Orlando Health Pricing Transparency Guide

Orlando Health recognizes that the financial aspect of your care may be confusing. Our commitment is to be as transparent as possible, and to provide you with information to make decisions about your health care.

Orlando Health wants to provide our patients with the information you need to make decisions about your care. We strive to provide you with an accurate financial estimate of care that is ordered or anticipated by your physician(s).

  1. Insured patients should first contact their insurance company to understand plan benefits for the care/services they anticipate at Orlando Health. Please note: Healthcare practitioners who provide services in the hospital may or may not participate with the same health insurers or health maintenance organizations as the hospital.  It is recommended to confirm/ contact the healthcare practitioner who will provide services in the hospital to determine which health insurers and health maintenance organizations the practitioner participates in as either a network provider or preferred provider.
  2. Whether insured or not, you may contact us directly for assistance with pricing estimates. We are available to offer assistance to all of our patients Monday – Friday, 8:00 am to 4:30 pm, by calling 844.318.4855.
  3. Service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services. Actual costs will be based on the services actually provided to the patient.
  4.  Patients and prospective patients have the right to request a personalized estimate from the hospital.

Like other healthcare systems around the nation, Orlando Health is working diligently to comply with the requirement from the Centers for Medicare & Medicaid Services (CMS) to make our charge-master descriptions and charges available on our website, effective January 1, 2019. However, it’s important to realize that these charges are very different from, and do not predict, out-of-pocket costs patients might pay for medical services and procedures. They are the contracted rates for commercial health insurance companies and the Medicare/Medicaid fee schedule, and are sometimes compared to automobile sticker prices.

Orlando Health encourages patients who are scheduled for services or procedures to contact our price estimate department, which will evaluate, calculate and provide patients with their actual out-of-pocket expense. The price estimate department can be reached Monday – Friday, 8:00 am to 4:30 pm, by phone at 844-318-4855 or email at [email protected]. An estimate request can also be submitted online by visiting www.orlandohealth.com/patients-and-visitors/patient-financial-resources and clicking on “estimates.”

 

Charge Description Price
3-d radiotherapy plan $2,596.00
3d render w/intrp postproces $918.00
3d render w/intrp postproces $614.00
Abd paracentesis $2,661.00
Abd paracentesis w/imaging $3,380.00
Abdomen surgery procedure $7,247.00
Ablate arrhythmia add on $93,367.00
Ablate bone tumor(s) perq $22,168.00
Ablate bone tumor(s) perq $30,688.00
Ablate heart dysrhythm focus $6,997.00
Ablate pulm tumor perq crybl $24,709.00
Ablate pulm tumor perq rf $24,709.00
Abortion $3,465.00
Abscess drainage under x-ray $2,249.00
Abscess imaging ltd area $5,661.00
Abscess imaging whole body $9,202.00
Acne surgery $759.00
Acoustic immitance testing $171.00
Acoustic refl threshold tst $171.00
Acute gi blood loss imaging $4,012.00
Acute hepatitis panel $39.67
ACUTE HEPATITIS PANEL $420.00
ACUTE TO/MI ART/DES/PTCA 1V-LC $87,673.00
ACUTE TO/MI ART/DES/PTCA 1V-LD $87,673.00
ACUTE TO/MI ART/DES/PTCA 1V-LM $87,673.00
ACUTE TO/MI ART/DES/PTCA 1V-RC $87,673.00
ACUTE TO/MI ART/DES/PTCA 1V-RI $87,673.00
Addition of walker to cast $340.00
Aerosol inhalation treatment $617.00
After cataract laser surgery $2,279.00
Air injection into abdomen $1,022.00
Airway inhalation treatment $440.00
Airway inhalation treatment $1,064.00
Airways surgical procedure $565.00
AMB. PER MILE ONE WAY NICU $22.00
AMB. PER MILE ONE WAY PICU $22.00
AMB. SERV CMPLX BASE RATE NICU $5,997.00
AMB. SERV CMPLX BASE RATE PICU $5,997.00
Ambulatory bp recording $767.00
AMIODARONE SERUM-REF $25.60
Amniocentesis diagnostic $4,501.00
Amniocentesis therapeutic $4,952.00
AMPHTAMINE/METHAMPHTAMINE-REF $18.48
Amputation toe & metatarsal $7,276.00
Anal pressure record $5,744.00
Anal/urinary muscle study $1,146.00
Anal/urinary muscle study $1,826.00
Analyze pacemaker system $2,569.00
Analyze sp inf pump w/reprog $1,279.00
Analyze spine infus pump $1,279.00
ANESTHESIA ADDTL MINUTE $44.00
ANESTHESIA FIRST 1/2 HOUR $1,319.00
Anl sp inf pmp w/mdreprg&fil $1,085.00
Anl sp inf pmp w/mdreprg&fil $1,085.00
Antepartum manipulation $8,375.00
ANTI THYROGLOBULIN (ENDO)-REF $20.70
AOX CAROT-REF $31.00
Apheresis plasma $3,703.00
Apheresis platelets $3,703.00
Apheresis rbc $3,703.00
Apheresis wbc $3,703.00
Application long leg splint $337.00
Application lower leg splint $337.00
Application of finger splint $356.00
Application of finger splint $191.00
Application of leg cast $535.00
Application of long leg cast $1,224.00
Application of long leg cast $669.00
Application of long leg cast $839.00
Application of paste boot $648.00
Application of paste boot $972.00
Applicaton on-body injector $275.00
Apply finger cast $335.00
Apply forearm splint $540.00
Apply forearm splint $337.00
Apply hand/wrist cast $490.00
Apply interstit radiat compl $5,931.00
Apply intrcav radiat compl $4,109.00
Apply intrcav radiat interm $1,579.00
Apply intrcav radiat simple $9,352.00
Apply long arm splint $707.00
Apply multlay comprs lwr leg $644.00
Apply multlay comprs lwr leg $966.00
Apply rigid leg cast $1,224.00
Apply short leg cast $669.00
Apply short leg cast $895.00
Apply short leg cast $669.00
Apply surf ldr radionuclide $5,931.00
Aquatic therapy/exercises $265.00
Artery x-ray each vessel $16,313.00
Artery x-rays abdomen $19,576.00
Artery x-rays adrenal gland $26,623.00
Artery x-rays adrenals $16,313.00
Artery x-rays arm/leg $26,623.00
Artery x-rays arm/leg $14,170.00
Artery x-rays arms/legs $16,313.00
Artery x-rays arms/legs $14,170.00
Artery x-rays chest $16,313.00
Artery x-rays lung $16,313.00
Artery x-rays lung $16,313.00
Artery x-rays lungs $16,313.00
Artery x-rays pelvis $16,313.00
Artery x-rays spine $5,933.00
ARTHREC/DES/PTCA ADDL-LC $35,001.00
ARTHREC/DES/PTCA ADDL-LD $35,001.00
ARTHREC/DES/PTCA ADDL-LM $35,001.00
ARTHREC/DES/PTCA ADDL-RC $35,001.00
ARTHREC/DES/PTCA ADDL-RI $35,001.00
ARTHREC/DES/PTCA SGL- LC $87,673.00
ARTHREC/DES/PTCA SGL- LD $87,673.00
ARTHREC/DES/PTCA SGL- LM $87,673.00
ARTHREC/DES/PTCA SGL- RC $87,673.00
ARTHREC/DES/PTCA SGL- RI $87,673.00
Aspir/inj thyroid cyst $3,964.00
Aspirate pleura w/ imaging $3,982.00
Aspirate pleura w/ imaging $5,476.00
Aspirate pleura w/o imaging $2,561.00
Aspirate/inj ganglion cyst $1,593.00
Assay alkaline phosphatases $42.00
Assay alkaline phosphatases $62.50
Assay alkaline phosphatases $28.00
Assay alkaline phosphatases $342.00
Assay carbamazepine free $83.00
Assay carbamazepine total $343.00
Assay carbamazepine total $89.00
Assay dipropylacetic acd tot $215.29
Assay dipropylacetic acd tot $41.82
Assay dipropylacetic acd tot $134.00
Assay of amikacin $60.00
Assay of amikacin $127.40
Assay of ascorbic acid $33.52
Assay of b hexosaminidase $11.52
Assay of b hexosaminidase $90.00
Assay of carotene $80.43
Assay of carotene $19.13
Assay of digoxin free $45.00
Assay of digoxin total $190.00
Assay of ethosuximide $26.73
Assay of gentamicin $87.67
Assay of gentamicin $205.00
Assay of gentamicin $101.00
Assay of haloperidol $19.13
Assay of lidocaine $154.70
Assay of lithium $191.00
Assay of natriuretic peptide $100.00
Assay of natriuretic peptide $139.00
Assay of phenobarbital $209.00
Assay of phenobarbital $76.00
Assay of phenobarbital $70.36
Assay of phenytoin free $16.68
Assay of phenytoin total $120.00
Assay of phenytoin total $11.28
Assay of primidone $8.66
Assay of primidone $124.00
Assay of procainamide $31.00
Assay of quinidine $23.80
Assay of sirolimus $170.00
Assay of sirolimus $59.45
Assay of tacrolimus $205.00
Assay of theophylline $119.90
Assay of tobramycin $251.68
Assay of tobramycin $159.02
Assay of tobramycin $143.00
Assay of topiramate $170.00
Assay of vancomycin $71.60
Assay of vancomycin $59.47
Assay of vancomycin $146.00
Assay of vancomycin $29.25
Assay serum cholinesterase $45.75
Assay serum cholinesterase $64.60
Assay serum cholinesterase $1,309.00
Assay triiodothyronine (t3) $76.00
Assay triiodothyronine (t3) $147.35
Assay triiodothyronine (t3) $57.40
Assess cyst contrast inject $1,530.00
Assess hlth/behave init $1,368.00
Assess hlth/behave subseq $466.00
Assessment of aphasia $140.00
Assessment of aphasia $240.00
Assistive technology assess $1,329.00
Assistive technology assess $144.00
Assistive technology assess $144.00
ATHERECTOMY W/S&I ABD AORTA $67,456.00
ATHERECTOMY W/S&I BRACEPH EA $67,456.00
ATHERECTOMY W/S&I ILEAC EA $103,296.00
ATHERECTOMY W/S&I RENAL $67,456.00
ATHERECTOMY W/S&I VISCERAL EA $22,737.00
Attendance at delivery $37.50
Aud rehab postling hear loss $118.00
Aud rehab pre-ling hear loss $459.00
Audiometry air & bone $537.00
Auditor evoke potent compre $537.00
Auditor evoke potent limit $171.00
Auditory function + 15 min $785.00
Auditory function 60 min $852.00
AUTO FFP THAW $330.00
AUTO FFP THAW 8-24 HRS $330.00
AUTO WB $1,287.00
Balloon dilate urtrl strix $4,063.00
Balo angiop ctr dialysis seg $41,786.00
Behav chng smoking 3-10 min $37.50
Behav chng smoking 3-10 min $37.50
Behavral qualit analys voice $244.00
BENZODIAZEPINE SCR-REF $13.80
Biliary endo perq dx w/speci $13,063.00
Biliary endoscopy thru skin $24,709.00
Biliary endoscopy thru skin $13,063.00
Biliary endoscopy thru skin $24,709.00
Biofeedback peri/uro/rectal $218.00
Biofeedback train any meth $218.00
Biopsy abdominal mass $6,659.00
Biopsy eyelid & lid margin $1,332.00
Biopsy nail unit $2,673.00
Biopsy of external ear $1,659.00
Biopsy of floor of mouth $4,994.00
Biopsy of heart lining $720.00
Biopsy of lip $1,659.00
Biopsy of mouth lesion $1,659.00
Biopsy of neck/chest $7,902.00
Biopsy of penis $6,133.00
Biopsy of rectum $14,682.00
Biopsy of salivary gland $6,659.00
Biopsy of soft tissues $6,659.00
Biopsy of soft tissues $6,659.00
Biopsy of throat $5,021.00
Biopsy of thyroid $3,964.00
Biopsy of tongue $3,656.00
Biopsy of upper nose/throat $8,960.00
Biopsy of uterus lining $933.00
Biopsy of vagina $3,377.00
Biopsy of vulva/perineum $2,870.00
Biopsy roof of mouth $3,656.00
Biopsy shoulder tissues $7,523.00
Biopsy skin add-on $1,329.00
Biopsy skin lesion $1,329.00
Bl draw <3 yrs other vein $455.00
Bl exchange/transfuse nb $2,095.00
Bl exchange/transfuse non-nb $2,095.00
Blood gases any combination $427.00
Blood gases any combination $427.00
Blood gases any combination $427.00
Blood gases any combination $427.00
Blood gases any combination $44.21
Blood gases any combination $70.00
Blood gases w/o2 saturation $55.00
Blood ph $83.00
Blood ph $39.85
Blood ph $35.00
Blood transfusion service $1,851.00
Blood volume $2,762.00
Blood/lymph system procedure $2,444.00
Bone biopsy open superficial $8,331.00
Bone biopsy trocar/needle $6,659.00
Bone biopsy trocar/needle $9,999.00
Bone imaging (3d) $3,350.00
Bone imaging 3 phase $3,350.00
Bone imaging limited area $3,295.00
Bone imaging multiple areas $3,295.00
Bone imaging whole body $2,948.00
Bone marrow imaging body $4,129.00
Bone marrow imaging ltd $4,129.00
BONE SPECIFIC ALK PHOS-REF $54.35
Brachytx isodose complex $919.00
Brachytx isodose intermed $2,371.00
Brachytx isodose plan simple $1,355.00
Brain canal shunt procedure $3,413.00
Brain canal shunt procedure $3,413.00
Brain image w/flow < 4 views $3,184.00
Brain image w/flow 4 + views $4,439.00
Brain imaging (3d) $4,064.00
Brain imaging (pet) $4,877.00
Breast reconstruction $5,071.00
Breast tomosynthesis bi $10,580.00
Breast tomosynthesis bi $92.00
Breast tomosynthesis bi $92.00
Breast tomosynthesis uni $6,612.00
Breath hydrogen/methane test $1,947.00
Breath recording infant $627.00
Breath tst attain/anal c-14 $3,295.00
Breathing capacity test $1,840.00
Brnchsc w/ther aspir 1st $8,267.00
Bronchoscopy w/markers $22,999.00
BRONCHOSCOPY W/TUMOR EXCISE $8,990.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (List separately in addition to code for primary procedure 31636) $17,798.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure[s]) $26,574.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe $26,574.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed $26,574.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage $8,990.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe $26,574.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes $26,574.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings $8,990.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy) $17,262.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures $17,262.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures $17,262.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus $26,574.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application $8,990.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required) $26,574.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure) $5,868.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe $11,237.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body $8,990.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial $8,990.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent $3,251.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (List separately in addition to code for primary procedure) $4,485.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (List separately in addition to code for primary procedure) $16,730.00
Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i) $17,262.00
B-TYPE NATRIURETIC PEPTIDE $188.00
Bundle of his recording $87,673.00
Bx breast 1st lesion mr imag $9,900.00
Bx breast 1st lesion mr imag $10,606.00
Bx breast 1st lesion strtctc $6,594.00
Bx breast 1st lesion strtctc $9,891.00
Bx breast 1st lesion us imag $6,594.00
Bx breast 1st lesion us imag $9,891.00
Bx breast add lesion mr imag $6,193.00
Bx breast add lesion strtctc $6,193.00
Bx breast add lesion us imag $6,193.00
Bx of cervix w/scope leep $8,375.00
Bx/curett of cervix w/scope $1,232.00
C motor evoked lwr limbs $1,429.00
C motor evoked uppr limbs $1,316.00
C motor evoked upr&lwr limbs $833.00
C-14 UREA CAP-DX $337.00
Canalith repositioning proc $3,426.00
Candida dna dir probe $28.00
CANNABINOID SCREEN-REF $22.07
Cannula declotting $22,772.00
Car seat/bed test + 30 min $1,916.00
Car seat/bed test 60 min $1,064.00
Card mri veloc flow mapping $4,800.00
Cardiac drug stress test $570.00
Cardiac mri for morph $886.00
Cardiac mri for morph w/dye $3,333.00
Cardiac rehab $2,128.00
Cardiac rehab/monitor $378.00
Cardiac surgery procedure $22,319.00
Cardiopulm exercise testing $565.00
Cardiovascular procedure $225.00
Cardiovascular procedure $225.00
Cardiovascular procedure $10,947.00
Cardiovascular procedure $27,553.00
Cardiovascular procedure $57,254.00
Cardiovascular procedure $57,254.00
Cardiovascular procedure $57,254.00
Cardiovascular procedure $14,829.00
Cardiovascular procedure $57,254.00
Cardiovascular procedure $57,254.00
Cardiovascular stress test $24,257.00
Cardioversion electric ext $771.00
CAROTENE-REF $17.69
Cat scan follow-up study $1,012.00
Catheter for hysterography $1,313.00
Cerebrospinal fluid scan $9,202.00
Cerebrospinal fluid scan $5,429.00
Cessj therapy cath removal $13,484.00
Change gastrostomy tube $1,766.00
Change g-tube to g-j perc $7,692.00
Change nephroureteral cath $8,538.00
Change of bladder tube $1,461.00
Change of bladder tube $3,413.00
Change of ureter tube/stent $8,538.00
Change of windpipe airway $537.00
Change stent via transureth $10,424.00
Change ureter stent percut $12,282.00
Chem caut of granltj tissue $694.00
Chemo anti-neopl sq/im $275.00
Chemo hormon antineopl sq/im $239.00
Chemo ia infuse each addl hr $1,457.00
Chemo ia infusion up to 1 hr $296.00
Chemo ia push tecnique $1,457.00
Chemo intralesional over 7 $640.00
Chemo intralesional up to 7 $640.00
Chemo iv infus each addl seq $219.00
Chemo iv infusion 1 hr $901.00
Chemo iv infusion addl hr $490.00
Chemo iv push addl drug $901.00
Chemo iv push sngl drug $640.00
Chemo prolong infuse w/pump $1,457.00
Chemodener muscle larynx emg $2,758.00
Chemodener muscle larynx emg $4,137.00
Chemodenerv 1 extrem 1-4 ea $1,376.00
Chemodenerv 1 extrem 5/> ea $1,376.00
Chemodenerv 1 extrem 5/> mus $2,758.00
Chemodenerv 1 extremity 1-4 $2,758.00
Chemodenerv musc migraine $1,054.00
Chemodenerv musc neck dyston $1,669.00
Chemodenerv musc neck dyston $2,503.00
Chemodenerv trunk musc 1-5 $1,669.00
Chemodenerv trunk musc 6/> $2,758.00
Chemodenervation anal musc $13,240.00
Chemotherapy infusion method $1,457.00
Chemotherapy injection $1,184.00
Chemotherapy into cns $1,457.00
Chemotherapy unspecified $327.00
Chemotx admn prtl cavity $430.00
Chest surgery procedure $2,897.00
Chest wall manipulation $617.00
Chest wall manipulation $601.00
Cholinesterase challenge $94.00
CHROMOSOME ADDED BAND-REF $7.50
Chromosome karyotype study $427.00
Chromosome karyotype study $11.28
Chromosome karyotype study $48.00
Chromosome karyotype study $14.38
CHRONIC TO ART/DES/PTC ADDL-LC $35,001.00
CHRONIC TO ART/DES/PTC ADDL-LD $35,001.00
CHRONIC TO ART/DES/PTC ADDL-LM $35,001.00
CHRONIC TO ART/DES/PTC ADDL-RC $35,001.00
CHRONIC TO ART/DES/PTC ADDL-RI $35,001.00
CHRONIC TO ART/DES/PTCA 1V-LC $87,673.00
CHRONIC TO ART/DES/PTCA 1V-LD $87,673.00
CHRONIC TO ART/DES/PTCA 1V-LM $87,673.00
CHRONIC TO ART/DES/PTCA 1V-RC $87,673.00
CHRONIC TO ART/DES/PTCA 1V-RI $87,673.00
Cine/vid x-ray throat/esoph $1,000.00
Cine/video x-rays $2,831.00
Cine/video x-rays add-on $929.00
Circumcision w/regionl block $7,987.00
Clearance of airways $617.00
Clearance of airways $6,661.00
Closure of split wound $2,272.00
Clot factor xii hageman $62.50
CLOZAPINE(CLOZARIL)-REF $171.10
Cmplx rpr e/n/e/l 1.1-2.5 cm $2,402.00
Cmplx rpr e/n/e/l 2.6-7.5 cm $2,642.00
Cmplx rpr e/n/e/l addl 5cm/< $2,247.00
Cmplx rpr f/c/c/m/n/ax/g/h/f $1,452.00
Cmplx rpr s/a/l 1.1-2.5 cm $2,247.00
Cmplx rpr s/a/l 2.6-7.5 cm $2,247.00
Cmplx rpr s/a/l addl 5 cm/> $2,247.00
Cmplx rpr trunk 1.1-2.5 cm $6,858.00
Cmplx rpr trunk 2.6-7.5 cm $7,544.00
Cmplx rpr trunk addl 5cm/< $2,247.00
Co/membane diffuse capacity $627.00
Co2 breathing response curve $440.00
COCAINE SCREEN-REF $22.07
Cochlear implt f/up exam <7 $171.00
Cochlear implt f/up exam 7/> $459.00
Cognitive test by hc pro $1,368.00
Collect blood from picc $483.00
Colon motility 6 hr study $5,590.00
COLONOSCOPY SCREEN $6,493.00
Colonoscopy through stoma; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) $6,524.00
Colonoscopy through stoma; with biopsy, single or multiple $6,524.00
Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps $7,121.00
Colonoscopy, flexible, proximal to splenic flexure; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) $6,524.00
Colonoscopy, flexible, proximal to splenic flexure; with dilation by balloon, 1 or more strictures $6,524.00
Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection(s), any substance $6,524.00
Colonoscopy, flexible, proximal to splenic flexure; with removal of foreign body $6,524.00
Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery $6,524.00
Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique $6,524.00
Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed $6,524.00
COLPOSCOPY OF VAGINA $1,305.00
Community/work reintegration $265.00
Community/work reintegration $265.00
Community/work reintegration $265.00
COMPLETE ECHO W/CONTRAST $3,759.00
Complex drainage wound $8,389.00
Comprehen metabolic panel $250.00
Comprehensive hearing test $171.00
COMPREHENSIVE METABOLIC PANEL $285.00
Conditioning play audiometry $1,642.00
CONFORMITY EVALUATION $110.00
Contrast bath therapy $186.00
Contrast bath therapy $120.00
Contrast exam abdominl aorta $16,313.00
Contrast exam thoracic aorta $2,677.00
Contrast exam thoracic aorta $16,313.00
Contrast x-ray bladder $2,426.00
Contrast x-ray esophagus $3,324.00
Contrast x-ray exam of colon $1,000.00
Contrast x-ray exam of colon $1,487.00
Contrast x-ray exam of colon $1,487.00
Contrast x-ray of ankle $1,214.00
Contrast x-ray of brain $3,071.00
Contrast x-ray of elbow $2,110.00
Contrast x-ray of hip $2,110.00
Contrast x-ray of hip $4,220.00
Contrast x-ray of knee joint $554.00
Contrast x-ray of knee joint $4,220.00
Contrast x-ray of shoulder $2,110.00
Contrast x-ray of shoulder $4,220.00
Contrast x-ray of wrist $1,697.00
Control nose/throat bleeding $836.00
Control of nosebleed $483.00
Contrst x-ray uppr gi tract $1,487.00
Contrst x-ray uppr gi tract $1,348.00
Contrst x-ray uppr gi tract $1,487.00
Contrst x-ray urinary tract $2,708.00
Contrst x-ray urinary tract $1,525.00
Contrst x-ray urinary tract $2,426.00
Conversion ext bil drg cath $13,063.00
Convert nephrostomy catheter $3,147.00
Coombs test direct $351.00
Coombs test direct $155.00
Coombs test direct $205.02
Coombs test direct $27.50
Coronary art/grft angio s&i $16,251.00
Coronary artery angio s&i $15,295.00
Correct inverted nipple(s) $5,477.00
Create passage to kidney $13,461.00
Critical care addl 30 min $3,755.00
Critical care first hour $2,543.00
Critical care first hour $2,543.00
CRYOPRECIPITATE $213.00
Cryosurgery anal lesion(s) $759.00
Cryosurgery penis lesion(s) $759.00
Csf leakage imaging $5,617.00
Csf shunt evaluation $12,965.00
Csf shunt reprogram $1,180.00
Ct abd & pelv 1/> regns $7,538.00
Ct abd & pelv w/contrast $5,116.00
Ct abd & pelvis w/o contrast $5,933.00
Ct abdomen w/dye $2,677.00
Ct abdomen w/o & w/dye $5,269.00
Ct abdomen w/o dye $695.00
Ct angio abd&pelv w/o&w/dye $5,933.00
Ct angio abdom w/o & w/dye $8,332.00
Ct angio abdominal arteries $16,313.00
Ct angio hrt w/3d image $2,677.00
Ct angio lwr extr w/o&w/dye $9,200.00
Ct angio lwr extr w/o&w/dye $5,159.00
Ct angio upr extrm w/o&w/dye $5,933.00
Ct angiograph pelv w/o&w/dye $5,933.00
Ct angiography chest $5,933.00
Ct angiography head $5,933.00
Ct angiography neck $5,933.00
CT CEREBRAL PERF W/CONTRAST $5,269.00
Ct chest spine w/dye $5,269.00
Ct chest spine w/o & w/dye $5,933.00
Ct chest spine w/o dye $2,677.00
Ct guide for tissue ablation $6,424.00
Ct head/brain w/dye $5,269.00
Ct head/brain w/o & w/dye $5,933.00
Ct head/brain w/o dye $2,677.00
Ct hrt w/3d image $172.00
Ct hrt w/3d image congen $2,677.00
Ct hrt w/o dye w/ca test $3,333.00
Ct hrt w/o dye w/ca test $100.00
Ct lower extremity w/dye $4,600.00
Ct lower extremity w/dye $4,582.00
Ct lower extremity w/o dye $748.00
Ct lower extremity w/o dye $2,328.00
Ct lumbar spine w/dye $5,269.00
Ct lumbar spine w/o & w/dye $5,933.00
Ct lumbar spine w/o dye $2,677.00
Ct lwr extremity w/o&w/dye $6,900.00
Ct lwr extremity w/o&w/dye $5,159.00
Ct maxillofacial w/dye $5,269.00
Ct maxillofacial w/o & w/dye $5,933.00
Ct maxillofacial w/o dye $2,677.00
Ct neck spine w/dye $5,269.00
Ct neck spine w/o & w/dye $5,933.00
Ct neck spine w/o dye $2,677.00
Ct orbit/ear/fossa w/dye $5,269.00
Ct orbit/ear/fossa w/o dye $2,677.00
Ct orbit/ear/fossa w/o&w/dye $5,933.00
Ct pelvis w/dye $5,269.00
Ct pelvis w/o & w/dye $5,933.00
Ct pelvis w/o dye $2,677.00
Ct perfusion w/contrast cbf $234.00
Ct scan for localization $792.00
Ct scan for needle biopsy $1,199.00
Ct sft tsue nck w/o & w/dye $5,933.00
Ct soft tissue neck w/dye $5,269.00
Ct soft tissue neck w/o dye $2,677.00
Ct thorax w/dye $5,269.00
Ct thorax w/o & w/dye $5,933.00
Ct thorax w/o dye $2,677.00
CT THORAX W/O-LUNG CA SCREEN $776.00
Ct upper extremity w/dye $4,582.00
Ct upper extremity w/dye $6,900.00
Ct upper extremity w/o dye $2,328.00
Ct upper extremity w/o dye $4,600.00
Ct uppr extremity w/o&w/dye $5,159.00
Ct uppr extremity w/o&w/dye $9,200.00
Cystoscopy and treatment $9,039.00
Cystoscopy and treatment $13,461.00
CYSTOSCOPY AND TREATMENT $5,756.00
CYSTOURETHROSCOPY $4,668.00
Cytotoxic antibody screening $23.52
D & c after delivery $8,375.00
Deb bone 20 sq cm/< $5,588.00
Deb bone add-on $5,549.00
Deb musc/fascia 20 sq cm/< $2,543.00
Deb musc/fascia add-on $2,525.00
Deb subq tissue 20 sq cm/< $1,339.00
Deb subq tissue 20 sq cm/< $1,339.00
Deb subq tissue add-on $1,329.00
Debride infected skin $2,525.00
Debride nail 1-5 $537.00
Debride nail 6 or more $537.00
Declot vascular device $1,059.00
Deliver placenta $9,867.00
Dental surgery procedure $582.00
DES ADDL VESSEL-LC $35,001.00
DES ADDL VESSEL-LD $35,001.00
DES ADDL VESSEL-LM $35,001.00
DES ADDL VESSEL-RC $35,001.00
DES ADDL VESSEL-RI $35,001.00
DES SGL VESSEL-LC $57,254.00
DES SGL VESSEL-LD $57,254.00
DES SGL VESSEL-LM $57,254.00
DES SGL VESSEL-RC $57,254.00
DES SGL VESSEL-RI $57,254.00
Design mlc device for imrt $2,371.00
DESIPRAMINE-REF $144.80
Destroy c/th facet jnt addl $752.00
Destroy cerv/thor facet jnt $6,267.00
Destroy l/s facet jnt addl $2,331.00
Destroy l/s facet jnt addl $3,497.00
Destroy lumb/sac facet jnt $6,267.00
Destroy lumb/sac facet jnt $8,112.00
Destroy nerve face muscle $1,581.00
Destroy nerve face muscle $1,054.00
Destroy premal lesions 15/> $1,452.00
Destroy vulva lesion/s compl $11,397.00
Destroy vulva lesions sim $6,497.00
Destruct b9 lesion 1-14 $759.00
Destruct lesion 15 or more $759.00
Destruct premalg les 2-14 $759.00
Destruct premalg lesion $759.00
Destruction anal lesion(s) $9,863.00
Destruction of skin lesions $1,452.00
Destruction of skin lesions $2,247.00
Destruction of skin lesions $759.00
Destruction of skin lesions $759.00
Destruction of skin lesions $759.00
Destruction of skin lesions $759.00
Destruction of skin lesions $759.00
Destruction of skin lesions $1,452.00
Destruction of skin lesions $1,452.00
Destruction of skin lesions $1,452.00
Destruction of skin lesions $1,452.00
Destruction penis lesion(s) $6,497.00
Detect agnt mult dna ampli $35.00
Detect agnt mult dna ampli $28.00
Detect agnt mult dna ampli $79.00
Detect agnt mult dna direc $50.00
Detect agnt mult dna direc $66.80
Diagnostic laryngoscopy $1,060.00
Diagnostic sigmoidoscopy $4,247.00
Dialysis circuit embolj $27,553.00
Dialysis one evaluation $2,898.00
Dialysis one evaluation $1,749.00
Dialysis one evaluation $1,442.00
Dialysis one evaluation $1,442.00
Dialysis training complete $1,481.00
Dialysis training incompl $773.00
DIHYDROTESTOSTERONE(SER)-REF $53.68
Dilate biliary duct/ampulla $4,063.00
Dilate ic vasospasm add-on $7,839.00
Dilate ic vasospasm add-on $6,815.00
Dilate ic vasospasm init $9,776.00
Dilation and curettage $9,867.00
Dilation of cervical canal $9,867.00
Dilation of esophagus, by unguided sound or bougie, single or multiple passes $6,459.00
Dipropylacetic acid free $200.00
Dipropylacetic acid free $22.96
Discography cerv/thor spine $16,664.00
DISOPYRAMIDE(NORPACE)-REF $39.00
DISPENSING FEE, BICROS $165.00
DISPENSING FEE, BINAURAL HA $759.00
DISPENSING FEE, CROS $83.00
DISPENSING FEE, UNSPECIFIED HA $380.00
Dissolve clot heart vessel $3,303.00
Dissolve clot heart vessel $10,947.00
Doppler color flow add-on $1,184.00
Doppler echo exam heart $5,784.00
Doppler echo exam heart $5,784.00
Doppler flow testing $1,060.00
DOXEPIN-REF $21.90
Drain bl w/cath insertion $10,650.00
Drain bladder by needle $3,708.00
Drain bladder by trocar/cath $6,054.00
Drain breast lesion add-on $510.00
Drain cerebro spinal fluid $3,511.00
Drain neck/chest lesion $9,999.00
Drain/inj joint/bursa w/o us $1,593.00
Drain/inj joint/bursa w/o us $1,593.00
Drain/inj joint/bursa w/o us $1,593.00
Drain/inj joint/bursa w/us $1,668.00
Drain/inj joint/bursa w/us $1,668.00
Drainage lymph node lesion $9,999.00
Drainage lymph node lesion $11,664.00
Drainage of bladder abscess $8,179.00
Drainage of breast lesion $3,964.00
Drainage of eye $10,765.00
Drainage of heart sac $2,897.00
Drainage of hematoma/fluid $7,770.00
Drainage of kidney lesion $6,659.00
Drainage of ovarian cyst(s) $11,167.00
Drainage of pelvis lesion $16,935.00
Drainage of skin abscess $1,354.00
Draw blood off venous device $483.00
Dress/debrid p-thick burn l $1,204.00
Dress/debrid p-thick burn m $1,204.00
Dress/debrid p-thick burn s $694.00
Drill skull for implantation $1,265.00
Drug admin & hemodynmic meas $20,524.00
Drug assay caffeine $133.20
Drug assay clozapine $267.00
Drug assay cyclosporine $55.00
Drug assay everolimus $36.96
Drug screen quan lamotrigine $60.00
Drug screen quant gabapentin $35.00
Drug screen quant tiagabine $161.40
Drug screen quant zonisamide $148.68
Drug scrn quan levetiracetam $83.80
Drug scrn quan mycophenolate $152.10
Drug scrn quant oxcarbazepin $31.48
Drug test prsmv chem anlyzr $23.04
Drug test prsmv chem anlyzr $26.22
Drug test prsmv chem anlyzr $89.00
Drug test prsmv chem anlyzr $490.00
Drug test prsmv chem anlyzr $267.00
Drug test prsmv chem anlyzr $41.82
Drug test prsmv chem anlyzr $21.23
Drug test prsmv chem anlyzr $267.00
Dx bone marrow aspirations $4,994.00
Dx bone marrow biopsies $7,498.00
Dx bone marrow bx & aspir $12,492.00
Dx bronchoscope/wash $8,990.00
Dx duod intub w/asp spec $890.00
Dx duod intub w/asp specs $6,586.00
Dx mammo incl cad bi $92.00
Dx mammo incl cad uni $92.00
Dxa bone density axial $911.00
Dxa bone density/peripheral $695.00
Ear protector evaluation $76.00
Ecg monit/reprt up to 48 hrs $1,428.00
Ecg monit/reprt up to 48 hrs $1,189.00
Ecg/monitoring and analysis $279.00
Ecg/signal-averaged $455.00
ECHO CONGEN COMPLETE W/CONTR $5,556.00
ECHO CONGEN LIMITED W/CONTRAST $3,759.00
Echo exam of abdomen $1,111.00
Echo exam of fetal heart $779.00
Echo exam of fetal heart $779.00
Echo exam of fetal heart $4,027.00
Echo exam of fetal heart $4,027.00
Echo exam of fetal heart $1,484.00
Echo exam of head $300.00
Echo examination procedure $1,075.00
Echo guidance radiotherapy $467.00
Echo guide cardiocentesis $1,525.00
Echo guide for amniocentesis $1,772.00
Echo guide for artery repair $1,247.00
Echo guide for biopsy $2,995.00
Echo guide for heart biopsy $1,484.00
Echo guide for transfusion $1,907.00
Echo guide villus sampling $478.00
ECHO REST/STRES W/ECG&MD W/DYE $5,556.00
Echo transesophageal $3,451.00
Echo transesophageal $1,613.00
Echo transesophageal $5,784.00
Echo transesophageal $5,784.00
Echo transesophageal (tee) $3,307.00
ECHO TRANSESOPHAGEAL W/CONTR $5,556.00
Echo transthoracic $385.00
Echo transthoracic $278.00
ECHO W/DOPP & COLOR FLOW W/DYE $5,556.00
Echograp trans r pros study $1,484.00
Ecmo/ecls daily mgmt artery $17,925.00
Ecmo/ecls daily mgmt-venous $17,925.00
Ecmo/ecls initiation artery $17,925.00
Ecmo/ecls initiation venous $17,925.00
Ecmo/ecls insj ctr cannula $14,423.00
Ecmo/ecls insj ctr cannula $13,112.00
Ecmo/ecls insj prph cannula $13,112.00
Ecmo/ecls insj prph cannula $13,112.00
Ecmo/ecls insj prph cannula $14,423.00
Ecmo/ecls insj prph cannula $14,423.00
Ecmo/ecls repos perph cnula $13,112.00
Ecmo/ecls repos perph cnula $13,112.00
Ecmo/ecls repos perph cnula $14,423.00
Ecmo/ecls repos perph cnula $13,112.00
Ecmo/ecls rmvl ctr cannula $13,112.00
Ecmo/ecls rmvl ctr cannula $13,112.00
Ecmo/ecls rmvl perph cannula $13,112.00
Ecmo/ecls rmvl perph cannula $14,423.00
Ecmo/ecls rmvl prph cannula $13,112.00
Ecmo/ecls rmvl prph cannula $13,112.00
ED TRAUMA TEAM ACTIVATE W/O CC $6,520.00
ED TRAUMA TEAM ACTIVATION $5,324.00
Eeg 41-60 minutes $4,138.00
Eeg awake and asleep $1,216.00
Eeg awake and drowsy $1,216.00
Eeg cerebral death only $1,281.00
Eeg coma or sleep only $1,281.00
Eeg digital analysis $868.00
Eeg during surgery $5,674.00
Eeg monitor technol attended $3,824.00
Eeg monitoring/computer $877.00
Eeg monitoring/function test $3,824.00
Eeg monitoring/videorecord $221.00
Eeg over 1 hour $4,138.00
Electric current therapy $186.00
Electric current therapy $186.00
Electric stimulation therapy $113.00
Electric stimulation therapy $113.00
Electrical stimulation $187.00
Electrical stimulation $110.00
Electrical stimulation $110.00
Electro hearng aid test one $912.00
Electro hearng aid tst both $912.00
Electrocardiogram tracing $57,254.00
Electrode stim brain add-on $4,036.00
Electrode stimulation brain $1,041.00
Electrolyte panel $37.03
Electrophys map 3d add-on $28,188.00
Electrophysiologic study $16,509.00
Electrophysiology evaluation $5,070.00
Electrophysiology evaluation $5,070.00
Electrophysiology evaluation $28,188.00
Electrophysiology evaluation $28,188.00
Electrophysiology evaluation $7,952.00
Electrophysiology evaluation $7,137.00
Electrophysiology evaluation $2,717.00
Emergency dept visit $1,922.00
Emergency dept visit $1,313.00
Emergency dept visit $72.00
Emergency dept visit $461.00
Emergency dept visit $860.00
Emergency dept visit $1,512.00
Emergency dept visit $1,512.00
Endocerv curettage w/scope $1,129.00
Endocervical curettage $3,377.00
Endoluminal bx biliary tree $4,063.00
Endoluminal bx urtr rnl plvs $4,063.00
Endoluminl ivus oct c 1st $4,696.00
Endoluminl ivus oct c ea $1,199.00
Endoscopic cannulation of papilla with direct visualization of common bile duct(s) and/or pancreatic duct(s) (List separately in addition to code(s) for primary procedure) $10,037.00
Endoscopic evaluation of small intestinal (abdominal or pelvic) pouch; with biopsy, single or multiple $6,524.00
Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) $6,524.00
Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed $17,162.00
Endoscopic retrograde cholangiopancreatography (ERCP); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy) $17,162.00
Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde removal of calculus/calculi from biliary and/or pancreatic ducts (Do not report 43264 if no calculi or debris are found, even if balloon cath is deployed.) $17,162.00
Endoscopic retrograde cholangiopancreatography (ERCP); with pressure measurement of sphincter of Odd $17,162.00
Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged (43276 may be reported for the initial stent exchange and 43276 with modifier 59 for each additional stent exchange) $31,316.00
Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent (s) from biliary/pancreatic duct(s) $17,162.00
Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy (may be reported when sphincterotomy is performed in addition to 43261, 43263, 43264, 43265, 43275, and 43278) $17,162.00
Endoscopic retrograde cholangiopancreatography (ERCP); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, each duct (Do not report 43277 for use of a balloon catheter to clear stones/debris from a duct. Any dilation of the duct that may occur during this maneuver is considered inherent to the work of 43264 & 43265) $17,162.00
Endoscopy of ureter $13,461.00
Endoscopy swallow (fees) vid $847.00
Endovasc tempory vessel occl $57,254.00
Endovenous laser 1st vein $13,484.00
Endovenous laser vein addon $12,745.00
Endovenous rf 1st vein $13,484.00
Endovenous rf vein add-on $12,745.00
Ep & ablate supravent arrhyt $2,717.00
Ep & ablate ventric tachy $28,188.00
Epidurography $2,188.00
Episiotomy or vaginal repair $9,867.00
Esoph imped funct test > 1hr $3,504.00
Esoph imped function test $3,504.00
Esophageal capsule endoscopy $2,240.00
Esophageal recording $28,188.00
Esophageal recording $7,952.00
Esophagogastroduodenoscopy (EGD) with endoscopic gastric plication $12,999.00
Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection $9,429.00
Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis) $9,429.00
Esophagoscopy, flexible; with balloon dilation (less than 30 mm diameter) (rigid) $9,429.00
Esophagoscopy, rigid or flexible; with band ligation of esophageal varices $9,429.00
Esophagoscopy, rigid or flexible; with biopsy, single or multiple - transoral or transnasal intruduction $6,459.00
Esophagoscopy, rigid or flexible; with removal of foreign body $9,429.00
Esophagoscopy, rigid or flexible; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) $9,429.00
Esophagoscopy,flexible; with insertion of guide wire followed by dilation over guide wire (rigid) $9,429.00
Esophagus motility study $283.00
Esrd home pt serv p mo <2yrs $2,107.00
Esrd home pt serv p mo 12-19 $1,786.00
Esrd home pt serv p mo 20+ $1,560.00
Esrd home pt serv p mo 2-11 $922.00
Esrd serv 4 visits p mo <2yr $1,640.00
Esrd serv 4 vsts p mo 2-11 $1,640.00
Esrd srv 4 visits p mo 20+ $2,667.00
Esrd srv 4 vsts p mo 12-19 $3,102.00
Establish access to aorta $4,995.00
Establish brain cavity shunt $9,909.00
Eval aud rehab status $151.00
Eval aud status rehab add-on $459.00
Evaluate speech production $626.00
Evaluate swallowing function $129.00
Evaluation heart device $28,188.00
Evaluation of speech fluency $636.00
Evaluation of wheezing $1,840.00
Evasc prlng admn rx agnt 1st $11,617.00
Evasc prlng admn rx agnt add $11,617.00
Evoked auditory test limited $1,072.00
Evoked auditory test qual $171.00
Evoked auditory tst complete $626.00
Ex for speech device rx 1hr $459.00
Ex for speech device rx addl $459.00
Exam of vulva w/scope $633.00
Exam/biopsy of vag w/scope $2,866.00
Exam/biopsy of vulva w/scope $1,129.00
Exc f/e/e/n/l mal+mrg >4 cm $8,331.00
Exc f/e/e/n/l mal+mrg 0.5cm< $4,994.00
Exc f/e/e/n/l mal+mrg 0.6-1 $5,493.00
Exc f/e/e/n/l mal+mrg 1.1-2 $6,043.00
Exc f/e/e/n/l mal+mrg 2.1-3 $6,647.00
Exc f/e/e/n/l mal+mrg 3.1-4 $6,133.00
Exc face-mm b9+marg >4 cm $8,331.00
Exc face-mm b9+marg 0.5 cm/< $2,549.00
Exc face-mm b9+marg 0.6-1 cm $2,673.00
Exc face-mm b9+marg 1.1-2 cm $4,994.00
Exc face-mm b9+marg 2.1-3 cm $6,133.00
Exc face-mm b9+marg 3.1-4 cm $6,133.00
Exc h-f-nk-sp b9+marg >4 cm $8,331.00
Exc h-f-nk-sp b9+marg 0.5/< $6,133.00
Exc h-f-nk-sp b9+marg 0.6-1 $6,747.00
Exc h-f-nk-sp b9+marg 1.1-2 $7,422.00
Exc h-f-nk-sp b9+marg 2.1-3 $8,164.00
Exc h-f-nk-sp b9+marg 3.1-4 $6,133.00
Exc h-f-nk-sp mal+marg 0.5/< $6,133.00
Exc s/n/h/f/g mal+mrg >4 cm $9,879.00
Exc s/n/h/f/g mal+mrg 0.6-1 $6,747.00
Exc s/n/h/f/g mal+mrg 1.1-2 $7,422.00
Exc s/n/h/f/g mal+mrg 2.1-3 $8,164.00
Exc s/n/h/f/g mal+mrg 3.1-4 $8,980.00
Exc tr-ext b9+marg >4.0 cm $6,747.00
Exc tr-ext b9+marg 0.5 cm< $2,549.00
Exc tr-ext b9+marg 0.6-1 cm $2,804.00
Exc tr-ext b9+marg 1.1-2 cm $3,084.00
Exc tr-ext b9+marg 2.1-3cm $3,393.00
Exc tr-ext b9+marg 3.1-4 cm $6,133.00
Exc tr-ext mal+marg >4 cm $7,498.00
Exc tr-ext mal+marg 0.5 cm/< $2,673.00
Exc tr-ext mal+marg 0.6-1 cm $2,941.00
Exc tr-ext mal+marg 1.1-2 cm $3,235.00
Exc tr-ext mal+marg 2.1-3 cm $4,994.00
Exc tr-ext mal+marg 3.1-4 cm $5,493.00
Exchange biliary drg cath $13,063.00
Exchange drainage catheter $7,247.00
Exchange nephrostomy cath $3,708.00
Excision of bone lower jaw $12,195.00
Excision of gum lesion $8,573.00
Excision of tongue fold $5,333.00
Exercise w/hemodynamic meas $14,429.00
Exhaled air analysis $231.00
Exhaled carbon dioxide test $373.00
External cannula declotting $5,175.00
EXTERNAL COUNTERPULSATION $657.00
Extracranial bilat study $57,254.00
Extracranial uni/ltd study $57,254.00
Extremity study $1,243.00
Extremity study $1,060.00
F 18 FLUCICLOVINE (AXUMIN) $13,801.00
F18 FDG-DX $648.00
F18 FLORBETAPIR/AMYVID-DX $10,049.00
F18 SODIUM FLUORIDE-DX $525.00
Fem/popl revas w/ather $57,254.00
Fem/popl revas w/tla $27,849.00
Fem/popl revasc stnt & ather $87,673.00
Fem/popl revasc w/stent $57,254.00
FERN TEST $67.00
Fetal biophys profil w/o nst $1,271.00
Fetal biophys profile w/nst $1,075.00
Fetal contract stress test $746.00
Fetal cord puncture prenatal $1,773.00
Fetal non-stress test $746.00
Fetal non-stress test $746.00
Fetal non-stress test $746.00
Fetal non-stress test $746.00
FFP THAW $255.00
FFP THAW 8-24 HRS $255.00
FFP THAW CRYO REDUCED $285.00
Fix g/colon tube w/device $2,897.00
FIXED WING AIR MILEAGE $35.00
FIXED WING AIR TRANSPORT $14,930.00
FLUCYTOSINE-REF $34.02
Fluoro exam of g/colon tube $1,266.00
Fluoroguide for spine inject $2,152.00
Fluoroguide for vein device $922.00
Fluoroscope exam extensive $1,152.00
Fluoroscopy <1 hr phys/qhp $2,502.00
Fmri brain by tech $3,333.00
Fna w/image $3,964.00
Fna w/o image $1,196.00
Follow-up angiography $22,600.00
FTA-ABS-REF $14.40
Full mouth x-ray of teeth $1,325.00
GA 68 DOTATATE $408.00
GA67 GALLIUM-DX $169.00
GABAPENTIN SERUM-REF $21.25
Gait training therapy $265.00
Gastric emptying imag study $3,295.00
Gastric emptying imag study $2,892.00
Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium, secretin), includes drug administration $1,124.00
Gastroenterology procedure $1,826.00
Gastroesophageal reflux exam $3,777.00
Gastroesophageal reflux test $283.00
Gated heart planar single $9,202.00
GENERAL HEALTH PANEL $583.00
Genetic counseling 30 min $1,257.00
GENTAMICIN $243.00
G-esoph reflx tst w/electrod $4,104.00
Gi tract capsule endoscopy $3,504.00
GRAFT ARTHREC/DES/PTCA ADDL-LC $35,001.00
GRAFT ARTHREC/DES/PTCA ADDL-LD $35,001.00
GRAFT ARTHREC/DES/PTCA ADDL-LM $35,001.00
GRAFT ARTHREC/DES/PTCA ADDL-RC $35,001.00
GRAFT ARTHREC/DES/PTCA ADDL-RI $35,001.00
GRAFT ARTHREC/DES/PTCA SGL- LC $57,254.00
GRAFT ARTHREC/DES/PTCA SGL- LD $57,254.00
GRAFT ARTHREC/DES/PTCA SGL- LM $57,254.00
GRAFT ARTHREC/DES/PTCA SGL- RC $57,254.00
GRAFT ARTHREC/DES/PTCA SGL- RI $57,254.00
Group therapeutic procedures $265.00
Group therapeutic procedures $265.00
Group therapeutic procedures $265.00
Guidance for radiaj tx dlvr $6,079.00
Guide cathet fluid drainage $6,659.00
Guide nerv destr needle emg $2,101.00
HALOPERIDOL-REF $211.30
Hand muscle testing manual $410.00
Harvest auto stem cells $4,320.00
Hast w/oxygen titrate $1,064.00
HCV AB SCRN -REF $13.77
HCV AB, RIBA-REF $55.52
Hdr rdncl ntrstl/icav brchtx $1,579.00
Hdr rdncl ntrstl/icav brchtx $1,579.00
Hdr rdncl ntrstl/icav brchtx $5,931.00
Hdr rdncl skn surf brachytx $4,109.00
Hdr rdncl skn surf brachytx $5,657.00
HEALTHFAIR LIPID (POCT) $8.00
HEARING AID CHECK BINAURAL $150.00
HEARING AID CHECK MONAURAL $100.00
HEARING AID EXAM BINAURAL $225.00
HEARING AID EXAM MONAURAL $150.00
Heart flow reserve measure $3,754.00
Heart flow reserve measure $3,754.00
Heart image (pet) multiple $12,965.00
Heart image spect $3,765.00
Heart muscle imaging (pet) $9,202.00
Heart pacing mapping $15,588.00
Heart rhythm pacing $5,070.00
Heart/lung resuscitation cpr $35,001.00
Hemagglutination inhibition $133.60
Hemagglutination inhibition $31.50
HEMAGLUTNATION INHIBITN TE-MAY $16.89
Hematopoietic nuclear tx $2,953.00
Hemodialysis one evaluation $81.00
Hemodialysis one evaluation $1,051.00
Hemodialysis one evaluation $3,352.00
Hep c ab test confirm $150.00
Hepatic function panel $89.00
HEPATIC FUNCTION PANEL $194.00
HEPATITIS C SCREEN $129.00
Hepatitis c ab test $919.00
Hepatitis c ab test $70.00
Hepatitis delta ag ia $125.00
HEPATITIS, DELTA AGENT-REF $81.00
Hepatobil syst image w/drug $3,048.00
Hepatobiliary system imaging $3,581.00
Hla i typing 1 locus hr $55.00
Hot or cold packs therapy $296.00
Hot or cold packs therapy $759.00
HST W/TYPE III PORTABLE,UNATT $627.00
HST W/TYPE IV PORTABLE,UNATT 3 $627.00
Ht muscle image spect mult $2,762.00
Ht muscle image spect sing $3,350.00
Hydrate iv infusion add-on $150.00
Hydration iv infusion init $150.00
HYPERBARIC OXYGEN PER 30 MIN $892.00
Hypothermia ill neonate $923.00
Hypoxia response curve $1,064.00
I&d abscess subfascial $9,999.00
I/P HEMODIALYSIS $2,061.00
I-123 IOBENGUANE/MIBG-DX $11,550.00
I-123 IOFLUPANE/DATSCAN-DX $8,675.00
I-123 SOD IODIDE CAP MICRO-DX $245.00
I-123 SOD IODIDE CAP MILI-DX $1,820.00
I-131 SOD IODIDE CAP-DX $683.00
I-131 SOD IODIDE CAP-TX PERMCI $284.00
Icm device eval $278.00
Icm/ilr remote tech serv $360.00
ICU SURGICAL $6,703.00
Iliac revasc $27,553.00
Iliac revasc add-on $24,257.00
Iliac revasc w/stent $57,254.00
Iliac revasc w/stent add-on $28,959.00
Ilr device eval progr $335.00
Ilr device interrogate $385.00
Im admin 1st/only component $2,621.00
Im admin 1st/only component $2,195.00
Im admin 1st/only component $218.00
Im admin 1st/only component $218.00
Im admin each addl component $218.00
Image cath fluid colxn visc $9,358.00
Image cath fluid peri/retro $9,358.00
Image cath fluid trns/vgnl $6,441.00
Immunization admin $218.00
Immunization admin $218.00
Immunization admin $218.00
Immunization admin $218.00
Immunization admin each add $218.00
Implant pat-active ht record $40,181.00
IMPLANT PRESS SENSOR W/ANGIO $18,021.00
Implant tcat pulm vlv perq $22,319.00
IN-111 AUTO WBC-DX $6,825.00
IN-111 CAPROMAB/PROSTASCINT-DX $8,750.00
IN-111 PENTETATE/DTPA-DX $6,388.00
IN-111 PENTETREO/OCTREOSCAN-DX $12,933.00
Incise & drain bladder $9,039.00
Incision of achilles tendon $7,716.00
Incision of anal abscess $3,482.00
Incision of anal sphincter $14,682.00
Incision of foot tendon(s) $6,714.00
Incision of gallbladder $13,063.00
Incision of heart sac $2,703.00
Incision of rectal abscess $11,745.00
Incision of tongue fold $2,844.00
Influenza assay w/optic $103.22
Influenza assay w/optic $171.00
Infrared therapy $156.00
Infrared therapy $187.00
Infuse radioactive materials $9,352.00
Initial observation care $110.00
Initial observation care $110.00
Initial observation care $110.00
INJ FACET JT C/T W/US 1 $4,358.00
INJ FACET JT C/T W/US 2 $816.00
INJ FACET JT C/T W/US 3 $816.00
INJ FACET JT L/S W/US 1 $4,358.00
INJ FACET JT L/S W/US 2 $816.00
INJ FACET JT L/S W/US 3 $816.00
Inj foramen epidural add-on $1,415.00
Inj foramen epidural add-on $1,415.00
Inj foramen epidural c/t $3,102.00
Inj foramen epidural l/s $3,102.00
Inj paravert f jnt c/t 1 lev $3,995.00
Inj paravert f jnt c/t 1 lev $5,993.00
Inj paravert f jnt c/t 2 lev $955.00
Inj paravert f jnt c/t 2 lev $1,431.00
Inj paravert f jnt c/t 3 lev $810.00
Inj paravert f jnt c/t 3 lev $1,215.00
Inj paravert f jnt l/s 1 lev $4,358.00
Inj paravert f jnt l/s 1 lev $5,993.00
Inj paravert f jnt l/s 2 lev $955.00
Inj paravert f jnt l/s 2 lev $1,431.00
Inj paravert f jnt l/s 3 lev $955.00
Inj paravert f jnt l/s 3 lev $1,431.00
Inj tendon origin/insertion $1,187.00
Inj tendon sheath/ligament $1,187.00
Inj trigger point 1/2 muscl $1,195.00
Inj w/fluor eval cv device $1,218.00
Inject congenital card cath $15,295.00
Inject epidural patch $3,102.00
Inject for lymphatic x-ray $1,877.00
Inject hrt congntl art/grft $15,295.00
Inject l ventr/atrial angio $3,819.00
Inject pulm art hrt cath $2,517.00
Inject r ventr/atrial angio $5,233.00
Inject sacroiliac joint $3,028.00
Inject sinus tract for x-ray $1,041.00
Inject skin lesions </w 7 $624.00
Inject skin lesions >7 $759.00
Inject suprvlv aortography $2,517.00
Inject trigger points 3/> $1,195.00
Injection abdominal shunt $592.00
Injection ext venography $1,877.00
Injection eye drug $1,668.00
Injection for ankle x-ray $266.00
Injection for bladder x-ray $2,187.00
Injection for bladder x-ray $950.00
Injection for breast x-ray $592.00
Injection for cholangiogram $2,110.00
Injection for cholangiogram $13,063.00
Injection for elbow x-ray $491.00
Injection for hip x-ray $1,126.00
Injection for hip x-ray $1,881.00
Injection for knee x-ray $332.00
Injection for myelogram $4,008.00
Injection for shoulder x-ray $4,934.00
Injection for spleen x-ray $1,626.00
Injection for ureter x-ray $698.00
Injection for ureter x-ray $213.00
Injection for wrist x-ray $217.00
Injection into brain canal $3,511.00
Injection of sinus tract $4,875.00
Injection treatment of nerve $6,372.00
Injection treatment of nerve $9,101.00
Injection treatment of nerve $4,358.00
Injection treatment of nerve $9,101.00
Ins cath abd/l-ext art 1st $5,665.00
Ins cath abd/l-ext art 2nd $5,511.00
Ins cath abd/l-ext art 3rd $8,821.00
Ins cath abd/l-ext art addl $767.00
Ins cath ren art 1st bilat $16,313.00
Ins cath ren art 1st unilat $16,313.00
Ins cath ren art 2nd+ bilat $16,313.00
Ins cath ren art 2nd+ unilat $16,313.00
Ins endovas vena cava filtr $22,772.00
Ins mark abd/pel for rt perq $8,306.00
Ins mark thor for rt perq $7,119.00
Ins tun ip cath for dial opn $15,675.00
Ins/rep subq defibrillator $182,939.00
Insert 1 electrode pm-defib $40,181.00
Insert 2 electrode pm-defib $40,181.00
Insert abdomen-venous drain $20,083.00
Insert bladder catheter $543.00
Insert card electrodes dual $40,181.00
Insert cath pleura w/ image $7,044.00
Insert cath pleura w/o image $6,403.00
Insert cervical dilator $1,331.00
Insert electrd/pm cath sngl $40,181.00
Insert emergency airway $453.00
Insert heart pm atrial $55,640.00
Insert heart pm ventricular $55,640.00
Insert hepatic shunt (tips) $24,363.00
Insert i-aort percut device $6,824.00
Insert intrauterine device $1,232.00
Insert non-tunnel cv cath $4,573.00
Insert non-tunnel cv cath $4,573.00
Insert pacing lead & connect $55,640.00
Insert picc cath $4,573.00
Insert picc cath $4,573.00
Insert picc cath $4,573.00
Insert picc cath $4,573.00
Insert picvad cath $15,887.00
Insert picvad cath $15,887.00
Insert pleural cath $15,391.00
Insert pulse gen dual leads $55,640.00
Insert pulse gen mult leads $101,486.00
Insert pulse gen sngl lead $40,181.00
Insert temp bladder cath $543.00
Insert tun ip cath perc $15,391.00
Insert tun ip cath w/port $16,744.00
Insert tunneled cv cath $15,887.00
Insert tunneled cv cath $15,887.00
Insert tunneled cv cath $15,887.00
Insert tunneled cv cath $14,563.00
Insert tunneled cv cath $24,594.00
Insert tunneled cv cath $14,563.00
Insert vad artery access $10,076.00
Insert/place heart catheter $600.00
Insertion catheter artery $671.00
Insertion of catheter vein $1,414.00
Insertion of catheter vein $540.00
Insertion of catheter vein $4,234.00
Insertion of left heart vent $13,112.00
Insj subq impltbl dfb elctrd $40,181.00
Insj/rplcmt defib w/lead(s) $182,939.00
Insrt heart pm atrial & vent $55,640.00
Insrt pulse gen w/dual leads $131,580.00
Insrt pulse gen w/mult leads $182,939.00
Insrt pulse gen w/singl lead $131,580.00
Interdiscal perq aspir dx $6,659.00
INTERMEDIATE CCU $4,108.00
Interrog device eval heart $485.00
Interrogate subq defib $1,145.00
Interrogation vad in person $8,358.00
Interv hlth/behav fam w/pt $150.00
Intervene hlth/behave group $150.00
Intervene hlth/behave indiv $150.00
Intmd rpr face/mm >30.0 cm $2,117.00
Intmd rpr face/mm 12.6-20 cm $1,750.00
Intmd rpr face/mm 2.5 cm/< $1,194.00
Intmd rpr face/mm 2.6-5.0 cm $1,314.00
Intmd rpr face/mm 20.1-30.0 $1,925.00
Intmd rpr face/mm 5.1-7.5 cm $1,446.00
Intmd rpr face/mm 7.6-12.5cm $1,591.00
Intmd rpr n-hf/genit >30.0cm $6,497.00
Intmd rpr n-hf/genit 2.5cm/< $1,452.00
Intmd rpr n-hf/genit12.6-20 $2,472.00
Intmd rpr n-hf/genit2.6-7.5 $1,596.00
Intmd rpr n-hf/genit20.1-30 $2,719.00
Intmd rpr n-hf/genit7.6-12.5 $2,247.00
Intmd rpr s/a/t/ext 12.6-20 $1,452.00
Intmd rpr s/a/t/ext 2.5 cm/< $1,452.00
Intmd rpr s/a/t/ext 2.6-7.5 $1,452.00
Intmd rpr s/a/t/ext 20.1-30 $2,247.00
Intmd rpr s/tr/ext >30.0 cm $11,542.00
Intmd rpr s/tr/ext 7.6-12.5 $1,452.00
Intra-atrial pacing $5,070.00
Intra-atrial recording $87,673.00
Intracardiac ecg (ice) $2,569.00
Intracran angioplsty w/stent $11,528.00
Intracranial angioplasty $9,305.00
Intracranial complete study $1,243.00
Intracranial limited study $1,243.00
Intranasal biopsy $3,656.00
INTRAOP NEURO 1:1 15MIN G0453 $221.00
Intraventricular pacing $7,952.00
Intro cath dialysis circuit $12,324.00
Intro cath dialysis circuit $54,110.00
Intro cath dialysis circuit $69,578.00
Intro gastrointestinal tube $3,413.00
Intro ndl icath upr/lxtr art $4,536.00
Intrvasc us noncoronary 1st $8,505.00
Intrvasc us noncoronary addl $8,505.00
Ionm in operatng room 15 min $2,188.00
Ionm remote/>1 pt or per hr $4,728.00
Irrig drug delivery device $901.00
Irrigation of bladder $1,096.00
ISOENZMES-REF $14.00
ISTAT BLOOD GASES $427.00
ISTAT PH $83.00
IV INFUSION >8 HRS VIA PUMP $1,486.00
Iv inj ra drug dx study $9,202.00
Joint survey single view $992.00
K flow/funct image multiple $5,089.00
K flow/funct image w/drug $4,241.00
K flow/funct image w/o drug $9,202.00
Kidney endoscopy $20,362.00
Kidney endoscopy & treatment $20,362.00
Kidney imaging (3d) $6,106.00
Kidney imaging morphol $9,202.00
L hrt art/grft angio $15,295.00
L hrt artery/ventricle angio $15,295.00
L hrt cath trnsptl puncture $19,795.00
L ventric pacing lead add-on $58,236.00
Laryngoscopic sensory vid $811.00
Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn $8,990.00
Laryngoscopy telescopic $2,813.00
Larynx surgery procedure $582.00
Laser surg penis lesion(s) $6,497.00
Left hrt cath w/ventrclgrphy $4,511.00
Leveen/shunt patency exam $3,295.00
LEVETIRACETAM SERUM-REF $48.80
Ligate/divide/excise vein $15,887.00
Ligation of a-v fistula $13,484.00
Limb muscle testing manual $1,216.00
Limb muscle testing manual $2,188.00
LIMITED ECHO W/CONTRAST $3,759.00
Lipid panel $240.00
Lipid panel $65.00
Lipid panel $28.00
Lipid panel $220.00
LIPID PANEL $193.00
Liver and spleen imaging $3,089.00
Liver image (3d) with flow $3,726.00
Liver imaging (3d) $3,725.00
Liver surgery procedure $13,484.00
LOW APP TRNK/ARM/LEG 1ST 25 $2,525.00
LOW APP TRNK/ARM/LEG ADD 25 $2,525.00
LOW BODY & EXTRM<100CM2 1ST $12,592.00
LOW BODY & EXTRM<100CM2 ADD $12,592.00
LOW HAND/FEET/FACE <100 1ST $8,314.00
LOW HAND/FEET/FACE <100 ADD $8,314.00
LOW HAND/FEET/FACE 1ST 25 $2,525.00
LOW HAND/FEET/FACE ADD 25 $2,525.00
Lower extremity study $896.00
Lower extremity study $896.00
Lung function test (mbc/mvv) $1,064.00
Lung perf&ventilat diferentl $4,439.00
Lung perfusion differential $3,132.00
Lung perfusion imaging $12,965.00
Lung ventilat&perfus imaging $3,481.00
Lwr xtr vasc stdy bilat $739.00
Lymph system imaging $3,458.00
Lymph vessel x-ray trunk $2,874.00
Lymphocytotoxicity assay $60.00
Lymphocytotoxicity assay $275.96
Lyse chest fibrin init day $3,380.00
Lysis penil circumic lesion $7,987.00
M TUBERCULOSIS QUANTIFERON-REF $123.40
Magnetic image jaw joint $3,333.00
Manual therapy 1/> regions $265.00
Manual therapy 1/> regions $265.00
Map tachycardia add-on $28,188.00
Massage therapy $265.00
Massage therapy $110.00
Measure blood oxygen level $1,064.00
Measure blood oxygen level $668.00
Measure blood oxygen level $46.00
Measure venous pressure $1,736.00
Mech remov tunneled cv cath $15,887.00
Mech remov tunneled cv cath $6,097.00
Mechanical chest wall oscill $376.00
Meckels divert exam $3,214.00
MED NUTR THER GRP EA 30 MIN $37.00
Med nutrition indiv subseq $292.00
Medical nutrition indiv in $292.00
Metabolic panel total ca $171.00
METHADONE CONFIRMATION, U-REF $39.96
METHADONE SCREEN-REF $13.80
METHYL ALCOHOL-REF $55.00
Microvolt t-wave assess $1,773.00
Middle cerebral artery echo $1,406.00
MNT SUB TX CHANGE DX EA 15 MIN $69.00
Mod sed oth phys/qhp <5 yrs $923.00
Mod sed oth phys/qhp 5/>yrs $923.00
Mod sed other phys/qhp ea $181.00
Mod sed same phys/qhp <5 yrs $71.00
Mod sed same phys/qhp 5/>yrs $71.00
Mod sed same phys/qhp ea $34.00
Mohs 1 stage h/n/hf/g $2,247.00
Mohs 1 stage t/a/l $2,247.00
Mohs addl stage $2,247.00
Mohs addl stage t/a/l $2,247.00
Mohs surg addl block $2,247.00
Motion fluoroscopy/swallow $324.00
Mr ang lwr ext w or w/o dye $9,200.00
Mr ang lwr ext w or w/o dye $9,200.00
Mr ang lwr ext w or w/o dye $2,898.00
Mr ang lwr ext w or w/o dye $4,174.00
Mr ang lwr ext w or w/o dye $4,722.00
Mr ang lwr ext w or w/o dye $8,050.00
Mr angio pelvis w/o & w/dye $3,333.00
Mr angio pelvis w/o & w/dye $4,800.00
Mr angio pelvis w/o & w/dye $5,430.00
Mr angio spine w/o&w/dye $3,333.00
Mr angio spine w/o&w/dye $5,430.00
Mr angio spine w/o&w/dye $4,800.00
Mr angio upr extr w/o&w/dye $3,333.00
Mr angio upr extr w/o&w/dye $5,430.00
Mr angio upr extr w/o&w/dye $4,800.00
Mr angiograph head w/o&w/dye $5,430.00
Mr angiograph neck w/o&w/dye $5,430.00
Mr angiography head w/dye $4,800.00
Mr angiography head w/o dye $3,333.00
Mr angiography neck w/dye $4,800.00
Mr angiography neck w/o dye $3,333.00
Mr guidance for needle place $1,427.00
Mr spectroscopy $811.00
Mri abdomen w/dye $3,333.00
Mri abdomen w/o & w/dye $4,800.00
Mri abdomen w/o dye $8,332.00
Mri angio abdom w orw/o dye $5,430.00
Mri angio abdom w orw/o dye $3,333.00
Mri angio abdom w orw/o dye $4,800.00
Mri angio chest w or w/o dye $3,333.00
Mri angio chest w or w/o dye $4,800.00
Mri angio chest w or w/o dye $5,430.00
Mri both breasts $4,800.00
Mri both breasts $5,430.00
Mri brain stem w/dye $4,800.00
Mri brain stem w/o & w/dye $5,430.00
Mri brain stem w/o dye $3,333.00
Mri chest spine w/dye $4,800.00
Mri chest spine w/o & w/dye $5,430.00
Mri chest spine w/o dye $3,333.00
Mri chest w/dye $4,800.00
Mri chest w/o & w/dye $5,430.00
Mri chest w/o dye $3,333.00
Mri fetal ea addl gestation $3,333.00
Mri fetal sngl/1st gestation $546.00
Mri for tissue ablation $4,640.00
Mri jnt of lwr extre w/o dye $9,200.00
Mri jnt of lwr extre w/o dye $2,898.00
Mri joint lwr extr w/o&w/dye $8,050.00
Mri joint lwr extr w/o&w/dye $4,722.00
Mri joint of lwr extr w/dye $5,750.00
Mri joint of lwr extr w/dye $4,174.00
Mri joint upr extr w/o&w/dye $4,722.00
Mri joint upr extr w/o&w/dye $9,200.00
Mri joint upr extrem w/dye $4,174.00
Mri joint upr extrem w/dye $8,050.00
Mri joint upr extrem w/o dye $2,898.00
Mri joint upr extrem w/o dye $5,750.00
Mri lower extremity w/dye $5,750.00
Mri lower extremity w/dye $4,174.00
Mri lower extremity w/o dye $9,200.00
Mri lower extremity w/o dye $2,898.00
Mri lumbar spine w/dye $4,800.00
Mri lumbar spine w/o & w/dye $5,430.00
Mri lumbar spine w/o dye $3,333.00
Mri lwr extremity w/o&w/dye $8,050.00
Mri lwr extremity w/o&w/dye $4,722.00
Mri neck spine w/dye $4,800.00
Mri neck spine w/o & w/dye $5,430.00
Mri neck spine w/o dye $3,333.00
Mri one breast $1,938.00
Mri one breast $1,938.00
Mri one breast $3,333.00
Mri orbit/face/neck w/dye $4,800.00
Mri orbit/face/neck w/o dye $3,333.00
Mri orbt/fac/nck w/o &w/dye $5,430.00
Mri pelvis w/dye $4,800.00
Mri pelvis w/o & w/dye $5,430.00
Mri pelvis w/o dye $3,333.00
Mri procedure $1,110.00
Mri procedure $3,333.00
Mri upper extremity w/dye $4,174.00
Mri upper extremity w/dye $8,050.00
Mri upper extremity w/o dye $2,898.00
Mri upper extremity w/o dye $5,750.00
Mri uppr extremity w/o&w/dye $4,722.00
Mri uppr extremity w/o&w/dye $9,200.00
Mtms by pharm addl 15 min $2,351.00
Mtms by pharm est 15 min $1,014.00
Mtms by pharm np 15 min $101.00
Multiple sleep latency test $4,138.00
Multiple sleep latency test $4,138.00
Musc test done w/n test comp $1,394.00
Musc test done w/n test comp $697.00
Musc tst done w/n tst nonext $1,394.00
Musc tst done w/n tst nonext $697.00
Musc tst done w/nerv tst lim $711.00
Musc tst done w/nerv tst lim $230.00
Muscle test 2 limbs $1,071.00
Muscle test 3 limbs $555.00
Muscle test 4 limbs $843.00
Muscle test cran nerv unilat $1,355.00
Muscle test cran nerve bilat $483.00
Muscle test larynx $1,256.00
Muscle test nonparaspinal $867.00
Muscle test one fiber $611.00
Muscle test one limb $168.00
Muscle test thor paraspinal $869.00
Myelography lumbar injection $4,008.00
Myelography lumbar injection $4,008.00
Myelography lumbar injection $4,008.00
Myelography lumbar injection $4,008.00
MYOCARDIAL STRAIN IMAGING $655.00
N blk inj sciatic cont inf $3,011.00
N block cont infuse b plex $4,358.00
N block inj axillary $3,102.00
N block inj brachial plexus $4,358.00
N block inj celiac pelus $5,811.00
N block inj cervical plexus $2,390.00
N block inj facial $759.00
N block inj fem cont inf $3,102.00
N block inj fem single $3,102.00
N block inj hypogas plxs $4,358.00
N block inj ilio-ing/hypogi $3,102.00
N block inj intercost mlt $3,102.00
N block inj intercost sng $3,102.00
N block inj lumbar plexus $3,011.00
N block inj occipital $1,409.00
N block inj occipital $2,115.00
N block inj paracervical $3,102.00
N block inj pudendal $3,102.00
N block inj sciatic sng $3,102.00
N block inj suprascapular $2,390.00
N block inj trigeminal $1,409.00
N block lumbar/thoracic $3,102.00
N block lumbar/thoracic $3,102.00
N block other peripheral $1,538.00
N block other peripheral $2,115.00
N block stellate ganglion $3,102.00
Nasal function studies $190.00
Nasal/orogastric w/tube plmt $1,358.00
Nasal/sinus endoscopy surg $8,990.00
Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report) $1,664.00
Nasopharyngoscopy $471.00
NAVIGATIONAL BRONCHOSCOPY Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation $16,730.00
Nb resuscitation $95.00
Needle biopsy chest lining $5,652.00
Needle biopsy liver add-on $208.00
Needle biopsy lymph nodes $6,659.00
Needle biopsy muscle $6,659.00
Needle biopsy of liver $7,770.00
Needle biopsy pancreas $5,652.00
Needle localization by xray $889.00
Neg press wnd tx </=50 sq cm $694.00
Neg press wound tx </=50 cm $694.00
Neg press wound tx >50 cm $694.00
Neg press wound tx >50 cm $694.00
Nervous system surgery $9,999.00
Neurobehavioral status exam $608.00
Neuromuscular junction test $4,728.00
Neuromuscular reeducation $265.00
Neuromuscular reeducation $265.00
Neuropsych testing by tec $1,368.00
Neuropsych tst by psych/phys $608.00
NICOTINE & METABOLITE-REF $40.00
NITRIC OXIDE HOURLY $1,540.00
Njx interlaminar crv/thrc $3,102.00
Njx interlaminar crv/thrc $4,514.00
Njx interlaminar crv/thrc $3,386.00
Njx interlaminar crv/thrc $4,798.00
Njx interlaminar lmbr/sac $4,480.00
Njx interlaminar lmbr/sac $5,892.00
Njx interlaminar lmbr/sac $4,358.00
Njx interlaminar lmbr/sac $5,770.00
Njx px discography crv/thrc $1,562.00
Njx px discography lumbar $1,562.00
Njx px nfrosgrm &/urtrgrm $3,147.00
Njx px nfrosgrm &/urtrgrm $3,147.00
Njx sclrsnt mlt incmptnt vn $1,594.00
NM TC99M MEDRONATE (MDP) $133.00
Non-routine bl draw 3/> yrs $219.00
Nonvascular shunt x-ray $16,313.00
NORTRIPTYLINE-REF $122.53
Nrv cndj test 11-12 studies $2,831.00
Nrv cndj test 13/> studies $3,587.00
Nrv cndj test 7-8 studies $1,322.00
Nrv cndj test 9-10 studies $2,077.00
Nrv cndj tst 3-4 studies $405.00
Nrv cndj tst 5-6 studies $833.00
Ntsty modul rad tx dlvr cplx $13,586.00
Ntsty modul rad tx dlvr smpl $59,327.00
Nuclear localization/abscess $9,202.00
Nuclear rx intra-arterial $2,360.00
Nuclear rx iv admin $14,459.00
Nuclear rx oral admin $14,459.00
Nvr cndj tst 1-2 studies $810.00
Ob us < 14 wks addl fetus $1,075.00
Ob us < 14 wks single fetus $1,587.00
Ob us >/= 14 wks addl fetus $582.00
Ob us >/= 14 wks sngl fetus $1,484.00
Ob us detailed addl fetus $1,113.00
Ob us detailed sngl fetus $1,587.00
Ob us follow-up per fetus $316.00
Ob us limited fetus(s) $1,222.00
Ob us nuchal meas 1 gest $1,815.00
Ob us nuchal meas add-on $2,285.00
Obstetric panel $163.20
Obstetric panel $82.00
OBSTETRIC PANEL $701.00
Obstetrical care $8,375.00
OBTAINING SCREEN PAP TEST $120.00
Office/outpatient visit est $110.00
Office/outpatient visit est $110.00
Office/outpatient visit est $110.00
Office/outpatient visit est $110.00
Office/outpatient visit est $110.00
Office/outpatient visit new $181.00
Office/outpatient visit new $21,119.00
Office/outpatient visit new $376.00
Office/outpatient visit new $110.00
Office/outpatient visit new $110.00
Open bowel to skin $1,102.00
Open thrombect av fistula $16,104.00
Open/perq place stent 1st $57,254.00
Open/perq place stent ea add $24,257.00
Open/perq place stent ea add $24,257.00
Open/perq place stent same $57,254.00
OPIATE SCREEN-REF $22.07
OPIATES, QUAL-REF $36.96
OR TIME - ADDTL MINUTE LEVEL 1 $167.00
OR TIME - ADDTL MINUTE LEVEL 2 $184.00
OR TIME - ADDTL MINUTE LEVEL 3 $202.00
OR TIME - ADDTL MINUTE LEVEL 4 $223.00
OR TIME - ADDTL MINUTE LEVEL 5 $256.00
OR TIME - ADDTL MINUTE LEVEL 6 $307.00
OR TIME - ADDTL MINUTE LEVEL 7 $322.00
OR TIME - FIRST 1/2 HR LEVEL 1 $5,010.00
OR TIME - FIRST 1/2 HR LEVEL 2 $5,515.00
OR TIME - FIRST 1/2 HR LEVEL 3 $6,067.00
OR TIME - FIRST 1/2 HR LEVEL 4 $6,666.00
OR TIME - FIRST 1/2 HR LEVEL 5 $7,667.00
OR TIME - FIRST 1/2 HR LEVEL 6 $9,198.00
OR TIME - FIRST 1/2 HR LEVEL 7 $9,657.00
Oral function therapy $507.00
Oral speech device eval $115.00
ORLANDO BALLET SCREEN PER HR $150.00
Orthc/prostc mgmt sbsq enc $91.00
Orthc/prostc mgmt sbsq enc $292.00
Orthotic mgmt&trainj 1st enc $91.00
Orthotic mgmt&trainj 1st enc $91.00
OT ELEC STIM UNATT M/SKELETAL $199.00
Ot eval high complex 60 min $591.00
Ot eval high complex 60 min $591.00
Ot eval high complex 60 min $591.00
Ot eval high complex 60 min $150.00
Ot eval low complex 30 min $591.00
Ot eval low complex 30 min $591.00
Ot eval mod complex 45 min $560.00
Ot eval mod complex 45 min $591.00
Ot re-eval est plan care $25.00
OTHER RESP PROC, GROUP Q15MIN $124.00
OTHER RESP PROC, INDIV Q15MIN $132.00
Outer ear surgery procedure $453.00
Panoramic x-ray of jaws $420.00
PAP SMEAR-SCREENING $87.00
Paraffin bath therapy $202.00
Paraffin bath therapy $140.00
Parathyrd planar w/spect&ct $2,762.00
Parathyrd planar w/wo subtrj $1,092.00
Parathyroid planar imaging $3,880.00
Pdt dstr prmlg les skn $901.00
Penile vascular study $1,243.00
Perc cryo ablate renal tum $29,111.00
Perc rf ablate renal tumor $29,111.00
Percut ablate liver rf $24,709.00
Percut bx lung/mediastinum $5,652.00
Percutaneous diskectomy $24,013.00
Peri-px device eval & prgr $242.00
Peri-px pacemaker device evl $335.00
Perq abltj lvr cryoablation $24,709.00
Perq art m-thrombect &/nfs $19,174.00
Perq cervicothoracic inject $14,374.00
Perq clsr tcat l atr apndge $48,992.00
Perq dev breast 1st mr guide $3,364.00
Perq dev breast 1st mr guide $5,046.00
Perq dev breast 1st us imag $3,364.00
Perq dev breast 1st us imag $5,046.00
Perq dev breast add mr guide $3,364.00
Perq dev breast add us imag $3,364.00
Perq dev soft tiss 1st imag $2,884.00
Perq device breast 1st imag $3,364.00
Perq device breast 1st imag $5,046.00
Perq device breast ea imag $3,364.00
Perq lumbosacral injection $14,374.00
Perq plmt bile duct stent $24,709.00
Perq plmt bile duct stent $24,709.00
Perq plmt bile duct stent $24,709.00
Perq stent/chest vert art $234.00
Perq transcath closure pda $87,673.00
Perq vertebral augmentation $42,384.00
Perq vertebral augmentation $42,384.00
Perq vertebral augmentation $20,857.00
Pet image w/ct full body $14,459.00
Pet image w/ct lmtd $4,957.00
Pet image w/ct skull-thigh $2,762.00
PHASE 2 RECOVERY ADDL MINUTE $36.00
PHASE 2 RECOVERY FIRST 30 MINS $1,074.00
Phleb veins - extrem 20+ $15,887.00
Phlebotomy $923.00
Physical performance test $904.00
Physical performance test $1,329.00
Pierce skull implant device $3,400.00
Place cath carotd art $26,623.00
Place cath carotid/inom art $16,313.00
Place cath carotid/inom art $22,772.00
Place cath intracranial art $4,325.00
Place cath subclavian art $16,313.00
Place cath thoracic aorta $16,313.00
Place cath vertebral art $26,623.00
Place cath xtrnl carotid $14,461.00
Place catheter in aorta $3,502.00
Place catheter in artery $8,126.00
Place catheter in artery $4,629.00
Place catheter in artery $4,913.00
Place catheter in artery $6,106.00
Place catheter in artery $6,678.00
Place catheter in artery $10,266.00
Place catheter in artery $1,451.00
Place catheter in vein $3,120.00
Place catheter in vein $4,673.00
Place catheter in vein $8,762.00
Place cecostomy tube perc $11,745.00
Place duod/jej tube perc $7,692.00
Place gastrostomy tube perc $7,854.00
Place needle in vein $444.00
Place needle in vein $444.00
Place needle in vein $444.00
Place rt device/marker pros $7,188.00
Placement bile duct support $4,013.00
PLATELET LEUKORED PHER $1,647.00
PLATELET LEUKORED(WHOLE BLOOD) $372.00
Plmt access bil tree sm bwl $13,063.00
Plmt biliary drainage cath $13,063.00
Plmt biliary drainage cath $13,063.00
Plmt nephrostomy catheter $9,039.00
Plmt nephroureteral catheter $9,039.00
Plmt ureteral stent prq $13,461.00
Plmt ureteral stent prq $13,461.00
Plmt ureteral stent prq $13,461.00
PLT PHER LR IRRAD $1,782.00
PLT PHERESIS/RAPID DETECTION $260.00
PLTPHER SPLIT UNIT $255.00
Pm device eval in person $306.00
Pm device progr eval dual $1,119.00
Pm device progr eval multi $232.00
Pm device progr eval sngl $735.00
PM LEADLESS EVAL IN PERSON $238.00
PM LEADLESS EVL/PROG IN PERSON $238.00
PM LEADLESS NEW OR REPL VENT $87,673.00
PM LEADLESS REMOVAL ONLY VENT $13,484.00
Pm phone r-strip device eval $253.00
Pm/icd remote tech serv $489.00
POCT BLOOD GASES $427.00
Polysom <6 yrs 4/> paramtrs $206.00
Polysom <6 yrs cpap/bilvl $627.00
Polysom 6/> yrs 4/> param $1,916.00
Polysom 6/> yrs 4/> param $4,138.00
Polysom 6/>yrs cpap 4/> parm $4,138.00
Polysom any age 1-3> param $1,916.00
POOL THAW CRYO 10 UNITS $150.00
POOL THAW CRYO 5 UNITS $194.00
POOLED PLATELETS LEUKOREDUCED $1,572.00
Pos airway pressure cpap $617.00
PRE/POST PM LEADLESS EVL/PROG $234.00
PREOP VESSEL MAP HEMO $691.00
Prepare face/oral prosthesis $6,812.00
Prepare face/oral prosthesis $20,974.00
Prepare face/oral prosthesis $20,974.00
Prepare face/oral prosthesis $12,195.00
Prepare face/oral prosthesis $7,276.00
Prepare face/oral prosthesis $7,276.00
Prepare face/oral prosthesis $7,276.00
Prepare face/oral prosthesis $2,371.00
Prgrmg dev eval impltbl sys $822.00
Prgrmg eval implantable dfb $232.00
Prgrmg eval implantable dfb $232.00
Prgrmg eval implantable dfb $321.00
Prim art m-thrmbc 1st vsl $22,772.00
Prim art m-thrmbc sbsq vsl $10,947.00
Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) $4,267.00
PROPOXYPHENE SCR-REF $13.80
PROPOXYPHENE URINE-REF $73.75
PROSTATE BIOPSY $990.00
Proton treatment complex $9,352.00
Proton trmt intermediate $4,126.00
Proton trmt simple w/comp $4,109.00
Proton trmt simple w/o comp $259.00
Prq card angio/athrect 1 art $24,257.00
Prq card angio/athrect 1 art $24,257.00
Prq card angio/athrect 1 art $57,254.00
Prq card angio/athrect 1 art $57,254.00
Prq card angio/athrect 1 art $57,254.00
Prq card angio/athrect addl $57,254.00
Prq card angio/athrect addl $57,254.00
Prq card angio/athrect addl $48,634.00
Prq card angio/athrect addl $48,634.00
Prq card angio/athrect addl $48,634.00
Prq card revasc chronic 1vsl $57,254.00
Prq card revasc chronic 1vsl $57,254.00
Prq card revasc chronic 1vsl $57,254.00
Prq card revasc chronic 1vsl $57,254.00
Prq card revasc chronic 1vsl $57,254.00
Prq card revasc chronic addl $57,254.00
Prq card revasc chronic addl $57,254.00
Prq card revasc chronic addl $35,001.00
Prq card revasc chronic addl $35,001.00
Prq card revasc chronic addl $35,001.00
Prq card revasc mi 1 vsl $35,001.00
Prq card revasc mi 1 vsl $35,001.00
Prq card revasc mi 1 vsl $57,254.00
Prq card revasc mi 1 vsl $57,254.00
Prq card revasc mi 1 vsl $57,254.00
Prq card stent w/angio 1 vsl $48,634.00
Prq card stent w/angio 1 vsl $48,634.00
Prq card stent w/angio 1 vsl $57,254.00
Prq card stent w/angio 1 vsl $57,254.00
Prq card stent w/angio 1 vsl $57,254.00
Prq card stent w/angio addl $57,254.00
Prq card stent w/angio addl $57,254.00
Prq card stent w/angio addl $35,001.00
Prq card stent w/angio addl $35,001.00
Prq card stent w/angio addl $35,001.00
Prq card stent/ath/angio $35,001.00
Prq card stent/ath/angio $35,001.00
Prq card stent/ath/angio $87,673.00
Prq card stent/ath/angio $87,673.00
Prq card stent/ath/angio $87,673.00
Prq card stent/ath/angio $87,673.00
Prq card stent/ath/angio $87,673.00
Prq card stent/ath/angio $35,001.00
Prq card stent/ath/angio $35,001.00
Prq card stent/ath/angio $35,001.00
Prq cardiac angio addl art $27,553.00
Prq cardiac angio addl art $27,553.00
Prq cardiac angio addl art $24,257.00
Prq cardiac angio addl art $24,257.00
Prq cardiac angio addl art $24,257.00
Prq cardiac angioplast 1 art $456.00
Prq cardiac angioplast 1 art $456.00
Prq cardiac angioplast 1 art $27,553.00
Prq cardiac angioplast 1 art $27,553.00
Prq cardiac angioplast 1 art $27,553.00
Prq coronary mech thrombect $2,476.00
Prq revasc byp graft 1 vsl $35,001.00
Prq revasc byp graft 1 vsl $35,001.00
Prq revasc byp graft 1 vsl $57,254.00
Prq revasc byp graft 1 vsl $57,254.00
Prq revasc byp graft 1 vsl $57,254.00
Prq revasc byp graft addl $57,254.00
Prq revasc byp graft addl $57,254.00
Prq revasc byp graft addl $35,001.00
Prq revasc byp graft addl $35,001.00
Prq revasc byp graft addl $35,001.00
Pseudoaneurysm injection trt $2,084.00
PSEUDOCHOLINESTERASE,S-REF $25.73
PT ELEC STIM UNATT M/SKELETAL $199.00
Pt eval high complex 45 min $177.00
Pt eval low complex 20 min $177.00
Pt eval mod complex 30 min $177.00
Pt re-eval est plan care $591.00
PT-CPM DAILY USE $150.00
Pul art balloon repr percut $33,867.00
Pul art balloon repr percut $10,491.00
Pulm funct test oscillometry $1,064.00
Pulm funct tst plethysmograp $617.00
Pulm function test by gas $147.00
PULMONARY REHAB W/EXERCISE $162.00
Pulmonary service/procedure $206.00
Pulmonary stress testing $440.00
Puncture drainage of lesion $1,882.00
Pure tone audiometry air $433.00
Quantitative assay drug $53.15
Quantitative assay drug $30.50
Quantitative assay drug $50.00
Quantitative assay drug $175.00
Quantitative assay drug $136.70
Quantitative assay drug $60.00
Quantitative assay drug $80.51
Quantitative assay drug $155.00
Quantitative assay drug $301.00
Quantitative assay drug $292.00
Quantitative assay drug $292.00
Quantitative assay drug $90.00
Quantitative assay drug $243.00
R & l heart cath congenital $13,484.00
R & l heart cath congenital $15,295.00
R & l heart cath congenital $16,542.00
R hrt art/grft angio $15,295.00
R hrt coronary artery angio $15,295.00
R&l hrt art/ventricle angio $16,539.00
R&l hrt art/ventricle angio $18,258.00
R&l hrt cath w/ventriclgrphy $15,295.00
Ra tracer id of sentinl node $2,678.00
RA-233 DICHL/XOFIGO-TX PER UCI $462.00
Radiation handling $5,287.00
Radiation physics consult $1,365.00
Radiation physics consult $919.00
Radiation therapy dose plan $1,173.00
Radiation treatment aid(s) $2,371.00
Radiation treatment aid(s) $919.00
Radiation treatment aid(s) $1,239.00
Radiation treatment delivery $6,079.00
Radiation treatment delivery $2,245.00
Radiation treatment delivery $896.00
Radiology port images(s) $896.00
Radiotherapy dose plan imrt $8,358.00
Range of motion measurements $410.00
Range of motion measurements $410.00
Range of motion measurements $94.00
RB82 RUBIDIUM-DX $2,255.00
RBC $642.00
RBC LEUKORED $662.00
RBC LR DEGLYC $1,076.00
RBC LR DEGLYC IRRAD $1,211.00
RBC LR IRRAD $797.00
RBCLR BLOOD SPLIT UNIT $165.00
Reconstruction of jaw $12,195.00
Reconstruction of jaw $12,195.00
Reconstruction of lower jaw $12,195.00
Redo endovas vena cava filtr $13,484.00
Refill/maint portable pump $1,457.00
Refill/maint pump/resvr syst $1,457.00
Relocate pocket for defib $8,467.00
Relocation pocket pacemaker $8,467.00
Rem endovas vena cava filter $13,484.00
Remote 30 day ecg rev/report $279.00
Removal biliary drg cath $2,897.00
Removal duct glbldr calculi $10,084.00
Removal foreign body gum $3,656.00
Removal of artery clot $22,772.00
Removal of breast lesion $4,976.00
Removal of clot in graft $22,772.00
Removal of foot foreign body $8,331.00
Removal of gum tissue $8,573.00
Removal of left heart vent $13,112.00
Removal of nail bed $1,842.00
Removal of nail plate $699.00
Removal of pacemaker system $14,938.00
Removal of pm generator $40,181.00
Removal of shunt $15,887.00
Removal of skin tags <w/15 $624.00
Removal of vein clot $16,358.00
Removal of vein clot $16,358.00
Removal of vein clot $16,358.00
Removal pacemaker electrode $14,938.00
Removal tunneled cv cath $3,413.00
Removal tunneled cv cath $6,097.00
Removal/revision of cast $981.00
Remove aortic assist device $15,064.00
Remove bone fixation device $6,714.00
Remove brain canal fluid $4,136.00
Remove brain cavity fluid $2,633.00
Remove brain cavity shunt $4,963.00
Remove cerclage suture $9,867.00
Remove contraceptive capsule $2,230.00
Remove cva device obstruct $4,135.00
Remove cva lumen obstruct $1,531.00
Remove drug implant device $1,521.00
Remove elctrd transvenously $14,938.00
Remove esophagus obstruction $1,000.00
Remove exostosis mandible $8,573.00
Remove exostosis maxilla $8,573.00
Remove foreign body $1,196.00
Remove foreign body $9,999.00
Remove hepatic shunt (tips) $48,352.00
Remove impacted ear wax uni $272.00
Remove impacted ear wax uni $544.00
Remove impacted ear wax uni $544.00
Remove impacted ear wax uni $272.00
Remove intrauterine device $1,331.00
Remove intrvas foreign body $13,484.00
Remove lung catheter $3,413.00
Remove nail plate add-on $699.00
Remove pat-active ht record $5,652.00
Remove pulse generator $14,938.00
Remove rectal obstruction $14,682.00
Remove renal tube w/fluoro $3,147.00
Remove skin tags add-on $759.00
Remove stent via transureth $9,039.00
Remove tunneled ip cath $15,887.00
Remove ureter stent percut $10,650.00
Remove vad different session $10,076.00
Remove&replace pm gen singl $40,181.00
Remv&replc pm gen dual lead $55,640.00
Remv&replc pm gen mult leads $101,486.00
Renal biopsy perq $9,999.00
Renal function panel $89.00
RENAL FUNCTION PANEL $247.00
Reopen fallopian tube $13,157.00
Repair blood vessel lesion $17,079.00
Repair brow defect $5,832.00
Repair lead pace-defib one $14,938.00
Repair of windpipe $7,276.00
Repair tcat mitral valve $17,845.00
Repair tcat mitral valve $17,845.00
Repair tooth socket $8,573.00
Repair tunneled cv cath $3,160.00
Repair tunneled cv cath $6,097.00
Repeat drainage of heart sac $2,897.00
Replace cvad cath $4,573.00
Replace duod/jej tube perc $3,413.00
Replace g/c tube perc $3,413.00
Replace g-j tube perc $3,413.00
Replace picc cath $4,573.00
Replace picvad cath $15,887.00
Replace tunneled cv cath $15,887.00
Replace tunneled cv cath $15,887.00
Replace tunneled cv cath $15,887.00
Replace tunneled cv cath $24,594.00
Repos prev impltbl subq dfb $14,938.00
Reposition gastrostomy tube $6,586.00
Reposition l ventric lead $13,484.00
Reposition pacing-defib lead $8,416.00
Reposition vad diff session $10,076.00
Reposition venous catheter $6,097.00
Reprogram cochlear implt <7 $874.00
Reprogram cochlear implt 7/> $459.00
Respirator motion mgmt simul $2,371.00
Respiratory flow volume loop $627.00
Revise circulation to head $5,195.00
Revision of aortic valve $8,505.00
Revision of heart chamber $57,254.00
Revision of heart chamber $57,254.00
Revision of iris $2,621.00
Revision of mitral valve $8,505.00
Revision of pulmonary valve $27,553.00
Revsc opn/prq tib/pero stent $45,000.00
Right heart cath $4,101.00
Right ventricular recording $28,188.00
Rmvl & rplcmt dfb gen 2 lead $131,580.00
Rmvl & rplcmt dfb gen mlt ld $182,939.00
Rmvl devital tis 20 cm/< $184.00
Rmvl devital tis addl 20cm/< $184.00
Rmvl of subq defibrillator $14,938.00
Rmvl& replc pulse gen 1 lead $131,580.00
ROOM & CARE CCU $6,703.00
ROOM & CARE DETOX SEMI PRIVATE $3,936.00
ROOM & CARE EXTENDED NURSERY $3,500.00
ROOM & CARE ICU INTERMED $4,108.00
ROOM & CARE ICU INTERMEDIATE $4,108.00
ROOM & CARE OHRI $3,661.00
ROOM & CARE PEDS CARDIO CCU $9,053.00
ROOM & CARE PEDS CCU INTERMEDI $4,240.00
ROOM & CARE PSYCH SEMI PRIVATE $3,936.00
ROOM & CARE SEMI PRIVATE $2,952.00
ROOM & CARE SEMI PRIVATE PEDS $2,952.00
ROOM & CARE SEMI-PRIV ONCOLOGY $2,952.00
ROOM & CARE SEMI-PRIVATE L&D $2,952.00
Routine venipuncture $29.00
Rpr f/e/e/n/l/m 2.5 cm/< $693.00
Rpr f/e/e/n/l/m 2.6-5.0 cm $693.00
Rpr s/n/a/gen/trk12.6-20.0cm $694.00
Rpr s/n/ax/gen/trnk 2.5cm/< $694.00
Rpr s/n/ax/gen/trnk2.6-7.5cm $694.00
Rt heart cath congenital $7,880.00
S&i stent/chest vert art $234.00
SACRAL AUGMENTATION-PERC-BILAT $16,935.00
SACRAL AUGMENTATION-PERC-UNI $16,935.00
Salivary gland function exam $3,777.00
Sbrt delivery $1,355.00
Sclerotx fluid collection $6,659.00
Scr mammo bi incl cad $670.00
Sec art thrombectomy add-on $10,947.00
Select picture audiometry $537.00
Self care mngment training $265.00
Self care mngment training $265.00
Sensory integration $265.00
Set radiation therapy field $811.00
Set radiation therapy field $420.00
Set radiation therapy field $1,355.00
Shave skin lesion >2.0 cm $1,452.00
Shave skin lesion >2.0 cm $1,452.00
Shave skin lesion >2.0 cm $1,452.00
Shave skin lesion 0.5 cm/< $759.00
Shave skin lesion 0.5 cm/< $759.00
Shave skin lesion 0.5 cm/< $759.00
Shave skin lesion 0.6-1.0 cm $759.00
Shave skin lesion 0.6-1.0 cm $759.00
Shave skin lesion 0.6-1.0 cm $759.00
Shave skin lesion 1.1-2.0 cm $759.00
Shave skin lesion 1.1-2.0 cm $759.00
Shave skin lesion 1.1-2.0 cm $1,452.00
Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) $6,524.00
Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids) $6,524.00
Sigmoidoscopy, flexible; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) $6,524.00
Sigmoidoscopy, flexible; with dilation by balloon, 1 or more strictures $6,524.00
Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance $4,267.00
Sigmoidoscopy, flexible; with endoscopic ultrasound examination $6,524.00
Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) $31,316.00
Sigmoidoscopy, flexible; with removal of foreign body(s) $6,524.00
Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique $6,524.00
SINGLE DRUG CLASS, EA-REF $60.00
SIROLIMUS $296.00
SIROLIMUS-REF $47.45
Skin full graft een & lips $6,016.00
Skin full graft sclp/arm/leg $7,056.00
Skin full grft face/genit/hf $7,056.00
Skin sub graft f/n/hf/g addl $7,056.00
Skin sub graft face/nk/hf/g $7,056.00
Skin sub graft t/a/l add-on $7,056.00
Skin sub graft trnk/arm/leg $7,056.00
Skin sub grft t/arm/lg child $10,687.00
Skin tissue procedure $40,181.00
Skin tissue procedure $7,770.00
Skn splt a-grft fac/nck/hf/g $10,553.00
Skn sub grft f/n/hf/g ch add $10,687.00
Skn sub grft f/n/hf/g child $10,687.00
Skn sub grft t/a/l child add $10,687.00
Sleep study attended $4,138.00
Sleep study attended $4,138.00
SM 153 LEXIDRONM/QUADRAMET-TX $44,019.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) $9,429.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple $9,429.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) $4,672.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique $6,169.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique $9,429.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) $9,429.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube $9,429.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube $9,429.00
Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery $6,169.00
Somatosensory testing $4,341.00
Somatosensory testing $5,098.00
Somatosensory testing $1,216.00
Special eye exam initial $5,429.00
Special eye exam initial $4,104.00
Special eye exam subsequent $650.00
Special eye exam subsequent $325.00
Special radiation dosimetry $2,371.00
Special radiation treatment $1,579.00
Special teletx port plan $2,371.00
Specimen handling pt-lab $292.00
Specimen handling pt-lab $82.00
Specimen handling pt-lab $80.00
Specimen handling pt-lab $218.00
Specimen handling pt-lab $218.00
Specimen handling pt-lab $25.00
Speech audiometry complete $537.00
Speech evaluation complex $918.00
Speech sound lang comprehen $301.00
Speech threshold audiometry $463.00
Speech/hearing therapy $650.00
Speech/hearing therapy $325.00
Spinal fluid tap diagnostic $3,102.00
Srs linear based $2,371.00
Stab phleb veins xtr 10-20 $15,887.00
Stenger test pure tone $537.00
Stenger test speech $126.00
Stent plmt ctr dialysis seg $57,254.00
Stimulation pacing heart $8,725.00
Strapping of ankle and/or ft $281.00
Strapping of knee $226.00
Strapping of shoulder $193.00
Strapping of shoulder $193.00
Strapping of toes $202.00
Strep a assay w/optic $45.00
STRESS ECHO W/PHARM W/CONTRAST $5,556.00
Stress tte complete $908.00
Stress tte only $768.00
Surfactant admin thru tube $627.00
Surgery/speech prosthesis $7,276.00
TACROLIMUS(FK506) $123.00
Tap block bi by infusion $2,613.00
Tap block bi injection $2,613.00
Tap block uni by infusion $2,613.00
Tap block unil by injection $2,613.00
TAY SACHS(HEXOSAMINIDASE)-REF $90.00
Tb test cell immun measure $35.92
Tb test cell immun measure $29.25
TC99M AUTO WBC-DX $5,233.00
TC99M BICISATE/NEUROLITE-DX $6,195.00
TC99M DTPA AEROSOL-DX $438.00
TC99M EXAMETAZIME/CERETEC-DX $4,725.00
TC99M LABELED RBC-DX $420.00
TC99M MAA-DX $770.00
TC99M MEBROFENIN/CHOLETEC-DX $147.00
TC99M MERTIATIDE/MAG-3-DX $1,015.00
TC99M OXIDRONATE/HDP-DX $123.00
TC99M PENTETATE/DTPA-DX $403.00
TC99M PERTECHNETATE-DX $53.00
TC99M PYROPHOSPHATE/PYP-DX $126.00
TC99M SESTAMIBI-DX $98.00
TC99M SUCCIMER/DMSA-DX $1,365.00
TC99M SULFUR COLLOID-DX UNFILT $368.00
TC99M SULFUR COLLOID-DX-1 BRST $382.00
TC99M SULFUR COLLOID-DX-2 BRST $763.00
TC99M SULFUR COLLOID-DX-MELANO $1,526.00
TC99M TETROFOSMIN/MYOVIEW-DX $136.00
Tcd emboli detect w/inj $1,309.00
Tcd emboli detect w/o inj $1,060.00
Tcd vasoreactivity study $1,243.00
Team conf w/o pat by hc pro $5,006.00
Team conf w/o pat by hc pro $5,006.00
Team conf w/o pat by hc pro $1,591.00
Team conf w/o pat by hc pro $37.50
Team conf w/o pat by hc pro $37.50
Team conf w/o pat by hc pro $37.50
Team conf w/o pat by hc pro $37.50
Team conf w/o pat by hc pro $37.50
TEE FOR MONITOR W/CONTRAST $5,556.00
Telethx isodose plan cplx $8,358.00
Telethx isodose plan simple $919.00
Temporary external pacing $35,001.00
Testicular imaging w/flow $8,793.00
TFFP SPLIT UNIT $275.00
Ther ivntj w/focus cog funcj $265.00
Ther ivntj w/focus cog funcj $174.00
Ther ivntj w/focus cog funcj $174.00
THER PROC STRG/ENDUR Q15MIN $215.00
Ther/diag concurrent inf $181.00
Ther/proph/diag inj iv push $239.00
Ther/proph/diag inj sc/im $239.00
Ther/proph/diag iv inf addon $164.00
Ther/proph/diag iv inf init $633.00
Therapeutic activities $591.00
Therapeutic activities $591.00
Therapeutic activities $560.00
Therapeutic exercises $265.00
Therapeutic exercises $199.00
Therapeutic exercises $199.00
Thrmbc/nfs dialysis circuit $39,877.00
Thrmbc/nfs dialysis circuit $81,663.00
Thrmbc/nfs dialysis circuit $97,131.00
Throat x-ray & fluoroscopy $918.00
Thromblytic art/ven therapy $13,484.00
Thrombolytic art therapy $22,772.00
Thrombolytic therapy stroke $1,457.00
Thrombolytic venous therapy $5,175.00
Thyroglobulin antibody $159.02
Thyroglobulin antibody $20.00
Thyroglobulin antibody $24.55
Thyroglobulin antibody $133.60
Thyroglobulin antibody $80.00
Thyroglobulin antibody $259.00
THYROGLOBULIN ANTIBODY-REF $72.25
Thyroid imaging w/blood flow $1,115.00
Thyroid met imaging body $837.00
Thyroid met uptake $2,762.00
Tib/per revasc add-on $30,554.00
Tib/per revasc stent & ather $87,673.00
Tib/per revasc stnt & ather $57,250.00
Tib/per revasc w/ather $87,673.00
Tib/per revasc w/stent $87,673.00
Tib/per revasc w/tla $57,254.00
Tibper revasc w/ather add-on $50,159.00
Tilt table evaluation $93,367.00
Tilt table evaluation $21,055.00
Tinnitus assessment $459.00
Tis trnfr any 30.1-60 sq cm $10,687.00
Tis trnfr e/n/e/l 10 sq cm/< $6,497.00
Tis trnfr e/n/e/l10.1-30sqcm $6,497.00
Tis trnfr f/c/c/m/n/a/g/h/f $6,497.00
Tis trnfr f/c/c/m/n/a/g/h/f $6,497.00
Tis trnfr s/a/l 10 sq cm/< $6,497.00
Tis trnfr s/a/l 10.1-30 sqcm $6,497.00
Tis trnfr trunk 10 sq cm/< $6,497.00
Tis trnfr trunk 10.1-30sqcm $6,497.00
TL201 THALLIUM-DX PER MCI $50.00
TOBRAMYCIN $267.00
TOPIRAMATE SERUM-MAYO $35.00
TPFP S/D NS $417.00
Tprnl plmt biodegrdabl matrl $14,269.00
Trabeculoplasty laser surg $2,621.00
Transcath closure of asd $894.00
Transcath closure of vsd $2,226.00
Transcath occlusion cns $3,995.00
Transcath occlusion non-cns $57,254.00
Transcath stent cca w/eps $20,562.00
Transcath stent cca w/o eps $20,562.00
TRANSCATH STENT ICA/ECV ADDTL $27,379.00
TRANSCATH STENT ICA/ECV-INIT $41,416.00
Transcatheter biopsy $22,772.00
Transfusion service fetal $1,571.00
Transplt autol hct/donor $10,553.00
Transvaginal us non-ob $1,484.00
Transvaginal us obstetric $1,271.00
Treat fracture radius/ulna $1,259.00
Treat pleurodesis w/agent $3,650.00
Treatment of bladder lesion $1,075.00
Treponema pallidum $60.00
Treponema pallidum $70.00
Treponema pallidum $243.00
TRIIODOTHYRONINE T3, TOTAL-REF $38.65
Trim nail(s) any number $332.00
Trim skin lesion $694.00
Trim skin lesions 2 to 4 $694.00
Trim skin lesions over 4 $1,329.00
Trluml balo angiop 1st art $41,786.00
Trluml balo angiop 1st vein $41,786.00
Trluml balo angiop addl art $41,786.00
Trluml balo angiop addl vein $41,786.00
Tte f-up or lmtd $3,451.00
Tte w/doppler complete $5,784.00
Tte w/o doppler complete $3,451.00
Tumor imaging (3d) $3,880.00
Tumor imaging limited area $4,241.00
Tumor imaging mult areas $2,762.00
Tumor imaging whole body $3,387.00
Tumor imaging whole body $6,025.00
Tx atrial fib pulm vein isol $93,367.00
Tx l/r atrial fib addl $21,055.00
Tx/pro/dx inj new drug addon $239.00
Tx/pro/dx inj same drug adon $490.00
Tx/proph/dg addl seq iv inf $918.00
Tympanometry $138.00
Tympanometry & reflex thresh $258.00
Ultrasound breast complete $1,484.00
Ultrasound breast complete $930.00
Ultrasound breast limited $741.00
Ultrasound breast limited $1,111.00
Ultrasound exam follow-up $689.00
Ultrasound therapy $120.00
Ultrasound therapy $265.00
ULTRASOUND WITH ELASTOGRAPHY $331.00
Umbilical artery echo $1,688.00
Upgrade of pacemaker system $55,640.00
Upper extremity study $1,243.00
Upper extremity study $1,060.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with balloon dilation of esophagus $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with band ligation of esophageal and/or gastric varices $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with control of bleeding, any method $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with dilation of gastric outlet for obstruction (eg, balloon, guide wire, bougie) $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed submucosal injection(s), any substance $6,459.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with endoscopic ultrasound examination limited to the esophagus $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum and/or jejunum as appropriate $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with injection sclerosis of esophageal and/or gastric varices $6,459.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with insertion of guide wire followed by dilation of esophagus over guide wire $6,459.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of foreign body $6,459.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic intraluminal tube or catheter placement $6,459.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum and/or jejunum as appropriate) $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), esophagus (includes endoscopic ultrasound examination limited to the esophagus) $9,429.00
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transmural drainage of pseudocyst $17,162.00
Upr/l xtremity art 2 levels $640.00
Upr/lxtr art stdy 3+ lvls $640.00
Ureteral reflux study $7,328.00
Us compl joint r-t w/img $1,484.00
Us exam abdo back wall lim $1,581.00
Us exam abdom complete $741.00
Us exam chest $1,243.00
Us exam infant hips dynamic $1,484.00
Us exam infant hips static $974.00
Us exam k transpl w/doppler $1,484.00
Us exam of head and neck $3,333.00
Us exam pelvic complete $1,484.00
Us exam pelvic limited $1,484.00
Us exam scrotum $1,484.00
Us exam spinal canal $1,484.00
Us guide intraop $1,664.00
Us guide tissue ablation $1,542.00
Us guide vascular access $1,247.00
Us lmtd jt/nonvasc xtr strux $1,484.00
Us transrectal $1,075.00
Us urine capacity measure $483.00
Use of speech device service $619.00
VAGINAL DELIVERY $11,207.00
VANCOMYCIN $292.00
VANCOMYCIN, CSF $292.00
Vasc embolize/occlude artery $57,254.00
Vasc embolize/occlude bleed $57,254.00
Vasc embolize/occlude organ $57,254.00
Vasc embolize/occlude venous $57,254.00
Vascular biopsy $788.00
Vascular flow imaging $3,350.00
Vascular study $1,243.00
Vascular study $1,060.00
Vascular study $2,816.00
Vascular study $1,877.00
Vascular surgery procedure $20,562.00
Vasopneumatic device therapy $140.00
Vasopneumatic device therapy $202.00
Vein x-ray adrenal gland $16,313.00
Vein x-ray adrenal glands $16,313.00
Vein x-ray arm/leg $16,313.00
Vein x-ray arms/legs $4,135.00
Vein x-ray chest $16,313.00
Vein x-ray kidney $4,135.00
Vein x-ray kidneys $16,313.00
Vein x-ray liver $16,313.00
Vein x-ray liver w/hemodynam $16,313.00
Vein x-ray liver w/hemodynam $4,979.00
Vein x-ray liver w/o hemodyn $16,313.00
Vein x-ray neck $16,313.00
Vein x-ray skull $16,313.00
Vein x-ray skull epidural $4,008.00
Vein x-ray spleen/liver $695.00
Vein x-ray trunk $4,962.00
Venous mech thrombectomy $22,772.00
Venous m-thrombectomy add-on $16,358.00
Venous sampling by catheter $16,313.00
Vent mgmt inpat init day $1,243.00
Vent mgmt inpat subq day $640.00
Vertebroplasty addl inject $8,583.00
Vessel injection procedure $1,386.00
Visual audiometry (vra) $537.00
Visual ep test cns w/i&r $4,728.00
Visualization of windpipe $3,585.00
Vital capacity test $627.00
VITAMIN C-REF $39.15
WBC PHERESIS $1,212.00
Wcd device interrogate $396.00
Wedging of cast $490.00
Wedging of clubfoot cast $490.00
Wheelchair mngment training $184.00
Wheelchair mngment training $184.00
Whirlpool therapy $140.00
Whirlpool therapy $156.00
Windowing of cast $482.00
Wnd prep f/n/hf/g addl cm $2,143.00
Wound prep addl 100 cm $7,056.00
Wound prep f/n/hf/g $2,143.00
Wound prep trk/arm/leg $7,056.00
Wound(s) care non-selective $184.00
Wound(s) care non-selective $1,329.00
Wound(s) care non-selective $1,329.00
XE133 XENON-DX $431.00
X-ray aorta leg arteries $16,313.00
X-ray bend only l-s spine $639.00
X-ray bile duct dilation $6,534.00
X-ray bile duct endoscopy $766.00
X-ray bile ducts/pancreas $1,293.00
X-ray bile/panc endoscopy $1,970.00
Xray control catheter change $4,664.00
X-ray exam abdomen 1 view $5,750.00
X-ray exam abdomen 2 views $420.00
X-ray exam abdomen 3+ views $503.00
X-ray exam breastbone 2/>vws $560.00
X-ray exam chest 1 view $437.00
X-ray exam chest 2 views $503.00
X-ray exam chest 2 views $503.00
X-ray exam chest 3 views $551.00
X-ray exam chest 4+ views $929.00
X-ray exam entire spi 1 vw $420.00
X-ray exam entire spi 2/3 vw $695.00
X-ray exam entire spi 4/5 vw $1,325.00
X-ray exam hip uni 1 view $466.00
X-ray exam hip uni 2-3 views $581.00
X-ray exam hips bi 2 views $695.00
X-ray exam hips bi 3-4 views $695.00
X-ray exam hips bi 5/> views $1,325.00
X-ray exam knee 4 or more $1,056.00
X-ray exam knee 4 or more $604.00
X-ray exam l-2 spine 4/>vws $774.00
X-ray exam l-s spine 2/3 vws $695.00
X-ray exam l-s spine bending $877.00
X-ray exam neck spine 2-3 vw $695.00
X-ray exam neck spine 4/5vws $695.00
X-ray exam neck spine 6/>vws $828.00
X-ray exam of ankle $950.00
X-ray exam of ankle $506.00
X-ray exam of ankle $1,012.00
X-ray exam of ankle $607.00
X-ray exam of arm infant $604.00
X-ray exam of arm infant $1,208.00
X-ray exam of body section $2,426.00
X-ray exam of collar bone $462.00
X-ray exam of collar bone $924.00
X-ray exam of elbow $456.00
X-ray exam of elbow $912.00
X-ray exam of elbow $505.00
X-ray exam of elbow $1,010.00
X-ray exam of eye sockets $695.00
X-ray exam of facial bones $503.00
X-ray exam of facial bones $776.00
X-ray exam of femur 2/> $505.00
X-ray exam of finger(s) $409.00
X-ray exam of finger(s) $818.00
X-ray exam of foot $2,110.00
X-ray exam of foot $433.00
X-ray exam of foot $866.00
X-ray exam of foot $437.00
X-ray exam of forearm $437.00
X-ray exam of forearm $874.00
X-ray exam of hand $604.00
X-ray exam of hand $1,208.00
X-ray exam of hand $725.00
X-ray exam of hand $1,450.00
X-ray exam of heel $874.00
X-ray exam of heel $898.00
X-ray exam of humerus $505.00
X-ray exam of humerus $1,010.00
X-ray exam of jaw <4views $489.00
X-ray exam of jaw 4/> views $774.00
X-ray exam of jaw joints $581.00
X-ray exam of kidney lesion $2,426.00
X-ray exam of knee 1 or 2 $1,010.00
X-ray exam of knee 1 or 2 $505.00
X-ray exam of knee 3 $1,010.00
X-ray exam of knee 3 $528.00
X-ray exam of knees $1,208.00
X-ray exam of leg infant $1,010.00
X-ray exam of leg infant $475.00
X-ray exam of lower leg $2,110.00
X-ray exam of lower leg $505.00
X-ray exam of mastoids $581.00
X-ray exam of mastoids $695.00
X-ray exam of nasal bones $473.00
X-ray exam of neck $481.00
X-ray exam of pelvis $695.00
X-ray exam of pelvis $695.00
X-ray exam of peritoneum $5,430.00
X-ray exam of shoulder $498.00
X-ray exam of shoulder $996.00
X-ray exam of shoulder $1,195.00
X-ray exam of shoulder $1,434.00
X-ray exam of shoulder blade $505.00
X-ray exam of shoulder blade $1,010.00
X-ray exam of shoulders $610.00
X-ray exam of sinuses $475.00
X-ray exam of sinuses $627.00
X-ray exam of skull $695.00
X-ray exam of skull $695.00
X-ray exam of small bowel $1,487.00
X-ray exam of spine 1 view $511.00
X-ray exam of toe(s) $449.00
X-ray exam of toe(s) $374.00
X-ray exam of wrist $474.00
X-ray exam of wrist $948.00
X-ray exam of wrist $492.00
X-ray exam of wrist $984.00
X-ray exam ribs bil 3 views $856.00
X-ray exam ribs uni 2 views $503.00
X-ray exam ribs/chest4/> vws $904.00
X-ray exam sacrum tailbone $515.00
X-ray exam series abdomen $627.00
X-ray exam si joints $695.00
X-ray exam si joints 3/> vws $695.00
X-ray exam surgical specimen $1,325.00
X-ray exam thorac spine 2vws $695.00
X-ray exam thorac spine 3vws $774.00
X-ray exam thorac spine4/>vw $929.00
X-ray exam thoracolmb 2/> vw $581.00
X-ray exam unilat ribs/chest $695.00
X-ray eye for foreign body $420.00
X-ray fallopian tube $2,426.00
X-ray female genital tract $1,984.00
X-ray guide for gi tube $2,826.00
X-ray guide gu dilation $4,676.00
X-ray guide intestinal tube $551.00
X-ray measurement of pelvis $10,395.00
X-ray nose to rectum $1,907.00
X-ray of lower spine disk $16,664.00
X-ray of mammary duct $2,744.00
X-ray of mammary ducts $4,694.00
X-ray strenoclavic jt 3/>vws $581.00
X-ray upper gi delay w/kub $1,342.00
X-ray upper gi delay w/o kub $1,515.00
X-ray upper gi&small intest $1,475.00
X-ray urethra/bladder $1,525.00
X-ray urethra/bladder $1,525.00
X-rays at surgery add-on $1,063.00
X-rays bone length studies $370.00
X-rays bone survey complete $545.00
X-rays bone survey infant $929.00
X-rays bone survey limited $695.00
X-rays for bone age $842.00
X-rays transcath therapy $16,313.00
Y90 IBRITUMOMAB/ZEVALIN-TX $157,500.00