2 TIS/ORG|0.01|0.01||
125|0519F|0519F - PLANNED CHEMO REGIMEN DOCD PRIOR START NEW TX|0.01|0.01||
125|0518F|0518F - FALLS PLAN OF CARE DOCUMENTED|0.01|0.01||
125|0517F|0517F - GLAUCOMA PLAN OF CARE DOCUMENTED|0.01|0.01||
125|0516F|0516F - ANEMIA PLAN OF CARE DOCUMENTED|0.01|0.01||
125|0514F|0514F - PLAN/CARE INCRSD HGB LVL DOCD PT ON ESA THXPY|0.01|0.01||
125|0513F|0513F - ELEVATED BLOOD PRESSURE PLAN OF CARE DOCUMENTED|0.01|0.01||
125|0509F|0509F - URINARY INCONTINENCE PLAN OF CARE DOCUMENTED|0.01|0.01||
125|0507F|0507F - PERITONEAL DIALYSIS PLAN DOCUMENTED|0.01|0.01||
125|0505F|0505F - HEMODIALYSIS PLAN OF CARE DOCUMENTED|0.01|0.01||
125|0503F|0503F - POSTPARTUM CARE VISIT|0.01|0.01||
125|0502F|0502F - SUBSEQUENT PRENATAL CARE VISIT|0.01|0.01||
125|0501F|0501F - PRENATAL FLOW SHEET|0.01|0.01||
125|0500F|0500F - INITIAL PRENATAL CARE VISIT|0.01|0.01||
125|0442T|0442T - ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV|893.76|893.76||
125|0441T|0441T - ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE|768|768||
125|0438T|0438T - TPRNL PLMT BIODEGRADABLE MATRL PERIPROSTATIC|941.63|941.63||
125|0437T|0437T - IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL|390.3|390.3||
125|0407T|0407T - NSL NDSC SURG ETHMD PLMT DRUG ELUTNG IMPLNT W/BX|305.29|305.29||
125|0406T|0406T - NSL NDSC SURG ETHMD SIN PLMT DRUG ELUTNG IMPLNT|248.03|248.03||
125|0403T|0403T - DIABETES PREVENTION PROG STANDARDIZED CURRICULUM|18.72|18.72||
125|0402T|0402T - COLLAGEN CROSS-LINKING OF CORNEA MED SEPARATE|1519.9|1519.9||
125|0399T|0399T - MYOCARDIAL STRAIN IMAGING QUAN ASSMT|107.94|107.94||
125|0396T|0396T - INTRAOP KINETIC BALANCE SENSR KNEE RPLCMT ARTHRP|93.94|93.94||30.13
125|0395T|0395T - HDR ELECTRONIC BRACHYTHERAPY NTRSTL/INTRCAV|712.25|712.25||483.8
125|0394T|0394T - HDR ELECTRONIC BRACHYTHERAPY SKIN SURFACE|191.32|191.32||
125|0391T|0391T - INTERROG DEVICE EVAL IN PERSON LEADLESS PM SYST|28.76|28.76||
125|0390T|0390T - PERI-PROC DEVICE EVAL IN PERS LEADLESS PM SYSTEM|43.75|43.75||
125|0389T|0389T - PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM|74.23|74.23||
125|0387T|0387T - TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR|714.82|714.82||
125|0385T|0385T - XTRNL HRT RATE EPI SEIZ OVER 30 DAYS COMPLETE|34.56|34.56||
125|0384T|0384T - XTRNL HRT RATE EPI SEIZ 15 TO 30 DAYS R&I ONLY|38.32|38.32||
125|0379T|0379T - VISUAL FIELD ASSESSMENT TECH SUPPORT W/INSTRUCT|43.63|43.63||
125|0377T|0377T - ANOSCOPY W/BULKING AGENT INJ FOR FECAL INCONT|652.8|652.8||
125|0376T|0376T - ANT SEGMENT INSERT DRAIN W/O RESERVOIR EA ADDL|592.01|592.01||
125|0374T|0374T - EXPOSURE BEHAVIOR TREATMENT ADDL 30 MIN|31.06|31.06||
125|0373T|0373T - ADAPT BHV TX PRTCL MODIFICAJ EA 15 MIN TECH TIME|62.1|62.1||
125|0372T|0372T - BEHAVIOR TREATMENT SOCIAL SKILLS TRAINING GROUP|83.76|83.76||
125|0371T|0371T - MULTIPLE FAMILY GROUP BEHAV TREATMENT GUIDANCE|83.76|83.76||
125|0370T|0370T - FAMILY BEHAVIOR TREATMENT GUIDANCE|83.76|83.76||
125|0369T|0369T - BEHAVIOR TREATMENT WITH MODIFICATION ADDL 30 MIN|41.88|41.88||
125|0368T|0368T - BEHAVIOR TX WITH MODIFICATION FIRST 30 MIN|41.88|41.88||
125|0367T|0367T - GROUP BEHAVIOR TREATMENT ADDL 30 MIN|31.06|31.06||
125|0366T|0366T - GROUP BEHAVIOR TREATMENT FIRST 30 MIN|31.06|31.06||
125|0365T|0365T - ADAPTIVE BEHAVIOR TX BY PROTOCOL ADDL 30 MIN|31.06|31.06||
125|0364T|0364T - ADAPTIVE BEHAVIOR TX BY PROTOCOL FIRST 30 MIN|31.06|31.06||
125|0363T|0363T - EXPOSURE BEHAV ASSESSMENT ADDL 30 MIN|31.06|31.06||
125|0362T|0362T - BEHAVIOR ID SUPPORT ASSMT EA 15 MIN TECH TIME|31.06|31.06||
125|0361T|0361T - OBSERVATIONAL BEHAV ASSESSMENT ADDL 30 MIN|31.06|31.06||
125|0360T|0360T - OBSERVATIONAL BEHAV ASSESSMENT FIRST 30 MIN|31.06|31.06||
125|0359T|0359T - BEHAVIORAL IDENTIFICATION ASSESSMENT|125.64|125.64||
125|0358T|0358T - BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R|24.05|24.05||
125|0356T|0356T - INSERT DRUG IMPLANT INTO LACRIMAL CANAL FOR IOP|16.99|16.99||
125|0355T|0355T - GI TRACT IMAGING INTRALUMINAL COLON WITH I&R|1014.35|1014.35||
125|0354T|0354T - OCT BREAST SURG CAVITY REAL TIME/REFERRED I&R|11.46|11.46||
125|0346T|0346T - ULTRASOUND ELASTOGRAPHY|110.77|110.77||
125|0345T|0345T - TRANSCATH MITRAL VALVE REPAIR VIA CORONARY SINUS|1720.33|1720.33||
125|0340T|0340T - ABLATE PULM TUMORS W/PLEURA/CHEST WALL EXTSN|1501.54|1501.54||
125|0339T|0339T - TRANSCATHETER RENAL SYMPATH DENERVATION BILAT|1481.93|1481.93||
125|0338T|0338T - TRANSCATHETER RENAL SYMPATH DENERVATION UNILAT|1233.47|1233.47||
125|0337T|0337T - ENDOTHELIAL FUNCTION ASSESSMENT NON-INVASIVE|157.42|157.42||
125|0335T|0335T - INSERTION OF SINUS TARSI IMPLANT|736.51|736.51||
125|0330T|0330T - TEAR FILM IMAGING UNILATERAL OR BILATERAL W/I&R|72|72||
125|0315T|0315T - REMOVAL PULSE GENERATOR VAGUS NERVE|12|12||
125|0310T|0310T - MOTOR FUNCTION MAPPING NAVIGATED TMS TX PLAN|36|36||
125|0309T|0309T - ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L4/L5|681.6|681.6||
125|0308T|0308T - INSJ OC TLSCP PROSTH RMVL CRYSTALLINE/IO LENS|1719.26|1719.26||
125|0298T|0298T - EXT ECG > 48HR TO 21 DAY REVIEW AND INTERPRETATN|29.81|29.81||
125|0297T|0297T - EXT ECG > 48HR TO 21 DAY SCAN ANALYSIS W/REPORT|166.69|166.69||
125|0296T|0296T - EXT ECG > 48HR TO 21 DAY RCRD W/CONECT INTL RCRD|26.58|26.58||
125|0295T|0295T - EXT ECG > 48HR TO 21 DAY RCRD SCAN ANLYS REP R&I|213.01|213.01||
125|0294T|0294T - INS LT ATRL HEMDYN MTR PRSR SENSR LEAD W/S&I|1360.92|1360.92||
125|0293T|0293T - INS LT ATRL HEMODYN MOTR CMPLETE SYST W/S&I|686.18|686.18||
125|0290T|0290T - CORNEA INCISNS RECIPIENT CORNEA W/LASR KERTPLSTY|483.95|483.95||
125|0278T|0278T - TRNSCUT ELECT MODLATION PAIN REPROCES EA TX SESS|237.6|237.6||
125|0275T|0275T - PERC LAMINO-/LAMINECTOMY INDIR IMAG GUIDE LUMBAR|1693.46|1693.46||
125|0274T|0274T - PERC LAMINO-/LAMINECTOMY IMAGE GUIDE CERV/THORAC|7841.02|7841.02||
125|0267T|0267T - IM/REPL CARTD SINS BAROREFLX ACTIV DEV LEAD ONLY|133.84|133.84||
125|0266T|0266T - IM/REPL CARTD SINUS BAROREFLX ACTIV DEV TOT SYST|133.84|133.84||
125|0265T|0265T - BONE MAR HARVST ONLY FOR INTMUSC AUTOLO CELL RX|339.48|339.48||
125|0264T|0264T - AUTO BONE MARRW CELL RX COMP W/O BONE MAR HARVST|171.4|171.4||
125|0263T|0263T - AUTO BONE MARRW CELL RX COMPLT BONE MARRW HARVST|67.16|67.16||
125|0255T|0255T - EVASC ILIAC ART BIFURC W/ENDOPROSTH UNI RS&I|204.61|204.61||
125|0254T|0254T - EVASC RPR ILAC ART BIFUR ENDGRFT CATHJ RS&I UNI|1135.86|1135.86||
125|0253T|0253T - INSERT ANT SGM DRAINAGE DEV W/O RESERVR INT APPR|1108.3|1108.3||
125|0249T|0249T - LIGATION HEMORRHOID BUNDLE W/US|393.88|393.88||
125|0238T|0238T - TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA|934.84|934.84||
125|0237T|0237T - TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL|744.48|744.48||
125|0236T|0236T - TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA|1335.29|1335.29||
125|0235T|0235T - TRLUML PERIPHERAL ATHERECTOMY VISCERAL ARTERY EA|1571.77|1571.77||
125|0234T|0234T - TRLUML PERIPHERAL ATHERECTOMY RENAL ARTERY EA|1571.77|1571.77||
125|0232T|0232T - NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION|53.58|53.58||
125|0231T|0231T - NJX ANES/STEROID TFRML EDRL W/US LUM/SAC EA ADDL|82|82||
125|0230T|0230T - NJX ANES/STEROID TFRML EDRL W/US LUM/SAC 1 LVL|134.71|134.71||
125|0229T|0229T - NJX ANES/STERD TFRML EDRL W/US CER/THOR EA ADDL|89.4|89.4||
125|0228T|0228T - NJX ANES/STEROID TFRML EDRL W/US CER/THOR 1 LVL|145.03|145.03||
125|0222T|0222T - PLACE POSTERIOR INTRAFACET IMPLANT ADDL SEGMENT|1186.31|1186.31||
125|0221T|0221T - PLMT POST FACET IMPLT UNI/BI W/IMG & GRFT LUMB|1581.8|1581.8||
125|0220T|0220T - PLMT POST FACET IMPLT UNI/BI W/IMG & GRFT THOR|1674.34|1674.34||
125|0219T|0219T - PLMT POST FACET IMPLANT UNI/BI W/IMG & GRFT CERV|1312.67|1312.67||
125|0218T|0218T - NJX PARAVERTBRL FCT JT W/US LUMB/SAC 3RD&> LVL|103.42|103.42||
125|0217T|0217T - NJX DX/THER PARAVER FCT JT W/US LUMB/SAC LVL 2|101.35|101.35||
125|0216T|0216T - NJX DX/THER PARAVER FCT JT W/US LUMB/SAC 1 LVL|203.12|203.12||
125|0215T|0215T - NJX PARAVERTBRL FACET JT W/US CER/THOR 3RD&> LVL|113.3|113.3||
125|0214T|0214T - NJX DX/THER PARAVER FCT JT W/US CER/THOR 2ND LVL|112.06|112.06||
125|0213T|0213T - NJX DX/THER PARAVER FCT JT W/US CER/THOR 1 LVL|226.61|226.61||
125|0212T|0212T - COMPRE AUDIOM THRESHOLD EVAL & SPEECH RECOG|45.22|45.22||
125|0211T|0211T - SPEECH AUDIOM THRESHLD AUTO W/SPEECH RECOGNITION|28.75|28.75||
125|0210T|0210T - SPEECH AUDIOMETRY THRESHOLD AUTOMATED|35.96|35.96||
125|0209T|0209T - PURE TONE AUDIOMETRY AUTOMATED AIR & BONE|54.13|54.13||
125|0208T|0208T - PURE TONE AUDIOMETRY AUTOMATED AIR ONLY|28.99|28.99||
125|0207T|0207T - EVAC MEIBOMIAN GLNDS AUTO HT& INTMT PRESS UNI|22.67|22.67||
125|0206T|0206T - CPTR DBS ALYS MLT CYCLS CAR ELEC DTA 2/> ECG LDS|219.47|219.47||
125|0205T|0205T - IV CATH CORONARY VESSEL/GRAFT SPECTROSCPY EA VSL|98.04|98.04||
125|0202T|0202T - POST VERT ARTHRPLSTY W/WO BONE CEMENT 1 LUMB LVL|2520.59|2520.59||
125|0201T|0201T - PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS|1481.14|1481.14||
125|0200T|0200T - PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL|1107.86|1107.86||
125|0198T|0198T - MEAS OCULAR BLOOD FLOW REPEAT IO PRES SAMP W/I&R|59.34|59.34||
125|0196T|0196T - ARTHRODESIS PRESACRAL INTRBDY W/O INSTRUM L4/L5|2715.41|2715.41||
125|0195T|0195T - ARTHRODESIS PRESACRAL INTRBDY W/O INSTRUM L5/S1|2984.78|2984.78||
125|0191T|0191T - ANT SEGMENT INSERTION DRAINAGE W/O RESERVOIR INT|675.68|675.68||
125|0190T|0190T - INTRAOCULAR RADIATION SRC APPLICATOR PLACEMENT|270.29|270.29||
125|0189T|0189T - VIDEOCONFERENCED CRITICAL CARE EA ADDL 30 MIN|133.32|133.32||
125|0188T|0188T - VIDEOCONFERENCED CRITICAL CARE FIRST 30-74 MIN|295.45|295.45||
125|0184T|0184T - RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC|876.31|876.31||
125|0180T|0180T - 64 LEAD ECG W/INTERPRETATION & REPORT ONLY|9|9||
125|0179T|0179T - 64 LEAD ECG W/TRACING & GRAPHICS|11.45|11.45||
125|0178T|0178T - 64 LEAD ECG W/INTERPRETATION & REPORT|19.28|19.28||
125|0175T|0175T - CAD CHEST RADIOGRAPH REMOTE FROM PRIMARY INTERPJ|16.64|16.64||2.71
125|0174T|0174T - CAD CHEST RADIOGRAPH CONCURRENT W/INTERPRETATION|16.64|16.64||2.71
125|0165T|0165T - REVJ TOT DISC ARTHRP ANT APPR LMBR EA NTRSPC|504.29|504.29||
125|0164T|0164T - RMVL TOT DISC ARTHRP ANT APPR LMBR EA NTRSPC|552.49|552.49||
125|0163T|0163T - TOT DISC ARTHRP ANT APPR DSKC PREP LMBR EA|2087.59|2087.59||
125|0159T|0159T - COMPUTER AIDED DETECTION BREAST MRI|12.66|12.66||5.02
125|0126T|0126T - COMMON CAROTID INTIMA MEDIA THICKNESS STUDY|100.87|100.87||20.17
125|0111T|0111T - LONG-CHAIN OMEGA-3 FATTY ACIDS RBC MEMBS|86.05|86.05||
125|0109T|0109T - QUANT SENAORY TEST&INTERPJ/XTR W/HT-PN STIMULI|59.21|59.21||
125|0108T|0108T - QUANT SENSORY TEST&INTERPJ/XTR W/COOL STIMULI|59.21|59.21||
125|0107T|0107T - QUANT SENSORY TEST&INTERPJ/XTR W/VIBRJ STIMULI|59.21|59.21||
125|0106T|0106T - QUANT SENSORY TEST&INTERPJ/XTR W/TOUCH STIMULI|45.5|45.5||
125|0102T|0102T - EXTRCRPL SHOCK WAVE W/ANES LAT HUMERL EPICONDYLE|328.38|328.38||
125|0101T|0101T - EXTRCORPL SHOCK WAVE MUSCSKELE NOS HIGH ENERGY|328.38|328.38||
125|0100T|0100T - PLMT SCJNCL RTA PROSTH&PLS&IMPLTJ INTRA-OC RTA|2402.34|2402.34||
125|0098T|0098T - REVJ TOT DISC ARTHRP ANT APPR CRV EA NTRSPC|269.96|269.96||
125|0095T|0095T - RMVL TOT DISC ARTHRP ANT APPR CRV EA NTRSPC|269.96|269.96||
125|0085T|0085T - BREATH TEST HEART TRANSPLANT REJECTION|1476.05|1476.05||
125|0076T|0076T - TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL|1122|1122||224.4
125|0075T|0075T - TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL|1434.89|1434.89||732.92
125|0071T|0071T - US ABLATJ UTERINE LEIOMYOMATA < 200 CC TISSUE|3607.64|3607.64||
125|0055T|0055T - CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI|232.8|232.8||
125|0054T|0054T - CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES|196.5|196.5||
125|0051T|0051T - IMPLTJ TOT RPLCMT HRT SYS W/RCP CARDIECTOMY|4679.93|4679.93||
125|0042T|0042T - CEREBRAL PERFUSION ANALYS CT W/BLOOD FLOW&VOLUME|330|330||66
125|0017U|0017U - ONC HMTLMF NEO JAK2 MUT DNA|184.47|184.47||
125|0016U|0016U - ONC HMTLMF NEO RNA BCR/ABL1|329.94|329.94||
125|0015F|0015F - MELANOMA FOLLOW UP COMPLETED|0.01|0.01||0.01
125|0014F|0014F - COMP PREOP ASSESS CATARACT SURG W/IOL PLACEMNT|0.01|0.01||0.01
125|0012F|0012F - COMMUNITY-ACQUIRED BACTERIAL PNEUMONIA ASSMT|0.01|0.01||0.01
125|0011U|0011U - RX MNTR LC-MS/MS ORAL FLUID|186.52|186.52||
125|0009M|0009M - FETAL ANEUPLOIDY TRISOM RISK|614.15|614.15||614.15
125|0008U|0008U - HPYLORI DETCJ ABX RSTNC DNA|974.59|974.59||
125|0008M|0008M - ONC BREAST RISK SCORE|3512.23|3512.23||3512.23
125|0007U|0007U - RX TEST PRSMV UR W/DEF CONF|186.52|186.52||
125|0006U|0006U - DETC IA MEDS 120+ ANALYTES|402.48|402.48||
125|0005U|0005U - ONCO PRST8 3 GENE UR ALG|1238.8|1238.8||
125|0003U|0003U - ONC OVAR 5 PRTN SER ALG SCOR|1548.5|1548.5||
125|0003M|0003M - LIVER DIS 10 ASSAYS W/NASH|820.54|820.54||
125|0002M|0002M - LIVER DIS 10 ASSAYS W/ASH|820.54|820.54||
125|0001M|0001M - NFCT DS CHRNC HCV 6 ASSAYS|117.67|117.67||105.34
125|0001F|0001F - HRT FAILURE ASSESSED|0.01|0.01||