[Federal Register Volume 64, Number 125 (Wednesday, June 30, 1999)]
[Proposed Rules]
[Pages 35258-35513]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-16550]



[[Page 35257]]

_______________________________________________________________________

Part II





Department of Health and Human Services





_______________________________________________________________________



Health Care Financing Administration



_______________________________________________________________________



Office of Inspector General



_______________________________________________________________________



42 CFR Part 409 et al.



Medicare Program; Prospective Payment System for Hospital Outpatient 
Services; Correction; Proposed Rule

  Federal Register / Vol. 64, No. 125 / Wednesday, June 30, 1999 / 
Proposed Rules  

[[Page 35258]]



DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
Office of Inspector General

42 CFR Parts 409, 410, 411, 412, 413, 419, 489, 498, and 1003

[HCFA-1005-CN]
RIN 0938-A156


Medicare Program; Prospective Payment System for Hospital 
Outpatient Services; Correction

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Correction of proposed rule.

-----------------------------------------------------------------------

SUMMARY: This document corrects technical and typographic errors that 
appeared in the proposed rule published in the Federal Register on 
September 8, 1998 entitled ``Medicare Program; Prospective Payment 
System for Hospital Outpatient Services.

FOR FURTHER INFORMATION CONTACT:

Janet Wellham, (410) 786-4510 (for general information).
Kitty Ahern, (410) 786-4515 (for information related to the 
classification of services into ambulatory payment classification (APC) 
groups).
Suzanne Letsch (410) 786-4558 (for information related to volume 
control measures and updates).
Janet Samen (410) 789-9161 (for information on the application of APCs 
to community health centers).

SUPPLEMENTARY INFORMATION:

Background

    In FR Doc. 98-23383 of September 8, 1998 (63 FR 47551), we 
published a proposed rule that reflected a number of technical errors, 
resulting in inconsistencies between the proposed policies and the 
associated numerical values. Specifically, the numerical values in the 
proposed rule reflected incorrect data and data programming. This 
document sets forth corrected numerical values.
    The problems in the data and data programming are a direct result 
of the frequent modifications to our databases during the initial 
development of the model prospective payment system and the changes we 
made during the development of the proposed rule to reflect the final 
legislative provision enacted on August 5, 1997 in the Balanced Budget 
Act of 1997 (BBA 1997), Public Law 105-33. We have corrected our 
databases and our data programming, and this document corrects the 
numerical values published in the September 8, 1998 proposed rule. 
Correcting the data errors does not mean that the proposed policies 
themselves need to be revised. Correcting the data changes the impacts 
of the proposed policies to a very limited extent, but this document 
does not revise any of the policies reflected in the September 8, 1998 
proposed rule.
    Accordingly, we have recalculated the current payment, total 
services (total units) and corrected relative weights, proposed payment 
rates, national unadjusted coinsurance, minimum unadjusted coinsurance, 
and service-mix index that were published on September 8, 1998.
    The service-mix indices previously published in the proposed rule 
are significantly different from the service-mix index published in 
this correction notice (in Addendum I) because the ambulatory payment 
classification (APC) relative weights used to calculate the service mix 
published in the proposed rule were scaled using a factor ``for a high-
level clinic visit for cardiovascular services (that is, APC 91356) 
rather than a mid-level clinic visit for cardiovascular services, 
identified as APC 91336.'' In addition, the service-mix index published 
in this correction notice incorporates the discount policy applied to 
multiple surgeries. However, the relative differences among hospitals 
did not change substantially between the proposed and corrected 
service-mix indices.
    These data corrections required that we also correct our 
simulations of current payment, costs, and total units, leading to 
slight differences from the September 8, 1998 published version. Fully 
modeling proposed payment after accounting for data corrections, we 
calculated a new calendar year (CY) 1996 conversion factor of $46.87, 
which is slightly higher than the published CY 1996 conversion factor 
of $46.32. In addition to the data corrections mentioned above, we also 
made a correction in the computation of the conversion factor to 
appropriately account for wage index adjustments in proposed payments. 
The adjusted CY 1999 conversion factor is $51.42.
    Corrected simulations of costs and total units impacted the results 
of the regression analyses that we use in conjunction with payment 
simulations to determine whether the payment system should include 
adjustments for specific classes of hospitals. However, the results do 
not change our conclusion hat no adjustments be proposed at this time.
    These corrections require revisions to the impact tables and they 
also affect entries contained in Addendum A, Addendum B, Addendum C, 
Addendum D, and Addendum G. Addendum J, Addendum K, and Addendum L are 
revised to reflect the correct version of the wage index. Because of 
the many corrections to these ``materials, we are reprinting portions 
of the impact analysis and the entire impact tables and agenda, below, 
in this notice.
    The September 8, 1998 proposed rule also contained other technical 
and typographic errors. Errors related to the incorrect assignment of 
status indicators to certain CPT codes listed in Addendum B are 
corrected and reflected in the revised Addendum B printed in full 
below.
    In FR Doc. 98-23383 of September 8, 1998, make the following 
corrections to the preamble, regulations text and addenda:

Correction of Errors in the Preamble

    1. On pages 47564 through 47565, the table titled ``Packaged 
Services by Revenue Center'' is corrected to read as follows:

                   Packaged Services by Revenue Center
------------------------------------------------------------------------
 
------------------------------------------------------------------------
                                 SURGERY
------------------------------------------------------------------------
250...............................  PHARMACY
251...............................  GENERIC
252...............................  NONGENERIC
257...............................  NONPRESCRIPTION DRUGS
258...............................  IV SOLUTIONS
259...............................  OTHER PHARMACY
270...............................  M&S SUPPLIES
271...............................  NONSTERILE SUPPLIES
272...............................  STERILE SUPPLIES
276...............................  INTRAOCULAR LENS
279...............................  OTHER M&S SUPPLIES
370...............................  ANESTHESIA
379...............................  OTHER ANESTHESIA
380...............................  BLOOD, GENERAL CLASS
381...............................  PACKED RED CELLS
382...............................  WHOLE BLOOD
383...............................  PLASMA
384...............................  PLATELETS
385...............................  LEUCOCYTES
386...............................  OTHER COMPONENTS
387...............................  OTHER DERIVATIVES
389...............................  OTHER BLOOD
390...............................  BLOOD STORAGE AND PROCESSING
391...............................  BLOOD ADMINISTRATION
399...............................  OTHER BLOOD PROC/STORAGE
700...............................  CAST ROOM
709...............................  OTHER CAST ROOM
710...............................  RECOVERY ROOM
719...............................  OTHER RECOVERY ROOM
720...............................  LABOR ROOM
721...............................  LABOR
723...............................  CIRCUMCISION
762...............................  OBSERVATION ROOM
810...............................  ORGAN ACQUISITION

[[Page 35259]]

 
819...............................  OTHER ORGAN ACQUISITION
890...............................  OTHER DONOR BANK
891...............................  BONE
892...............................  ORGAN
893...............................  SKIN
899...............................  OTHER DONOR BANK, OTHER
------------------------------------------------------------------------
                              MEDICAL VISIT
------------------------------------------------------------------------
250...............................  PHARMACY
251...............................  GENERIC
252...............................  NONGENERIC
257...............................  NONPRESCRIPTION DRUGS
258...............................  IV SOLUTIONS
259...............................  OTHER PHARMACY
270...............................  M&S SUPPLIES
271...............................  NONSTERILE SUPPLIES
272...............................  STERILE SUPPLIES
279...............................  OTHER M&S SUPPLIES
380...............................  BLOOD, GENERAL CLASS
381...............................  PACKED RED CELLS
382...............................  WHOLE BLOOD
383...............................  PLASMA
384...............................  PLATELETS
385...............................  LEUCOCYTES
386...............................  OTHER COMPONENTS
387...............................  OTHER DERIVATIVES
389...............................  OTHER BLOOD
390...............................  BLOOD STORAGE AND PROCESSING
391...............................  BLOOD ADMINISTRATION
399...............................  OTHER BLOOD PROC/STORAGE
700...............................  CAST ROOM
709...............................  OTHER CAST ROOM
762...............................  OBSERVATION ROOM
------------------------------------------------------------------------
                   OTHER DIAGNOSTIC (BLENDED SERVICES)
------------------------------------------------------------------------
254...............................  PHARMACY INCIDENT TO OTHER
                                     DIAGNOSTIC
372...............................  ANESTHESIA INCIDENT TO OTHER
                                     DIAGNOSTIC
380...............................  BLOOD, GENERAL CLASS
381...............................  PACKED RED CELLS
382...............................  WHOLE BLOOD
383...............................  PLASMA
384...............................  PLATELETS
385...............................  LEUCOCYTES
386...............................  OTHER COMPONENTS
397...............................  OTHER DERIVATIVES
389...............................  OTHER BLOOD
390...............................  BLOOD STORAGE AND PROCESSING
391...............................  BLOOD ADMINISTRATION
399...............................  OTHER BLOOD PROC/STORAGE
622...............................  SUPPLIES INCIDENT TO OTHER
                                     DIAGNOSTIC
710...............................  RECOVERY ROOM
719...............................  OTHER RECOVERY ROOM
762...............................  OBSERVATION ROOM
------------------------------------------------------------------------
                                RADIOLOGY
------------------------------------------------------------------------
255...............................  PHARMACY INCIDENT TO RADIOLOGY
371...............................  ANESTHESIA INCIDENT TO RADIOLOGY
380...............................  BLOOD, GENERAL CLASS
381...............................  PACKED RED CELLS
382...............................  WHOLE BLOOD
383...............................  PLASMA
384...............................  PLATELETS
385...............................  LEUCOCYTES
386...............................  OTHER COMPONENTS
387...............................  OTHER DERIVATIVES
389...............................  OTHER BLOOD
390...............................  BLOOD STORAGE AND PROCESSING
391...............................  BLOOD ADMINISTRATION
399...............................  OTHER BLOOD PROC/STORAGE
621...............................  SUPPLIES INCIDENT TO RADIOLOGY
710...............................  RECOVERY ROOM
719...............................  OTHER RECOVERY ROOM
762...............................  OBSERVATION ROOM
------------------------------------------------------------------------
                          ALL OTHER APC GROUPS
------------------------------------------------------------------------
250...............................  PHARMACY
251...............................  GENERIC
252...............................  NONGENERIC
257...............................  NONPRESCRIPTION DRUGS
258...............................  IV SOLUTIONS
259...............................  OTHER PHARMACY
270...............................  M&S SUPPLIES
271...............................  NONSTERILE SUPPLIES
272...............................  STERILE SUPPLIES
279...............................  OTHER M&S SUPPLIES
380...............................  BLOOD, GENERAL CLASS
381...............................  PACKED RED CELLS
382...............................  WHOLE BLOOD
383...............................  PLASMA
384...............................  PLATELETS
385...............................  LEUCOCYTES
386...............................  OTHER COMPONENTS
387...............................  OTHER DERIVATIVES
389...............................  OTHER BLOOD
390...............................  BLOOD STORAGE AND PROCESSING
391...............................  BLOOD ADMINISTRATION
399...............................  OTHER BLOOD PROC/STORAGE
762...............................  OBSERVATION ROOM
------------------------------------------------------------------------

    2. On page 47568, column two, line 16, the figure ``$208.25'' is 
corrected to read ``$206.71''.
    3. On page 47572, column one, last paragraph, the date and Federal 
Register citation are corrected to read as follows: August 29, 1997 (62 
FR 45984).
    4. On page 47573, column three, line nine, ``$46.32'' is corrected 
to read ``$46.87''.
    5. On page 47573, column three, line 12, ``1.0939'' is corrected to 
read ``1.097''.
    6. On page 47573, column three, line 24, the text beginning with 
the sentence ``In estimating the update factor, HCFA's Office of the 
Actuary assumed * * *'' through the phrase ending ``Medicare absorbing 
this impact'' in line 44 is removed.
    7. On page 47573, column three, line 46, ``$50.67'' is corrected to 
read ``$51.42''.
    8. On page 47574, column two, in section 2(a)(ii), line four, 
``29.2'' is corrected to read ``13.0''.
    9. On page 47576, column two, line 26, ``1999'' is corrected to 
read ``1998''.
    10. On page 47576, column two, line 28, the Federal Register title, 
date, and citation are corrected to read as follows: ``Changes to the 
Hospital Inpatient Prospective Payment Systems and Fiscal Year 1998 
Rates (BPD-878-FC) published in the Federal Register on August 29, 1997 
(62 FR 45995)''.
    11. On page 47577, column one, paragraph two, line 39, ``1996'' is 
corrected to read ``1998''.
    12. On page 47577, column two, last paragraph, line nine, ``$105'' 
is corrected to read ``$120''.
    13. On page 47578, column two, second full paragraph, line four, 
the following new sentence is added to read as follows: ``The edits 
referred to in this section were not used in the development of the 
weights or the impact analysis described in this proposed rule.''
    14. On page 47580, column one, First line, the words ``level 1'' 
are added after the words ``hospitals with'' and before the word 
``trauma''.
    15. On page 47580, column one, line two, the sentence beginning 
``These costs were * * *'' is removed and is replaced with the 
following: ``These costs were 200 percent or more higher than the 
average cost per unit for all hospitals.''
    16. On page 47580, column one, last paragraph, line one, ``83'' is 
corrected to read ``96''.
    17. On page 47580, column one, last paragraph, line three, ``51'' 
is corrected to read ``46''.
    18. On page 47580, column one, last paragraph, line six, ``32'' is 
corrected to read ``50''.
    19. On page 47580, column two, line five, ``5,419'' is corrected to 
read ``5,335''.
    20. On page 47580, column two, second full paragraph, line 14, the 
words ``level 1'' are added before the words ``trauma unit''.
    21. On page 47580, column two, last paragraph, line four, the 
sentence beginning ``We also calculated * * *'' is removed and is 
replaced with the following: ``This service mix is ``discounted'' to 
reflect the reduced weight for additional surgical procedures performed 
at the same time, which is consistent with the proposed payment 
system.''
    22. On page 47580, column two, last paragraph, line 10, the 
sentence beginning ``The national average * * *'' is removed and is 
replaced with the following: ``The national average service mix 
discounted for multiple procedures is 2.05.''

[[Page 35260]]

    23. On page 47580, column two, last paragraph, last line, remove 
text from the sentence beginning ``The differences between * * *'' 
through line seven in column three.
    24. On page 47580, column three, first full paragraph, line 13, 
``0.68'' is corrected to read ``0.76''.
    25. On page 47580, column three, first full paragraph, line 17, 
``6.8 percent'' is corrected to read ``7.6 percent''.
    26. On page 47580, column three, paragraph two, line 25, ``7.5 
percent'' is corrected to read ``8.9 percent''.
    27. On page 47580, column three, the third full paragraph through 
page 47581, column one, line 10, is removed and is replaced with the 
following: ``While the regression analysis shows less than a 
proportional relationship between the service mix and the cost per 
unit, the difference is relatively small. The coefficient of service 
mix ranged from 0.76 to 0.92 over the regression models we examined. We 
will continue to monitor the method of basing payments on median APC 
costs to ascertain whether it is representative of both high-weighted 
and low-weighted procedures.''
    28. On page 47581, column one, first full paragraph, line nine, 
``0.51 to 0.68'' is corrected to read ``0.40 to 0.58.''
    29. On page 47581, column one, first full paragraph, lines 10 to 
11, ``50 and 70 percent.'' is corrected to read ``40 and 60 percent.''
    30. On page 47581, column one, first full paragraph, line 29, the 
sentence beginning ``The explanatory regression * * *'' is removed.
    31. On page 47581, column two, first full paragraph, line 10, the 
word ``not'' is added before ``significant''.
    32. On page 47581, column two, first full paragraph, line 13, ``4.5 
percent [calculated (eDSHP*0.11-1)*100]'' is corrected read 
``1.6 percent [calculated (eDSHP*0.04-1)*100]''.
    33. On page 47581, column two, first full paragraph, line 16, the 
text beginning with ``Teaching intensity * * *'' through line 21 ending 
with ``services.'' is removed and is replaced with the following: ``The 
extremely small percentage difference in costs reflects the lack of 
significance observed for the disproportionate share variable. In most 
regression specifications, the teaching intensity variables were 
positive, significant (p<0.05), but small in magnitude.''
    34. On page 47581, column two, last paragraph, line five, the text 
beginning with ``We determined * * *'' through line 23 in column three, 
is removed and is replaced with the following: ``The results of our 
threshold analysis of disproportionate share percentage reflected the 
lack of significance observed above. We could not identify a threshold 
at which hospitals with a disproportionate share of low-income patients 
evidenced higher standardized costs. The connection between 
disproportionate share and volume warrants further analysis. However, 
at this time, we cannot identify a threshold and, therefore, did not 
calculate a new disproportionate share variable. Positive and 
significant effects for the teaching variable do not occur for 
hospitals whose ratio of residents to inpatient and outpatient days is 
less than 0.28. We used these results to estimate a new ratio of 
residents to inpatient and outpatient ``days'' based on a 0.28 
threshold. We subtracted this threshold from the original variable to 
create a new teaching variable. Subtracting The threshold removes the 
effect of values that are not significantly related to cost per unit 
and eliminates the sudden increase (notch effect) in the teaching 
variable at the threshold level. The new variable suggests that a 
hospital with a ratio of residents to inpatient and outpatient 
utilization 0.07 higher than the 0.28 threshold is approximately 1 
percent more costly [calculated ((1+IME)0.14-1)*100].''
    35. On page 47581, column three, first full paragraph, line eight, 
``8 percent'' is corrected to read ``12 percent''.
    36. On page 47581, column three, first full paragraph, line nine, 
``other'' is added before ``urban''.
    37. On page 47581, column three, second full paragraph, line two, 
``(long-term care, children's, and psychiatric)'' is corrected to read 
``(long-term care and children's)''.
    38. On page 47581, column three, second full paragraph, line six, 
``Cancer, children's and long-term care'' is removed and is replaced 
with ``These''.
    39. On pages 47581 through 47582 and continued on page 47585, 
through line five of the first full paragraph in column two, the text 
in the section titled ``Estimated Payments'' is removed and is replaced 
with the following:
    The appropriateness of potential payment adjustments must be based 
on both cost effects estimated by regression analysis and other factors 
including simulated payment impacts. We simulated the impact of the 
proposed system on hospitals by calculating the percentage difference 
between payments made under current law and payments under the proposed 
system (column 3). Section X. contains a more complete table that 
considers the impact of proposed payments on additional classes of 
hospitals, including TEFRA and cancer hospitals. Although Column 3 
represents the net effect of the new PPS on hospitals, we though it was 
necessary to show the impacts on hospitals of simply changing the 
payment system without including the effects of the overall reduced 
payment to hospitals because the PPS system is not budget neutral to 
current payment. To reiterate, the conversion factor is set by summing 
Medicare payments under the current system and beneficiary copayment 
under the new system and dividing by the sum of the relative weights. 
Beneficiary copayments under the new system will reduce overall 
payments to most hospitals because 20 percent of the median group 
charges is less than 20 percent of actual charges. Therefore, we 
simulated the impacts as though the conversion factor were set as if 
the system were to be budget neutral. Column 4 demonstrates the 
distributional impacts resulting from implementing the new system after 
eliminating the overall reduction in payment most hospitals will 
experience due to the effect of the methodology used to set the 
conversion factor. We believe the column 4 percentage differences are 
what we should examine since any adjustment we would consider should 
correct for inequities caused by moving to a PPS (not the legislated 
reduction in total payment). Therefore, we based our decision about 
adjustments on these percentage differences rather than percentages 
combining the PPS and the overall reduction in coinsurance amounts 
required by law. We also estimated payment-to-cost ratios associated 
with the new payment methods and the percent change in total Medicare 
payments. All simulations used a labor share of 60 percent. The table 
below shows the results of two simulations. The first contains only the 
wage index adjustment to the APC rates. The second also includes the 
threshold adjustment for teaching intensity discussed above.
    Based on our analyses, we are not proposing to make adjustments to 
the outpatient payment rates for disproportionate share patient 
percentage and teaching intensity and rural location for the following 
reasons.
    1. Estimated effects of disproportionate share patient percentage 
on costs were small and most often not statistically significant.
    2. After removing the copay effect, most teaching hospitals gain 
under the proposed system payments relative to current law. Although 
teaching hospitals with a large number of residents relative to 
outpatient and inpatient utilization demonstrate slightly higher costs, 
targeting these hospitals with a small adjustment does not greatly 
improve their payment

[[Page 35261]]

impacts. These impacts should also be evaluated in terms of the overall 
effect on Medicare payments because on average, outpatient services 
account for 10 percent of hospitals' Medicare payments. For example, 
the associated reduction of total Medicare payments for major teaching 
hospitals would be about 1 percent.
    3. With the teaching adjustment we considered, estimated overall 
payment reductions for rural hospitals would be 7.9 percent under the 
proposed system, rather than 7.4 percent. These hospitals also receive 
a greater percent of their Medicare income (14.7 percent) from 
providing outpatient services. Similarly, payment reductions for low-
volume rural hospitals would be 17.8 percent of current payments, 
rather than 17.4 percent, and these hospitals also earn a greater 
percentage of their Medicare income (18.4 percent) from providing 
outpatient services. Because of these potential shifts in payments, any 
adjustment should be based on stronger analytic results then those 
found with the current data.
    4. We also believe the issue of payment adjustments should be 
reexamined using data from initial years of the implemented system 
because current cost calculations and relationships among key factors 
and costs probably are affected by variation in coding patterns.
    5. HCFA is working towards standardizing payment across all sites 
of service. Fewer adjustments to the outpatient PPS would allow HCFA to 
move ahead more quickly with this approach.
    6. We believe that we should monitor the impact of basing APC 
weight calculations on the median rather than the geometric mean 
because better correlation between costs and service mix would impact 
the size of adjustments.
    Although the payment simulations show potentially large percentage 
losses and low payment-to-cost ratios for low-volume hospitals, we are 
not proposing an adjustment for volume. The low-volume hospitals get a 
much greater percent of their Medicare income from the provision of 
outpatient services than the average, and total Medicare payments would 
drop by 3.2 percent for rural low-volume hospitals and 1.7 percent for 
urban low-volume hospitals. Low-volume hospitals have higher than 
average standardized unit costs, which may be attributable to economies 
of scale, undercoding, or cost allocations to the outpatient 
departments that are not volume related. However, an adjustment to the 
rates based on volume alone might reward inefficiency and create 
adverse incentives such as a reduction in services in order to increase 
payment rates.
    We are particularly concerned about the potential impact of the 
outpatient PPS on low-volume rural hospitals that are sole community 
hospitals or Medicare-dependent hospitals.
    39a. On page 47585, column two, first full paragraph, line six, the 
sentence beginning ``Approximately 60 percent * * * is removed.
    39b. On page 47585, the text in column three, first full paragraph, 
through the third full paragraph is removed and replaced with the 
following:
    We also are not proposing adjustments for cancer or TEFRA hospitals 
at this time. We believe that claims from cancer and TEFRA hospitals 
have been undercoded, due to the lack of payment incentives for proper 
coding of these services under the current system. Further analysis 
will be conducted to determine if current coding practices explain the 
negative impact. If we determine that cancer hospitals would be unduly 
harmed because of the new outpatient PPS, we will consider whether an 
adjustment or perhaps a transition period is needed to moderate the 
impact. By statute, any adjustment would have to be budget neutral.
    We do not believe that this action will restrict beneficiary access 
because other hospitals provide many of the same services provided at 
TEFRA hospitals. In addition, rehabilitation and long-term care 
hospitals are less dependent than other hospitals on Medicare 
outpatient revenues.
    We are not proposing adjustments for any eye and ear hospitals 
because payment simulations demonstrated an increase in payments under 
the proposed PPS. We also are not proposing an adjustment for trauma 
hospitals because these hospitals did not demonstrate significantly 
higher costs and only lose a modest percentage of their total Medicare 
payments, 0.8 percent, compared to all hospitals. We will assess the 
need for additional adjustments and make any appropriate changes as 
data become available under the new system.''
    40. On pages 47583 through 47584, the table ``Changes for 1999 
Outpatient Prospective Payment System'' is retitled ``Changes for 
Outpatient Prospective Payment Systems'' and is corrected to read as 
follows:

                                                    Changes for Outpatient Prospective Payment System
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                            No teaching adjustment                        Teaching adjustment
                                                                 ---------------------------------------------------------------------------------------
                                                                   Percent                                     Percent
                                                                   change                            Percent   change                            Percent
                                           Number of  Outpatient     in       Copay   Standardized   change      in       Copay   Standardized   change
                                           hospitals    percent   Medicare   Effect    payment to   is total  Medicare   Effect    payment to   in total
                                                                    out-     removed   cost ratio   Medicare    out-     removed   cost ratio   Medicare
                                                                   patient                          payments   patient                          payments
                                                                  payments                                    payments
                                                 (1)        (2)        (3)       (4)         (5)         (6)       (7)       (8)         (9)        (10)
--------------------------------------------------------------------------------------------------------------------------------------------------------
ALL HOSPITALS............................      5,335        9.9       -5.7       0.0      1.0000        -0.6      -5.7       0.0      1.0000        -0.6
    NON-TEFRA HOSPITALS..................
                                               4,818       10.0       -5.7       0.0      1.0001        -0.6      -5.7       0.0      1.0001        -0.6
           NON-TEFRA HOSPITALS
 
GEOGRAPHIC LOCATION:
    URBAN HOSPITALS......................      2,643        9.3       -5.3       0.4      1.0053        -0.5      -5.2       0.5      1.0065        -0.5
        LARGE URBAN AREAS................      1,492        9.1       -6.6      -0.9      0.9890        -0.6      -6.3      -0.6      0.9928        -0.6
        OTHER URBAN AREAS................      1,151        9.6       -3.5       2.4      1.0287        -0.3      -3.7       2.1      1.0262        -0.4
    RURAL HOSPITALS......................      2,173       14.7       -7.4      -1.8      0.9784        -1.1      -7.9      -2.3      0.9734        -1.2
VOLUME (URBAN):
    0-4,999 UNITS........................        357       12.2      -13.6      -8.3      0.8493        -1.7     -13.9      -8.7      0.8458        -1.7
    5,000-10, 999 UNITS..................        502        9.6       -6.6      -0.9      0.9577        -0.6      -7.0      -1.3      0.9535        -0.7
    11,000-20,999 UNITS..................        597        9.0       -5.7       0.0      0.9839        -0.5      -6.1      -0.4      0.9802        -0.5
    21,000-42,999 UNITS..................        756        8.8       -4.2       1.6      1.0202        -0.4      -4.4       1.4      1.0180        -0.4
    43,000 OR MORE UNITS.................        431        9.7       -5.7       0.0      1.0133        -0.6      -5.1       0.7      1.0201        -0.5

[[Page 35262]]

 
VOLUME (RURAL):
    0-4,999 UNITS........................      1,047       18.4      -17.4     -12.4      0.8216        -3.2     -17.8     -12.8      0.8170        -3.3
    5,000-10,999 UNITS...................        601       15.3      -10.1      -4.6      0.9384        -1.5     -10.6      -5.2      0.9332        -1.6
    11,000- 20,999 UNITS.................        333       13.7       -6.5      -0.8      0.9962        -0.9      -7.0      -1.4      0.9910        -1.0
    21,000- 42,999 UNITS.................        170       13.5       -3.2       2.7      1.0435        -0.4      -3.7       2.2      1.0376        -0.5
    43,000 OR MORE UNITS.................         22       13.3       -2.6      +3.3      1.0674        -0.3      -2.6       3.3      1.0677        -0.3
TEACHING STATUS:
    NON-TEACHING.........................      3,814       11.2       -5.1       0.7      1.0029        -0.6      -5.6       0.1      0.9973        -0.6
    FEWER THAN 100 RESIDENTS.............        758        9.1       -4.4       1.4      1.0256        -0.4      -4.9       0.9      1.0204        -0.4
    100 OR MORE RESIDENTS................        245        9.2      -10.6      -5.2      0.9414        -1.0      -7.9      -2.3      0.9697        -0.7
DISPROPORTIONATE SHARE PATIENT RATIO:
    0....................................         17       20.3      -20.0     -15.1      0.7376        -4.1     -20.0     -15.1      0.7377        -4.1
    0.001-0.099..........................        904       10.3       -6.6      -0.9      0.9860        -0.7      -6.9      -1.2      0.9825        -0.7
    0.100-0.159..........................      1,008       10.9       -3.7       2.2      1.0307        -0.4      -4.1       1.7      1.0261        -0.4
    0.160-0.229..........................        971       10.2       -4.8       1.0      1.0143        -0.5      -4.9       0.9      1.0132        -0.5
    0.230-0.349..........................        956        9.6       -6.2      -0.5      0.9977        -0.6      -6.0      -0.3      1.0001        -0.6
    0.350 AND GREATER....................        962        9.2       -8.4      -2.9      0.9579        -0.8      -7.5      -1.9      0.9675        -0.7
--------------------------------------------------------------------------------------------------------------------------------------------------------
Note: Urban and rural breakouts in this table are based on MSA status/location only.

    41. On page 47596, in the table titled ``Estimated Annual Burden'', 
column one, line two, ``419.42(b) and (d)'' is corrected to read 
``419.42(b) and (c)''.
    42. On page 47596, in the table titled ``Estimated Annual Burden'', 
column one, line three, ``419.42(f)'' is corrected to read 
``419.42(e)''.
    42a. On page 47597, column one, first full paragraph, line 14, 
``$300'' is corrected to read ``$600''.
    42b. On page 47597, column two, the table is corrected to read as 
follows:

------------------------------------------------------------------------
                                                             Impact ($
                       Fiscal year                           millions)
------------------------------------------------------------------------
1998....................................................            -940
1999....................................................           -1640
2000....................................................           -1320
2001....................................................           -1070
2002....................................................            -990
2003....................................................            -700
------------------------------------------------------------------------

    42c. On page 47597, column two, line five of text, ``6.9'' is 
corrected to read ``10.9''.
    43. On pages 47597 through 47598, entire section F. is removed and 
replaced with the following:

F. Quantitative Impact Analysis of the Proposed Policy Changes Under 
the Prospective Payment System for Operating Costs and Capital Costs

Basis and Methodology of Estimates
    The data used in developing quantitative analyses presented below 
are taken from the CY 1996 cost and charge data and the most current 
provider-specific file that is used for payment purposes. Our analysis 
has several qualifications. First, we draw upon various sources for the 
data used to categorize hospitals in the tables. In some cases, there 
is a fair degree of variation in the data from different sources. We 
have attempted to construct these variables with the best available 
source overall. For individual hospitals, however, some 
miscategorizations are possible.
    Using CY 1996 cost and charge data, we simulated payments using the 
current and proposed payment methodologies. We used both single and 
multiple bills to calculate current and proposed Medicare and 
beneficiary hospital outpatient payment amounts. Both current and 
proposed payment estimates include operating and capital costs. We 
excluded Kaiser, New York Health and Hospital Corporation, and all-
inclusive providers because reported charges on their cost reports are 
not actual charges. Cost-to-charge ratios for these hospitals are not 
comparable to all other hospitals. The exempted Maryland hospitals were 
also excluded from the simulations; however, we included the 10 cancer 
hospitals that will be paid under the proposed system.
    We also trimmed outlier hospitals from the impact analysis because 
we had indications that hospitals with extreme unit costs would not 
allow us to access the impacts among the various classes of hospitals 
accurately. First, we identified all the outlier hospitals by using an 
edit of three standard deviations from the mean of the logged unit 
costs. Trimming the data in this manner ensures that only the hospitals 
with extremely high and low costs are eliminated from the impacts. In 
doing this, we removed 96 hospitals of which 50 hospitals had extremely 
low unit costs and 46 hospitals had extremely high unit costs. We 
conducted a thorough analysis of these hospitals to ensure that we did 
not remove any particular type of hospital (for example, teaching 
hospitals) that would further harm the integrity of the data. We 
speculate many of these hospitals are not coding accurately, and we 
will continue to perform further analysis in this area after 
implementation of the new APC system.
    After removing the 54 exempted Maryland hospitals, the all-
inclusive rate hospitals, the outlier hospitals, and hospitals for 
which we could not identify payment variables, we included 5,335 
hospitals in our analysis. The impact analysis focuses on this set of 
hospitals. The table below demonstrates the results of our analysis. 
The table categorizes hospitals by various geographic and special 
payment consideration groups to illustrate the varying impacts on 
different types of hospitals. The first column represents the number of 
hospitals in each category. The second column is the hospitals' 
Medicate outpatient payments as a percentage of the hospitals' total 
Medicare payment. The third column shows the percentage change in 
Medicare outpatient payments comparing the current and proposed payment 
systems. The fourth column shows the change in total Medicare

[[Page 35263]]

payments, resulting from implementing the PPS for outpatient services.
    The top row of the table shows the overall impact on the 5,335 
hospitals included in the analysis. We included as much of the data as 
possible to the extent that we were able to capture all the provider 
information necessary to determine payment. Further, our estimates 
include the same set of services for both current and proposed APC 
payments so that we could determine the impact as accurately as 
possible. Since payment under the proposed APC system can only be 
determined if bills are accurately coded, the data upon which the 
impacts were developed do not reflect all CY 1996 hospital outpatient 
services, but only those that were coded using valid HCPCS.
    The second row identifies the hospitals in our analysis with the 
exception of psychiatric, long-term care, children, and rehabilitation 
hospitals, which account for 4,818 hospitals.
    The next four rows of the table contain hospitals categorized 
according to their geographic location (all urban, which is further 
divided into large urban and other urban, or rural). There are 2,643 
hospitals located in urban areas (MSAs or NECMAs) included in our 
analysis. Among these, there are 1,492 hospitals located in large urban 
areas (populations over 1 million), and 1,151 hospitals in other urban 
areas (populations of 1 million or fewer). In addition, there are 2,173 
hospitals in rural areas. The next two groupings are by bed-size 
categories, shown separately for urban and rural hospitals. The next 
category includes the volume of outpatient services, also shown 
separately for urban and rural hospitals. The final groupings by 
geographic location are by census divisions, also shown separately for 
urban and rural hospitals.
    The next three groupings examine the impacts of the proposed 
changes on hospitals grouped by whether or not they have residency 
programs (teaching hospitals that receive an indirect medical education 
(IME) adjustment), receive disproportionate share hospital (DSH) 
payments, or some combination of these two adjustments. There are 3,814 
non-teaching hospitals in our analysis, 758 teaching hospitals with 
fewer than 100 residents, and 245 teaching hospitals with 100 or more 
residents.
    In the DSH categories, hospitals are grouped according to their DSH 
payment status. The next category groups hospitals considered urban 
after geographic reclassification, in terms of whether they receive the 
IME adjustment, the DSH adjustment, both, or neither. The next five 
rows examine the impacts of the proposed changes on rural hospitals by 
special payment groups (rural referral centers (RRCs), sole community 
hospitals/essential access community hospitals (SCHs/EACHs), Medicare 
dependent hospitals (MDHs), and SCHs and RRCs), as well as rural 
hospitals not receiving a special payment designation. The RRCs (168), 
SCH/EACHs (626), MDHs (365), and SCH and RRCs (55) shown here were not 
reclassified for purposes of the standardized amount.
    The next grouping is based on type of ownership. These data are 
taken primarily from the FY 1995 Medicare cost report files, if 
available (otherwise, FY 1994 data are used).
    The next groupings are the specialty hospitals. The first set 
includes the categorizations of eye and ear hospitals and trauma 
hospitals (hospitals having a level one trauma center) and cancer 
hospitals. The final groupings are the TEFRA hospitals, specifically 
rehabilitation, psychiatric, long-term care, and children hospitals.
    43a. On page 47598, the text in section G. Beginning in column two, 
first full paragraph, through page 47599, column three, line 16, is 
removed and replaced with the following:

G. Estimated Impact of the New APC System

    Column 3 compares our estimate of payments, incorporating statutory 
and policy changes reflected in this proposed rule for CY 1996, to our 
estimate of payments in CY 1996 under the current payment system. 
Percent differences between current and proposed payment reflect the 
combined impact of a proportionally equal reduction in payments due to 
the calculation of the conversion factor and distributional differences 
attributable to variation in cost and charge structures among 
hospitals. The methodology described in section 1833(t)(3)(C) of the 
Act outlining the calculation of the conversion factor reduces payment 
to hospitals overall by 5.7 percent relative to current law. As noted, 
section 1833(t)(3)(C) of the Act requires us to set the conversion 
factor so that total 1999 payments to hospitals under the proposed PPS 
system equal Medicare payment amounts as calculated under the current 
payment system plus beneficiary copayments as calculated under the 
proposed system (20 percent of the APC median charge or, at minimum, 20 
percent of the APC rate). The 5.7 percent loss implies that the 
difference between the median and charges higher than the median was 
proportionally larger than the difference between the median and 
charges lower than the median. Because this reduction is incorporated 
into the conversion factor, the 5.7 percent is distributed among 
hospitals proportional to their total payments. After removing the 
effect of the conversion factor calculation on total payments, the 
remaining percent differences demonstrate the redistribution of 
payments among hospitals and can be attributed to variation in both 
costs and charge structures. Variation in costs among hospitals results 
in differences between current and proposed Medicare payments, and 
variation in charge structures results in differences between current 
and proposed beneficiary copayment.
    Redistributions may also occur as a result of current payment 
methods. Total Medicare outpatient payments are less than reported 
total costs because (in addition to the 5.8 and 10 percent reductions 
for operating and capital costs) the blended payment methods applicable 
to many surgical and diagnostic services often result in payments that 
are less than reported costs. Other services such as medical visits, 
chemotherapy services, and non-ASC approved surgeries are paid based on 
hospital costs. The new system redistributes the current total Medicare 
payments, based in part on cost-based payments and in part on blended 
payment amounts, across all services. Hospitals, in the aggregate, will 
receive proportionately less for services that are currently paid based 
on costs and more for services that had been paid under blended payment 
methods.
    The impact on TEFRA hospitals is shown separately at the end of the 
table; however, these hospitals were not included in determining the 
impact on any of the other categories (for example, geographic 
location, bed size, volume, etc.). These hospitals demonstrated a very 
low service mix, but an average unit cost that approximates the 
national average. We believe that billing practices may account for 
this phenomenon. Some TEFRA hospitals appear to undercode HCPCS and 
units. This may be because correct coding is not required for payment 
or because they bill an all-inclusive rate. Undercoding or billing an 
all-inclusive rate could account for their low-volume, low-service mix, 
and average cost per unit. We expect that once these hospitals begin to 
code HCPCS according to the new payment system, new payments will 
better reflect current payments.
    In general, differences among hospital classifications for short-
term acute care

[[Page 35264]]

hospitals were relatively small. This is, payments under the proposed 
outpatient system were within a few percentage points of payments made 
under current law. The following discussion highlights some of the 
variation in payments among hospital classifications.
    Based on comparing current and proposed payment estimates, minor 
teaching hospitals lose 4.4 percent, while major teaching hospitals 
experience a reduction of 10.6 percent. Non-teaching hospitals 
experience a decrease of 5.1 percent. However, major teaching hospitals 
gain less of their total Medicare income (9.2 percent) from outpatient 
services than the national average (10 percent). This results in a 1 
percent loss in their total Medicare income.
    Hospitals with a high percentage of low-income patients 
(disproportionate share patient percentage greater than or equal to 
0.35) appear to experience payment reductions of 8.4 percent relative 
to current law. These hospitals have lower than average volume, and 
like major teaching hospitals, they receive a smaller than average 
percent of their Medicare income from outpatient services.
    Rural hospitals would lose about 7.4 percent, large urban hospitals 
would lose about 6.6 percent, and other urban hospitals would lose 3.5 
under the new system. Rural hospitals get a greater percentage of their 
Medicare income (14.7 percent) from outpatient services compared to the 
national average of 10 percent.
    Low-volume hospitals appear to lose a large percentage of their 
payments under the new payment system (17.4 percent for rural and 13.6 
percent for urban hospitals with less than 5,000 units of service). We 
believe several factors are contributing to this outcome, including 
undercoding, lack of economies of scale, and underpayment due to the 
reliance on the median instead of the geometric mean in the calculation 
of APC weights. The majority of these hospitals (about 75 percent) are 
rural. For these small hospitals, some of the higher standardized unit 
costs could be attributed to economies of scale. These low-volume rural 
hospitals also receive a greater percentage of their Medicare income 
(18.4 percent) from outpatient services than the average.
    43b. On page 47599, the table titled: Estimated Impact of a 
Transition Policy on Medicare Outpatient Payment for Medicare-Dependent 
and Sole Community Hospitals,'' is corrected to read as follows:

 Estimated Impact of a Transition Policy on Medicare Outpatient Payments
           for Medicare-Dependent and Sole Community Hospitals
                              [In percent]
------------------------------------------------------------------------
                                Year 1     Year 2     Year 3     Year 4
------------------------------------------------------------------------
MDH.........................       -2.8       -5.6       -8.5      -11.3
SCH.........................       -3.2       -6.4       -9.7      -12.9
SCH/RRC.....................       -1.9       -3.8       -5.8       -7.7
------------------------------------------------------------------------

    43c. On page 47599, the text in section G. beginning in column two, 
line seven from the bottom through page 47600, is corrected to read as 
follows:
    As noted above, rural hospitals lose a larger percent of their 
payments than urban hospitals. Among the census divisions, rural New 
England hospitals experience the largest negative payment impact of 
12.2 percent. This could be attributed to higher nonlabor costs in New 
England.
    Urban census division breakouts reveal that Middle Atlantic urban 
hospitals have the largest negative payment impact of 9.7 percent.
    Hospitals located in Puerto Rico gain because of the change in the 
beneficiary copayment. Previously these hospitals received 20 percent 
of their charges from the beneficiary, whereas under the new PPS they 
would receive 20 percent of the APC median charge or, at minimum, they 
would receive 20 percent of the payment rate. Hospitals in Puerto Rico 
gain under the new proposed system because 20 percent of their charges 
are lower than 20 percent of the APC median charges or 20 percent of 
the rates
    Among special categories of rural hospitals, MDHs and SCHs/EACHs 
would experience decreases of 11.3 and 12.9 percent, respectively, Some 
of this decrease may be attributed to the impact on low-volume rural 
hospitals.
    Cancer hospitals experience a 32.4 percent loss. Several factors 
may contribute to this loss. Undercoding could be a factor contributing 
to the percentage loss. In addition, the current requirements for batch 
billing of services such as chemotherapy and radiation therapy and the 
fact that we used only single procedure bills to calculate group 
weights may also have contributed to the impact on these hospitals. 
Further analysis will be conducted to determine if current coding 
practices explain the negative impact. We will be verifying the 
accuracy of the rates for these types of procedures. Specifically, the 
APC weights were calculated using single bill procedures. Using single 
bill procedures to compute a weight for services that are not typically 
billed as a single procedure could result in rates that are not 
accurate for these services. We will verify the accuracy of the rates 
for these types of procedures by analyzing the costs from the multiple 
bills. If further analysis reveals that cancer hospitals would be 
unduly harmed because of the new outpatient PPS, we will consider 
whether an adjustment or perhaps a transition period is needed to 
moderate the impact. By statute, any adjustment would have to be budget 
neutral. Until further analysis can be conducted, we are not proposing 
an adjustment for cancer hospitals.
    In accordance with the provisions of Executive Order 12866, this 
regulation was reviewed by the Office of Management and Budget.
    44. On pages 47601 through 47604, the table titled ``Changes for 
Outpatient Prospective Payment System'' is re-titled ``Impact of 
Outpatient Prospective Payment System'' and corrected to read as 
follows:

[[Page 35265]]



                                 Impact of Outpatient Prospective Payment System
----------------------------------------------------------------------------------------------------------------
                                                                                          Percent      Percent
                                                                                         change in    change in
                                                               Number of    Outpatient    Medicare      total
                                                               hospitals     percent     outpatient    Medicare
                                                                                          payments     payments
                                                                      (1)          (2)          (3)          (4)
----------------------------------------------------------------------------------------------------------------
ALL HOSPITALS...............................................        5,335          9.9         -5.7         -0.6
    NON-TEFRA HOSPITALS.....................................
                                                                    4,819         10.0         -5.7         -0.6
                     NON-TEFRA HOSPITALS
 
GEOGRAPHIC LOCATION:
    URBAN HOSPITALS.........................................        2,643          9.3         -5.3         -0.5
        LARGE URBAN AREAS...................................        1,492          9.1         -6.6         -0.6
        OTHER URBAN AREAS...................................        1,151          9.6         -3.5         -0.3
    RURAL HOSPITALS.........................................        2,173         14.7         -7.4         -1.1
BED SIZE (URBAN):
    0-99 BEDS...............................................          646         15.4         -7.3         -1.1
    100-199 BEDS............................................          910         10.4         -4.2         -0.4
    200-299 BEDS............................................          531          9.2         -3.8         -0.3
    300-499 BEDS............................................          418          8.6         -4.8         -0.4
    500 OR MORE BEDS........................................          138          8.3         -9.7         -0.8
BED SIZE (RURAL):
    0-49 BEDS...............................................        1,138         19.6        -13.8         -2.7
    50-99 BEDS..............................................          641         15.5         -8.4         -1.3
    100-149 BEDS............................................          229         13.5         -6.0         -0.8
    150-199 BEDS............................................           91         13.0         -4.3         -0.6
    200 OR MORE BEDS........................................           74         11.4         -2.9         -0.3
VOLUME (URBAN):
    0-4,999 UNITS...........................................          357         12.2        -13.6         -1.7
    5,000-10,999 UNITS......................................          502          9.6         -6.6         -0.6
    11,000-20,999 UNITS.....................................          597          9.0         -5.7         -0.5
    21,000-42,999 UNITS.....................................          756          8.8         -4.2         -0.4
    43,000 OR MORE UNITS....................................          431          9.7         -5.7         -0.6
VOLUME (RURAL):
    0-4,999 UNITS...........................................        1,047         18.4        -17.4         -3.2
    5,000-10,999 UNITS......................................          601         15.3        -10.1         -1.5
    11,000-20,999 UNITS.....................................          333         13.7         -6.5         -0.9
    21,000-42,999 UNITS.....................................          170         13.5         -3.2         -0.4
    43,000 OR MORE UNITS....................................           22         13.3         -2.6         -0.3
URBAN BY CENSUS DIV.:
    NEW ENGLAND.............................................          148         10.8         -3.2         -0.3
    MIDDLE ATLANTIC.........................................          391          8.3         -9.7         -0.8
    SOUTH ATLANTIC..........................................          393          8.6         -5.8         -0.5
    EAST NORTH CENTRAL......................................          446         10.6         -4.3         -0.5
    EAST SOUTH CENTRAL......................................          158          7.9         -1.8         -0.1
    WEST NORTH CENTRAL......................................          187          9.5         -6.5         -0.6
    WEST SOUTH CENTRAL......................................          337          9.7         -7.4         -0.7
    MOUNTAIN................................................          120         10.3         -2.2         -0.2
    PACIFIC.................................................          428          9.3         -1.8         -0.2
    PUERTO RICO.............................................           35          6.6          8.5          0.6
RURAL BY CENSUS DIV.:
    NEW ENGLAND.............................................           56         16.9        -12.2         -2.1
    MIDDLE ATLANTIC.........................................           81         13.5          0.2          0.0
    SOUTH ATLANTIC..........................................          282         11.8         -7.7         -0.9
    EAST NORTH CENTRAL......................................          287         15.8         -6.1         -1.0
    EAST SOUTH CENTRAL......................................          266         11.2         -6.5         -0.7
    WEST NORTH CENTRAL......................................          516         19.6        -10.9         -2.1
    WEST SOUTH CENTRAL......................................          339         14.2        -10.6         -1.5
    MOUNTAIN................................................          207         16.7         -8.3         -1.4
    PACIFIC.................................................          137         16.4         -3.4         -0.6
    PUERTO RICO.............................................            2          6.6         28.5          1.9
TEACHING STATUS:
    NON-TEACHING............................................        3,814         11.2         -5.1         -0.6
    FEWER THAN 100 RESIDENTS................................          758          9.1         -4.4         -0.4
    100 OR MORE RESIDENTS...................................          245          9.2        -10.6         -1.0
DISPROPORTIONATE SHARE PATIENT RATIO:
    0.......................................................           17         20.3        -20.0         -4.1
    0.001-0.099.............................................          904         10.3         -6.6         -0.7
    0.100-0.159.............................................        1,008         10.9         -3.7         -0.4
    0.160-0.229.............................................          971         10.2         -4.8         -0.5
    0.230-0.349.............................................          956          9.6         -6.2         -0.6
    0.350 AND GREATER.......................................          962          9.2         -8.4         -0.8

[[Page 35266]]

 
URBAN TEACHING AND DSH:
    BOTH TEACHING AND DSH...................................          944          9.0         -6.6         -0.6
    TEACHING AND NO DSH.....................................            2         19.8        -31.0         -6.1
    NO TEACHING AND DSH.....................................        1,688          9.8         -3.7         -0.4
    NO TEACHING AND NO DSH..................................            9         30.4          7.2          2.2
RURAL HOSPITAL TYPES:
    NONSPECIAL STATUS HOSPITALS.............................          944         15.0         -6.8         -1.0
    RRC.....................................................          168         12.4         -2.3         -0.3
    SCH/EACH................................................          626         16.4        -12.9         -2.1
    MDH.....................................................          365         18.2        -11.3         -2.1
    SCHM/EACH AND RRC.......................................           55         13.7         -7.7         -1.1
TYPE OF OWNERSHIP:
    VOLUNTARY...............................................        2,839          9.9         -5.6         -0.6
    PROPRIETARY.............................................          671          7.9         -4.7         -0.4
    GOVERNMENT..............................................        1,308         12.3         -7.4         -0.9
SPECIALTY HOSPITALS:
    EYE AND EAR.............................................           10         31.1         10.4          3.2
    TRAUMA..................................................          157          9.1         -8.4         -0.8
    CANCER..................................................           10         22.0        -32.4         -7.1
TEFRA HOSPITALS:
    REHABILITATION..........................................          138          3.7        -11.1         -0.4
    PSYCHIATRIC.............................................          278         10.7         -0.5         -0.1
    LONG-TERM CARE..........................................           63          3.7        -19.6         -0.7
    CHILDREN'S..............................................           38          9.4        -23.9         -2.2
----------------------------------------------------------------------------------------------------------------
Note: Urban and rural breakouts in this table are based on MSA status/location only.

Correction to the Regulations Text


Sec. 419.32  [Corrected]

    45. On page 47613, in the regulations text, in column one, in 
paragraph (b)(1), in the second line, ``paragraph (c)(2)'' is corrected 
to read ``paragraph (b)(2)''; and in paragraph (b)(2), in the fourth 
line, ``paragraph (c)(1)'' is corrected to read ``paragraph (b)(1)''.

Corrections to the Addenda

    46. On pages 47615 through 47620, Addendum A is corrected to read 
as follows:

  Addendum A.--List of Proposed Hospital Outpatient Ambulatory Payment Classes with Status Indicators, Relative
                                 Weights, Payment Rates, and Coinsurance Amounts
----------------------------------------------------------------------------------------------------------------
                                                                                            \7\        Minimum
  APC        Group title                               Status      Relative   Payment     National    unadjusted
                                                     indicator      weight      rate     unadjusted  coinsurance
----------------------------------------------------------------------------------------coinsurance-------------
\6\ 020  Partial              ...................  P                   4.02    $206.71       $46.78       $41.34
          Hospitalizaiton.
    031  Dental procedures..  ...................  S                   1.37     $70.45       $14.09       $14.09
    061  Level I              ...................  X                   1.15     $59.13       $37.52       $11.83
          Chemotherapeutic
          agents.
    062  Level II             ...................  X                   1.78     $91.53       $36.61       $18.31
          Chemotherapeutic
          agents.
    063  Level III            ...................  X                   2.94    $151.17      $110.97       $30.24
          Chemotherapeutic
          agents.
    064  Level IV             ...................  X                   4.15    $213.39      $138.99       $42.68
          Chemotherapeutic
          agents.
    089  Neuropsychological   ...................  X                   4.06    $208.77       $46.10       $41.75
          Testing.
    090  Monitoring           ...................  X                   0.85     $43.71       $12.20        $8.74
          psychiatric drugs.
\1\ 091  Brief Individual     ...................  S                   1.09     $56.05       $14.01       $11.21
          Psychotherapy.
\2\ 092  Extended Individual  ...................  S                   1.63     $83.81       $21.47       $16.76
          Psychotherapy.
    093  Family               ...................  S                   1.56     $80.22       $20.11       $16.04
          Psychotherapy.
    094  Group Psychotherapy  ...................  S                   1.31     $67.36       $19.89       $13.47
    121  Level I needle       ...................  T                   0.63     $32.39       $21.02        $6.48
          biopsy/aspiration.
    122  Level II needle      ...................  T                   4.59    $236.02      $113.00       $47.20
          biopsy/aspiration.
    131  Level I incision &   ...................  T                   1.93     $99.24       $36.61       $19.85
          drainage.
    132  Level II incision &  ...................  T                   5.63    $289.49      $132.89       $57.90
          drainage.
    137  Nail procedures....  ...................  T                   0.60     $30.85        $9.27        $6.17
    141  Level I Destruction  ...................  T                   0.52     $26.74        $9.49        $5.35
          of lesion.
    142  Level II             ...................  T                   2.94    $151.17       $54.24       $30.24
          Destruction of
          lesion.
    151  Level I debridement/ ...................  T                   1.63     $83.81       $33.22       $16.76
          destruction.
    152  Level II             ...................  T                  10.07    $517.80      $251.54      $103.56
          debridement/
          destruction.
    161  Level I excision/    ...................  T                   3.43    $176.37       $75.71       $35.27
          biopsy.
    162  Level II excision/   ...................  T                   5.59    $287.44      $125.66       $57.49
          biopsy.
    163  Level III excision/  ...................  T                  10.48    $538.88      $260.80      $107.78
          biopsy.
    181  Level I skin repair  ...................  T                   2.17    $111.58       $44.07       $22.32
    182  Level II skin        ...................  T                   4.11    $211.34       $92.43       $42.27
          repair.
    183  Level III skin       ...................  T                  11.04    $567.68      $283.18      $113.54
          repair.

[[Page 35267]]

 
    184  Level IV skin        ...................  T                  14.85    $763.59      $397.99      $152.72
          repair.
    197  Incision/excision    ...................  T                  11.94    $613.95      $308.26      $122.79
          breast.
    198  Breast               ...................  T                  18.63    $957.95      $523.42      $191.59
          reconstruction/
          mastectomy.
    200  Arthrocentesis &     ...................  T                   1.76     $90.50       $39.10       $18.10
          Ligament/Tendon
          Injection.
    207  Closed treatment     ...................  T                   1.70     $87.41       $32.32       $17.48
          fracture finger/
          toe/trunk.
    209  Closed treatment     ...................  T                   1.94     $99.75       $37.74       $19.95
          fracture/
          dislocation/except
          finger/toe/trunk.
    210  Bone/joint           ...................  T                  10.06    $517.29      $279.34      $103.46
          manipulation under
          anesthesia.
    216  Open/percutaneous    ...................  T                  20.09  $1,033.03      $524.09      $206.61
          treatment fracture
          or dislocation.
    217  Arthroplasty.......  ...................  T                  20.54  $1,056.17      $530.42      $211.23
    218  Arthroplasty with    ...................  T                  27.80  $1,429.48      $720.71      $285.90
          prosthesis.
    226  Maxillofacial        ...................  T                   1.56     $80.22       $21.92       $16.04
          prostheses.
    231  Level I skull and    ...................  T                  11.31    $581.56      $286.79      $116.31
          facial bone
          procedures.
    232  Level II skull and   ...................  T                  23.82  $1,224.82      $636.87      $244.96
          facial bone
          procedures.
    251  Level I              ...................  T                  13.88    $713.71      $365.89      $142.74
          musculoskeletal
          procedures.
    252  Level II             ...................  T                  19.24    $989.32      $512.34      $197.86
          Musculoskeletal
          Procedures.
    253  Level III            ...................  T                  25.74  $1,323.55      $684.55      $264.71
          Musculoskeletal
          Procedures.
    254  Level IV             ...................  T                  32.70  $1,681.43      $922.98      $336.29
          Musculoskeletal
          Procedures.
    261  Level I Hand         ...................  T                  10.41    $535.28      $259.00      $107.06
          Musculoskeletal
          Procedures.
    262  Level II Hand        ...................  T                  18.07    $929.16      $475.96      $185.83
          Musculoskeletal
          Procedures.
    271  Level I Foot         ...................  T                  14.12    $726.05      $365.44      $145.21
          Musculoskeletal
          Procedures.
    272  Level II Foot        ...................  T                  16.11    $828.38      $411.09      $165.68
          Musculoskeletal
          Procedures.
    276  Bunion Procedures..  ...................  T                  19.00    $976.98      $495.39      $195.40
    280  Diagnostic           ...................  T                  22.15  $1,138.95      $581.72      $227.79
          Arthroscopy.
    281  Level I Surgical     ...................  T                  22.37  $1,150.27      $589.18      $230.05
          Arthroscopy.
    282  Level II Surgical    ...................  T                  23.65  $1,216.08      $609.97      $243.22
          Arthroscopy.
    286  Arthroscopically-    ...................  T                  27.69  $1,423.82      $791.90      $284.76
          Aided Procedures.
    311  Level I ENT          ...................  T                   1.41     $72.50       $20.57       $14.50
          Procedures.
    312  Level II ENT         ...................  T                   7.07    $363.54      $170.86       $72.71
          Procedures.
    313  Level III ENT        ...................  T                  15.46    $794.95      $407.70      $158.99
          Procedures.
    314  Level IV ENT         ...................  T                  25.15  $1,293.21      $687.72      $258.64
          Procedures.
\5\ 317  Implantation of      ...................  T              .........  .........  ...........  ...........
          Cochlear Device.
    318  Nasal Cauterization/ ...................  T                   2.07    $106.44       $38.87       $21.29
          Packing.
    319  Tonsil/Adenoid       ...................  T                  16.20    $833.00      $463.53      $166.60
          Procedures.
    320  Thoracentesis/       ...................  T                   3.09    $158.89       $80.91       $31.78
          Lavage Procedures.
    331  Level I Endoscopy    ...................  T                   0.57     $29.31       $14.01        $5.86
          Upper Airway.
    332  Level II Endoscopy   ...................  T                   9.67    $497.23      $242.72       $99.45
          Upper Airway.
    333  Level III Endoscopy  ...................  T                  16.81    $864.37      $461.04      $172.87
          Upper Airway.
    336  Endoscopy Lower      ...................  T                   7.24    $372.28      $195.49       $74.46
          Airway.
    339  Injection of         ...................  T                   0.98     $50.39       $19.66       $10.08
          Sclerosing
          Solution.
    341  Level I Needle and   ...................  T                   0.09      $4.63        $2.49        $0.93
          Catheter Placement.
    342  Level II Needle and  ...................  T                   2.61    $134.21       $68.70       $26.84
          Catheter Placement.
    343  Level III Needle     ...................  T                   8.76    $450.44      $240.24       $90.09
          and Catheter
          Placement.
    346  Placement            ...................  T                   4.63    $238.07      $121.59       $47.61
          Transvenous Caths/
          Cutdown.
    347  Injection            ...................  T                   2.57    $132.15       $62.38       $26.43
          Procedures for
          Interventional
          Radiology.
    360  Removal/Revision,    ...................  T                   6.04    $310.58      $138.54       $62.12
          Pacemaker/Vascular
          Device.
    367  Vascular Ligation..  ...................  T                  17.02    $875.17      $441.15      $175.03
    368  Vascular Repair/     ...................  T                  22.59  $1,161.58      $647.49      $232.32
          Fistula
          Construction.
    369  Blood and Blood      ...................  T                   6.33    $325.49      $155.49       $65.10
          Product Exchange.
    396  Lymph Node           ...................  T                  12.98    $667.43      $334.48      $133.49
          Excisions.
    397  Thyroid/             ...................  T                  19.12    $983.15      $542.17      $196.63
          Lymphadenectomy
          Procedures.
    406  Esophageal Dilation  ...................  T                   4.17    $214.42      $106.67       $42.88
          without Endoscopy.
    407  Esophagoscopy......  ...................  T                   6.89    $354.28      $189.39       $70.86
    417  Diagnostic Upper GI  ...................  T                   6.35    $326.52      $179.22       $65.30
          Endoscopy.
    418  Therapeutic Upper    ...................  T                   7.44    $382.56      $213.57       $76.51
          GI Endoscopy.
    419  Small Intestine      ...................  T                   6.83    $351.20      $164.08       $70.24
          Endoscopy.
    426  Diagnostic Lower GI  ...................  T                   6.74    $346.57      $185.32       $69.31
          Endoscopy.
    427  Therapeutic Lower    ...................  T                   8.09    $415.99      $222.84       $83.20
          GI Endoscopy.
    437  Therapeutic          ...................  T                   6.54    $336.29      $173.79       $67.26
          Anoscopy.
    446  Diagnostic           ...................  T                   2.54    $130.61       $64.86       $26.12
          Sigmoidoscopy.
    447  Therapeutic          ...................  T                   7.06    $363.03      $191.87       $72.61
          Proctosigmoidoscop
          y.
    448  Therapeutic          ...................  T                   5.28    $271.50      $139.22       $54.30
          Flexible
          Sigmoidoscopy.
    449  Complex GI           ...................  T                   7.63    $392.33      $213.57       $78.47
          Endoscopy.
    451  Level I Anal/Rectal  ...................  T                   2.42    $124.44       $53.56       $24.89
          Procedures.
    452  Level II Anal/       ...................  T                   4.52    $232.42      $103.06       $46.48
          Rectal Procedures.
    453  Level III Anal/      ...................  T                  16.26    $836.09      $440.47      $167.22
          Rectal Procedures.
    456  Endoscopic           ...................  T                   9.61    $494.15      $249.05       $98.83
          Retrograde
          Cholangio-
          Pancreatography
          (ERCP).
    458  Percutaneous         ...................  T                   6.81    $350.17      $181.70       $70.03
          Biliary Endoscopic
          Procedures.
    459  Peritoneal and       ...................  T                  17.85    $917.85      $497.88      $183.57
          Abdominal
          Procedures.
    466  Hernia/Hydrocele     ...................  T                  20.67  $1,062.85      $556.64      $212.57
          Procedures.
    470  Tube Procedures....  ...................  T                   2.19    $112.61       $54.92       $22.52
    521  Level I              ...................  T                   4.89    $251.44      $110.06       $50.29
          Cystourethroscopy
          and other
          Genitourinary
          Procedures.

[[Page 35268]]

 
    522  Level II             ...................  T                  10.15    $521.91      $259.45      $104.38
          Cystourethroscopy
          and other
          Genitourinary
          Procedures.
    523  Level III            ...................  T                  16.35    $840.72      $438.89      $168.14
          Cystourethroscopy
          and other
          Genitourinary
          Procedures.
    524  Level IV             ...................  T                  27.20  $1,398.62      $824.90      $279.72
          Cystourethroscopy
          and other
          Genitourinary
          Procedures.
    527  Lithotripsy........  ...................  T                  43.48  $2,235.74    $1,372.95      $447.15
    529  Simple Urinary       ...................  T                   2.33    $119.81       $59.66       $23.96
          Studies and
          Procedures.
    530  Genitourinary        ...................  T                   2.46    $126.49       $53.34       $25.30
          Procedures.
    531  Level I Urethral     ...................  T                  18.59    $955.90      $531.55      $191.18
          Procedures.
    532  Level II Urethral    ...................  T                  23.02  $1,183.69      $588.50      $236.74
          Procedures.
    536  Circumcision.......  ...................  T                  12.89    $662.80      $321.60      $132.56
    537  Penile Procedures..  ...................  T                  28.65  $1,473.18      $872.36      $294.64
    538  Insertion of Penile  ...................  T                  48.41  $2,489.24    $1,563.47      $497.85
          Prosthesis.
    546  Testes/Epididymis    ...................  T                  16.54    $850.49      $449.51      $170.10
          Procedures.
    547  Prostate Biopsy....  ...................  T                   4.39    $225.73      $125.20       $45.15
    550  Surgical             ...................  T                  16.46    $846.37      $445.22      $169.27
          Hysteroscopy.
    551  Level I Laparoscopy  ...................  T                  24.61  $1,265.45      $701.73      $253.09
    552  Level II             ...................  T                  37.09  $1,907.17    $1,053.84      $381.43
          Laparoscopy.
    561  Level I Female       ...................  T                   1.46     $75.07       $24.41       $15.01
          Reproductive
          Procedures.
    562  Level II Female      ...................  T                  12.30    $632.47      $325.44      $126.49
          Reproductive
          Procedures.
    563  Level III Female     ...................  T                  16.50    $848.43      $461.72      $169.69
          Reproductive
          Procedures.
    567  D & C..............  ...................  T                  13.18    $677.72      $360.70      $135.54
    568  Infertility          ...................  T                   2.79    $143.46       $55.60       $28.69
          Procedures.
    578  Pregnancy and        ...................  T                   1.17     $60.16       $32.77       $12.03
          Neonatal Care
          Procedures.
    580  Vaginal Delivery...  ...................  T                   4.31    $221.62       $44.32       $44.32
    586  Therapeutic          ...................  T                  11.98    $616.01      $409.29      $123.20
          Abortion.
    587  Spontaneous          ...................  T                  12.96    $666.40      $347.14      $133.28
          Abortion.
    600  Spinal Tap.........  ...................  T                   2.41    $123.92       $61.47       $24.78
    601  Level I Nervous      ...................  T                   3.00    $154.26       $74.13       $30.85
          System Injections.
    602  Level II Nervous     ...................  T                   3.19    $164.03       $87.01       $32.81
          System Injections.
    616  Implantation of      ...................  T                  11.85    $609.33      $329.06      $121.87
          Neurostimulator
          Electrodes.
    617  Revision/Removal     ...................  T                  11.31    $581.56      $280.01      $116.31
          Neurological
          Device.
    618  Implantation of      ...................  T                  24.78  $1,274.19      $808.18      $254.84
          Neurological
          Device.
    631  Level I Nerve        ...................  T                  12.70    $653.03      $329.06      $130.61
          Procedures.
    632  Level II Nerve       ...................  T                  16.48    $847.40      $453.58      $169.48
          Procedures.
    648  Laser Retinal        ...................  T                   3.76    $193.34       $93.56       $38.67
          Procedures.
    649  Laser Eye            ...................  T                   4.37    $224.71      $111.64       $44.94
          Procedures except
          Retinal.
    651  Level I Anterior     ...................  T                   6.85    $352.23      $171.99       $70.45
          Segment Eye
          Procedures.
    652  Level II Anterior    ...................  T                  16.35    $840.72      $433.92      $168.14
          Segment Eye
          Procedures.
    667  Cataract Procedures  ...................  T                  20.35  $1,046.40      $538.11      $209.28
    668  Cataract Procedures  ...................  T                  22.02  $1,132.27      $617.21      $226.45
          with IOL Insert.
    670  Corneal Transplant.  ...................  T                  30.78  $1,582.71      $885.92      $316.54
    676  Posterior Segment    ...................  T                   5.87    $301.84      $138.54       $60.37
          Eye Procedures.
    677  Strabismus/Muscle    ...................  T                  16.11    $828.38      $428.95      $165.68
          Procedures.
    681  Level I Eye          ...................  T                   1.65     $84.84       $30.51       $16.97
          Procedures.
    682  Level II Eye         ...................  T                   3.41    $175.34       $80.68       $35.07
          Procedures.
    683  Level III Eye        ...................  T                   9.56    $491.58      $252.44       $98.32
          Procedures.
    684  Level IV Eye         ...................  T                  13.26    $681.83      $341.94      $136.37
          Procedures.
    690  Vitrectomy.........  ...................  T                  30.39  $1,562.65      $845.69      $312.53
    700  Plain Film.........  ...................  X                   0.80     $41.14       $22.37        $8.23
    706  Miscellaneous        ...................  X                   1.43     $73.53       $39.10       $14.71
          Radiological
          Procedures.
    710  Computerized Axial   ...................  S                   4.98    $256.07      $173.12       $51.21
          Tomography.
    716  Fluoroscopy........  ...................  X                   1.39     $71.47       $40.00       $14.29
    720  Magnetic Resonance   ...................  S                   6.37    $327.55      $204.98       $65.51
          Angiography.
    726  Magnetic Resonance   ...................  S                   7.91    $406.73      $256.06       $81.35
          Imaging.
    728  Myelography........  ...................  S                   3.50    $179.97       $91.98       $35.99
    730  Arthography........  ...................  S                   2.30    $118.27       $65.77       $23.65
    736  Digestive Radiology  ...................  S                   1.85     $95.13       $53.79       $19.03
    737  Diagnostic           ...................  S                   2.69    $138.32       $81.81       $27.66
          Urography.
    738  Therapeutic          ...................  S                   3.74    $192.31      $104.86       $38.46
          Radiologic
          Procedures.
    739  Diagnostic           ...................  S                   5.33    $274.07      $150.74       $54.81
          Angiography and
          Venography.
    746  Mammography........  ...................  S                   0.69     $35.48       $19.44        $7.10
    747  Diagnostic           ...................  S                   1.65     $84.84       $54.47       $16.97
          Ultrasound Except
          Vascular.
    749  Guidance under       ...................  X                   2.22    $114.15       $70.06       $22.83
          Ultrasound.
    750  Therapeutic          ...................  X                   0.96     $49.36       $25.99        $9.87
          Radiation
          Treatment Planning.
    751  Level I Therapeutic  ...................  X                   1.15     $59.13       $33.22       $11.83
          Radiation
          Treatment
          Preparation.
    752  Level II             ...................  X                   3.48    $178.94       $86.56       $35.79
          Therapeutic
          Radiation
          Treatment
          Preparation.
    757  Radiation Therapy..  ...................  S                   2.26    $116.21       $52.43       $23.24
    758  Hyperthermic         ...................  S                   5.08    $261.21      $137.18       $52.24
          Therapies.
    759  Brachytherapy and    ...................  S                   7.98    $410.33      $157.97       $82.07
          Complex
          Radioelement
          Applications.
    760  PET Scans..........  ...................  S                  14.89    $765.64      $419.46      $153.13
    761  Standard Non-        ...................  S                   1.80     $92.56       $54.01       $18.51
          Imaging Nuclear
          Medicine.
    762  Complex Non-Imaging  ...................  S                   2.02    $103.87       $55.82       $20.77
          Nuclear Medicine.
    771  Standard Planar      ...................  S                   3.81    $195.91      $117.29       $39.18
          Nuclear Medicine.

[[Page 35269]]

 
    772  Complex Planar       ...................  S                   4.26    $219.05      $128.37       $43.81
          Nuclear Medicine.
    781  Standard SPECT       ...................  S                   5.43    $279.21      $155.04       $55.84
          Nuclear Medicine.
    782  Complex SPECT        ...................  S                   9.00    $462.78      $267.13       $92.56
          Nuclear Medicine.
    791  Standard             ...................  S                  14.74    $757.93      $539.91      $151.59
          Therapeutic
          Nuclear Medicine.
    792  Complex Therapeutic  ...................  S                   4.81    $247.33      $143.06       $49.47
          Nuclear Medicine.
    861  Immunology Tests...  ...................  X                   0.13      $6.68        $3.62        $1.34
    881  Level I Pathology..  ...................  X                   0.22     $11.31        $6.78        $2.26
    882  Level II Pathology.  ...................  X                   0.39     $20.05       $11.75        $4.01
    883  Level III Pathology  ...................  X                   0.69     $35.48       $20.34        $7.10
    900  Critical Care......  ...................  S                   7.54    $387.71      $145.09       $77.54
    901  Level I              ...................  X                   0.07      $3.60        $2.49        $0.72
          Immunization.
    902  Level II             ...................  X                   1.31     $67.36       $38.19       $13.47
          Immunization.
    903  Level III            ...................  X                   1.00     $51.42       $24.86       $10.28
          Immunization.
    906  Infusion Therapy     ...................  X                   1.93     $99.24       $57.18       $19.85
          except
          Chemotherapy.
    907  Intramuscular        ...................  X                   0.74     $38.05       $11.53        $7.61
          Injections.
\3\ 911  Low Level Clinic     Well care and        V                   1.24     $63.76       $15.14       $12.75
      11  Visits.              administrative.
  91118  Low Level Clinic     Skin and breast      V                   0.83     $42.68        $9.27        $8.54
          Visits.              diseases.
  91124  Low Level Clinic     Musculoskeletal      V                   0.87     $44.74        $9.49        $8.95
          Visits.              diseases.
  91131  Low Level Clinic     Ear, nose, mouth     V                   0.81     $41.65        $9.04        $8.33
          Visits.              and throat
                               diseases.
  91133  Low Level Clinic     Respiratory system   V                   0.83     $42.68        $8.59        $8.54
          Visits.              diseases.
  91136  Low Level Clinic     Cardiovascular       V                   0.87     $44.74        $8.95        $8.95
          Visits.              system diseases.
  91141  Low Level Clinic     Digestive system     V                   0.96     $49.36       $10.40        $9.87
          Visits.              diseases.
  91153  Low Level Clinic     Kidney, urinary      V                   0.91     $46.79        $9.49        $9.36
          Visits.              tract and male
                               genital diseases.
  91156  Low Level Clinic     Female genital       V                   0.93     $47.82        $9.56        $9.56
          Visits.              system diseases.
  91157  Low Level Clinic     Pregnancy and        V                   1.37     $70.45       $17.85       $14.09
          Visits.              neonatal care.
  91163  Low Level Clinic     Nervous system       V                   0.98     $50.39       $10.17       $10.08
          Visits.              diseases.
  91168  Low Level Clinic     Eye diseases.......  V                   0.96     $49.36       $10.40        $9.87
          Visits.
  91172  Low Level Clinic     Trauma and           V                   1.06     $54.51       $14.24       $10.90
          Visits.              poisoning.
  91178  Low Level Clinic     Major signs,         V                   1.52     $78.16       $21.47       $15.63
          Visits.              symptoms and
                               findings.
  91182  Low Level Clinic     Endocrine,           V                   0.87     $44.74        $9.04        $8.95
          Visits.              nutritional and
                               metabolic diseases.
  91186  Low Level Clinic     Immunologic and      V                   1.07     $55.02       $11.53       $11.00
          Visits.              hematologic
                               diseases.
  91188  Low Level Clinic     Malignancy.........  V                   0.72     $37.02        $8.14        $7.40
          Visits.
\1\ 911  Low Level Clinic     Psychiatric          V                   1.09     $56.05       $14.01       $11.21
      91  Visits.              disorders.
  91197  Low Level Clinic     Infectious disease.  V                   1.02     $52.45       $11.53       $10.49
          Visits.
\4\ 911  Low Level Clinic     Unknown cause of     V                   1.41     $72.50       $24.86       $14.50
      99  Visits.              mortality.
\3\ 913  Mid Level Clinic     Well care and        V                   1.24     $63.76       $15.14       $12.75
      11  Visits.              administrative.
  91318  Mid Level Clinic     Skin and breast      V                   0.98     $50.39       $10.08       $10.08
          Visits.              diseases.
  91324  Mid Level Clinic     Musculoskeletal      V                   0.96     $49.36        $9.87        $9.87
          Visits.              diseases.
  91331  Mid Level Clinic     Ear, nose, mouth     V                   0.94     $48.33        $9.67        $9.67
          Visits.              and throat
                               diseases.
  91333  Mid Level Clinic     Respiratory system   V                   0.93     $47.82        $9.56        $9.56
          Visits.              diseases.
  91336  Mid Level Clinic     Cardiovascular       V                   1.00     $51.42       $10.28       $10.28
          Visits.              system diseases.
  91341  Mid Level Clinic     Digestive system     V                   1.00     $51.42       $10.28       $10.28
          Visits.              diseases.
  91353  Mid Level Clinic     Kidney, urinary      V                   1.00     $51.42       $10.28       $10.28
          Visits.              tract and male
                               genital diseases.
  91356  Mid Level Clinic     Female genital       V                   1.04     $53.48       $10.70       $10.70
          Visits.              system diseases.
  91357  Mid Level Clinic     Pregnancy and        V                   1.33     $68.39       $13.68       $13.68
          Visits.              neonatal care.
  91363  Mid Level Clinic     Nervous system       V                   1.04     $53.48       $10.70       $10.70
          Visits.              diseases.
  91368  Mid Level Clinic     Eye diseases.......  V                   0.85     $43.71        $8.74        $8.74
          Visits.
  91372  Mid Level Clinic     Trauma and           V                   1.06     $54.51       $10.90       $10.90
          Visits.              poisoning.
  91378  Mid Level Clinic     Major signs,         V                   1.13     $58.10       $11.62       $11.62
          Visits.              symptoms and
                               findings.
  91382  Mid Level Clinic     Endocrine,           V                   1.00     $51.42       $10.28       $10.28
          Visits.              nutritional and
                               metabolic diseases.
  91386  Mid Level Clinic     Immunologic and      V                   1.04     $53.48       $10.70       $10.70
          Visits.              hematologic
                               diseases.
  91388  Mid Level Clinic     Malignancy.........  V                   0.83     $42.68        $8.54        $8.54
          Visits.
\1\ 913  Mid Level Clinic     Psychiatric          V                   1.09     $56.05       $14.01       $11.21
      91  Visits.              disorders.
  91397  Mid Level Clinic     Infectious disease.  V                   1.04     $53.48       $10.70       $10.70
          Visits.
\4\ 913  Mid Level Clinic     Unknown cause of     V                   1.41     $72.50       $24.86       $14.50
      99  Visits.              mortality.
\3\ 915  High Level Clinic    Well care and        V                   1.24     $63.76       $15.14       $12.75
      11  Visits.              administrative.
  91518  High Level Clinic    Skin and breast      V                   1.72     $88.44       $19.21       $17.69
          Visits.              diseases.
  91524  High Level Clinic    Musculoskeletal      V                   1.46     $75.07       $15.37       $15.01
          Visits.              diseases.
  91531  High Level Clinic    Ear, nose, mouth     V                   1.35     $69.42       $14.24       $13.88
          Visits.              and throat
                               diseases.
  91533  High Level Clinic    Respiratory system   V                   1.44     $74.04       $14.81       $14.81
          Visits.              diseases.
  91536  High Level Clinic    Cardiovascular       V                   1.46     $75.07       $15.37       $15.01
          Visits.              system diseases.
  91541  High Level Clinic    Digestive system     V                   1.54     $79.19       $15.84       $15.84
          Visits.              diseases.
  91553  High Level Clinic    Kidney, urinary      V                   1.44     $74.04       $14.81       $14.81
          Visits.              tract and male
                               genital diseases.
  91556  High Level Clinic    Female genital       V                   1.44     $74.04       $15.14       $14.81
          Visits.              system diseases.
  91557  High Level Clinic    Pregnancy and        V                   1.76     $90.50       $22.83       $18.10
          Visits.              neonatal care.
  91563  High Level Clinic    Nervous system       V                   1.50     $77.13       $16.05       $15.43
          Visits.              diseases.
  91568  High Level Clinic    Eye diseases.......  V                   1.33     $68.39       $13.79       $13.68
          Visits.
  91572  High Level Clinic    Trauma and           V                   1.72     $88.44       $22.15       $17.69
          Visits.              poisoning.
  91578  High Level Clinic    Major signs,         V                   1.89     $97.18       $29.15       $19.44
          Visits.              symptoms and
                               findings.
  91582  High Level Clinic    Endocrine,           V                   1.46     $75.07       $15.14       $15.01
          Visits.              nutritional and
                               metabolic diseases.
  91586  High Level Clinic    Immunologic and      V                   1.76     $90.50       $19.21       $18.10
          Visits.              hematologic
                               diseases.
  91588  High Level Clinic    Malignancy.........  V                   1.19     $61.19       $12.88       $12.24
          Visits.

[[Page 35270]]

 
\2\ 915  High Level Clinic    Psychiatric          V                   1.63     $83.81       $21.47       $16.76
      91  Visits.              disorders.
  91597  High Level Clinic    Infectious disease.  V                   1.76     $90.50       $19.66       $18.10
          Visits.
\4\ 915  High Level Clinic    Unknown cause of     V                   1.41     $72.50       $24.86       $14.50
      99  Visits.              mortality.
    919  Electroconvulsive    ...................  S                   3.09    $158.89       $80.00       $31.78
          Therapy.
    920  Biofeedback and      ...................  S                   1.17     $60.16       $29.61       $12.03
          other Training.
\5\ 921  Diabetes Education.  ...................  S              .........  .........  ...........  ...........
    926  Dialysis for other   ...................  S                   4.22    $216.99       $69.83       $43.40
          than ESRD patients.
    928  Alimentary Tests...  ...................  X                   2.91    $149.63       $79.78       $29.93
    930  Minor Eye            ...................  X                   1.04     $53.48       $22.83       $10.70
          Examinations.
    931  Level I Eye Tests..  ...................  X                   0.74     $38.05       $21.47        $7.61
    932  Level II Eye Tests.  ...................  X                   2.41    $123.92       $63.73       $24.78
    936  Fitting of Vision    ...................  X                   0.48     $24.68        $9.49        $4.94
          Aids.
    940  Otorhinolaryngologi  ...................  X                   3.13    $160.94       $52.21       $32.19
          c Function Tests.
    941  Level I Audiometry.  ...................  X                   0.74     $38.05       $13.33        $7.61
    942  Level II Audiometry  ...................  X                   1.46     $75.07       $22.15       $15.01
    947  Resuscitation and    ...................  S                   4.11    $211.34      $106.22       $42.27
          Cardioversion.
    948  Cardiac              ...................  X                   0.81     $41.65       $16.95        $8.33
          Rehabilitation.
    949  Cardiovascular       ...................  X                   1.43     $73.53       $61.92       $14.71
          Stress Test.
    950  Electrocardiogram    ...................  X                   0.35     $18.00       $15.82        $3.60
          (ECG).
\3\ 951  Low Level ER Visits  Well care and        V                   1.24     $63.76       $15.14       $12.75
      11                       administrative.
  95118  Low Level ER Visits  Skin and breast      V                   1.17     $60.16       $19.21       $12.03
                               diseases.
  95124  Low Level ER Visits  Musculoskeletal      V                   1.17     $60.16       $20.11       $12.03
                               diseases.
  95131  Low Level ER Visits  Ear, nose, mouth     V                   1.11     $57.08       $17.63       $11.42
                               and throat
                               diseases.
  95133  Low Level ER Visits  Respiratory system   V                   1.15     $59.13       $18.53       $11.83
                               diseases.
  95136  Low Level ER Visits  Cardiovascular       V                   1.26     $64.79       $19.89       $12.96
                               system diseases.
  95141  Low Level ER Visits  Digestive system     V                   1.30     $66.85       $21.02       $13.37
                               diseases.
  95153  Low Level ER Visits  Kidney, urinary      V                   1.43     $73.53       $24.86       $14.71
                               tract and male
                               genital diseases.
  95156  Low Level ER Visits  Female genital       V                   1.41     $72.50       $23.96       $14.50
                               system diseases.
  95157  Low Level ER Visits  Pregnancy and        V                   1.46     $75.07       $24.63       $15.01
                               neonatal care.
  95163  Low Level ER Visits  Nervous system       V                   1.30     $66.85       $22.60       $13.37
                               diseases.
  95168  Low Level ER Visits  Eye diseases.......  V                   1.20     $61.70       $20.79       $12.34
  95172  Low Level ER Visits  Trauma and           V                   1.28     $65.82       $22.15       $13.16
                               poisoning.
  95178  Low Level ER Visits  Major signs,         V                   1.94     $99.75       $36.39       $19.95
                               symptoms and
                               findings.
  95182  Low Level ER Visits  Endocrine,           V                   1.50     $77.13       $24.63       $15.43
                               nutritional and
                               metabolic diseases.
  95186  Low Level ER Visits  Immunologic and      V                   1.46     $75.07       $26.89       $15.01
                               hematologic
                               diseases.
  95188  Low Level ER Visits  Malignancy.........  V                   1.57     $80.73       $27.35       $16.15
\1\ 951  Low Level ER Visits  Psychiatric          V                   1.09     $56.05       $14.01       $11.21
      91                       Disorders.
  95197  Low Level ER Visits  Infectious disease.  V                   1.24     $63.76       $20.57       $12.75
\4\ 951  Low Level ER Visits  Unknown cause of     V                   1.41     $72.50       $24.86       $14.50
      99                       mortality.
\3\ 953  Mid Level ER Visits  Well care and        V                   1.24     $63.76       $15.14       $12.75
      11                       administrative.
  95318  Mid Level ER Visits  Skin and breast      V                   1.89     $97.18       $34.80       $19.44
                               diseases.
  95324  Mid Level ER Visits  Musculoskeletal      V                   1.78     $91.53       $32.32       $18.31
                               diseases.
  95331  Mid Level ER Visits  Ear, nose, mouth     V                   1.80     $92.56       $31.64       $18.51
                               and throat
                               diseases.
  95333  Mid Level ER Visits  Respiratory system   V                   1.91     $98.21       $33.67       $19.64
                               diseases.
  95336  Mid Level ER Visits  Cardiovascular       V                   2.02    $103.87       $36.16       $20.77
                               system diseases.
  95341  Mid Level ER Visits  Digestive system     V                   2.02    $103.87       $36.61       $20.77
                               diseases.
  95353  Mid Level ER Visits  Kidney, urinary      V                   2.06    $105.93       $38.65       $21.19
                               tract and male
                               genital diseases.
  95356  Mid Level ER Visits  Female genital       V                   2.06    $105.93       $36.84       $21.19
                               system diseases.
  95357  Mid Level ER Visits  Pregnancy and        V                   2.10    $107.98       $40.68       $21.60
                               neonatal care.
  95363  Mid Level ER Visits  Nervous system       V                   1.89     $97.18       $35.03       $19.44
                               diseases.
  95368  Mid Level ER Visits  Eye diseases.......  V                   1.67     $85.87       $33.00       $17.17
  95372  Mid Level ER Visits  Trauma and           V                   2.02    $103.87       $39.10       $20.77
                               poisoning.
  95378  Mid Level ER Visits  Major signs,         V                   3.07    $157.86       $58.76       $31.57
                               symptoms and
                               findings.
  95382  Mid Level ER Visits  Endocrine,           V                   2.30    $118.27       $43.84       $23.65
                               nutritional and
                               metabolic diseases.
  95386  Mid Level ER Visits  Immunologic and      V                   2.48    $127.52       $49.27       $25.50
                               hematologic
                               diseases.
  95388  Mid Level ER Visits  Malignancy.........  V                   2.17    $111.58       $42.26       $22.32
  95391  Mid Level ER Visits  Psychiatric          V                   2.02    $103.87       $35.93       $20.77
                               Disorders.
  95397  Mid Level ER Visits  Infectious disease.  V                   1.99    $102.33       $36.61       $20.47
\4\ 953  Mid Level ER Visits  Unknown cause of     V                   1.41     $72.50       $24.86       $14.50
      99                       mortality.
\3\ 955  High Level ER        Well care and        V                   1.24     $63.76       $15.14       $12.75
      11  Visits.              administrative.
  95518  High Level ER        Skin and breast      V                   2.59    $133.18       $46.78       $26.64
          Visits.              diseases.
  95524  High Level ER        Musculoskeletal      V                   2.46    $126.49       $41.36       $25.30
          Visits.              diseases.
  95531  High Level ER        Ear, nose, mouth     V                   2.57    $132.15       $44.07       $26.43
          Visits.              and throat
                               diseases.
  95533  High Level ER        Respiratory system   V                   3.13    $160.94       $54.69       $32.19
          Visits.              diseases.
  95536  High Level ER        Cardiovascular       V                   3.13    $160.94       $54.69       $32.19
          Visits.              system diseases.
  95541  High Level ER        Digestive system     V                   2.89    $148.60       $54.69       $29.72
          Visits.              diseases.
  95553  High Level ER        Kidney, urinary      V                   2.87    $147.58       $54.69       $29.52
          Visits.              tract and male
                               genital diseases.
  95556  High Level ER        Female genital       V                   2.70    $138.83       $51.08       $27.77
          Visits.              system diseases.
  95557  High Level ER        Pregnancy and        V                   2.89    $148.60       $54.92       $29.72
          Visits.              neonatal care.
  95563  High Level ER        Nervous system       V                   2.74    $140.89       $52.43       $28.18
          Visits.              diseases.
  95568  High Level ER        Eye diseases.......  V                   2.33    $119.81       $40.23       $23.96
          Visits.
  95572  High Level ER        Trauma and           V                   2.72    $139.86       $50.17       $27.97
          Visits.              poisoning.
  95578  High Level ER        Major signs,         V                   6.83    $351.20      $148.48       $70.24
          Visits.              symptoms and
                               findings.

[[Page 35271]]

 
  95582  High Level ER        Endocrine,           V                   3.26    $167.63       $64.86       $33.53
          Visits.              nutritional and
                               metabolic diseases.
  95586  High Level ER        Immunologic and      V                   3.89    $200.02       $81.81       $40.00
          Visits.              hematologic
                               diseases.
  95588  High Level ER        Malignancy.........  V                   3.63    $186.65       $68.48       $37.33
          Visits.
  95591  High Level ER        Psychiatric          V                   3.48    $178.94       $62.60       $35.79
          Visits.              Disorders.
  95597  High Level ER        Infectious disease.  V                   2.78    $142.95       $53.11       $28.59
          Visits.
\4\ 955  High Level ER        Unknown cause of     V                   1.41     $72.50       $24.86       $14.50
      99  Visits.              mortality.
    956  Continuous ECG and   ...................  X                   1.09     $56.05       $54.47       $11.21
          Blood Pressure
          Monitoring.
    957  Echocardiography...  ...................  S                   4.04    $207.74      $114.13       $41.55
    958  Diagnostic Cardiac   ...................  S                  23.74  $1,220.71      $705.57      $244.14
          Catheterization.
    960  Cardiac              ...................  S                   4.80    $246.82      $143.74       $49.36
          Electrophysiologic
          Tests/Procedures.
    966  Electronic Analysis  ...................  X                   0.39     $20.05       $12.43        $4.01
          of Pacemakers/
          other Devices.
    967  Non-Invasive         ...................  X                   1.70     $87.41       $57.40       $17.48
          Vascular Studies.
    968  Vascular Ultrasound  ...................  X                   2.39    $122.89       $79.55       $24.58
    969  Hyperbaric Oxygen..  ...................  S                   2.65    $136.26      $141.70       $27.25
    971  Level I Pulmonary    ...................  X                   0.98     $50.39       $26.44       $10.08
          Tests.
    972  Level II Pulmonary   ...................  X                   1.00     $51.42       $29.38       $10.28
          Tests.
    973  Level III Pulmonary  ...................  S                   1.81     $93.07       $55.82       $18.61
          Tests.
    976  Pulmonary Therapy..  ...................  S                   0.44     $22.62       $14.69        $4.53
    977  Allergy Tests......  ...................  X                   0.56     $28.80       $11.30        $5.76
    978  Allergy Injections.  ...................  X                   0.30     $15.43        $3.39        $3.09
    979  Extended EEG         ...................  S                  10.15    $521.91      $287.25      $104.38
          Studies and Sleep
          Studies.
    980  Electroencephalogra  ...................  S                   2.15    $110.55       $57.86       $22.11
          m.
    981  Level I Nerve and    ...................  X                   1.22     $62.73       $34.35       $12.55
          Muscle Tests.
    982  Level II Nerve and   ...................  X                   1.37     $70.45       $38.42       $14.09
          Muscle Tests.
    987  Subcutaneous or      ...................  S                   2.09    $107.47       $65.09       $21.49
          Intramuscular
          Chemotherapy.
    988  Chemotherapy except  ...................  S                   4.02    $206.71      $110.29       $41.34
          by Extended
          Infusion.
    989  Chemotherapy by      ...................  S                   1.91     $98.21       $44.52       $19.64
          Extended Infusion.
    990  Photochemotherapy..  ...................  S                   0.43     $22.11        $8.14        $4.42
    997  Manipulation         ...................  S                   0.69     $35.48        $7.46        $7.10
          Therapy.
    999  Therapeutic          ...................  X                   0.43     $22.11       $11.07       $4.42
          Phlebotomy.
----------------------------------------------------------------------------------------------------------------
Notes:
\1\ Median costs APCs 091, 91191, 91391, 95191 computed together because there is no differences in facility
  resources.
\2\ Median costs APCs 092 and 91591 computed together because there is no differences in facility resources.
\3\ Median costs for all claims in combined visit levels for MDC 11; one rate is paid for multiple levels.
\4\ Median costs for all claims in combined visit levels for MDC 99; one rate is paid for multiple levels.
\5\ APCs 317 and 921 have anomalous weights. Refer to preamble for discussion.
\6\ This APC reflects the per-diem payment for patients recieving services under a partial hospitalization
  program.
\7\ The national unadjusted coinsurance amount is subtracted from the proposed payment rate to determine the
  amount Medicare pays.

    47. On pages 47621 through 47761, Addendum B is corrected to read 
as follows:

          CPT codes and descriptions only are 
copyright 1997 American Medical Association. All rights reserved. 
Applicable FARS/DFARS apply.

Copyright 1994 American Dental Association. All rights reserved.

[[Page 35271]]



Addendum B.--Proposed Hospital Outpatient Department (HOPD) Payment Status by HCPCS Code and Related Information
----------------------------------------------------------------------------------------------------------------
                                                                              Proposed    National     Minimum
  CPT/        HOPD status           Description         Proposed   Relative   payment    unadjusted   unadjusted
  HCPCS        indicator                                  APC       weight      rate    coinsurance  coinsurance
----------------------------------------------------------------------------------------------------------------
   00100  N                   Anesth, skin surgery...  .........  .........  .........  ...........  ...........
   00102  N                   Anesth, repair of cleft  .........  .........  .........  ...........  ...........
                               lip.
   00103  N                   Anesth, blepharoplasty.  .........  .........  .........  ...........  ...........
   00104  N                   Anesth for electroshock  .........  .........  .........  ...........  ...........
   00120  N                   Anesthesia for ear       .........  .........  .........  ...........  ...........
                               surgery.
   00124  N                   Anesthesia for ear exam  .........  .........  .........  ...........  ...........
   00126  N                   Anesth, tympanotomy....  .........  .........  .........  ...........  ...........
   00140  N                   Anesth, procedures on    .........  .........  .........  ...........  ...........
                               eye.
   00142  N                   Anesthesia for lens      .........  .........  .........  ...........  ...........
                               surgery.
   00144  N                   Anesth, corneal          .........  .........  .........  ...........  ...........
                               transplant.
   00145  N                   Anesth, vitrectomy.....  .........  .........  .........  ...........  ...........
   00147  N                   Anesth, iridectomy.....  .........  .........  .........  ...........  ...........
   00148  N                   Anesthesia for eye exam  .........  .........  .........  ...........  ...........
   00160  N                   Anesth, nose, sinus      .........  .........  .........  ...........  ...........
                               surgery.
   00162  N                   Anesth, nose, sinus      .........  .........  .........  ...........  ...........
                               surgery.
   00164  N                   Anesth, biopsy of nose.  .........  .........  .........  ...........  ...........
   00170  N                   Anesth, procedure on     .........  .........  .........  ...........  ...........
                               mouth.
   00172  N                   Anesth, cleft palate     .........  .........  .........  ...........  ...........
                               repair.
   00174  C                   Anesth, pharyngeal       .........  .........  .........  ...........  ...........
                               surgery.
   00176  C                   Anesth, pharyngeal       .........  .........  .........  ...........  ...........
                               surgery.

[[Page 35272]]

 
   00190  N                   Anesth, facial bone      .........  .........  .........  ...........  ...........
                               surgery.
   00192  C                   Anesth, facial bone      .........  .........  .........  ...........  ...........
                               surgery.
   00210  N                   Anesth, open head        .........  .........  .........  ...........  ...........
                               surgery.
   00212  N                   Anesth, skull drainage.  .........  .........  .........  ...........  ...........
   00214  C                   Anesth, skull drainage.  .........  .........  .........  ...........  ...........
   00215  C                   Anesth, skull fracture.  .........  .........  .........  ...........  ...........
   00216  N                   Anesth, head vessel      .........  .........  .........  ...........  ...........
                               surgery.
   00218  N                   Anesth, special head     .........  .........  .........  ...........  ...........
                               surgery.
   00220  N                   Anesth, spinal fluid     .........  .........  .........  ...........  ...........
                               shunt.
   00222  N                   Anesth, head nerve       .........  .........  .........  ...........  ...........
                               surgery.
   00300  N                   Anesth, skin surgery,    .........  .........  .........  ...........  ...........
                               neck.
   00320  N                   Anesth, neck organ       .........  .........  .........  ...........  ...........
                               surgery.
   00322  N                   Anesth, biopsy of        .........  .........  .........  ...........  ...........
                               thyroid.
   00350  N                   Anesth, neck vessel      .........  .........  .........  ...........  ...........
                               surgery.
   00352  N                   Anesth, neck vessel      .........  .........  .........  ...........  ...........
                               surgery.
   00400  N                   Anesth, chest skin       .........  .........  .........  ...........  ...........
                               surgery.
   00402  N                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               breast.
   00404  C                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               breast.
   00406  C                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               breast.
   00410  N                   Anesth, correct heart    .........  .........  .........  ...........  ...........
                               rhythm.
   00420  N                   Anesth, skin surgery,    .........  .........  .........  ...........  ...........
                               back.
   00450  N                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               shoulder.
   00452  C                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               shoulder.
   00454  N                   Anesth, collar bone      .........  .........  .........  ...........  ...........
                               biopsy.
   00470  N                   Anesth, removal of rib.  .........  .........  .........  ...........  ...........
   00472  N                   Anesth, chest wall       .........  .........  .........  ...........  ...........
                               repair.
   00474  C                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               rib(s).
   00500  N                   Anesth, esophageal       .........  .........  .........  ...........  ...........
                               surgery.
   00520  N                   Anesth, chest procedure  .........  .........  .........  ...........  ...........
   00522  N                   Anesth, chest lining     .........  .........  .........  ...........  ...........
                               biopsy.
   00524  C                   Anesth, chest drainage.  .........  .........  .........  ...........  ...........
   00528  N                   Anesth, chest partition  .........  .........  .........  ...........  ...........
                               view.
   00530  C                   Anesth, pacemaker        .........  .........  .........  ...........  ...........
                               insertion.
   00532  N                   Anesth, vascular access  .........  .........  .........  ...........  ...........
   00534  N                   Anesth, cardioverter/    .........  .........  .........  ...........  ...........
                               defib.
   00540  C                   Anesth, chest surgery..  .........  .........  .........  ...........  ...........
   00542  C                   Anesth, release of lung  .........  .........  .........  ...........  ...........
   00544  C                   Anesth, chest lining     .........  .........  .........  ...........  ...........
                               removal.
   00546  C                   Anesth, lung,chest wall  .........  .........  .........  ...........  ...........
                               surg.
   00548  N                   Anesth, trachea,bronchi  .........  .........  .........  ...........  ...........
                               surg.
   00560  C                   Anesth, open heart       .........  .........  .........  ...........  ...........
                               surgery.
   00562  C                   Anesth, open heart       .........  .........  .........  ...........  ...........
                               surgery.
   00580  C                   Anesth,heart/lung        .........  .........  .........  ...........  ...........
                               transplant.
   00600  N                   Anesth, spine, cord      .........  .........  .........  ...........  ...........
                               surgery.
   00604  C                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               vertebra.
   00620  N                   Anesth, spine, cord      .........  .........  .........  ...........  ...........
                               surgery.
   00622  C                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               nerves.
   00630  N                   Anesth, spine, cord      .........  .........  .........  ...........  ...........
                               surgery.
   00632  C                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               nerves.
   00634  C                   Anesth for               .........  .........  .........  ...........  ...........
                               chemonucleolysis.
   00670  C                   Anesth, spine, cord      .........  .........  .........  ...........  ...........
                               surgery.
   00700  N                   Anesth, abdominal wall   .........  .........  .........  ...........  ...........
                               surg.
   00702  N                   Anesth, for liver        .........  .........  .........  ...........  ...........
                               biopsy.
   00730  N                   Anesth, abdominal wall   .........  .........  .........  ...........  ...........
                               surg.
   00740  N                   Anesth, gi               .........  .........  .........  ...........  ...........
                               visualization.
   00750  N                   Anesth, repair of        .........  .........  .........  ...........  ...........
                               hernia.
   00752  N                   Anesth, repair of        .........  .........  .........  ...........  ...........
                               hernia.
   00754  N                   Anesth, repair of        .........  .........  .........  ...........  ...........
                               hernia.
   00756  N                   Anesth, repair of        .........  .........  .........  ...........  ...........
                               hernia.
   00770  N                   Anesth, blood vessel     .........  .........  .........  ...........  ...........
                               repair.
   00790  N                   Anesth, surg upper       .........  .........  .........  ...........  ...........
                               abdomen.
   00792  C                   Anesth, part liver       .........  .........  .........  ...........  ...........
                               removal.
   00794  C                   Anesth, pancreas         .........  .........  .........  ...........  ...........
                               removal.
   00796  C                   Anesth, for liver        .........  .........  .........  ...........  ...........
                               transplant.
   00800  N                   Anesth, abdominal wall   .........  .........  .........  ...........  ...........
                               surg.
   00802  C                   Anesth, fat layer        .........  .........  .........  ...........  ...........
                               removal.
   00810  N                   Anesth, intestine        .........  .........  .........  ...........  ...........
                               endoscopy.
   00820  N                   Anesth, abdominal wall   .........  .........  .........  ...........  ...........
                               surg.
   00830  N                   Anesth, repair of        .........  .........  .........  ...........  ...........
                               hernia.
   00832  N                   Anesth, repair of        .........  .........  .........  ...........  ...........
                               hernia.
   00840  N                   Anesth, surg lower       .........  .........  .........  ...........  ...........
                               abdomen.
   00842  N                   Anesth, amniocentesis..  .........  .........  .........  ...........  ...........
   00844  C                   Anesth, pelvis surgery.  .........  .........  .........  ...........  ...........
   00846  C                   Anesth, hysterectomy...  .........  .........  .........  ...........  ...........
   00848  C                   Anesth, pelvic organ     .........  .........  .........  ...........  ...........
                               surg.

[[Page 35273]]

 
   00850  C                   Anesth, cesarean         .........  .........  .........  ...........  ...........
                               section.
   00855  C                   Anesth, hysterectomy...  .........  .........  .........  ...........  ...........
   00857  C                   Analgesia, labor & c-    .........  .........  .........  ...........  ...........
                               section.
   00860  N                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               abdomen.
   00862  N                   Anesth, kidney, ureter   .........  .........  .........  ...........  ...........
                               surg.
   00864  C                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               bladder.
   00865  C                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               prostate.
   00866  C                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               adrenal.
   00868  C                   Anesth, kidney           .........  .........  .........  ...........  ...........
                               transplant.
   00870  N                   Anesth, bladder stone    .........  .........  .........  ...........  ...........
                               surg.
   00872  N                   Anesth,kidney stone      .........  .........  .........  ...........  ...........
                               destruct.
   00873  N                   Anesth,kidney stone      .........  .........  .........  ...........  ...........
                               destruct.
   00880  N                   Anesth, abdomen vessel   .........  .........  .........  ...........  ...........
                               surg.
   00882  C                   Anesth, major vein       .........  .........  .........  ...........  ...........
                               ligation.
   00884  C                   Anesth, major vein       .........  .........  .........  ...........  ...........
                               revision.
   00900  N                   Anesth, perineal         .........  .........  .........  ...........  ...........
                               procedure.
   00902  N                   Anesth, anorectal        .........  .........  .........  ...........  ...........
                               surgery.
   00904  C                   Anesth, perineal         .........  .........  .........  ...........  ...........
                               surgery.
   00906  N                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               vulva.
   00908  C                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               prostate.
   00910  N                   Anesth, bladder surgery  .........  .........  .........  ...........  ...........
   00912  N                   Anesth, bladder tumor    .........  .........  .........  ...........  ...........
                               surg.
   00914  N                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               prostate.
   00916  N                   Anesth, bleeding         .........  .........  .........  ...........  ...........
                               control.
   00918  N                   Anesth, stone removal..  .........  .........  .........  ...........  ...........
   00920  N                   Anesth, genitalia        .........  .........  .........  ...........  ...........
                               surgery.
   00922  N                   Anesth, sperm duct       .........  .........  .........  ...........  ...........
                               surgery.
   00924  N                   Anesth, testis           .........  .........  .........  ...........  ...........
                               exploration.
   00926  N                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               testis.
   00928  C                   Anesth, removal of       .........  .........  .........  ...........  ...........
                               testis.
   00930  N                   Anesth, testis           .........  .........  .........  ...........  ...........
                               suspension.
   00932  C                   Anesth, amputation of    .........  .........  .........  ...........  ...........
                               penis.
   00934  C                   Anesth, penis, nodes     .........  .........  .........  ...........  ...........
                               removal.
   00936  C                   Anesth, penis, nodes     .........  .........  .........  ...........  ...........
                               removal.
   00938  N                   Anesth, insert penis     .........  .........  .........  ...........  ...........
                               device.
   00940  N                   Anesth, vaginal          .........  .........  .........  ...........  ...........
                               procedures.
   00942  N                   Anesth, surgery on       .........  .........  .........  ...........  ...........
                               vagina.
   00944  C                   Anesth, vaginal          .........  .........  .........  ...........  ...........
                               hysterectomy.
   00946  N                   Anesth, vaginal          .........  .........  .........  ...........  ...........
                               delivery.
   00948  N                   Anesth, repair of        .........  .........  .........  ...........  ...........
                               cervix.
   00950  N                   Anesth, vaginal          .........  .........  .........  ...........  ...........
                               endoscopy.
   00952  N                   Anesth, uterine          .........  .........  .........  ...........  ...........
                               endoscopy.
   00955  C                   Analgesia, vaginal       .........  .........  .........  ...........  ...........
                               delivery.
   01000  N                   Anesth, skin surgery,    .........  .........  .........  ...........  ...........
                               pelvis.
   01110  N                   Anesth, skin surgery,    .........  .........  .........  ...........  ...........
                               pelvis.
   01120  N                   Anesth, pelvis surgery.  .........  .........  .........  ...........  ...........
   01130  N                   Anesth, body cast        .........  .........  .........  ...........  ...........
                               procedure.
   01140  C                   Anesth, amputation at    .........  .........  .........  ...........  ...........
                               pelvis.
   01150  C                   Anesth, pelvic tumor     .........  .........  .........  ...........  ...........
                               surgery.
   01160  N                   Anesth, pelvis           .........  .........  .........  ...........  ...........
                               procedure.
   01170  N                   Anesth, pelvis surgery.  .........  .........  .........  ...........  ...........
   01180  N                   Anesth, pelvis nerve     .........  .........  .........  ...........  ...........
                               removal.
   01190  C                   Anesth, pelvis nerve     .........  .........  .........  ...........  ...........
                               removal.
   01200  N                   Anesth, hip joint        .........  .........  .........  ...........  ...........
                               procedure.
   01202  N                   Anesth, arthroscopy of   .........  .........  .........  ...........  ...........
                               hip.
   01210  N                   Anesth, hip joint        .........  .........  .........  ...........  ...........
                               surgery.
   01212  C                   Anesth, hip              .........  .........  .........  ...........  ...........
                               disarticulation.
   01214  C                   Anesth, replacement of   .........  .........  .........  ...........  ...........
                               hip.
   01220  N                   Anesth, procedure on     .........  .........  .........  ...........  ...........
                               femur.
   01230  N                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               femur.
   01232  C                   Anesth, amputation of    .........  .........  .........  ...........  ...........
                               femur.
   01234  C                   Anesth, radical femur    .........  .........  .........  ...........  ...........
                               surg.
   01240  N                   Anesth, upper leg skin   .........  .........  .........  ...........  ...........
                               surg.
   01250  N                   Anesth, upper leg        .........  .........  .........  ...........  ...........
                               surgery.
   01260  N                   Anesth, upper leg veins  .........  .........  .........  ...........  ...........
                               surg.
   01270  N                   Anesth, thigh arteries   .........  .........  .........  ...........  ...........
                               surg.
   01272  C                   Anesth, femoral artery   .........  .........  .........  ...........  ...........
                               surg.
   01274  C                   Anesth, femoral          .........  .........  .........  ...........  ...........
                               embolectomy.
   01300  N                   Anesth, skin surgery,    .........  .........  .........  ...........  ...........
                               knee.
   01320  N                   Anesth, knee area        .........  .........  .........  ...........  ...........
                               surgery.
   01340  N                   Anesth, knee area        .........  .........  .........  ...........  ...........
                               procedure.
   01360  N                   Anesth, knee area        .........  .........  .........  ...........  ...........
                               surgery.
   01380  N                   Anesth, knee joint       .........  .........  .........  ...........  ...........
                               procedure.
   01382  N                   Anesth, knee             .........  .........  .........  ...........  ...........
                               arthroscopy.
   01390  N                   Anesth, knee area        .........  .........  .........  ...........  ...........
                               procedure.

[[Page 35274]]

 
   01392  N                   Anesth, knee area        .........  .........  .........  ...........  ...........
                               surgery.
   01400  N                   Anesth, knee joint       .........  .........  .........  ...........  ...........
                               surgery.
   01402  C                   Anesth, replacement of   .........  .........  .........  ...........  ...........
                               knee.
   01404  C                   Anesth, amputation at    .........  .........  .........  ...........  ...........
                               knee.
   01420  N                   Anesth, knee joint       .........  .........  .........  ...........  ...........
                               casting.
   01430  N                   Anesth, knee veins       .........  .........  .........  ...........  ...........
                               surgery.
   01432  N                   Anesth, knee vessel      .........  .........  .........  ...........  ...........
                               surg.
   01440  N                   Anesth, knee arteries    .........  .........  .........  ...........  ...........
                               surg.
   01442  C                   Anesth, knee artery      .........  .........  .........  ...........  ...........
                               surg.
   01444  C                   Anesth, knee artery      .........  .........  .........  ...........  ...........
                               repair.
   01460  N                   Anesth, lower leg skin   .........  .........  .........  ...........  ...........
                               surg.
   01462  N                   Anesth, lower leg        .........  .........  .........  ...........  ...........
                               procedure.
   01464  N                   Anesth, ankle            .........  .........  .........  ...........  ...........
                               arthroscopy.
   01470  N                   Anesth, lower leg        .........  .........  .........  ...........  ...........
                               surgery.
   01472  N                   Anesth, achilles tendon  .........  .........  .........  ...........  ...........
                               surg.
   01474  N                   Anesth, lower leg        .........  .........  .........  ...........  ...........
                               surgery.
   01480  N                   Anesth, lower leg bone   .........  .........  .........  ...........  ...........
                               surg.
   01482  N                   Anesth, radical leg      .........  .........  .........  ...........  ...........
                               surgery.
   01484  N                   Anesth, lower leg        .........  .........  .........  ...........  ...........
                               revision.
   01486  C                   Anesth, ankle            .........  .........  .........  ...........  ...........
                               replacement.
   01490  N                   Anesth, lower leg        .........  .........  .........  ...........  ...........
                               casting.
   01500  N                   Anesth, leg arteries     .........  .........  .........  ...........  ...........
                               surg.
   01502  C                   Anesth, lowerleg         .........  .........  .........  ...........  ...........
                               embolectomy.
   01520  N                   Anesth, lower leg vein   .........  .........  .........  ...........  ...........
                               surg.
   01522  N                   Anesth, lower leg vein   .........  .........  .........  ...........  ...........
                               surg.
   01600  N                   Anesth, shoulder skin    .........  .........  .........  ...........  ...........
                               surg.
   01610  N                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               shoulder.
   01620  N                   Anesth, shoulder         .........  .........  .........  ...........  ...........
                               procedure.
   01622  N                   Anesth, shoulder         .........  .........  .........  ...........  ...........
                               arthroscopy.
   01630  N                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               shoulder.
   01632  C                   Anesth, surgery of       .........  .........  .........  ...........  ...........
                               shoulder.
   01634  C                   Anesth, shoulder joint   .........  .........  .........  ...........  ...........
                               amput.
   01636  C                   Anesth, forequarter      .........  .........  .........  ...........  ...........
                               amput.
   01638  C                   Anesth, shoulder         .........  .........  .........  ...........  ...........
                               replacement.
   01650  N                   Anesth, shoulder artery  .........  .........  .........  ...........  ...........
                               surg.
   01652  C                   Anesth, shoulder vessel  .........  .........  .........  ...........  ...........
                               surg.
   01654  C                   Anesth, shoulder vessel  .........  .........  .........  ...........  ...........
                               surg.
   01656  C                   Anesth, arm-leg vessel   .........  .........  .........  ...........  ...........
                               surg.
   01670  N                   Anesth, shoulder vein    .........  .........  .........  ...........  ...........
                               surg.
   01680  N                   Anesth, shoulder         .........  .........  .........  ...........  ...........
                               casting.
   01682  N                   Anesth, airplane cast..  .........  .........  .........  ...........  ...........
   01700  N                   Anesth, elbow area skin  .........  .........  .........  ...........  ...........
                               surg.
   01710  N                   Anesth, elbow area       .........  .........  .........  ...........  ...........
                               surgery.
   01712  N                   Anesth, upperarm tendon  .........  .........  .........  ...........  ...........
                               surg.
   01714  N                   Anesth, upperarm tendon  .........  .........  .........  ...........  ...........
                               surg.
   01716  N                   Anesth, biceps tendon    .........  .........  .........  ...........  ...........
                               repair.
   01730  N                   Anesth, upperarm         .........  .........  .........  ...........  ...........
                               procedure.
   01732  N                   Anesth, elbow            .........  .........  .........  ...........  ...........
                               arthroscopy.
   01740  N                   Anesth, upper arm        .........  .........  .........  ...........  ...........
                               surgery.
   01742  N                   Anesth, humerus surgery  .........  .........  .........  ...........  ...........
   01744  N                   Anesth, humerus repair.  .........  .........  .........  ...........  ...........
   01756  C                   Anesth, radical humerus  .........  .........  .........  ...........  ...........
                               surg.
   01758  N                   Anesth, humeral lesion   .........  .........  .........  ...........  ...........
                               surg.
   01760  N                   Anesth, elbow            .........  .........  .........  ...........  ...........
                               replacement.
   01770  N                   Anesth, upperarm artery  .........  .........  .........  ...........  ...........
                               surg.
   01772  C                   Anesth, upperarm         .........  .........  .........  ...........  ...........
                               embolectomy.
   01780  N                   Anesth, upper arm vein   .........  .........  .........  ...........  ...........
                               surg.
   01782  C                   Anesth, upperarm vein    .........  .........  .........  ...........  ...........
                               repair.
   01784  N                   Anesth, av fistula       .........  .........  .........  ...........  ...........
                               repair.
   01800  N                   Anesth, lower arm skin   .........  .........  .........  ...........  ...........
                               surg.
   01810  N                   Anesth, lower arm        .........  .........  .........  ...........  ...........
                               surgery.
   01820  N                   Anesth, lower arm        .........  .........  .........  ...........  ...........
                               procedure.
   01830  N                   Anesth, lower arm        .........  .........  .........  ...........  ...........
                               surgery.
   01832  N                   Anesth, wrist            .........  .........  .........  ...........  ...........
                               replacement.
   01840  N                   Anesth, lowerarm artery  .........  .........  .........  ...........  ...........
                               surg.
   01842  C                   Anesth, lowerarm         .........  .........  .........  ...........  ...........
                               embolectomy.
   01844  N                   Anesth, vascular shunt   .........  .........  .........  ...........  ...........
                               surg.
   01850  N                   Anesth, lower arm vein   .........  .........  .........  ...........  ...........
                               surg.
   01852  C                   Anesth, lowerarm vein    .........  .........  .........  ...........  ...........
                               repair.
   01860  N                   Anesth, lower arm        .........  .........  .........  ...........  ...........
                               casting.
   01900  N                   Anesth, uterus/tube      .........  .........  .........  ...........  ...........
                               inject.
   01902  C                   Anesth, burr holes,      .........  .........  .........  ...........  ...........
                               skull.
   01904  C                   Anesth, skull x-ray      .........  .........  .........  ...........  ...........
                               inject.
   01906  N                   Anesth, lumbar           .........  .........  .........  ...........  ...........
                               myelography.
   01908  N                   Anesth, cervical         .........  .........  .........  ...........  ...........
                               myelography.

[[Page 35275]]

 
   01910  N                   Anesth, skull            .........  .........  .........  ...........  ...........
                               myelography.
   01912  N                   Anesth, lumbar           .........  .........  .........  ...........  ...........
                               discography.
   01914  N                   Anesth, cervical         .........  .........  .........  ...........  ...........
                               discography.
   01916  C                   Anesth, head             .........  .........  .........  ...........  ...........
                               arteriogram.
   01918  C                   Anesth, limb             .........  .........  .........  ...........  ...........
                               arteriogram.
   01920  N                   Anesth, catheterize      .........  .........  .........  ...........  ...........
                               heart.
   01921  C                   Anesth, vessel surgery.  .........  .........  .........  ...........  ...........
   01922  N                   Anesth, cat or MRI scan  .........  .........  .........  ...........  ...........
   01990  C                   Support for organ donor  .........  .........  .........  ...........  ...........
   01995  N                   Regional anesthesia,     .........  .........  .........  ...........  ...........
                               limb.
   01996  N                   Manage daily drug        .........  .........  .........  ...........  ...........
                               therapy.
   01999  N                   Unlisted anesth          .........  .........  .........  ...........  ...........
                               procedure.
   10040  T                   Acne surgery of skin           131       1.93     $99.24       $36.61       $19.85
                               abscess.
   10060  T                   Drainage of skin               131       1.93     $99.24       $36.61       $19.85
                               abscess.
   10061  T                   Drainage of skin               131       1.93     $99.24       $36.61       $19.85
                               abscess.
   10080  T                   Drainage of pilonidal          131       1.93     $99.24       $36.61       $19.85
                               cyst.
   10081  T                   Drainage of pilonidal          131       1.93     $99.24       $36.61       $19.85
                               cyst.
   10120  T                   Remove foreign body....        131       1.93     $99.24       $36.61       $19.85
   10121  T                   Remove foreign body....        163      10.48    $538.88      $260.80      $107.78
   10140  T                   Drainage of hematoma/          131       1.93     $99.24       $36.61       $19.85
                               fluid.
   10160  T                   Puncture drainage of           131       1.93     $99.24       $36.61       $19.85
                               lesion.
   10180  T                   Complex drainage, wound        131       1.93     $99.24       $36.61       $19.85
   11000  T                   Debride infected skin..        151       1.63     $83.81       $33.22       $16.76
   11001  T                   Debride infect skin add-       151       1.63     $83.81       $33.22       $16.76
                               on.
   11010  T                   Debride skin, fx.......        163      10.48    $538.88      $260.80      $107.78
   11011  T                   Debride skin/muscle, fx        163      10.48    $538.88      $260.80      $107.78
   11012  T                   Debride skin/muscle/           163      10.48    $538.88      $260.80      $107.78
                               bone, fx.
   11040  T                   Debride skin partial...        151       1.63     $83.81       $33.22       $16.76
   11041  T                   Debride skin full......        151       1.63     $83.81       $33.22       $16.76
   11042  T                   Debride skin/tissue....        151       1.63     $83.81       $33.22       $16.76
   11043  T                   Debride tissue/muscle..        162       5.59    $287.44      $125.66       $57.49
   11044  T                   Debride tissue/muscle/         162       5.59    $287.44      $125.66       $57.49
                               bone.
\2\ 1105  T                   Trim skin lesion.......        151       1.63     $83.81       $33.22       $16.76
        0
\2\ 1105  T                   Trim 2 to 4 skin               151       1.63     $83.81       $33.22       $16.76
        1                      lesions.
\2\ 1105  T                   Trim over 4 skin               151       1.63     $83.81       $33.22       $16.76
        2                      lesions.
   11055  T                   Trim skin lesion.......        151       1.63     $83.81       $33.22       $16.76
   11056  T                   Trim 2 to 4 skin               151       1.63     $83.81       $33.22       $16.76
                               lesions.
   11057  T                   Trim over 4 skin               151       1.63     $83.81       $33.22       $16.76
                               lesions.
   11100  T                   Biopsy of skin lesion..        161       3.43    $176.37       $75.71       $35.27
   11101  T                   Biopsy, skin add-on....        161       3.43    $176.37       $75.71       $35.27
   11200  T                   Removal of skin tags...        151       1.63     $83.81       $33.22       $16.76
   11201  T                   Remove skin tags add-on        151       1.63     $83.81       $33.22       $16.76
   11300  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11301  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11302  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11303  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11305  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11306  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11307  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11308  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11310  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11311  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11312  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11313  T                   Shave skin lesion......        151       1.63     $83.81       $33.22       $16.76
   11400  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11401  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11402  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11403  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11404  T                   Removal of skin lesion.        162       5.59    $287.44      $125.66       $57.49
   11406  T                   Removal of skin lesion.        163      10.48    $538.88      $260.80      $107.78
   11420  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11421  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11422  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11423  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11424  T                   Removal of skin lesion.        162       5.59    $287.44      $125.66       $57.49
   11426  T                   Removal of skin lesion.        163      10.48    $538.88      $260.80      $107.78
   11440  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11441  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11442  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11443  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11444  T                   Removal of skin lesion.        162       5.59    $287.44      $125.66       $57.49
   11446  T                   Removal of skin lesion.        163      10.48    $538.88      $260.80      $107.78
   11450  T                   Removal, sweat gland           163      10.48    $538.88      $260.80      $107.78
                               lesion.
   11451  T                   Removal, sweat gland           163      10.48    $538.88      $260.80      $107.78
                               lesion.
   11462  T                   Removal, sweat gland           163      10.48    $538.88      $260.80      $107.78
                               lesion.

[[Page 35276]]

 
   11463  T                   Removal, sweat gland           163      10.48    $538.88      $260.80      $107.78
                               lesion.
   11470  T                   Removal, sweat gland           163      10.48    $538.88      $260.80      $107.78
                               lesion.
   11471  T                   Removal, sweat gland           163      10.48    $538.88      $260.80      $107.78
                               lesion.
   11600  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11601  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11602  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11603  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11604  T                   Removal of skin lesion.        162       5.59    $287.44      $125.66       $57.49
   11606  T                   Removal of skin lesion.        163      10.48    $538.88      $260.80      $107.78
   11620  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11621  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11622  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11623  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11624  T                   Removal of skin lesion.        163      10.48    $538.88      $260.80      $107.78
   11626  T                   Removal of skin lesion.        163      10.48    $538.88      $260.80      $107.78
   11640  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11641  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11642  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11643  T                   Removal of skin lesion.        161       3.43    $176.37       $75.71       $35.27
   11644  T                   Removal of skin lesion.        163      10.48    $538.88      $260.80      $107.78
   11646  T                   Removal of skin lesion.        163      10.48    $538.88      $260.80      $107.78
\2\ 1170  T                   Scraping of 1-5 nails..        137       0.60     $30.85        $9.27        $6.17
        0
\2\ 1170  T                   Scraping of additional         137       0.60     $30.85        $9.27        $6.17
        1                      nails.
\2\ 1171  T                   Scraping of 1-5 nails..        137       0.60     $30.85        $9.27        $6.17
        0
\2\ 1171  T                   Scraping of additional         137       0.60     $30.85        $9.27        $6.17
        1                      nails.
   11719  T                   Trim nail(s)...........        137       0.60     $30.85        $9.27        $6.17
   11720  T                   Debride nail, 1-5......        137       0.60     $30.85        $9.27        $6.17
   11721  T                   Debride nail, 6 or more        137       0.60     $30.85        $9.27        $6.17
   11730  T                   Removal of nail plate..        151       1.63     $83.81       $33.22       $16.76
\2\ 1173  T                   Removal of second nail         151       1.63     $83.81       $33.22       $16.76
        1                      plate.
   11732  T                   Remove additional nail         151       1.63     $83.81       $33.22       $16.76
                               plate.
   11740  T                   Drain blood from under         137       0.60     $30.85        $9.27        $6.17
                               nail.
   11750  T                   Removal of nail bed....        161       3.43    $176.37       $75.71       $35.27
   11752  T                   Remove nail bed/finger         163      10.48    $538.88      $260.80      $107.78
                               tip.
   11755  T                   Biopsy, nail unit......        137       0.60     $30.85        $9.27        $6.17
   11760  T                   Reconstruction of nail         181       2.17    $111.58       $44.07       $22.32
                               bed.
   11762  T                   Reconstruction of nail         181       2.17    $111.58       $44.07       $22.32
                               bed.
   11765  T                   Excision of nail fold,         151       1.63     $83.81       $33.22       $16.76
                               toe.
   11770  T                   Removal of pilonidal           162       5.59    $287.44      $125.66       $57.49
                               lesion.
   11771  T                   Removal of pilonidal           163      10.48    $538.88      $260.80      $107.78
                               lesion.
   11772  T                   Removal of pilonidal           163      10.48    $538.88      $260.80      $107.78
                               lesion.
   11900  T                   Injection into skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   11901  T                   Added skin lesions             151       1.63     $83.81       $33.22       $16.76
                               injection.
   11920  T                   Correct skin color             181       2.17    $111.58       $44.07       $22.32
                               defects.
   11921  T                   Correct skin color             181       2.17    $111.58       $44.07       $22.32
                               defects.
   11922  T                   Correct skin color             181       2.17    $111.58       $44.07       $22.32
                               defects.
   11950  T                   Therapy for contour            181       2.17    $111.58       $44.07       $22.32
                               defects.
   11951  T                   Therapy for contour            181       2.17    $111.58       $44.07       $22.32
                               defects.
   11952  T                   Therapy for contour            181       2.17    $111.58       $44.07       $22.32
                               defects.
   11954  T                   Therapy for contour            181       2.17    $111.58       $44.07       $22.32
                               defects.
   11960  T                   Insert tissue                  183      11.04    $567.68      $283.18      $113.54
                               expander(s).
   11970  T                   Replace tissue expander        183      11.04    $567.68      $283.18      $113.54
   11971  T                   Remove tissue                  163      10.48    $538.88      $260.80      $107.78
                               expander(s).
   11975  E                   Insert contraceptive     .........  .........  .........  ...........  ...........
                               cap.
   11976  T                   Removal of                     131       1.93     $99.24       $36.61       $19.85
                               contraceptive cap.
   11977  E                   Removal/reinsert contra  .........  .........  .........  ...........  ...........
                               cap.
   12001  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12002  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12004  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12005  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12006  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12007  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12011  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12013  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12014  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12015  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12016  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12017  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12018  T                   Repair superficial             181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12020  T                   Closure of split wound.        181       2.17    $111.58       $44.07       $22.32
   12021  T                   Closure of split wound.        181       2.17    $111.58       $44.07       $22.32
   12031  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12032  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12034  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12035  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).

[[Page 35277]]

 
   12036  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12037  T                   Layer closure of               183      11.04    $567.68      $283.18      $113.54
                               wound(s).
   12041  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12042  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12044  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12045  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12046  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12047  T                   Layer closure of               183      11.04    $567.68      $283.18      $113.54
                               wound(s).
   12051  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12052  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12053  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12054  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12055  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12056  T                   Layer closure of               181       2.17    $111.58       $44.07       $22.32
                               wound(s).
   12057  T                   Layer closure of               183      11.04    $567.68      $283.18      $113.54
                               wound(s).
   13100  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13101  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13120  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13121  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13131  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13132  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13150  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13151  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13152  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   13160  T                   Late closure of wound..        182       4.11    $211.34       $92.43       $42.27
   13300  T                   Repair of wound or             182       4.11    $211.34       $92.43       $42.27
                               lesion.
   14000  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14001  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14020  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14021  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14040  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14041  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14060  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14061  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14300  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   14350  T                   Skin tissue                    183      11.04    $567.68      $283.18      $113.54
                               rearrangement.
   15000  T                   Skin graft.............        183      11.04    $567.68      $283.18      $113.54
   15050  T                   Skin pinch graft.......        183      11.04    $567.68      $283.18      $113.54
   15100  T                   Skin split graft.......        183      11.04    $567.68      $283.18      $113.54
   15101  T                   Skin split graft add-on        183      11.04    $567.68      $283.18      $113.54
   15120  T                   Skin split graft.......        183      11.04    $567.68      $283.18      $113.54
   15121  T                   Skin split graft add-on        183      11.04    $567.68      $283.18      $113.54
   15200  T                   Skin full graft........        183      11.04    $567.68      $283.18      $113.54
   15201  T                   Skin full graft add-on.        183      11.04    $567.68      $283.18      $113.54
   15220  T                   Skin full graft........        183      11.04    $567.68      $283.18      $113.54
   15221  T                   Skin full graft add-on.        183      11.04    $567.68      $283.18      $113.54
   15240  T                   Skin full graft........        183      11.04    $567.68      $283.18      $113.54
   15241  T                   Skin full graft add-on.        183      11.04    $567.68      $283.18      $113.54
   15260  T                   Skin full graft........        183      11.04    $567.68      $283.18      $113.54
   15261  T                   Skin full graft add-on.        183      11.04    $567.68      $283.18      $113.54
   15350  T                   Skin homograft.........        183      11.04    $567.68      $283.18      $113.54
   15400  T                   Skin heterograft.......        183      11.04    $567.68      $283.18      $113.54
   15570  T                   Form skin pedicle flap.        183      11.04    $567.68      $283.18      $113.54
   15572  T                   Form skin pedicle flap.        183      11.04    $567.68      $283.18      $113.54
   15574  T                   Form skin pedicle flap.        183      11.04    $567.68      $283.18      $113.54
   15576  T                   Form skin pedicle flap.        183      11.04    $567.68      $283.18      $113.54
   15580  T                   Attach skin pedicle            183      11.04    $567.68      $283.18      $113.54
                               graft.
   15600  T                   Skin graft.............        183      11.04    $567.68      $283.18      $113.54
   15610  T                   Skin graft.............        183      11.04    $567.68      $283.18      $113.54
   15620  T                   Skin graft.............        183      11.04    $567.68      $283.18      $113.54
   15625  T                   Skin graft.............        183      11.04    $567.68      $283.18      $113.54
   15630  T                   Skin graft.............        183      11.04    $567.68      $283.18      $113.54
   15650  T                   Transfer skin pedicle          183      11.04    $567.68      $283.18      $113.54
                               flap.
   15732  T                   Muscle-skin graft, head/       184      14.85    $763.59      $397.99      $152.72
                               neck.
   15734  T                   Muscle-skin graft,             184      14.85    $763.59      $397.99      $152.72
                               trunk.
   15736  T                   Muscle-skin graft, arm.        184      14.85    $763.59      $397.99      $152.72
   15738  T                   Muscle-skin graft, leg.        184      14.85    $763.59      $397.99      $152.72
   15740  T                   Island pedicle flap            184      14.85    $763.59      $397.99      $152.72
                               graft.
   15750  T                   Neurovascular pedicle          184      14.85    $763.59      $397.99      $152.72
                               graft.
\2\ 1575  C                   Microvascular flap       .........  .........  .........  ...........  ...........
        5                      graft.
   15756  C                   Free muscle flap,        .........  .........  .........  ...........  ...........
                               microvasc.
   15757  C                   Free skin flap,          .........  .........  .........  ...........  ...........
                               microvasc.
   15758  C                   Free fascial flap,       .........  .........  .........  ...........  ...........
                               microvasc.
   15760  T                   Composite skin graft...        184      14.85    $763.59      $397.99      $152.72
   15770  T                   Derma-fat-fascia graft.        184      14.85    $763.59      $397.99      $152.72

[[Page 35278]]

 
   15775  T                   Hair transplant punch          183      11.04    $567.68      $283.18      $113.54
                               grafts.
   15776  T                   Hair transplant punch          183      11.04    $567.68      $283.18      $113.54
                               grafts.
   15780  T                   Abrasion treatment of          163      10.48    $538.88      $260.80      $107.78
                               skin.
   15781  T                   Abrasion treatment of          163      10.48    $538.88      $260.80      $107.78
                               skin.
   15782  T                   Abrasion treatment of          163      10.48    $538.88      $260.80      $107.78
                               skin.
   15783  T                   Abrasion treatment of          151       1.63     $83.81       $33.22       $16.76
                               skin.
   15786  T                   Abrasion, lesion,              151       1.63     $83.81       $33.22       $16.76
                               single.
   15787  T                   Abrasion, lesions, add-        151       1.63     $83.81       $33.22       $16.76
                               on.
   15788  T                   Chemical peel, face,           151       1.63     $83.81       $33.22       $16.76
                               epiderm.
   15789  T                   Chemical peel, face,           151       1.63     $83.81       $33.22       $16.76
                               dermal.
   15792  T                   Chemical peel,                 151       1.63     $83.81       $33.22       $16.76
                               nonfacial.
   15793  T                   Chemical peel,                 151       1.63     $83.81       $33.22       $16.76
                               nonfacial.
   15810  T                   Salabrasion............        151       1.63     $83.81       $33.22       $16.76
   15811  T                   Salabrasion............        163      10.48    $538.88      $260.80      $107.78
   15819  T                   Plastic surgery, neck..        183      11.04    $567.68      $283.18      $113.54
   15820  T                   Revision of lower              183      11.04    $567.68      $283.18      $113.54
                               eyelid.
   15821  T                   Revision of lower              183      11.04    $567.68      $283.18      $113.54
                               eyelid.
   15822  T                   Revision of upper              183      11.04    $567.68      $283.18      $113.54
                               eyelid.
   15823  T                   Revision of upper              183      11.04    $567.68      $283.18      $113.54
                               eyelid.
   15824  T                   Removal of forehead            184      14.85    $763.59      $397.99      $152.72
                               wrinkles.
   15825  T                   Removal of neck                183      11.04    $567.68      $283.18      $113.54
                               wrinkles.
   15826  T                   Removal of brow                184      14.85    $763.59      $397.99      $152.72
                               wrinkles.
   15828  T                   Removal of face                184      14.85    $763.59      $397.99      $152.72
                               wrinkles.
   15829  T                   Removal of skin                183      11.04    $567.68      $283.18      $113.54
                               wrinkles.
   15831  T                   Excise excessive skin          184      14.85    $763.59      $397.99      $152.72
                               tissue.
   15832  T                   Excise excessive skin          184      14.85    $763.59      $397.99      $152.72
                               tissue.
   15833  T                   Excise excessive skin          184      14.85    $763.59      $397.99      $152.72
                               tissue.
   15834  T                   Excise excessive skin          184      14.85    $763.59      $397.99      $152.72
                               tissue.
   15835  T                   Excise excessive skin          183      11.04    $567.68      $283.18      $113.54
                               tissue.
   15836  T                   Excise excessive skin          184      14.85    $763.59      $397.99      $152.72
                               tissue.
   15837  T                   Excise excessive skin          184      14.85    $763.59      $397.99      $152.72
                               tissue.
   15838  T                   Excise excessive skin          163      10.48    $538.88      $260.80      $107.78
                               tissue.
   15839  T                   Excise excessive skin          184      14.85    $763.59      $397.99      $152.72
                               tissue.
   15840  T                   Graft for face nerve           184      14.85    $763.59      $397.99      $152.72
                               palsy.
   15841  T                   Graft for face nerve           184      14.85    $763.59      $397.99      $152.72
                               palsy.
   15842  T                   Graft for face nerve           184      14.85    $763.59      $397.99      $152.72
                               palsy.
   15845  T                   Skin and muscle repair,        184      14.85    $763.59      $397.99      $152.72
                               face.
   15850  T                   Removal of sutures.....        151       1.63     $83.81       $33.22       $16.76
   15851  T                   Removal of sutures.....        151       1.63     $83.81       $33.22       $16.76
   15852  T                   Dressing change,not for        151       1.63     $83.81       $33.22       $16.76
                               burn.
   15860  N                   Test for blood flow in   .........  .........  .........  ...........  ...........
                               graft.
   15876  T                   Suction assisted               184      14.85    $763.59      $397.99      $152.72
                               lipectomy.
   15877  T                   Suction assisted               184      14.85    $763.59      $397.99      $152.72
                               lipectomy.
   15878  T                   Suction assisted               184      14.85    $763.59      $397.99      $152.72
                               lipectomy.
   15879  T                   Suction assisted               184      14.85    $763.59      $397.99      $152.72
                               lipectomy.
   15920  T                   Removal of tail bone           163      10.48    $538.88      $260.80      $107.78
                               ulcer.
   15922  T                   Removal of tail bone           184      14.85    $763.59      $397.99      $152.72
                               ulcer.
   15931  T                   Remove sacrum pressure         163      10.48    $538.88      $260.80      $107.78
                               sore.
   15933  T                   Remove sacrum pressure         163      10.48    $538.88      $260.80      $107.78
                               sore.
   15934  T                   Remove sacrum pressure         184      14.85    $763.59      $397.99      $152.72
                               sore.
   15935  T                   Remove sacrum pressure         184      14.85    $763.59      $397.99      $152.72
                               sore.
   15936  T                   Remove sacrum pressure         184      14.85    $763.59      $397.99      $152.72
                               sore.
   15937  T                   Remove sacrum pressure         184      14.85    $763.59      $397.99      $152.72
                               sore.
   15940  T                   Removal of pressure            163      10.48    $538.88      $260.80      $107.78
                               sore.
   15941  T                   Removal of pressure            163      10.48    $538.88      $260.80      $107.78
                               sore.
   15944  T                   Removal of pressure            184      14.85    $763.59      $397.99      $152.72
                               sore.
   15945  T                   Removal of pressure            184      14.85    $763.59      $397.99      $152.72
                               sore.
   15946  T                   Removal of pressure            184      14.85    $763.59      $397.99      $152.72
                               sore.
   15950  T                   Remove thigh pressure          163      10.48    $538.88      $260.80      $107.78
                               sore.
   15951  T                   Remove thigh pressure          163      10.48    $538.88      $260.80      $107.78
                               sore.
   15952  T                   Remove thigh pressure          184      14.85    $763.59      $397.99      $152.72
                               sore.
   15953  T                   Remove thigh pressure          184      14.85    $763.59      $397.99      $152.72
                               sore.
   15956  T                   Remove thigh pressure          184      14.85    $763.59      $397.99      $152.72
                               sore.
   15958  T                   Remove thigh pressure          184      14.85    $763.59      $397.99      $152.72
                               sore.
   15999  T                   Removal of pressure            163      10.48    $538.88      $260.80      $107.78
                               sore.
   16000  T                   Initial treatment of           151       1.63     $83.81       $33.22       $16.76
                               burn(s).
   16010  T                   Treatment of burn(s)...        152      10.07    $517.80      $251.54      $103.56
   16015  T                   Treatment of burn(s)...        152      10.07    $517.80      $251.54      $103.56
   16020  T                   Treatment of burn(s)...        151       1.63     $83.81       $33.22       $16.76
   16025  T                   Treatment of burn(s)...        151       1.63     $83.81       $33.22       $16.76
   16030  T                   Treatment of burn(s)...        151       1.63     $83.81       $33.22       $16.76
   16035  T                   Incision of burn scab..        162       5.59    $287.44      $125.66       $57.49
\2\ 1604  T                   Burn wound excision....        162       5.59    $287.44      $125.66       $57.49
        0
\2\ 1604  T                   Burn wound excision....        162       5.59    $287.44      $125.66       $57.49
        1
\2\ 1604  T                   Burn wound excision....        162       5.59    $287.44      $125.66       $57.49
        2

[[Page 35279]]

 
   17000  T                   Destroy benign/premal          141       0.52     $26.74        $9.49        $5.35
                               lesion.
\2\ 1700  T                   Destruction of add'l           141       0.52     $26.74        $9.49        $5.35
        1                      lesions.
\2\ 1700  T                   Destruction of add'l           141       0.52     $26.74        $9.49        $5.35
        2                      lesions.
   17003  T                   Destroy 2-14 lesions...        141       0.52     $26.74        $9.49        $5.35
   17004  T                   Destroy 15 & more              142       2.94    $151.17       $54.24       $30.24
                               lesions.
\2\ 1710  T                   Destruction of skin            141       0.52     $26.74        $9.49        $5.35
        0                      lesion.
\2\ 1710  T                   Destruction of 2nd             141       0.52     $26.74        $9.49        $5.35
        1                      lesion.
\2\ 1710  T                   Destruction of add'l           141       0.52     $26.74        $9.49        $5.35
        2                      lesions.
\2\ 1710  T                   Destruction of skin            142       2.94    $151.17       $54.24       $30.24
        4                      lesions.
\2\ 1710  T                   Destruction of skin            142       2.94    $151.17       $54.24       $30.24
        5                      lesions.
   17106  T                   Destruction of skin            141       0.52     $26.74        $9.49        $5.35
                               lesions.
   17107  T                   Destruction of skin            142       2.94    $151.17       $54.24       $30.24
                               lesions.
   17108  T                   Destruction of skin            142       2.94    $151.17       $54.24       $30.24
                               lesions.
   17110  T                   Destruct lesion, 1-14..        141       0.52     $26.74        $9.49        $5.35
   17111  T                   Destruct lesion, 15 or         142       2.94    $151.17       $54.24       $30.24
                               more.
\2\ 1720  T                   Electrocautery of skin         151       1.63     $83.81       $33.22       $16.76
        0                      tags.
\2\ 1720  T                   Electrocautery added           151       1.63     $83.81       $33.22       $16.76
        1                      lesions.
   17250  T                   Chemical cautery,              151       1.63     $83.81       $33.22       $16.76
                               tissue.
   17260  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17261  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17262  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17263  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17264  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17266  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17270  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17271  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17272  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17273  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17274  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17276  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17280  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17281  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17282  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17283  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17284  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17286  T                   Destruction of skin            151       1.63     $83.81       $33.22       $16.76
                               lesions.
   17304  T                   Chemosurgery of skin           162       5.59    $287.44      $125.66       $57.49
                               lesion.
   17305  T                   2nd stage chemosurgery.        162       5.59    $287.44      $125.66       $57.49
   17306  T                   3rd stage chemosurgery.        162       5.59    $287.44      $125.66       $57.49
   17307  T                   Followup skin lesion           162       5.59    $287.44      $125.66       $57.49
                               therapy.
   17310  T                   Extensive skin                 162       5.59    $287.44      $125.66       $57.49
                               chemosurgery.
   17340  T                   Cryotherapy of skin....        151       1.63     $83.81       $33.22       $16.76
   17360  T                   Skin peel therapy......        151       1.63     $83.81       $33.22       $16.76
   17380  T                   Hair removal by                151       1.63     $83.81       $33.22       $16.76
                               electrolysis.
   17999  T                   Skin tissue procedure..        121       0.63     $32.39       $21.02        $6.48
   19000  T                   Drainage of breast             121       0.63     $32.39       $21.02        $6.48
                               lesion.
   19001  T                   Drain breast lesion add-       121       0.63     $32.39       $21.02        $6.48
                               on.
   19020  T                   Incision of breast             132       5.63    $289.49      $132.89       $57.90
                               lesion.
   19030  T                   Injection for breast x-        347       2.57    $132.15       $62.38       $26.43
                               ray.
   19100  T                   Biopsy of breast.......        122       4.59    $236.02      $113.00       $47.20
   19101  T                   Biopsy of breast.......        197      11.94    $613.95      $308.26      $122.79
   19110  T                   Nipple exploration.....        197      11.94    $613.95      $308.26      $122.79
   19112  T                   Excise breast duct             197      11.94    $613.95      $308.26      $122.79
                               fistula.
   19120  T                   Removal of breast              197      11.94    $613.95      $308.26      $122.79
                               lesion.
   19125  T                   Excision, breast lesion        197      11.94    $613.95      $308.26      $122.79
   19126  T                   Excision,add'l breast          197      11.94    $613.95      $308.26      $122.79
                               lesion.
   19140  T                   Removal of breast              197      11.94    $613.95      $308.26      $122.79
                               tissue.
   19160  T                   Removal of breast              198      18.63    $957.95      $523.42      $191.59
                               tissue.
   19162  T                   Remove breast tissue,          198      18.63    $957.95      $523.42      $191.59
                               nodes.
   19180  T                   Removal of breast......        198      18.63    $957.95      $523.42      $191.59
   19182  T                   Removal of breast......        198      18.63    $957.95      $523.42      $191.59
   19200  C                   Removal of breast......  .........  .........  .........  ...........  ...........
   19220  C                   Removal of breast......  .........  .........  .........  ...........  ...........
   19240  C                   Removal of breast......  .........  .........  .........  ...........  ...........
   19260  C                   Removal of chest wall    .........  .........  .........  ...........  ...........
                               lesion.
   19271  C                   Revision of chest wall.  .........  .........  .........  ...........  ...........
   19272  C                   Extensive chest wall     .........  .........  .........  ...........  ...........
                               surgery.
   19290  T                   Place needle wire,             197      11.94    $613.95      $308.26      $122.79
                               breast.
   19291  T                   Place needle wire,             197      11.94    $613.95      $308.26      $122.79
                               breast.
   19316  T                   Suspension of breast...        198      18.63    $957.95      $523.42      $191.59
   19318  T                   Reduction of large             198      18.63    $957.95      $523.42      $191.59
                               breast.
   19324  T                   Enlarge breast.........        198      18.63    $957.95      $523.42      $191.59
   19325  T                   Enlarge breast with            198      18.63    $957.95      $523.42      $191.59
                               implant.
   19328  T                   Removal of breast              198      18.63    $957.95      $523.42      $191.59
                               implant.
   19330  T                   Removal of implant             198      18.63    $957.95      $523.42      $191.59
                               material.

[[Page 35280]]

 
   19340  T                   Immediate breast               198      18.63    $957.95      $523.42      $191.59
                               prosthesis.
   19342  T                   Delayed breast                 198      18.63    $957.95      $523.42      $191.59
                               prosthesis.
   19350  T                   Breast reconstruction..        198      18.63    $957.95      $523.42      $191.59
   19355  T                   Correct inverted               198      18.63    $957.95      $523.42      $191.59
                               nipple(s).
   19357  T                   Breast reconstruction..        198      18.63    $957.95      $523.42      $191.59
   19361  C                   Breast reconstruction..  .........  .........  .........  ...........  ...........
   19364  C                   Breast reconstruction..  .........  .........  .........  ...........  ...........
   19366  T                   Breast reconstruction..        198      18.63    $957.95      $523.42      $191.59
   19367  C                   Breast reconstruction..  .........  .........  .........  ...........  ...........
   19368  C                   Breast reconstruction..  .........  .........  .........  ...........  ...........
   19369  C                   Breast reconstruction..  .........  .........  .........  ...........  ...........
   19370  T                   Surgery of breast              198      18.63    $957.95      $523.42      $191.59
                               capsule.
   19371  T                   Removal of breast              198      18.63    $957.95      $523.42      $191.59
                               capsule.
   19380  T                   Revise breast                  198      18.63    $957.95      $523.42      $191.59
                               reconstruction.
   19396  T                   Design custom breast           197      11.94    $613.95      $308.26      $122.79
                               implant.
   19499  T                   Breast surgery                 197      11.94    $613.95      $308.26      $122.79
                               procedure.
   20000  T                   Incision of abscess....        131       1.93     $99.24       $36.61       $19.85
   20005  T                   Incision of deep               251      13.88    $713.71      $365.89      $142.74
                               abscess.
   20100  C                   Explore wound, neck....  .........  .........  .........  ...........  ...........
   20101  C                   Explore wound, chest...  .........  .........  .........  ...........  ...........
   20102  C                   Explore wound, abdomen.  .........  .........  .........  ...........  ...........
   20103  C                   Explore wound,           .........  .........  .........  ...........  ...........
                               extremity.
   20150  C                   Excise epiphyseal bar..  .........  .........  .........  ...........  ...........
   20200  T                   Muscle biopsy..........        162       5.59    $287.44      $125.66       $57.49
   20205  T                   Deep muscle biopsy.....        162       5.59    $287.44      $125.66       $57.49
   20206  T                   Needle biopsy, muscle..        122       4.59    $236.02      $113.00       $47.20
   20220  T                   Bone biopsy, trocar/           162       5.59    $287.44      $125.66       $57.49
                               needle.
   20225  T                   Bone biopsy, trocar/           162       5.59    $287.44      $125.66       $57.49
                               needle.
   20240  T                   Bone biopsy, excisional        163      10.48    $538.88      $260.80      $107.78
   20245  T                   Bone biopsy, excisional        163      10.48    $538.88      $260.80      $107.78
   20250  T                   Open bone biopsy.......        251      13.88    $713.71      $365.89      $142.74
   20251  T                   Open bone biopsy.......        251      13.88    $713.71      $365.89      $142.74
   20500  T                   Injection of sinus             181       2.17    $111.58       $44.07       $22.32
                               tract.
   20501  T                   Inject sinus tract for         347       2.57    $132.15       $62.38       $26.43
                               x-ray.
   20520  T                   Removal of foreign body        161       3.43    $176.37       $75.71       $35.27
   20525  T                   Removal of foreign body        163      10.48    $538.88      $260.80      $107.78
   20550  T                   Inj tendon/ligament/           200       1.76     $90.50       $39.10       $18.10
                               cyst.
   20600  T                   Drain/inject joint/            200       1.76     $90.50       $39.10       $18.10
                               bursa.
   20605  T                   Drain/inject joint/            200       1.76     $90.50       $39.10       $18.10
                               bursa.
   20610  T                   Drain/inject joint/            200       1.76     $90.50       $39.10       $18.10
                               bursa.
   20615  T                   Treatment of bone cyst.        121       0.63     $32.39       $21.02        $6.48
   20650  T                   Insert and remove bone         251      13.88    $713.71      $365.89      $142.74
                               pin.
   20660  C                   Apply,remove fixation    .........  .........  .........  ...........  ...........
                               device.
   20661  C                   Application of head      .........  .........  .........  ...........  ...........
                               brace.
   20662  C                   Application of pelvis    .........  .........  .........  ...........  ...........
                               brace.
   20663  C                   Application of thigh     .........  .........  .........  ...........  ...........
                               brace.
   20664  C                   Halo brace application.  .........  .........  .........  ...........  ...........
   20665  N                   Removal of fixation      .........  .........  .........  ...........  ...........
                               device.
   20670  T                   Removal of support             162       5.59    $287.44      $125.66       $57.49
                               implant.
   20680  T                   Removal of support             163      10.48    $538.88      $260.80      $107.78
                               implant.
   20690  T                   Apply bone fixation            252      19.24    $989.32      $512.34      $197.86
                               device.
   20692  T                   Apply bone fixation            252      19.24    $989.32      $512.34      $197.86
                               device.
   20693  T                   Adjust bone fixation           251      13.88    $713.71      $365.89      $142.74
                               device.
   20694  T                   Remove bone fixation           251      13.88    $713.71      $365.89      $142.74
                               device.
   20802  C                   Replantation, arm,       .........  .........  .........  ...........  ...........
                               complete.
   20805  C                   Replant forearm,         .........  .........  .........  ...........  ...........
                               complete.
   20808  C                   Replantation, hand,      .........  .........  .........  ...........  ...........
                               complete.
   20816  C                   Replantation digit,      .........  .........  .........  ...........  ...........
                               complete.
   20822  C                   Replantation digit,      .........  .........  .........  ...........  ...........
                               complete.
   20824  C                   Replantation thumb,      .........  .........  .........  ...........  ...........
                               complete.
   20827  C                   Replantation thumb,      .........  .........  .........  ...........  ...........
                               complete.
   20838  C                   Replantation, foot,      .........  .........  .........  ...........  ...........
                               complete.
   20900  T                   Removal of bone for            252      19.24    $989.32      $512.34      $197.86
                               graft.
   20902  T                   Removal of bone for            252      19.24    $989.32      $512.34      $197.86
                               graft.
   20910  T                   Remove cartilage for           183      11.04    $567.68      $283.18      $113.54
                               graft.
   20912  T                   Remove cartilage for           183      11.04    $567.68      $283.18      $113.54
                               graft.
   20920  T                   Removal of fascia for          183      11.04    $567.68      $283.18      $113.54
                               graft.
   20922  T                   Removal of fascia for          183      11.04    $567.68      $283.18      $113.54
                               graft.
   20924  T                   Removal of tendon for          252      19.24    $989.32      $512.34      $197.86
                               graft.
   20926  T                   Removal of tissue for          183      11.04    $567.68      $283.18      $113.54
                               graft.
   20930  C                   Spinal bone allograft..  .........  .........  .........  ...........  ...........
   20931  C                   Spinal bone allograft..  .........  .........  .........  ...........  ...........
   20936  C                   Spinal bone autograft..  .........  .........  .........  ...........  ...........
   20937  C                   Spinal bone autograft..  .........  .........  .........  ...........  ...........
   20938  C                   Spinal bone autograft..  .........  .........  .........  ...........  ...........

[[Page 35281]]

 
   20950  T                   Record fluid                   132       5.63    $289.49      $132.89       $57.90
                               pressure,muscle.
   20955  C                   Fibula bone graft,       .........  .........  .........  ...........  ...........
                               microvasc.
   20956  C                   Iliac bone graft,        .........  .........  .........  ...........  ...........
                               microvasc.
   20957  C                   Mt bone graft,           .........  .........  .........  ...........  ...........
                               microvasc.
\2\ 2096  C                   Microvascular rib graft  .........  .........  .........  ...........  ...........
        0
   20962  C                   Other bone graft,        .........  .........  .........  ...........  ...........
                               microvasc.
   20969  C                   Bone/skin graft,         .........  .........  .........  ...........  ...........
                               microvasc.
   20970  C                   Bone/skin graft, iliac   .........  .........  .........  ...........  ...........
                               crest.
\2\ 2097  C                   Bone-skin graft, rib...  .........  .........  .........  ...........  ...........
        1
   20972  C                   Bone-skin graft,         .........  .........  .........  ...........  ...........
                               metatarsal.
   20973  C                   Bone-skin graft, great   .........  .........  .........  ...........  ...........
                               toe.
   20974  A                   Electrical bone          .........  .........  .........  ...........  ...........
                               stimulation.
   20975  T                   Electrical bone                251      13.88    $713.71      $365.89      $142.74
                               stimulation.
   20999  N                   Musculoskeletal surgery  .........  .........  .........  ...........  ...........
   21010  T                   Incision of jaw joint..        232      23.82  $1,224.82      $636.87      $244.96
   21015  T                   Resection of facial            231      11.31    $581.56      $286.79      $116.31
                               tumor.
   21025  T                   Excision of bone, lower        231      11.31    $581.56      $286.79      $116.31
                               jaw.
   21026  T                   Excision of facial             231      11.31    $581.56      $286.79      $116.31
                               bone(s).
   21029  T                   Contour of face bone           231      11.31    $581.56      $286.79      $116.31
                               lesion.
   21030  T                   Removal of face bone           231      11.31    $581.56      $286.79      $116.31
                               lesion.
   21031  T                   Remove exostosis,              231      11.31    $581.56      $286.79      $116.31
                               mandible.
   21032  T                   Remove exostosis,              231      11.31    $581.56      $286.79      $116.31
                               maxilla.
   21034  T                   Removal of face bone           232      23.82  $1,224.82      $636.87      $244.96
                               lesion.
   21040  T                   Removal of jaw bone            231      11.31    $581.56      $286.79      $116.31
                               lesion.
   21041  T                   Removal of jaw bone            231      11.31    $581.56      $286.79      $116.31
                               lesion.
   21044  T                   Removal of jaw bone            232      23.82  $1,224.82      $636.87      $244.96
                               lesion.
   21045  C                   Extensive jaw surgery..  .........  .........  .........  ...........  ...........
   21050  T                   Removal of jaw joint...        232      23.82  $1,224.82      $636.87      $244.96
   21060  T                   Remove jaw joint               232      23.82  $1,224.82      $636.87      $244.96
                               cartilage.
   21070  T                   Remove coronoid process        232      23.82  $1,224.82      $636.87      $244.96
   21076  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21077  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21079  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21080  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21081  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21082  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21083  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21084  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21085  N                   Prepare face/oral        .........  .........  .........  ...........  ...........
                               prosthesis.
   21086  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21087  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21088  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21089  T                   Prepare face/oral              226       1.56     $80.22       $21.92       $16.04
                               prosthesis.
   21100  T                   Maxillofacial fixation.        231      11.31    $581.56      $286.79      $116.31
   21110  T                   Interdental fixation...        231      11.31    $581.56      $286.79      $116.31
   21116  T                   Injection, jaw joint x-        347       2.57    $132.15       $62.38       $26.43
                               ray.
   21120  T                   Reconstruction of chin.        231      11.31    $581.56      $286.79      $116.31
   21121  T                   Reconstruction of chin.        232      23.82  $1,224.82      $636.87      $244.96
   21122  T                   Reconstruction of chin.        232      23.82  $1,224.82      $636.87      $244.96
   21123  T                   Reconstruction of chin.        232      23.82  $1,224.82      $636.87      $244.96
   21125  T                   Augmentation lower jaw         231      11.31    $581.56      $286.79      $116.31
                               bone.
   21127  T                   Augmentation lower jaw         232      23.82  $1,224.82      $636.87      $244.96
                               bone.
   21137  C                   Reduction of forehead..  .........  .........  .........  ...........  ...........
   21138  C                   Reduction of forehead..  .........  .........  .........  ...........  ...........
   21139  C                   Reduction of forehead..  .........  .........  .........  ...........  ...........
   21141  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21142  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21143  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21145  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21146  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21147  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21150  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21151  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21154  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21155  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21159  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21160  C                   Reconstruct midface,     .........  .........  .........  ...........  ...........
                               lefort.
   21172  C                   Reconstruct orbit/       .........  .........  .........  ...........  ...........
                               forehead.
   21175  C                   Reconstruct orbit/       .........  .........  .........  ...........  ...........
                               forehead.
   21179  C                   Reconstruct entire       .........  .........  .........  ...........  ...........
                               forehead.
   21180  C                   Reconstruct entire       .........  .........  .........  ...........  ...........
                               forehead.
   21181  T                   Contour cranial bone           232      23.82  $1,224.82      $636.87      $244.96
                               lesion.
   21182  C                   Reconstruct cranial      .........  .........  .........  ...........  ...........
                               bone.
   21183  C                   Reconstruct cranial      .........  .........  .........  ...........  ...........
                               bone.
   21184  C                   Reconstruct cranial      .........  .........  .........  ...........  ...........
                               bone.

[[Page 35282]]

 
   21188  C                   Reconstruction of        .........  .........  .........  ...........  ...........
                               midface.
   21193  C                   Reconstruct lower jaw    .........  .........  .........  ...........  ...........
                               bone.
   21194  C                   Reconstruct lower jaw    .........  .........  .........  ...........  ...........
                               bone.
   21195  C                   Reconstruct lower jaw    .........  .........  .........  ...........  ...........
                               bone.
   21196  C                   Reconstruct lower jaw    .........  .........  .........  ...........  ...........
                               bone.
   21198  C                   Reconstruct lower jaw    .........  .........  .........  ...........  ...........
                               bone.
   21206  T                   Reconstruct upper jaw          232      23.82  $1,224.82      $636.87      $244.96
                               bone.
   21208  T                   Augmentation of facial         232      23.82  $1,224.82      $636.87      $244.96
                               bones.
   21209  T                   Reduction of facial            232      23.82  $1,224.82      $636.87      $244.96
                               bones.
   21210  T                   Face bone graft........        232      23.82  $1,224.82      $636.87      $244.96
   21215  T                   Lower jaw bone graft...        232      23.82  $1,224.82      $636.87      $244.96
   21230  T                   Rib cartilage graft....        232      23.82  $1,224.82      $636.87      $244.96
   21235  T                   Ear cartilage graft....        232      23.82  $1,224.82      $636.87      $244.96
   21240  T                   Reconstruction of jaw          232      23.82  $1,224.82      $636.87      $244.96
                               joint.
   21242  T                   Reconstruction of jaw          232      23.82  $1,224.82      $636.87      $244.96
                               joint.
   21243  T                   Reconstruction of jaw          218      27.80  $1,429.48      $720.71      $285.90
                               joint.
   21244  T                   Reconstruction of lower        232      23.82  $1,224.82      $636.87      $244.96
                               jaw.
   21245  T                   Reconstruction of jaw..        232      23.82  $1,224.82      $636.87      $244.96
   21246  T                   Reconstruction of jaw..        232      23.82  $1,224.82      $636.87      $244.96
   21247  C                   Reconstruct lower jaw    .........  .........  .........  ...........  ...........
                               bone.
   21248  T                   Reconstruction of jaw..        232      23.82  $1,224.82      $636.87      $244.96
   21249  T                   Reconstruction of jaw..        232      23.82  $1,224.82      $636.87      $244.96
   21255  C                   Reconstruct lower jaw    .........  .........  .........  ...........  ...........
                               bone.
   21256  C                   Reconstruction of orbit  .........  .........  .........  ...........  ...........
   21260  T                   Revise eye sockets.....        232      23.82  $1,224.82      $636.87      $244.96
   21261  C                   Revise eye sockets.....  .........  .........  .........  ...........  ...........
   21263  C                   Revise eye sockets.....  .........  .........  .........  ...........  ...........
   21267  T                   Revise eye sockets.....        232      23.82  $1,224.82      $636.87      $244.96
   21268  C                   Revise eye sockets.....  .........  .........  .........  ...........  ...........
   21270  T                   Augmentation cheek bone        232      23.82  $1,224.82      $636.87      $244.96
   21275  T                   Revision orbitofacial          232      23.82  $1,224.82      $636.87      $244.96
                               bones.
   21280  T                   Revision of eyelid.....        231      11.31    $581.56      $286.79      $116.31
   21282  T                   Revision of eyelid.....        231      11.31    $581.56      $286.79      $116.31
   21295  T                   Revision of jaw muscle/        231      11.31    $581.56      $286.79      $116.31
                               bone.
   21296  T                   Revision of jaw muscle/        231      11.31    $581.56      $286.79      $116.31
                               bone.
   21299  T                   Cranio/maxillofacial           231      11.31    $581.56      $286.79      $116.31
                               surgery.
   21300  T                   Treatment of skull             231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21310  T                   Treatment of nose              231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21315  T                   Treatment of nose              231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21320  T                   Treatment of nose              231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21325  T                   Repair of nose fracture        231      11.31    $581.56      $286.79      $116.31
   21330  T                   Repair of nose fracture        232      23.82  $1,224.82      $636.87      $244.96
   21335  T                   Repair of nose fracture        232      23.82  $1,224.82      $636.87      $244.96
   21336  T                   Repair nasal septal            216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   21337  T                   Repair nasal septal            231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21338  T                   Repair nasoethmoid             232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21339  T                   Repair nasoethmoid             232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21340  T                   Repair of nose fracture        232      23.82  $1,224.82      $636.87      $244.96
   21343  T                   Repair of sinus                232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21344  C                   Repair of sinus          .........  .........  .........  ...........  ...........
                               fracture.
   21345  T                   Repair of nose/jaw             232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21346  C                   Repair of nose/jaw       .........  .........  .........  ...........  ...........
                               fracture.
   21347  C                   Repair of nose/jaw       .........  .........  .........  ...........  ...........
                               fracture.
   21348  C                   Repair of nose/jaw       .........  .........  .........  ...........  ...........
                               fracture.
   21355  T                   Repair cheek bone              231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21356  C                   Repair cheek bone        .........  .........  .........  ...........  ...........
                               fracture.
   21360  C                   Repair cheek bone        .........  .........  .........  ...........  ...........
                               fracture.
   21365  C                   Repair cheek bone        .........  .........  .........  ...........  ...........
                               fracture.
   21366  C                   Repair cheek bone        .........  .........  .........  ...........  ...........
                               fracture.
   21385  C                   Repair eye socket        .........  .........  .........  ...........  ...........
                               fracture.
   21386  C                   Repair eye socket        .........  .........  .........  ...........  ...........
                               fracture.
   21387  C                   Repair eye socket        .........  .........  .........  ...........  ...........
                               fracture.
   21390  C                   Repair eye socket        .........  .........  .........  ...........  ...........
                               fracture.
   21395  C                   Repair eye socket        .........  .........  .........  ...........  ...........
                               fracture.
   21400  T                   Treat eye socket               231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21401  T                   Repair eye socket              231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21406  C                   Repair eye socket        .........  .........  .........  ...........  ...........
                               fracture.
   21407  C                   Repair eye socket        .........  .........  .........  ...........  ...........
                               fracture.
   21408  C                   Repair eye socket        .........  .........  .........  ...........  ...........
                               fracture.
   21421  T                   Treat mouth roof               232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21422  C                   Repair mouth roof        .........  .........  .........  ...........  ...........
                               fracture.
   21423  C                   Repair mouth roof        .........  .........  .........  ...........  ...........
                               fracture.
   21431  C                   Treat craniofacial       .........  .........  .........  ...........  ...........
                               fracture.
   21432  C                   Repair craniofacial      .........  .........  .........  ...........  ...........
                               fracture.
   21433  C                   Repair craniofacial      .........  .........  .........  ...........  ...........
                               fracture.

[[Page 35283]]

 
   21435  C                   Repair craniofacial      .........  .........  .........  ...........  ...........
                               fracture.
   21436  C                   Repair craniofacial      .........  .........  .........  ...........  ...........
                               fracture.
   21440  T                   Repair dental ridge            231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21445  T                   Repair dental ridge            232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21450  T                   Treat lower jaw                232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21451  T                   Treat lower jaw                231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21452  T                   Treat lower jaw                232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21453  T                   Treat lower jaw                232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21454  T                   Treat lower jaw                232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21461  T                   Repair lower jaw               232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21462  T                   Repair lower jaw               232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21465  T                   Repair lower jaw               232      23.82  $1,224.82      $636.87      $244.96
                               fracture.
   21470  C                   Repair lower jaw         .........  .........  .........  ...........  ...........
                               fracture.
   21480  T                   Reset dislocated jaw...        231      11.31    $581.56      $286.79      $116.31
   21485  T                   Reset dislocated jaw...        231      11.31    $581.56      $286.79      $116.31
   21490  T                   Repair dislocated jaw..        232      23.82  $1,224.82      $636.87      $244.96
   21493  T                   Treat hyoid bone               231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21494  T                   Repair hyoid bone              231      11.31    $581.56      $286.79      $116.31
                               fracture.
   21495  C                   Repair hyoid bone        .........  .........  .........  ...........  ...........
                               fracture.
   21497  T                   Interdental wiring.....        231      11.31    $581.56      $286.79      $116.31
   21499  T                   Head surgery procedure.        231      11.31    $581.56      $286.79      $116.31
   21501  T                   Drain neck/chest lesion        132       5.63    $289.49      $132.89       $57.90
   21502  T                   Drain chest lesion.....        252      19.24    $989.32      $512.34      $197.86
   21510  C                   Drainage of bone lesion  .........  .........  .........  ...........  ...........
   21550  T                   Biopsy of neck/chest...        161       3.43    $176.37       $75.71       $35.27
   21555  T                   Remove lesion neck/            163      10.48    $538.88      $260.80      $107.78
                               chest.
   21556  T                   Remove lesion neck/            163      10.48    $538.88      $260.80      $107.78
                               chest.
   21557  C                   Remove tumor, neck or    .........  .........  .........  ...........  ...........
                               chest.
   21600  T                   Partial removal of rib.        252      19.24    $989.32      $512.34      $197.86
   21610  T                   Partial removal of rib.        252      19.24    $989.32      $512.34      $197.86
   21615  C                   Removal of rib.........  .........  .........  .........  ...........  ...........
   21616  C                   Removal of rib and       .........  .........  .........  ...........  ...........
                               nerves.
   21620  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               sternum.
   21627  C                   Sternal debridement....  .........  .........  .........  ...........  ...........
   21630  C                   Extensive sternum        .........  .........  .........  ...........  ...........
                               surgery.
   21632  C                   Extensive sternum        .........  .........  .........  ...........  ...........
                               surgery.
   21700  T                   Revision of neck muscle        132       5.63    $289.49      $132.89       $57.90
   21705  C                   Revision of neck muscle/ .........  .........  .........  ...........  ...........
                               rib.
   21720  T                   Revision of neck muscle        132       5.63    $289.49      $132.89       $57.90
   21725  T                   Revision of neck muscle        132       5.63    $289.49      $132.89       $57.90
   21740  C                   Reconstruction of        .........  .........  .........  ...........  ...........
                               sternum.
   21750  C                   Repair of sternum        .........  .........  .........  ...........  ...........
                               separation.
   21800  T                   Treatment of rib               207       1.70     $87.41       $32.32       $17.48
                               fracture.
   21805  T                   Treatment of rib               216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   21810  C                   Treatment of rib         .........  .........  .........  ...........  ...........
                               fracture(s).
   21820  T                   Treat sternum fracture.        207       1.70     $87.41       $32.32       $17.48
   21825  C                   Repair sternum fracture  .........  .........  .........  ...........  ...........
   21899  T                   Neck/chest surgery             207       1.70     $87.41       $32.32       $17.48
                               procedure.
   21920  T                   Biopsy soft tissue of          161       3.43    $176.37       $75.71       $35.27
                               back.
   21925  T                   Biopsy soft tissue of          163      10.48    $538.88      $260.80      $107.78
                               back.
   21930  T                   Remove lesion, back or         163      10.48    $538.88      $260.80      $107.78
                               flank.
   21935  T                   Remove tumor of back...        163      10.48    $538.88      $260.80      $107.78
   22100  C                   Remove part of neck      .........  .........  .........  ...........  ...........
                               vertebra.
   22101  C                   Remove part, thorax      .........  .........  .........  ...........  ...........
                               vertebra.
   22102  C                   Remove part, lumbar      .........  .........  .........  ...........  ...........
                               vertebra.
   22103  C                   Remove extra spine       .........  .........  .........  ...........  ...........
                               segment.
   22110  C                   Remove part of neck      .........  .........  .........  ...........  ...........
                               vertebra.
   22112  C                   Remove part, thorax      .........  .........  .........  ...........  ...........
                               vertebra.
   22114  C                   Remove part, lumbar      .........  .........  .........  ...........  ...........
                               vertebra.
   22116  C                   Remove extra spine       .........  .........  .........  ...........  ...........
                               segment.
   22210  C                   Revision of neck spine.  .........  .........  .........  ...........  ...........
   22212  C                   Revision of thorax       .........  .........  .........  ...........  ...........
                               spine.
   22214  C                   Revision of lumbar       .........  .........  .........  ...........  ...........
                               spine.
   22216  C                   Revise, extra spine      .........  .........  .........  ...........  ...........
                               segment.
   22220  C                   Revision of neck spine.  .........  .........  .........  ...........  ...........
   22222  C                   Revision of thorax       .........  .........  .........  ...........  ...........
                               spine.
   22224  C                   Revision of lumbar       .........  .........  .........  ...........  ...........
                               spine.
   22226  C                   Revise, extra spine      .........  .........  .........  ...........  ...........
                               segment.
   22305  T                   Treat spine process            207       1.70     $87.41       $32.32       $17.48
                               fracture.
   22310  T                   Treat spine fracture...        207       1.70     $87.41       $32.32       $17.48
   22315  T                   Treat spine fracture...        207       1.70     $87.41       $32.32       $17.48
   22325  C                   Repair of spine          .........  .........  .........  ...........  ...........
                               fracture.
   22326  C                   Repair neck spine        .........  .........  .........  ...........  ...........
                               fracture.
   22327  C                   Repair thorax spine      .........  .........  .........  ...........  ...........
                               fracture.
   22328  C                   Repair each add spine    .........  .........  .........  ...........  ...........
                               fx.

[[Page 35284]]

 
   22505  T                   Manipulation of spine..        210      10.06    $517.29      $279.34      $103.46
   22548  C                   Neck spine fusion......  .........  .........  .........  ...........  ...........
   22554  C                   Neck spine fusion......  .........  .........  .........  ...........  ...........
   22556  C                   Thorax spine fusion....  .........  .........  .........  ...........  ...........
   22558  C                   Lumbar spine fusion....  .........  .........  .........  ...........  ...........
   22585  C                   Additional spinal        .........  .........  .........  ...........  ...........
                               fusion.
   22590  C                   Spine & skull spinal     .........  .........  .........  ...........  ...........
                               fusion.
   22595  C                   Neck spinal fusion.....  .........  .........  .........  ...........  ...........
   22600  C                   Neck spine fusion......  .........  .........  .........  ...........  ...........
   22610  C                   Thorax spine fusion....  .........  .........  .........  ...........  ...........
   22612  C                   Lumbar spine fusion....  .........  .........  .........  ...........  ...........
   22614  C                   Spine fusion, extra      .........  .........  .........  ...........  ...........
                               segment.
   22630  C                   Lumbar spine fusion....  .........  .........  .........  ...........  ...........
   22632  C                   Spine fusion, extra      .........  .........  .........  ...........  ...........
                               segment.
   22800  C                   Fusion of spine........  .........  .........  .........  ...........  ...........
   22802  C                   Fusion of spine........  .........  .........  .........  ...........  ...........
   22804  C                   Fusion of spine........  .........  .........  .........  ...........  ...........
   22808  C                   Fusion of spine........  .........  .........  .........  ...........  ...........
   22810  C                   Fusion of spine........  .........  .........  .........  ...........  ...........
   22812  C                   Fusion of spine........  .........  .........  .........  ...........  ...........
   22818  C                   Kyphectomy, 1-2          .........  .........  .........  ...........  ...........
                               segments.
   22819  C                   Kyphectomy, 3 & more     .........  .........  .........  ...........  ...........
                               segment.
   22830  C                   Exploration of spinal    .........  .........  .........  ...........  ...........
                               fusion.
   22840  C                   Insert spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22841  C                   Insert spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22842  C                   Insert spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22843  C                   Insert spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22844  C                   Insert spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22845  C                   Insert spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22846  C                   Insert spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22847  C                   Insert spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22848  C                   Insert pelvic            .........  .........  .........  ...........  ...........
                               fixationdevice.
   22849  C                   Reinsert spinal          .........  .........  .........  ...........  ...........
                               fixation.
   22850  C                   Remove spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22851  C                   Apply spine prosth       .........  .........  .........  ...........  ...........
                               device.
   22852  C                   Remove spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22855  C                   Remove spine fixation    .........  .........  .........  ...........  ...........
                               device.
   22899  T                   Spine surgery procedure        207       1.70     $87.41       $32.32       $17.48
   22900  T                   Remove abdominal wall          163      10.48    $538.88      $260.80      $107.78
                               lesion.
   22999  T                   Abdomen surgery                163      10.48    $538.88      $260.80      $107.78
                               procedure.
   23000  T                   Removal of calcium             162       5.59    $287.44      $125.66       $57.49
                               deposits.
   23020  T                   Release shoulder joint.        253      25.74  $1,323.55      $684.55      $264.71
   23030  T                   Drain shoulder lesion..        132       5.63    $289.49      $132.89       $57.90
   23031  T                   Drain shoulder bursa...        132       5.63    $289.49      $132.89       $57.90
   23035  C                   Drain shoulder bone      .........  .........  .........  ...........  ...........
                               lesion.
   23040  T                   Exploratory shoulder           252      19.24    $989.32      $512.34      $197.86
                               surgery.
   23044  T                   Exploratory shoulder           252      19.24    $989.32      $512.34      $197.86
                               surgery.
   23065  T                   Biopsy shoulder tissues        161       3.43    $176.37       $75.71       $35.27
   23066  T                   Biopsy shoulder tissues        163      10.48    $538.88      $260.80      $107.78
   23075  T                   Removal of shoulder            162       5.59    $287.44      $125.66       $57.49
                               lesion.
   23076  T                   Removal of shoulder            163      10.48    $538.88      $260.80      $107.78
                               lesion.
   23077  T                   Remove tumor of                163      10.48    $538.88      $260.80      $107.78
                               shoulder.
   23100  T                   Biopsy of shoulder             251      13.88    $713.71      $365.89      $142.74
                               joint.
   23101  T                   Shoulder joint surgery.        252      19.24    $989.32      $512.34      $197.86
   23105  T                   Remove shoulder joint          252      19.24    $989.32      $512.34      $197.86
                               lining.
   23106  T                   Incision of collarbone         252      19.24    $989.32      $512.34      $197.86
                               joint.
   23107  T                   Explore,treat shoulder         252      19.24    $989.32      $512.34      $197.86
                               joint.
   23120  T                   Partial removal, collar        253      25.74  $1,323.55      $684.55      $264.71
                               bone.
   23125  C                   Removal of collarbone..  .........  .........  .........  ...........  ...........
   23130  T                   Partial                        253      25.74  $1,323.55      $684.55      $264.71
                               removal,shoulderbone.
   23140  T                   Removal of bone lesion.        251      13.88    $713.71      $365.89      $142.74
   23145  T                   Removal of bone lesion.        252      19.24    $989.32      $512.34      $197.86
   23146  T                   Removal of bone lesion.        252      19.24    $989.32      $512.34      $197.86
   23150  T                   Removal of humerus             252      19.24    $989.32      $512.34      $197.86
                               lesion.
   23155  T                   Removal of humerus             252      19.24    $989.32      $512.34      $197.86
                               lesion.
   23156  T                   Removal of humerus             252      19.24    $989.32      $512.34      $197.86
                               lesion.
   23170  T                   Remove collarbone              252      19.24    $989.32      $512.34      $197.86
                               lesion.
   23172  T                   Remove shoulder blade          252      19.24    $989.32      $512.34      $197.86
                               lesion.
   23174  T                   Remove humerus lesion..        252      19.24    $989.32      $512.34      $197.86
   23180  T                   Remove collar bone             252      19.24    $989.32      $512.34      $197.86
                               lesion.
   23182  T                   Remove shoulder blade          252      19.24    $989.32      $512.34      $197.86
                               lesion.
   23184  T                   Remove humerus lesion..        252      19.24    $989.32      $512.34      $197.86
   23190  T                   Partial removal of             252      19.24    $989.32      $512.34      $197.86
                               scapula.
   23195  C                   Removal of head of       .........  .........  .........  ...........  ...........
                               humerus.
   23200  C                   Removal of collar bone.  .........  .........  .........  ...........  ...........

[[Page 35285]]

 
   23210  C                   Removal of               .........  .........  .........  ...........  ...........
                               shoulderblade.
   23220  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               humerus.
   23221  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               humerus.
   23222  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               humerus.
   23330  T                   Remove shoulder foreign        163      10.48    $538.88      $260.80      $107.78
                               body.
   23331  T                   Remove shoulder foreign        163      10.48    $538.88      $260.80      $107.78
                               body.
   23332  C                   Remove shoulder foreign  .........  .........  .........  ...........  ...........
                               body.
   23350  T                   Injection for shoulder         347       2.57    $132.15       $62.38       $26.43
                               x-ray.
   23395  C                   Muscle                   .........  .........  .........  ...........  ...........
                               transfer,shoulder/arm.
   23397  C                   Muscle transfers.......  .........  .........  .........  ...........  ...........
   23400  C                   Fixation of shoulder     .........  .........  .........  ...........  ...........
                               blade.
   23405  T                   Incision of tendon &           252      19.24    $989.32      $512.34      $197.86
                               muscle.
   23406  T                   Incise tendon(s) &             252      19.24    $989.32      $512.34      $197.86
                               muscle(s).
   23410  T                   Repair of tendon(s)....        254      32.70  $1,681.43      $922.98      $336.29
   23412  T                   Repair of tendon(s)....        254      32.70  $1,681.43      $922.98      $336.29
   23415  T                   Release of shoulder            253      25.74  $1,323.55      $684.55      $264.71
                               ligament.
   23420  T                   Repair of shoulder.....        254      32.70  $1,681.43      $922.98      $336.29
   23430  T                   Repair biceps tendon...        254      32.70  $1,681.43      $922.98      $336.29
   23440  C                   Removal/transplant       .........  .........  .........  ...........  ...........
                               tendon.
   23450  T                   Repair shoulder capsule        254      32.70  $1,681.43      $922.98      $336.29
   23455  T                   Repair shoulder capsule        254      32.70  $1,681.43      $922.98      $336.29
   23460  T                   Repair shoulder capsule        254      32.70  $1,681.43      $922.98      $336.29
   23462  T                   Repair shoulder capsule        254      32.70  $1,681.43      $922.98      $336.29
   23465  T                   Repair shoulder capsule        254      32.70  $1,681.43      $922.98      $336.29
   23466  T                   Repair shoulder capsule        254      32.70  $1,681.43      $922.98      $336.29
   23470  C                   Reconstruct shoulder     .........  .........  .........  ...........  ...........
                               joint.
   23472  C                   Reconstruct shoulder     .........  .........  .........  ...........  ...........
                               joint.
   23480  T                   Revision of collarbone.        253      25.74  $1,323.55      $684.55      $264.71
   23485  T                   Revision of collar bone        253      25.74  $1,323.55      $684.55      $264.71
   23490  T                   Reinforce clavicle.....        253      25.74  $1,323.55      $684.55      $264.71
   23491  T                   Reinforce shoulder             253      25.74  $1,323.55      $684.55      $264.71
                               bones.
   23500  T                   Treat clavicle fracture        207       1.70     $87.41       $32.32       $17.48
   23505  T                   Treat clavicle fracture        207       1.70     $87.41       $32.32       $17.48
   23515  T                   Repair clavicle                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   23520  T                   Treat clavicle                 207       1.70     $87.41       $32.32       $17.48
                               dislocation.
   23525  T                   Treat clavicle                 207       1.70     $87.41       $32.32       $17.48
                               dislocation.
   23530  T                   Repair clavicle                216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   23532  T                   Repair clavicle                216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   23540  T                   Treat clavicle                 207       1.70     $87.41       $32.32       $17.48
                               dislocation.
   23545  T                   Treat clavicle                 207       1.70     $87.41       $32.32       $17.48
                               dislocation.
   23550  T                   Repair clavicle                216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   23552  T                   Repair clavicle                216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   23570  T                   Treat shoulderblade            207       1.70     $87.41       $32.32       $17.48
                               fracture.
   23575  T                   Treat shoulderblade            207       1.70     $87.41       $32.32       $17.48
                               fracture.
   23585  T                   Repair scapula fracture        216      20.09  $1,033.03      $524.09      $206.61
   23600  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   23605  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   23615  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   23616  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   23620  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   23625  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   23630  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   23650  T                   Treat shoulder                 207       1.70     $87.41       $32.32       $17.48
                               dislocation.
   23655  T                   Treat shoulder                 210      10.06    $517.29      $279.34      $103.46
                               dislocation.
   23660  T                   Repair shoulder                216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   23665  T                   Treat dislocation/             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   23670  T                   Repair dislocation/            216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   23675  T                   Treat dislocation/             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   23680  T                   Repair dislocation/            216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   23700  T                   Fixation of shoulder...        210      10.06    $517.29      $279.34      $103.46
   23800  T                   Fusion of shoulder             253      25.74  $1,323.55      $684.55      $264.71
                               joint.
   23802  T                   Fusion of shoulder             253      25.74  $1,323.55      $684.55      $264.71
                               joint.
   23900  C                   Amputation of arm &      .........  .........  .........  ...........  ...........
                               girdle.
   23920  C                   Amputation at shoulder   .........  .........  .........  ...........  ...........
                               joint.
   23921  T                   Amputation follow-up           183      11.04    $567.68      $283.18      $113.54
                               surgery.
   23929  T                   Shoulder surgery               207       1.70     $87.41       $32.32       $17.48
                               procedure.
   23930  T                   Drainage of arm lesion.        132       5.63    $289.49      $132.89       $57.90
   23931  T                   Drainage of arm bursa..        132       5.63    $289.49      $132.89       $57.90
   23935  T                   Drain arm/elbow bone           251      13.88    $713.71      $365.89      $142.74
                               lesion.
   24000  T                   Exploratory elbow              252      19.24    $989.32      $512.34      $197.86
                               surgery.
   24006  T                   Release elbow joint....        252      19.24    $989.32      $512.34      $197.86
   24065  T                   Biopsy arm/elbow soft          161       3.43    $176.37       $75.71       $35.27
                               tissue.
   24066  T                   Biopsy arm/elbow soft          163      10.48    $538.88      $260.80      $107.78
                               tissue.
   24075  T                   Remove arm/elbow lesion        162       5.59    $287.44      $125.66       $57.49
   24076  T                   Remove arm/elbow lesion        163      10.48    $538.88      $260.80      $107.78

[[Page 35286]]

 
   24077  T                   Remove tumor of arm/           163      10.48    $538.88      $260.80      $107.78
                               elbow.
   24100  T                   Biopsy elbow joint             251      13.88    $713.71      $365.89      $142.74
                               lining.
   24101  T                   Explore/treat elbow            252      19.24    $989.32      $512.34      $197.86
                               joint.
   24102  T                   Remove elbow joint             252      19.24    $989.32      $512.34      $197.86
                               lining.
   24105  T                   Removal of elbow bursa.        251      13.88    $713.71      $365.89      $142.74
   24110  T                   Remove humerus lesion..        251      13.88    $713.71      $365.89      $142.74
   24115  T                   Remove/graft bone              252      19.24    $989.32      $512.34      $197.86
                               lesion.
   24116  T                   Remove/graft bone              252      19.24    $989.32      $512.34      $197.86
                               lesion.
   24120  T                   Remove elbow lesion....        251      13.88    $713.71      $365.89      $142.74
   24125  T                   Remove/graft bone              252      19.24    $989.32      $512.34      $197.86
                               lesion.
   24126  T                   Remove/graft bone              252      19.24    $989.32      $512.34      $197.86
                               lesion.
   24130  T                   Removal of head of             252      19.24    $989.32      $512.34      $197.86
                               radius.
   24134  T                   Removal of arm bone            252      19.24    $989.32      $512.34      $197.86
                               lesion.
   24136  T                   Remove radius bone             252      19.24    $989.32      $512.34      $197.86
                               lesion.
   24138  T                   Remove elbow bone              252      19.24    $989.32      $512.34      $197.86
                               lesion.
   24140  T                   Partial removal of arm         252      19.24    $989.32      $512.34      $197.86
                               bone.
   24145  T                   Partial removal of             252      19.24    $989.32      $512.34      $197.86
                               radius.
   24147  T                   Partial removal of             252      19.24    $989.32      $512.34      $197.86
                               elbow.
   24149  C                   Radical resection of     .........  .........  .........  ...........  ...........
                               elbow.
   24150  C                   Extensive humerus        .........  .........  .........  ...........  ...........
                               surgery.
   24151  C                   Extensive humerus        .........  .........  .........  ...........  ...........
                               surgery.
   24152  C                   Extensive radius         .........  .........  .........  ...........  ...........
                               surgery.
   24153  C                   Extensive radius         .........  .........  .........  ...........  ...........
                               surgery.
   24155  T                   Removal of elbow joint.        253      25.74  $1,323.55      $684.55      $264.71
   24160  T                   Remove elbow joint             252      19.24    $989.32      $512.34      $197.86
                               implant.
   24164  T                   Remove radius head             252      19.24    $989.32      $512.34      $197.86
                               implant.
   24200  T                   Removal of arm foreign         161       3.43    $176.37       $75.71       $35.27
                               body.
   24201  T                   Removal of arm foreign         163      10.48    $538.88      $260.80      $107.78
                               body.
   24220  T                   Injection for elbow x-         347       2.57    $132.15       $62.38       $26.43
                               ray.
   24301  T                   Muscle/tendon transfer.        252      19.24    $989.32      $512.34      $197.86
   24305  T                   Arm tendon lengthening.        252      19.24    $989.32      $512.34      $197.86
   24310  T                   Revision of arm tendon.        251      13.88    $713.71      $365.89      $142.74
   24320  T                   Repair of arm tendon...        253      25.74  $1,323.55      $684.55      $264.71
   24330  T                   Revision of arm muscles        253      25.74  $1,323.55      $684.55      $264.71
   24331  T                   Revision of arm muscles        253      25.74  $1,323.55      $684.55      $264.71
   24340  T                   Repair of biceps tendon        253      25.74  $1,323.55      $684.55      $264.71
   24341  T                   Repair tendon/muscle           253      25.74  $1,323.55      $684.55      $264.71
                               arm.
   24342  T                   Repair of ruptured             253      25.74  $1,323.55      $684.55      $264.71
                               tendon.
   24350  T                   Repair of tennis elbow.        252      19.24    $989.32      $512.34      $197.86
   24351  T                   Repair of tennis elbow.        252      19.24    $989.32      $512.34      $197.86
   24352  T                   Repair of tennis elbow.        252      19.24    $989.32      $512.34      $197.86
   24354  T                   Repair of tennis elbow.        252      19.24    $989.32      $512.34      $197.86
   24356  T                   Revision of tennis             252      19.24    $989.32      $512.34      $197.86
                               elbow.
   24360  T                   Reconstruct elbow joint        217      20.54  $1,056.17      $530.42      $211.23
   24361  T                   Reconstruct elbow joint        218      27.80  $1,429.48      $720.71      $285.90
   24362  T                   Reconstruct elbow joint        218      27.80  $1,429.48      $720.71      $285.90
   24363  T                   Replace elbow joint....        218      27.80  $1,429.48      $720.71      $285.90
   24365  T                   Reconstruct head of            217      20.54  $1,056.17      $530.42      $211.23
                               radius.
   24366  T                   Reconstruct head of            218      27.80  $1,429.48      $720.71      $285.90
                               radius.
   24400  T                   Revision of humerus....        252      19.24    $989.32      $512.34      $197.86
   24410  T                   Revision of humerus....        252      19.24    $989.32      $512.34      $197.86
   24420  T                   Revision of humerus....        253      25.74  $1,323.55      $684.55      $264.71
   24430  T                   Repair of humerus......        253      25.74  $1,323.55      $684.55      $264.71
   24435  T                   Repair humerus with            253      25.74  $1,323.55      $684.55      $264.71
                               graft.
   24470  T                   Revision of elbow joint        253      25.74  $1,323.55      $684.55      $264.71
   24495  T                   Decompression of               252      19.24    $989.32      $512.34      $197.86
                               forearm.
   24498  T                   Reinforce humerus......        253      25.74  $1,323.55      $684.55      $264.71
   24500  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   24505  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   24515  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   24516  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   24530  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   24535  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   24538  T                   Treat humerus fracture.        216      20.09  $1,033.03      $524.09      $206.61
   24545  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   24546  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   24560  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   24565  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   24566  T                   Treat humerus fracture.        216      20.09  $1,033.03      $524.09      $206.61
   24575  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   24576  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   24577  T                   Treat humerus fracture.        209       1.94     $99.75       $37.74       $19.95
   24579  T                   Repair humerus fracture        216      20.09  $1,033.03      $524.09      $206.61
   24582  T                   Treat humerus fracture.        216      20.09  $1,033.03      $524.09      $206.61
   24586  T                   Repair elbow fracture..        216      20.09  $1,033.03      $524.09      $206.61

[[Page 35287]]

 
   24587  T                   Repair elbow fracture..        216      20.09  $1,033.03      $524.09      $206.61
   24600  T                   Treat elbow dislocation        209       1.94     $99.75       $37.74       $19.95
   24605  T                   Treat elbow dislocation        210      10.06    $517.29      $279.34      $103.46
   24615  T                   Repair elbow                   216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   24620  T                   Treat elbow fracture...        209       1.94     $99.75       $37.74       $19.95
   24635  T                   Repair elbow fracture..        216      20.09  $1,033.03      $524.09      $206.61
   24640  T                   Treat elbow dislocation        209       1.94     $99.75       $37.74       $19.95
   24650  T                   Treat radius fracture..        209       1.94     $99.75       $37.74       $19.95
   24655  T                   Treat radius fracture..        209       1.94     $99.75       $37.74       $19.95
   24665  T                   Repair radius fracture.        216      20.09  $1,033.03      $524.09      $206.61
   24666  T                   Repair radius fracture.        216      20.09  $1,033.03      $524.09      $206.61
   24670  T                   Treatment of ulna              209       1.94     $99.75       $37.74       $19.95
                               fracture.
   24675  T                   Treatment of ulna              209       1.94     $99.75       $37.74       $19.95
                               fracture.
   24685  T                   Repair ulna fracture...        216      20.09  $1,033.03      $524.09      $206.61
   24800  T                   Fusion of elbow joint..        253      25.74  $1,323.55      $684.55      $264.71
   24802  T                   Fusion/graft of elbow          253      25.74  $1,323.55      $684.55      $264.71
                               joint.
   24900  C                   Amputation of upper arm  .........  .........  .........  ...........  ...........
   24920  C                   Amputation of upper arm  .........  .........  .........  ...........  ...........
   24925  T                   Amputation follow-up           251      13.88    $713.71      $365.89      $142.74
                               surgery.
   24930  C                   Amputation follow-up     .........  .........  .........  ...........  ...........
                               surgery.
   24931  C                   Amputate upper arm &     .........  .........  .........  ...........  ...........
                               implant.
   24935  C                   Revision of amputation.  .........  .........  .........  ...........  ...........
   24940  C                   Revision of upper arm..  .........  .........  .........  ...........  ...........
   24999  T                   Upper arm/elbow surgery        209       1.94     $99.75       $37.74       $19.95
   25000  T                   Incision of tendon             251      13.88    $713.71      $365.89      $142.74
                               sheath.
   25020  T                   Decompression of               251      13.88    $713.71      $365.89      $142.74
                               forearm.
   25023  T                   Decompression of               252      19.24    $989.32      $512.34      $197.86
                               forearm.
   25028  T                   Drainage of forearm            251      13.88    $713.71      $365.89      $142.74
                               lesion.
   25031  T                   Drainage of forearm            251      13.88    $713.71      $365.89      $142.74
                               bursa.
   25035  T                   Treat forearm bone             251      13.88    $713.71      $365.89      $142.74
                               lesion.
   25040  T                   Explore/treat wrist            252      19.24    $989.32      $512.34      $197.86
                               joint.
   25065  T                   Biopsy forearm soft            161       3.43    $176.37       $75.71       $35.27
                               tissues.
   25066  T                   Biopsy forearm soft            163      10.48    $538.88      $260.80      $107.78
                               tissues.
   25075  T                   Removal of forearm             162       5.59    $287.44      $125.66       $57.49
                               lesion.
   25076  T                   Removal of forearm             163      10.48    $538.88      $260.80      $107.78
                               lesion.
   25077  T                   Remove tumor, forearm/         163      10.48    $538.88      $260.80      $107.78
                               wrist.
   25085  T                   Incision of wrist              251      13.88    $713.71      $365.89      $142.74
                               capsule.
   25100  T                   Biopsy of wrist joint..        251      13.88    $713.71      $365.89      $142.74
   25101  T                   Explore/treat wrist            252      19.24    $989.32      $512.34      $197.86
                               joint.
   25105  T                   Remove wrist joint             252      19.24    $989.32      $512.34      $197.86
                               lining.
   25107  T                   Remove wrist joint             252      19.24    $989.32      $512.34      $197.86
                               cartilage.
   25110  T                   Remove wrist tendon            251      13.88    $713.71      $365.89      $142.74
                               lesion.
   25111  T                   Remove wrist tendon            261      10.41    $535.28      $259.00      $107.06
                               lesion.
   25112  T                   Reremove wrist tendon          261      10.41    $535.28      $259.00      $107.06
                               lesion.
   25115  T                   Remove wrist/forearm           251      13.88    $713.71      $365.89      $142.74
                               lesion.
   25116  T                   Remove wrist/forearm           251      13.88    $713.71      $365.89      $142.74
                               lesion.
   25118  T                   Excise wrist tendon            252      19.24    $989.32      $512.34      $197.86
                               sheath.
   25119  T                   Partial removal of ulna        252      19.24    $989.32      $512.34      $197.86
   25120  T                   Removal of forearm             252      19.24    $989.32      $512.34      $197.86
                               lesion.
   25125  T                   Remove/graft forearm           252      19.24    $989.32      $512.34      $197.86
                               lesion.
   25126  T                   Remove/graft forearm           252      19.24    $989.32      $512.34      $197.86
                               lesion.
   25130  T                   Removal of wrist lesion        252      19.24    $989.32      $512.34      $197.86
   25135  T                   Remove & graft wrist           252      19.24    $989.32      $512.34      $197.86
                               lesion.
   25136  T                   Remove & graft wrist           252      19.24    $989.32      $512.34      $197.86
                               lesion.
   25145  T                   Remove forearm bone            252      19.24    $989.32      $512.34      $197.86
                               lesion.
   25150  T                   Partial removal of ulna        252      19.24    $989.32      $512.34      $197.86
   25151  T                   Partial removal of             252      19.24    $989.32      $512.34      $197.86
                               radius.
   25170  C                   Extensive forearm        .........  .........  .........  ...........  ...........
                               surgery.
   25210  T                   Removal of wrist bone..        262      18.07    $929.16      $475.96      $185.83
   25215  T                   Removal of wrist bones.        262      18.07    $929.16      $475.96      $185.83
   25230  T                   Partial removal of             252      19.24    $989.32      $512.34      $197.86
                               radius.
   25240  T                   Partial removal of ulna        252      19.24    $989.32      $512.34      $197.86
   25246  T                   Injection for wrist x-         347       2.57    $132.15       $62.38       $26.43
                               ray.
   25248  T                   Remove forearm foreign         251      13.88    $713.71      $365.89      $142.74
                               body.
   25250  T                   Removal of wrist               252      19.24    $989.32      $512.34      $197.86
                               prosthesis.
   25251  T                   Removal of wrist               252      19.24    $989.32      $512.34      $197.86
                               prosthesis.
   25260  T                   Repair forearm tendon/         252      19.24    $989.32      $512.34      $197.86
                               muscle.
   25263  T                   Repair forearm tendon/         252      19.24    $989.32      $512.34      $197.86
                               muscle.
   25265  T                   Repair forearm tendon/         252      19.24    $989.32      $512.34      $197.86
                               muscle.
   25270  T                   Repair forearm tendon/         252      19.24    $989.32      $512.34      $197.86
                               muscle.
   25272  T                   Repair forearm tendon/         252      19.24    $989.32      $512.34      $197.86
                               muscle.
   25274  T                   Repair forearm tendon/         252      19.24    $989.32      $512.34      $197.86
                               muscle.
   25280  T                   Revise wrist/forearm           252      19.24    $989.32      $512.34      $197.86
                               tendon.
   25290  T                   Incise wrist/forearm           252      19.24    $989.32      $512.34      $197.86
                               tendon.
   25295  T                   Release wrist/forearm          251      13.88    $713.71      $365.89      $142.74
                               tendon.

[[Page 35288]]

 
   25300  T                   Fusion of tendons at           252      19.24    $989.32      $512.34      $197.86
                               wrist.
   25301  T                   Fusion of tendons at           252      19.24    $989.32      $512.34      $197.86
                               wrist.
   25310  T                   Transplant forearm             253      25.74  $1,323.55      $684.55      $264.71
                               tendon.
   25312  T                   Transplant forearm             253      25.74  $1,323.55      $684.55      $264.71
                               tendon.
   25315  T                   Revise palsy hand              253      25.74  $1,323.55      $684.55      $264.71
                               tendon(s).
   25316  T                   Revise palsy hand              253      25.74  $1,323.55      $684.55      $264.71
                               tendon(s).
   25320  T                   Repair/revise wrist            253      25.74  $1,323.55      $684.55      $264.71
                               joint.
\2\ 2533  T                   Revise wrist joint.....        217      20.54  $1,056.17      $530.42      $211.23
        0
\2\ 2533  T                   Revise wrist joint.....        217      20.54  $1,056.17      $530.42      $211.23
        1
   25332  T                   Revise wrist joint.....        217      20.54  $1,056.17      $530.42      $211.23
   25335  T                   Realignment of hand....        253      25.74  $1,323.55      $684.55      $264.71
   25337  T                   Reconstruct ulna/              253      25.74  $1,323.55      $684.55      $264.71
                               radioulnar.
   25350  T                   Revision of radius.....        253      25.74  $1,323.55      $684.55      $264.71
   25355  T                   Revision of radius.....        253      25.74  $1,323.55      $684.55      $264.71
   25360  T                   Revision of ulna.......        252      19.24    $989.32      $512.34      $197.86
   25365  T                   Revise radius & ulna...        252      19.24    $989.32      $512.34      $197.86
   25370  T                   Revise radius or ulna..        253      25.74  $1,323.55      $684.55      $264.71
   25375  T                   Revise radius & ulna...        253      25.74  $1,323.55      $684.55      $264.71
   25390  C                   Shorten radius/ulna....  .........  .........  .........  ...........  ...........
   25391  C                   Lengthen radius/ulna...  .........  .........  .........  ...........  ...........
   25392  C                   Shorten radius & ulna..  .........  .........  .........  ...........  ...........
   25393  C                   Lengthen radius & ulna.  .........  .........  .........  ...........  ...........
   25400  T                   Repair radius or ulna..        252      19.24    $989.32      $512.34      $197.86
   25405  C                   Repair/graft radius or   .........  .........  .........  ...........  ...........
                               ulna.
   25415  T                   Repair radius & ulna...        252      19.24    $989.32      $512.34      $197.86
   25420  C                   Repair/graft radius &    .........  .........  .........  ...........  ...........
                               ulna.
   25425  T                   Repair/graft radius or         253      25.74  $1,323.55      $684.55      $264.71
                               ulna.
   25426  T                   Repair/graft radius &          253      25.74  $1,323.55      $684.55      $264.71
                               ulna.
   25440  T                   Repair/graft wrist bone        253      25.74  $1,323.55      $684.55      $264.71
   25441  T                   Reconstruct wrist joint        218      27.80  $1,429.48      $720.71      $285.90
   25442  T                   Reconstruct wrist joint        218      27.80  $1,429.48      $720.71      $285.90
   25443  T                   Reconstruct wrist joint        218      27.80  $1,429.48      $720.71      $285.90
   25444  T                   Reconstruct wrist joint        218      27.80  $1,429.48      $720.71      $285.90
   25445  T                   Reconstruct wrist joint        218      27.80  $1,429.48      $720.71      $285.90
   25446  T                   Wrist replacement......        218      27.80  $1,429.48      $720.71      $285.90
   25447  T                   Repair wrist joint(s)..        217      20.54  $1,056.17      $530.42      $211.23
   25449  T                   Remove wrist joint             217      20.54  $1,056.17      $530.42      $211.23
                               implant.
   25450  T                   Revision of wrist joint        253      25.74  $1,323.55      $684.55      $264.71
   25455  T                   Revision of wrist joint        253      25.74  $1,323.55      $684.55      $264.71
   25490  T                   Reinforce radius.......        253      25.74  $1,323.55      $684.55      $264.71
   25491  T                   Reinforce ulna.........        253      25.74  $1,323.55      $684.55      $264.71
   25492  T                   Reinforce radius and           253      25.74  $1,323.55      $684.55      $264.71
                               ulna.
   25500  T                   Treat fracture of              209       1.94     $99.75       $37.74       $19.95
                               radius.
   25505  T                   Treat fracture of              209       1.94     $99.75       $37.74       $19.95
                               radius.
   25515  T                   Repair fracture of             216      20.09  $1,033.03      $524.09      $206.61
                               radius.
   25520  T                   Repair fracture of             209       1.94     $99.75       $37.74       $19.95
                               radius.
   25525  T                   Repair fracture of             216      20.09  $1,033.03      $524.09      $206.61
                               radius.
   25526  T                   Repair fracture of             216      20.09  $1,033.03      $524.09      $206.61
                               radius.
   25530  T                   Treat fracture of ulna.        209       1.94     $99.75       $37.74       $19.95
   25535  T                   Treat fracture of ulna.        209       1.94     $99.75       $37.74       $19.95
   25545  T                   Repair fracture of ulna        216      20.09  $1,033.03      $524.09      $206.61
   25560  T                   Treat fracture radius &        209       1.94     $99.75       $37.74       $19.95
                               ulna.
   25565  T                   Treat fracture radius &        209       1.94     $99.75       $37.74       $19.95
                               ulna.
   25574  T                   Treat fracture radius &        216      20.09  $1,033.03      $524.09      $206.61
                               ulna.
   25575  T                   Repair fracture radius/        216      20.09  $1,033.03      $524.09      $206.61
                               ulna.
   25600  T                   Treat fracture radius/         209       1.94     $99.75       $37.74       $19.95
                               ulna.
   25605  T                   Treat fracture radius/         209       1.94     $99.75       $37.74       $19.95
                               ulna.
   25611  T                   Repair fracture radius/        216      20.09  $1,033.03      $524.09      $206.61
                               ulna.
   25620  T                   Repair fracture radius/        216      20.09  $1,033.03      $524.09      $206.61
                               ulna.
   25622  T                   Treat wrist bone               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   25624  T                   Treat wrist bone               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   25628  T                   Repair wrist bone              216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   25630  T                   Treat wrist bone               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   25635  T                   Treat wrist bone               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   25645  T                   Repair wrist bone              216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   25650  T                   Repair wrist bone              209       1.94     $99.75       $37.74       $19.95
                               fracture.
   25660  T                   Treat wrist dislocation        209       1.94     $99.75       $37.74       $19.95
   25670  T                   Repair wrist                   216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   25675  T                   Treat wrist dislocation        209       1.94     $99.75       $37.74       $19.95
   25676  T                   Repair wrist                   216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   25680  T                   Treat wrist fracture...        209       1.94     $99.75       $37.74       $19.95
   25685  T                   Repair wrist fracture..        216      20.09  $1,033.03      $524.09      $206.61
   25690  T                   Treat wrist dislocation        209       1.94     $99.75       $37.74       $19.95
   25695  T                   Repair wrist                   216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   25800  T                   Fusion of wrist joint..        253      25.74  $1,323.55      $684.55      $264.71

[[Page 35289]]

 
   25805  T                   Fusion/graft of wrist          253      25.74  $1,323.55      $684.55      $264.71
                               joint.
   25810  T                   Fusion/graft of wrist          253      25.74  $1,323.55      $684.55      $264.71
                               joint.
   25820  T                   Fusion of hand bones...        261      10.41    $535.28      $259.00      $107.06
   25825  T                   Fusion hand bones with         262      18.07    $929.16      $475.96      $185.83
                               graft.
   25830  T                   Fusion radioulnar jnt/         253      25.74  $1,323.55      $684.55      $264.71
                               ulna.
   25900  C                   Amputation of forearm..  .........  .........  .........  ...........  ...........
   25905  C                   Amputation of forearm..  .........  .........  .........  ...........  ...........
   25907  T                   Amputation follow-up           251      13.88    $713.71      $365.89      $142.74
                               surgery.
   25909  C                   Amputation follow-up     .........  .........  .........  ...........  ...........
                               surgery.
   25915  C                   Amputation of forearm..  .........  .........  .........  ...........  ...........
   25920  C                   Amputate hand at wrist.  .........  .........  .........  ...........  ...........
   25922  T                   Amputate hand at wrist.        251      13.88    $713.71      $365.89      $142.74
   25924  C                   Amputation follow-up     .........  .........  .........  ...........  ...........
                               surgery.
   25927  C                   Amputation of hand.....  .........  .........  .........  ...........  ...........
   25929  T                   Amputation follow-up           183      11.04    $567.68      $283.18      $113.54
                               surgery.
   25931  C                   Amputation follow-up     .........  .........  .........  ...........  ...........
                               surgery.
   25999  T                   Forearm or wrist               209       1.94     $99.75       $37.74       $19.95
                               surgery.
   26010  T                   Drainage of finger             131       1.93     $99.24       $36.61       $19.85
                               abscess.
   26011  T                   Drainage of finger             131       1.93     $99.24       $36.61       $19.85
                               abscess.
   26020  T                   Drain hand tendon              261      10.41    $535.28      $259.00      $107.06
                               sheath.
   26025  T                   Drainage of palm bursa.        261      10.41    $535.28      $259.00      $107.06
   26030  T                   Drainage of palm               261      10.41    $535.28      $259.00      $107.06
                               bursa(s).
   26034  T                   Treat hand bone lesion.        261      10.41    $535.28      $259.00      $107.06
   26035  T                   Decompress fingers/hand        261      10.41    $535.28      $259.00      $107.06
   26037  T                   Decompress fingers/hand        261      10.41    $535.28      $259.00      $107.06
   26040  T                   Release palm                   262      18.07    $929.16      $475.96      $185.83
                               contracture.
   26045  T                   Release palm                   262      18.07    $929.16      $475.96      $185.83
                               contracture.
   26055  T                   Incise finger tendon           261      10.41    $535.28      $259.00      $107.06
                               sheath.
   26060  T                   Incision of finger             261      10.41    $535.28      $259.00      $107.06
                               tendon.
   26070  T                   Explore/treat hand             261      10.41    $535.28      $259.00      $107.06
                               joint.
   26075  T                   Explore/treat finger           261      10.41    $535.28      $259.00      $107.06
                               joint.
   26080  T                   Explore/treat finger           261      10.41    $535.28      $259.00      $107.06
                               joint.
   26100  T                   Biopsy hand joint              261      10.41    $535.28      $259.00      $107.06
                               lining.
   26105  T                   Biopsy finger joint            261      10.41    $535.28      $259.00      $107.06
                               lining.
   26110  T                   Biopsy finger joint            261      10.41    $535.28      $259.00      $107.06
                               lining.
   26115  T                   Removal of hand lesion.        163      10.48    $538.88      $260.80      $107.78
   26116  T                   Removal of hand lesion.        163      10.48    $538.88      $260.80      $107.78
   26117  T                   Remove tumor, hand/            163      10.48    $538.88      $260.80      $107.78
                               finger.
   26121  T                   Release palm                   262      18.07    $929.16      $475.96      $185.83
                               contracture.
   26123  T                   Release palm                   262      18.07    $929.16      $475.96      $185.83
                               contracture.
   26125  T                   Release palm                   262      18.07    $929.16      $475.96      $185.83
                               contracture.
   26130  T                   Remove wrist joint             261      10.41    $535.28      $259.00      $107.06
                               lining.
   26135  T                   Revise finger joint,           262      18.07    $929.16      $475.96      $185.83
                               each.
   26140  T                   Revise finger joint,           261      10.41    $535.28      $259.00      $107.06
                               each.
   26145  T                   Tendon excision, palm/         261      10.41    $535.28      $259.00      $107.06
                               finger.
   26160  T                   Remove tendon sheath           261      10.41    $535.28      $259.00      $107.06
                               lesion.
   26170  T                   Removal of palm tendon,        261      10.41    $535.28      $259.00      $107.06
                               each.
   26180  T                   Removal of finger              261      10.41    $535.28      $259.00      $107.06
                               tendon.
   26185  T                   Remove finger bone.....        261      10.41    $535.28      $259.00      $107.06
   26200  T                   Remove hand bone lesion        261      10.41    $535.28      $259.00      $107.06
   26205  T                   Remove/graft bone              262      18.07    $929.16      $475.96      $185.83
                               lesion.
   26210  T                   Removal of finger              261      10.41    $535.28      $259.00      $107.06
                               lesion.
   26215  T                   Remove/graft finger            261      10.41    $535.28      $259.00      $107.06
                               lesion.
   26230  T                   Partial removal of hand        261      10.41    $535.28      $259.00      $107.06
                               bone.
   26235  T                   Partial removal, finger        261      10.41    $535.28      $259.00      $107.06
                               bone.
   26236  T                   Partial removal, finger        261      10.41    $535.28      $259.00      $107.06
                               bone.
   26250  T                   Extensive hand surgery.        261      10.41    $535.28      $259.00      $107.06
   26255  T                   Extensive hand surgery.        262      18.07    $929.16      $475.96      $185.83
   26260  T                   Extensive finger               261      10.41    $535.28      $259.00      $107.06
                               surgery.
   26261  T                   Extensive finger               261      10.41    $535.28      $259.00      $107.06
                               surgery.
   26262  T                   Partial removal of             261      10.41    $535.28      $259.00      $107.06
                               finger.
   26320  T                   Removal of implant from        163      10.48    $538.88      $260.80      $107.78
                               hand.
   26350  T                   Repair finger/hand             262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26352  T                   Repair/graft hand              262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26356  T                   Repair finger/hand             262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26357  T                   Repair finger/hand             262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26358  T                   Repair/graft hand              262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26370  T                   Repair finger/hand             262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26372  T                   Repair/graft hand              262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26373  T                   Repair finger/hand             262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26390  T                   Revise hand/finger             262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26392  T                   Repair/graft hand              262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26410  T                   Repair hand tendon.....        261      10.41    $535.28      $259.00      $107.06
   26412  T                   Repair/graft hand              262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26415  T                   Excision, hand/finger          262      18.07    $929.16      $475.96      $185.83
                               tendon.

[[Page 35290]]

 
   26416  T                   Graft hand or finger           262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26418  T                   Repair finger tendon...        261      10.41    $535.28      $259.00      $107.06
   26420  T                   Repair/graft finger            262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26426  T                   Repair finger/hand             262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26428  T                   Repair/graft finger            262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26432  T                   Repair finger tendon...        261      10.41    $535.28      $259.00      $107.06
   26433  T                   Repair finger tendon...        261      10.41    $535.28      $259.00      $107.06
   26434  T                   Repair/graft finger            262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26437  T                   Realignment of tendons.        261      10.41    $535.28      $259.00      $107.06
   26440  T                   Release palm/finger            261      10.41    $535.28      $259.00      $107.06
                               tendon.
   26442  T                   Release palm & finger          262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26445  T                   Release hand/finger            261      10.41    $535.28      $259.00      $107.06
                               tendon.
   26449  T                   Release forearm/hand           262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26450  T                   Incision of palm tendon        261      10.41    $535.28      $259.00      $107.06
   26455  T                   Incision of finger             261      10.41    $535.28      $259.00      $107.06
                               tendon.
   26460  T                   Incise hand/finger             261      10.41    $535.28      $259.00      $107.06
                               tendon.
   26471  T                   Fusion of finger               261      10.41    $535.28      $259.00      $107.06
                               tendons.
   26474  T                   Fusion of finger               261      10.41    $535.28      $259.00      $107.06
                               tendons.
   26476  T                   Tendon lengthening.....        261      10.41    $535.28      $259.00      $107.06
   26477  T                   Tendon shortening......        261      10.41    $535.28      $259.00      $107.06
   26478  T                   Lengthening of hand            261      10.41    $535.28      $259.00      $107.06
                               tendon.
   26479  T                   Shortening of hand             261      10.41    $535.28      $259.00      $107.06
                               tendon.
   26480  T                   Transplant hand tendon.        262      18.07    $929.16      $475.96      $185.83
   26483  T                   Transplant/graft hand          262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26485  T                   Transplant palm tendon.        262      18.07    $929.16      $475.96      $185.83
   26489  T                   Transplant/graft palm          262      18.07    $929.16      $475.96      $185.83
                               tendon.
   26490  T                   Revise thumb tendon....        262      18.07    $929.16      $475.96      $185.83
   26492  T                   Tendon transfer with           262      18.07    $929.16      $475.96      $185.83
                               graft.
   26494  T                   Hand tendon/muscle             262      18.07    $929.16      $475.96      $185.83
                               transfer.
   26496  T                   Revise thumb tendon....        262      18.07    $929.16      $475.96      $185.83
   26497  T                   Finger tendon transfer.        262      18.07    $929.16      $475.96      $185.83
   26498  T                   Finger tendon transfer.        262      18.07    $929.16      $475.96      $185.83
   26499  T                   Revision of finger.....        262      18.07    $929.16      $475.96      $185.83
   26500  T                   Hand tendon                    261      10.41    $535.28      $259.00      $107.06
                               reconstruction.
   26502  T                   Hand tendon                    262      18.07    $929.16      $475.96      $185.83
                               reconstruction.
   26504  T                   Hand tendon                    262      18.07    $929.16      $475.96      $185.83
                               reconstruction.
   26508  T                   Release thumb                  261      10.41    $535.28      $259.00      $107.06
                               contracture.
   26510  T                   Thumb tendon transfer..        262      18.07    $929.16      $475.96      $185.83
   26516  T                   Fusion of knuckle joint        262      18.07    $929.16      $475.96      $185.83
   26517  T                   Fusion of knuckle              262      18.07    $929.16      $475.96      $185.83
                               joints.
   26518  T                   Fusion of knuckle              262      18.07    $929.16      $475.96      $185.83
                               joints.
   26520  T                   Release knuckle                261      10.41    $535.28      $259.00      $107.06
                               contracture.
   26525  T                   Release finger                 261      10.41    $535.28      $259.00      $107.06
                               contracture.
   26530  T                   Revise knuckle joint...        217      20.54  $1,056.17      $530.42      $211.23
   26531  T                   Revise knuckle with            218      27.80  $1,429.48      $720.71      $285.90
                               implant.
   26535  T                   Revise finger joint....        217      20.54  $1,056.17      $530.42      $211.23
   26536  T                   Revise/implant finger          218      27.80  $1,429.48      $720.71      $285.90
                               joint.
   26540  T                   Repair hand joint......        261      10.41    $535.28      $259.00      $107.06
   26541  T                   Repair hand joint with         262      18.07    $929.16      $475.96      $185.83
                               graft.
   26542  T                   Repair hand joint with         261      10.41    $535.28      $259.00      $107.06
                               graft.
   26545  T                   Reconstruct finger             262      18.07    $929.16      $475.96      $185.83
                               joint.
   26546  T                   Repair non-union hand..        262      18.07    $929.16      $475.96      $185.83
   26548  T                   Reconstruct finger             262      18.07    $929.16      $475.96      $185.83
                               joint.
   26550  T                   Construct thumb                262      18.07    $929.16      $475.96      $185.83
                               replacement.
   26551  C                   Great toe-hand transfer  .........  .........  .........  ...........  ...........
\2\ 2655  C                   Construct thumb          .........  .........  .........  ...........  ...........
        2                      replacement.
   26553  C                   Single toe-hand          .........  .........  .........  ...........  ...........
                               transfer.
   26554  C                   Double toe-hand          .........  .........  .........  ...........  ...........
                               transfer.
   26555  T                   Positional change of           262      18.07    $929.16      $475.96      $185.83
                               finger.
   26556  C                   Toe joint transfer.....  .........  .........  .........  ...........  ...........
\2\ 2655  C                   Construct finger         .........  .........  .........  ...........  ...........
        7                      replacement.
\2\ 2655  C                   Added finger surgery...  .........  .........  .........  ...........  ...........
        8
\2\ 2655  C                   Added finger surgery...  .........  .........  .........  ...........  ...........
        9
   26560  T                   Repair of web finger...        261      10.41    $535.28      $259.00      $107.06
   26561  T                   Repair of web finger...        262      18.07    $929.16      $475.96      $185.83
   26562  T                   Repair of web finger...        262      18.07    $929.16      $475.96      $185.83
   26565  T                   Correct metacarpal flaw        262      18.07    $929.16      $475.96      $185.83
   26567  T                   Correct finger                 262      18.07    $929.16      $475.96      $185.83
                               deformity.
   26568  T                   Lengthen metacarpal/           262      18.07    $929.16      $475.96      $185.83
                               finger.
   26580  T                   Repair hand deformity..        262      18.07    $929.16      $475.96      $185.83
   26585  T                   Repair finger deformity        262      18.07    $929.16      $475.96      $185.83
   26587  T                   Reconstruct extra              261      10.41    $535.28      $259.00      $107.06
                               finger.
   26590  T                   Repair finger deformity        262      18.07    $929.16      $475.96      $185.83
   26591  T                   Repair muscles of hand.        262      18.07    $929.16      $475.96      $185.83
   26593  T                   Release muscles of hand        261      10.41    $535.28      $259.00      $107.06

[[Page 35291]]

 
   26596  T                   Excision constricting          262      18.07    $929.16      $475.96      $185.83
                               tissue.
   26597  T                   Release of scar                262      18.07    $929.16      $475.96      $185.83
                               contracture.
   26600  T                   Treat metacarpal               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   26605  T                   Treat metacarpal               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   26607  T                   Treat metacarpal               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   26608  T                   Treat metacarpal               216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   26615  T                   Repair metacarpal              216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   26641  T                   Treat thumb dislocation        209       1.94     $99.75       $37.74       $19.95
   26645  T                   Treat thumb fracture...        209       1.94     $99.75       $37.74       $19.95
   26650  T                   Repair thumb fracture..        216      20.09  $1,033.03      $524.09      $206.61
   26665  T                   Repair thumb fracture..        216      20.09  $1,033.03      $524.09      $206.61
   26670  T                   Treat hand dislocation.        209       1.94     $99.75       $37.74       $19.95
   26675  T                   Treat hand dislocation.        210      10.06    $517.29      $279.34      $103.46
   26676  T                   Pin hand dislocation...        216      20.09  $1,033.03      $524.09      $206.61
   26685  T                   Repair hand dislocation        216      20.09  $1,033.03      $524.09      $206.61
   26686  T                   Repair hand dislocation        216      20.09  $1,033.03      $524.09      $206.61
   26700  T                   Treat knuckle                  207       1.70     $87.41       $32.32       $17.48
                               dislocation.
   26705  T                   Treat knuckle                  210      10.06    $517.29      $279.34      $103.46
                               dislocation.
   26706  T                   Pin knuckle dislocation        209       1.94     $99.75       $37.74       $19.95
   26715  T                   Repair knuckle                 216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   26720  T                   Treat finger fracture,         207       1.70     $87.41       $32.32       $17.48
                               each.
   26725  T                   Treat finger fracture,         207       1.70     $87.41       $32.32       $17.48
                               each.
   26727  T                   Treat finger fracture,         216      20.09  $1,033.03      $524.09      $206.61
                               each.
   26735  T                   Repair finger fracture,        216      20.09  $1,033.03      $524.09      $206.61
                               each.
   26740  T                   Treat finger fracture,         207       1.70     $87.41       $32.32       $17.48
                               each.
   26742  T                   Treat finger fracture,         209       1.94     $99.75       $37.74       $19.95
                               each.
   26746  T                   Repair finger fracture,        216      20.09  $1,033.03      $524.09      $206.61
                               each.
   26750  T                   Treat finger fracture,         207       1.70     $87.41       $32.32       $17.48
                               each.
   26755  T                   Treat finger fracture,         207       1.70     $87.41       $32.32       $17.48
                               each.
   26756  T                   Pin finger fracture,           216      20.09  $1,033.03      $524.09      $206.61
                               each.
   26765  T                   Repair finger fracture,        216      20.09  $1,033.03      $524.09      $206.61
                               each.
   26770  T                   Treat finger                   207       1.70     $87.41       $32.32       $17.48
                               dislocation.
   26775  T                   Treat finger                   210      10.06    $517.29      $279.34      $103.46
                               dislocation.
   26776  T                   Pin finger dislocation.        216      20.09  $1,033.03      $524.09      $206.61
   26785  T                   Repair finger                  216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   26820  T                   Thumb fusion with graft        262      18.07    $929.16      $475.96      $185.83
   26841  T                   Fusion of thumb........        262      18.07    $929.16      $475.96      $185.83
   26842  T                   Thumb fusion with graft        262      18.07    $929.16      $475.96      $185.83
   26843  T                   Fusion of hand joint...        262      18.07    $929.16      $475.96      $185.83
   26844  T                   Fusion/graft of hand           262      18.07    $929.16      $475.96      $185.83
                               joint.
   26850  T                   Fusion of knuckle......        262      18.07    $929.16      $475.96      $185.83
   26852  T                   Fusion of knuckle with         262      18.07    $929.16      $475.96      $185.83
                               graft.
   26860  T                   Fusion of finger joint.        262      18.07    $929.16      $475.96      $185.83
   26861  T                   Fusion of finger               262      18.07    $929.16      $475.96      $185.83
                               joint,added.
   26862  T                   Fusion/graft of finger         262      18.07    $929.16      $475.96      $185.83
                               joint.
   26863  T                   Fuse/graft added joint.        262      18.07    $929.16      $475.96      $185.83
   26910  T                   Amputate metacarpal            262      18.07    $929.16      $475.96      $185.83
                               bone.
   26951  T                   Amputation of finger/          261      10.41    $535.28      $259.00      $107.06
                               thumb.
   26952  T                   Amputation of finger/          261      10.41    $535.28      $259.00      $107.06
                               thumb.
   26989  T                   Hand/finger surgery....        207       1.70     $87.41       $32.32       $17.48
   26990  T                   Drainage of pelvis             251      13.88    $713.71      $365.89      $142.74
                               lesion.
   26991  T                   Drainage of pelvis             251      13.88    $713.71      $365.89      $142.74
                               bursa.
   26992  C                   Drainage of bone lesion  .........  .........  .........  ...........  ...........
   27000  T                   Incision of hip tendon.        251      13.88    $713.71      $365.89      $142.74
   27001  T                   Incision of hip tendon.        252      19.24    $989.32      $512.34      $197.86
   27003  T                   Incision of hip tendon.        252      19.24    $989.32      $512.34      $197.86
   27005  C                   Incision of hip tendon.  .........  .........  .........  ...........  ...........
   27006  C                   Incision of hip tendons  .........  .........  .........  ...........  ...........
   27025  C                   Incision of hip/thigh    .........  .........  .........  ...........  ...........
                               fascia.
   27030  C                   Drainage of hip joint..  .........  .........  .........  ...........  ...........
   27033  T                   Exploration of hip             253      25.74  $1,323.55      $684.55      $264.71
                               joint.
   27035  C                   Denervation of hip       .........  .........  .........  ...........  ...........
                               joint.
   27036  C                   Excision of hip joint/   .........  .........  .........  ...........  ...........
                               muscle.
   27040  T                   Biopsy of soft tissues.        162       5.59    $287.44      $125.66       $57.49
   27041  T                   Biopsy of soft tissues.        163      10.48    $538.88      $260.80      $107.78
   27047  T                   Remove hip/pelvis              163      10.48    $538.88      $260.80      $107.78
                               lesion.
   27048  T                   Remove hip/pelvis              163      10.48    $538.88      $260.80      $107.78
                               lesion.
   27049  T                   Remove tumor, hip/             163      10.48    $538.88      $260.80      $107.78
                               pelvis.
   27050  T                   Biopsy of sacroiliac           251      13.88    $713.71      $365.89      $142.74
                               joint.
   27052  T                   Biopsy of hip joint....        251      13.88    $713.71      $365.89      $142.74
   27054  C                   Removal of hip joint     .........  .........  .........  ...........  ...........
                               lining.
   27060  T                   Removal of ischial             251      13.88    $713.71      $365.89      $142.74
                               bursa.
   27062  T                   Remove femur lesion/           251      13.88    $713.71      $365.89      $142.74
                               bursa.
   27065  T                   Removal of hip bone            251      13.88    $713.71      $365.89      $142.74
                               lesion.
   27066  T                   Removal of hip bone            252      19.24    $989.32      $512.34      $197.86
                               lesion.

[[Page 35292]]

 
   27067  T                   Remove/graft hip bone          252      19.24    $989.32      $512.34      $197.86
                               lesion.
   27070  C                   Partial removal of hip   .........  .........  .........  ...........  ...........
                               bone.
   27071  C                   Partial removal of hip   .........  .........  .........  ...........  ...........
                               bone.
   27075  C                   Extensive hip surgery..  .........  .........  .........  ...........  ...........
   27076  C                   Extensive hip surgery..  .........  .........  .........  ...........  ...........
   27077  C                   Extensive hip surgery..  .........  .........  .........  ...........  ...........
   27078  C                   Extensive hip surgery..  .........  .........  .........  ...........  ...........
   27079  C                   Extensive hip surgery..  .........  .........  .........  ...........  ...........
   27080  T                   Removal of tail bone...        252      19.24    $989.32      $512.34      $197.86
   27086  T                   Remove hip foreign body        251      13.88    $713.71      $365.89      $142.74
   27087  T                   Remove hip foreign body        251      13.88    $713.71      $365.89      $142.74
   27090  C                   Removal of hip           .........  .........  .........  ...........  ...........
                               prosthesis.
   27091  C                   Removal of hip           .........  .........  .........  ...........  ...........
                               prosthesis.
   27093  T                   Injection for hip x-ray        347       2.57    $132.15       $62.38       $26.43
   27095  T                   Injection for hip x-ray        347       2.57    $132.15       $62.38       $26.43
   27097  T                   Revision of hip tendon.        252      19.24    $989.32      $512.34      $197.86
   27098  T                   Transfer tendon to             252      19.24    $989.32      $512.34      $197.86
                               pelvis.
   27100  T                   Transfer of abdominal          253      25.74  $1,323.55      $684.55      $264.71
                               muscle.
   27105  T                   Transfer of spinal             253      25.74  $1,323.55      $684.55      $264.71
                               muscle.
   27110  T                   Transfer of iliopsoas          253      25.74  $1,323.55      $684.55      $264.71
                               muscle.
   27111  T                   Transfer of iliopsoas          253      25.74  $1,323.55      $684.55      $264.71
                               muscle.
   27120  C                   Reconstruction of hip    .........  .........  .........  ...........  ...........
                               socket.
   27122  C                   Reconstruction of hip    .........  .........  .........  ...........  ...........
                               socket.
   27125  C                   Partial hip replacement  .........  .........  .........  ...........  ...........
   27130  C                   Total hip replacement..  .........  .........  .........  ...........  ...........
   27132  C                   Total hip replacement..  .........  .........  .........  ...........  ...........
   27134  C                   Revise hip joint         .........  .........  .........  ...........  ...........
                               replacement.
   27137  C                   Revise hip joint         .........  .........  .........  ...........  ...........
                               replacement.
   27138  C                   Revise hip joint         .........  .........  .........  ...........  ...........
                               replacement.
   27140  C                   Transplant of femur      .........  .........  .........  ...........  ...........
                               ridge.
   27146  C                   Incision of hip bone...  .........  .........  .........  ...........  ...........
   27147  C                   Revision of hip bone...  .........  .........  .........  ...........  ...........
   27151  C                   Incision of hip bones..  .........  .........  .........  ...........  ...........
   27156  C                   Revision of hip bones..  .........  .........  .........  ...........  ...........
   27158  C                   Revision of pelvis.....  .........  .........  .........  ...........  ...........
   27161  C                   Incision of neck of      .........  .........  .........  ...........  ...........
                               femur.
   27165  C                   Incision/fixation of     .........  .........  .........  ...........  ...........
                               femur.
   27170  C                   Repair/graft femur head/ .........  .........  .........  ...........  ...........
                               neck.
   27175  C                   Treat slipped epiphysis  .........  .........  .........  ...........  ...........
   27176  C                   Treat slipped epiphysis  .........  .........  .........  ...........  ...........
   27177  C                   Repair slipped           .........  .........  .........  ...........  ...........
                               epiphysis.
   27178  C                   Repair slipped           .........  .........  .........  ...........  ...........
                               epiphysis.
   27179  C                   Revise head/neck of      .........  .........  .........  ...........  ...........
                               femur.
   27181  C                   Repair slipped           .........  .........  .........  ...........  ...........
                               epiphysis.
   27185  C                   Revision of femur        .........  .........  .........  ...........  ...........
                               epiphysis.
   27187  C                   Reinforce hip bones....  .........  .........  .........  ...........  ...........
   27193  T                   Treat pelvic ring              209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27194  T                   Treat pelvic ring              210      10.06    $517.29      $279.34      $103.46
                               fracture.
   27200  T                   Treat tail bone                207       1.70     $87.41       $32.32       $17.48
                               fracture.
   27202  T                   Repair tail bone               216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27215  C                   Pelvic fracture(s)       .........  .........  .........  ...........  ...........
                               treatment.
   27216  C                   Treat pelvic ring        .........  .........  .........  ...........  ...........
                               fracture.
   27217  C                   Treat pelvic ring        .........  .........  .........  ...........  ...........
                               fracture.
   27218  C                   Treat pelvic ring        .........  .........  .........  ...........  ...........
                               fracture.
   27220  T                   Treat hip socket               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27222  C                   Treat hip socket         .........  .........  .........  ...........  ...........
                               fracture.
   27226  C                   Treat hip wall fracture  .........  .........  .........  ...........  ...........
   27227  C                   Treat hip fracture(s)..  .........  .........  .........  ...........  ...........
   27228  C                   Treat hip fracture(s)..  .........  .........  .........  ...........  ...........
   27230  T                   Treat fracture of thigh        209       1.94     $99.75       $37.74       $19.95
   27232  C                   Treat fracture of thigh  .........  .........  .........  ...........  ...........
   27235  C                   Repair of thigh          .........  .........  .........  ...........  ...........
                               fracture.
   27236  C                   Repair of thigh          .........  .........  .........  ...........  ...........
                               fracture.
   27238  T                   Treatment of thigh             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27240  C                   Treatment of thigh       .........  .........  .........  ...........  ...........
                               fracture.
   27244  C                   Repair of thigh          .........  .........  .........  ...........  ...........
                               fracture.
   27245  C                   Repair of thigh          .........  .........  .........  ...........  ...........
                               fracture.
   27246  T                   Treatment of thigh             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27248  C                   Repair of thigh          .........  .........  .........  ...........  ...........
                               fracture.
   27250  T                   Treat hip dislocation..        209       1.94     $99.75       $37.74       $19.95
   27252  T                   Treat hip dislocation..        210      10.06    $517.29      $279.34      $103.46
   27253  C                   Repair of hip            .........  .........  .........  ...........  ...........
                               dislocation.
   27254  C                   Repair of hip            .........  .........  .........  ...........  ...........
                               dislocation.
   27256  T                   Treatment of hip               209       1.94     $99.75       $37.74       $19.95
                               dislocation.
   27257  T                   Treatment of hip               210      10.06    $517.29      $279.34      $103.46
                               dislocation.

[[Page 35293]]

 
   27258  C                   Repair of hip            .........  .........  .........  ...........  ...........
                               dislocation.
   27259  C                   Repair of hip            .........  .........  .........  ...........  ...........
                               dislocation.
   27265  T                   Treatment of hip               209       1.94     $99.75       $37.74       $19.95
                               dislocation.
   27266  T                   Treatment of hip               217      20.54  $1,056.17      $530.42      $211.23
                               dislocation.
   27275  T                   Manipulation of hip            210      10.06    $517.29      $279.34      $103.46
                               joint.
   27280  C                   Fusion of sacroiliac     .........  .........  .........  ...........  ...........
                               joint.
   27282  C                   Fusion of pubic bones..  .........  .........  .........  ...........  ...........
   27284  C                   Fusion of hip joint....  .........  .........  .........  ...........  ...........
   27286  C                   Fusion of hip joint....  .........  .........  .........  ...........  ...........
   27290  C                   Amputation of leg at     .........  .........  .........  ...........  ...........
                               hip.
   27295  C                   Amputation of leg at     .........  .........  .........  ...........  ...........
                               hip.
   27299  T                   Pelvis/hip joint               207       1.70     $87.41       $32.32       $17.48
                               surgery.
   27301  T                   Drain thigh/knee lesion        132       5.63    $289.49      $132.89       $57.90
   27303  C                   Drainage of bone lesion  .........  .........  .........  ...........  ...........
   27305  T                   Incise thigh tendon &          251      13.88    $713.71      $365.89      $142.74
                               fascia.
   27306  T                   Incision of thigh              251      13.88    $713.71      $365.89      $142.74
                               tendon.
   27307  T                   Incision of thigh              251      13.88    $713.71      $365.89      $142.74
                               tendons.
   27310  T                   Exploration of knee            252      19.24    $989.32      $512.34      $197.86
                               joint.
   27315  T                   Partial removal, thigh         631      12.70    $653.03      $329.06      $130.61
                               nerve.
   27320  T                   Partial removal, thigh         631      12.70    $653.03      $329.06      $130.61
                               nerve.
   27323  T                   Biopsy thigh soft              162       5.59    $287.44      $125.66       $57.49
                               tissues.
   27324  T                   Biopsy thigh soft              163      10.48    $538.88      $260.80      $107.78
                               tissues.
   27327  T                   Removal of thigh lesion        163      10.48    $538.88      $260.80      $107.78
   27328  T                   Removal of thigh lesion        163      10.48    $538.88      $260.80      $107.78
   27329  T                   Remove tumor, thigh/           163      10.48    $538.88      $260.80      $107.78
                               knee.
   27330  T                   Biopsy knee joint              252      19.24    $989.32      $512.34      $197.86
                               lining.
   27331  T                   Explore/treat knee             252      19.24    $989.32      $512.34      $197.86
                               joint.
   27332  T                   Removal of knee                252      19.24    $989.32      $512.34      $197.86
                               cartilage.
   27333  T                   Removal of knee                252      19.24    $989.32      $512.34      $197.86
                               cartilage.
   27334  T                   Remove knee joint              252      19.24    $989.32      $512.34      $197.86
                               lining.
   27335  T                   Remove knee joint              252      19.24    $989.32      $512.34      $197.86
                               lining.
   27340  T                   Removal of kneecap             251      13.88    $713.71      $365.89      $142.74
                               bursa.
   27345  T                   Removal of knee cyst...        251      13.88    $713.71      $365.89      $142.74
   27350  T                   Removal of kneecap.....        252      19.24    $989.32      $512.34      $197.86
   27355  T                   Remove femur lesion....        252      19.24    $989.32      $512.34      $197.86
   27356  T                   Remove femur lesion/           252      19.24    $989.32      $512.34      $197.86
                               graft.
   27357  T                   Remove femur lesion/           252      19.24    $989.32      $512.34      $197.86
                               graft.
   27358  T                   Remove femur lesion/           252      19.24    $989.32      $512.34      $197.86
                               fixation.
   27360  T                   Partial removal leg            252      19.24    $989.32      $512.34      $197.86
                               bone(s).
   27365  C                   Extensive leg surgery..  .........  .........  .........  ...........  ...........
   27370  T                   Injection for knee x-          347       2.57    $132.15       $62.38       $26.43
                               ray.
   27372  T                   Removal of foreign body        163      10.48    $538.88      $260.80      $107.78
   27380  T                   Repair of kneecap              251      13.88    $713.71      $365.89      $142.74
                               tendon.
   27381  T                   Repair/graft kneecap           251      13.88    $713.71      $365.89      $142.74
                               tendon.
   27385  T                   Repair of thigh muscle.        251      13.88    $713.71      $365.89      $142.74
   27386  T                   Repair/graft of thigh          251      13.88    $713.71      $365.89      $142.74
                               muscle.
   27390  T                   Incision of thigh              251      13.88    $713.71      $365.89      $142.74
                               tendon.
   27391  T                   Incision of thigh              251      13.88    $713.71      $365.89      $142.74
                               tendons.
   27392  T                   Incision of thigh              251      13.88    $713.71      $365.89      $142.74
                               tendons.
   27393  T                   Lengthening of thigh           252      19.24    $989.32      $512.34      $197.86
                               tendon.
   27394  T                   Lengthening of thigh           252      19.24    $989.32      $512.34      $197.86
                               tendons.
   27395  T                   Lengthening of thigh           253      25.74  $1,323.55      $684.55      $264.71
                               tendons.
   27396  T                   Transplant of thigh            252      19.24    $989.32      $512.34      $197.86
                               tendon.
   27397  T                   Transplants of thigh           253      25.74  $1,323.55      $684.55      $264.71
                               tendons.
   27400  T                   Revise thigh muscles/          253      25.74  $1,323.55      $684.55      $264.71
                               tendons.
   27403  T                   Repair of knee                 252      19.24    $989.32      $512.34      $197.86
                               cartilage.
   27405  T                   Repair of knee ligament        253      25.74  $1,323.55      $684.55      $264.71
   27407  T                   Repair of knee ligament        253      25.74  $1,323.55      $684.55      $264.71
   27409  T                   Repair of knee                 253      25.74  $1,323.55      $684.55      $264.71
                               ligaments.
   27418  T                   Repair degenerated             253      25.74  $1,323.55      $684.55      $264.71
                               kneecap.
   27420  T                   Revision of unstable           253      25.74  $1,323.55      $684.55      $264.71
                               kneecap.
   27422  T                   Revision of unstable           253      25.74  $1,323.55      $684.55      $264.71
                               kneecap.
   27424  T                   Revision/removal of            253      25.74  $1,323.55      $684.55      $264.71
                               kneecap.
   27425  T                   Lateral retinacular            252      19.24    $989.32      $512.34      $197.86
                               release.
   27427  T                   Reconstruction, knee...        254      32.70  $1,681.43      $922.98      $336.29
   27428  T                   Reconstruction, knee...        254      32.70  $1,681.43      $922.98      $336.29
   27429  T                   Reconstruction, knee...        254      32.70  $1,681.43      $922.98      $336.29
   27430  T                   Revision of thigh              253      25.74  $1,323.55      $684.55      $264.71
                               muscles.
   27435  T                   Incision of knee joint.        253      25.74  $1,323.55      $684.55      $264.71
   27437  T                   Revise kneecap.........        217      20.54  $1,056.17      $530.42      $211.23
   27438  T                   Revise kneecap with            218      27.80  $1,429.48      $720.71      $285.90
                               implant.
   27440  T                   Revision of knee joint.        217      20.54  $1,056.17      $530.42      $211.23
   27441  T                   Revision of knee joint.        217      20.54  $1,056.17      $530.42      $211.23
   27442  T                   Revision of knee joint.        217      20.54  $1,056.17      $530.42      $211.23
   27443  T                   Revision of knee joint.        217      20.54  $1,056.17      $530.42      $211.23

[[Page 35294]]

 
   27445  C                   Revision of knee joint.  .........  .........  .........  ...........  ...........
   27446  C                   Revision of knee joint.  .........  .........  .........  ...........  ...........
   27447  C                   Total knee replacement.  .........  .........  .........  ...........  ...........
   27448  C                   Incision of thigh......  .........  .........  .........  ...........  ...........
   27450  C                   Incision of thigh......  .........  .........  .........  ...........  ...........
   27454  C                   Realignment of thigh     .........  .........  .........  ...........  ...........
                               bone.
   27455  C                   Realignment of knee....  .........  .........  .........  ...........  ...........
   27457  C                   Realignment of knee....  .........  .........  .........  ...........  ...........
   27465  C                   Shortening of thigh      .........  .........  .........  ...........  ...........
                               bone.
   27466  C                   Lengthening of thigh     .........  .........  .........  ...........  ...........
                               bone.
   27468  C                   Shorten/lengthen thighs  .........  .........  .........  ...........  ...........
   27470  C                   Repair of thigh........  .........  .........  .........  ...........  ...........
   27472  C                   Repair/graft of thigh..  .........  .........  .........  ...........  ...........
   27475  C                   Surgery to stop leg      .........  .........  .........  ...........  ...........
                               growth.
   27477  C                   Surgery to stop leg      .........  .........  .........  ...........  ...........
                               growth.
   27479  C                   Surgery to stop leg      .........  .........  .........  ...........  ...........
                               growth.
   27485  C                   Surgery to stop leg      .........  .........  .........  ...........  ...........
                               growth.
   27486  C                   Revise knee joint        .........  .........  .........  ...........  ...........
                               replace.
   27487  C                   Revise knee joint        .........  .........  .........  ...........  ...........
                               replace.
   27488  C                   Removal of knee          .........  .........  .........  ...........  ...........
                               prosthesis.
   27495  C                   Reinforce thigh........  .........  .........  .........  ...........  ...........
   27496  T                   Decompression of thigh/        251      13.88    $713.71      $365.89      $142.74
                               knee.
   27497  T                   Decompression of thigh/        251      13.88    $713.71      $365.89      $142.74
                               knee.
   27498  T                   Decompression of thigh/        251      13.88    $713.71      $365.89      $142.74
                               knee.
   27499  T                   Decompression of thigh/        251      13.88    $713.71      $365.89      $142.74
                               knee.
   27500  T                   Treatment of thigh             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27501  T                   Treatment of thigh             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27502  T                   Treatment of thigh             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27503  T                   Treatment of thigh             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27506  C                   Repair of thigh          .........  .........  .........  ...........  ...........
                               fracture.
   27507  C                   Treatment of thigh       .........  .........  .........  ...........  ...........
                               fracture.
   27508  T                   Treatment of thigh             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27509  T                   Treatment of thigh             216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27510  T                   Treatment of thigh             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27511  C                   Treatment of thigh       .........  .........  .........  ...........  ...........
                               fracture.
   27513  C                   Treatment of thigh       .........  .........  .........  ...........  ...........
                               fracture.
   27514  C                   Repair of thigh          .........  .........  .........  ...........  ...........
                               fracture.
   27516  T                   Repair of thigh growth         209       1.94     $99.75       $37.74       $19.95
                               plate.
   27517  T                   Repair of thigh growth         209       1.94     $99.75       $37.74       $19.95
                               plate.
   27519  C                   Repair of thigh growth   .........  .........  .........  ...........  ...........
                               plate.
   27520  T                   Treat kneecap fracture.        209       1.94     $99.75       $37.74       $19.95
   27524  C                   Repair of kneecap        .........  .........  .........  ...........  ...........
                               fracture.
   27530  T                   Treatment of knee              209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27532  T                   Treatment of knee              209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27535  C                   Treatment of knee        .........  .........  .........  ...........  ...........
                               fracture.
   27536  C                   Repair of knee fracture  .........  .........  .........  ...........  ...........
   27538  T                   Treat knee fracture(s).        209       1.94     $99.75       $37.74       $19.95
   27540  C                   Repair of knee fracture  .........  .........  .........  ...........  ...........
   27550  T                   Treat knee dislocation.        209       1.94     $99.75       $37.74       $19.95
   27552  T                   Treat knee dislocation.        210      10.06    $517.29      $279.34      $103.46
   27556  T                   Repair of knee                 216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   27557  C                   Repair of knee           .........  .........  .........  ...........  ...........
                               dislocation.
   27558  C                   Repair of knee           .........  .........  .........  ...........  ...........
                               dislocation.
   27560  T                   Treat kneecap                  209       1.94     $99.75       $37.74       $19.95
                               dislocation.
   27562  T                   Treat kneecap                  210      10.06    $517.29      $279.34      $103.46
                               dislocation.
   27566  T                   Repair kneecap                 216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   27570  T                   Fixation of knee joint.        210      10.06    $517.29      $279.34      $103.46
   27580  C                   Fusion of knee.........  .........  .........  .........  ...........  ...........
   27590  C                   Amputate leg at thigh..  .........  .........  .........  ...........  ...........
   27591  C                   Amputate leg at thigh..  .........  .........  .........  ...........  ...........
   27592  C                   Amputate leg at thigh..  .........  .........  .........  ...........  ...........
   27594  T                   Amputation follow-up           251      13.88    $713.71      $365.89      $142.74
                               surgery.
   27596  C                   Amputation follow-up     .........  .........  .........  ...........  ...........
                               surgery.
   27598  C                   Amputate lower leg at    .........  .........  .........  ...........  ...........
                               knee.
   27599  T                   Leg surgery procedure..        209       1.94     $99.75       $37.74       $19.95
   27600  T                   Decompression of lower         251      13.88    $713.71      $365.89      $142.74
                               leg.
   27601  T                   Decompression of lower         251      13.88    $713.71      $365.89      $142.74
                               leg.
   27602  T                   Decompression of lower         251      13.88    $713.71      $365.89      $142.74
                               leg.
   27603  T                   Drain lower leg lesion.        132       5.63    $289.49      $132.89       $57.90
   27604  T                   Drain lower leg bursa..        251      13.88    $713.71      $365.89      $142.74
   27605  T                   Incision of achilles           271      14.12    $726.05      $365.44      $145.21
                               tendon.
   27606  T                   Incision of achilles           251      13.88    $713.71      $365.89      $142.74
                               tendon.
   27607  T                   Treat lower leg bone           251      13.88    $713.71      $365.89      $142.74
                               lesion.
   27610  T                   Explore/treat ankle            252      19.24    $989.32      $512.34      $197.86
                               joint.
   27612  T                   Exploration of ankle           252      19.24    $989.32      $512.34      $197.86
                               joint.

[[Page 35295]]

 
   27613  T                   Biopsy lower leg soft          161       3.43    $176.37       $75.71       $35.27
                               tissue.
   27614  T                   Biopsy lower leg soft          163      10.48    $538.88      $260.80      $107.78
                               tissue.
   27615  T                   Remove tumor, lower leg        216      20.09  $1,033.03      $524.09      $206.61
   27618  T                   Remove lower leg lesion        163      10.48    $538.88      $260.80      $107.78
   27619  T                   Remove lower leg lesion        163      10.48    $538.88      $260.80      $107.78
   27620  T                   Explore, treat ankle           252      19.24    $989.32      $512.34      $197.86
                               joint.
   27625  T                   Remove ankle joint             252      19.24    $989.32      $512.34      $197.86
                               lining.
   27626  T                   Remove ankle joint             252      19.24    $989.32      $512.34      $197.86
                               lining.
   27630  T                   Removal of tendon              251      13.88    $713.71      $365.89      $142.74
                               lesion.
   27635  T                   Remove lower leg bone          252      19.24    $989.32      $512.34      $197.86
                               lesion.
   27637  T                   Remove/graft leg bone          252      19.24    $989.32      $512.34      $197.86
                               lesion.
   27638  T                   Remove/graft leg bone          252      19.24    $989.32      $512.34      $197.86
                               lesion.
   27640  T                   Partial removal of             253      25.74  $1,323.55      $684.55      $264.71
                               tibia.
   27641  T                   Partial removal of             252      19.24    $989.32      $512.34      $197.86
                               fibula.
   27645  C                   Extensive lower leg      .........  .........  .........  ...........  ...........
                               surgery.
   27646  C                   Extensive lower leg      .........  .........  .........  ...........  ...........
                               surgery.
   27647  T                   Extensive ankle/heel           253      25.74  $1,323.55      $684.55      $264.71
                               surgery.
   27648  T                   Injection for ankle x-         347       2.57    $132.15       $62.38       $26.43
                               ray.
   27650  T                   Repair achilles tendon.        253      25.74  $1,323.55      $684.55      $264.71
   27652  T                   Repair/graft achilles          253      25.74  $1,323.55      $684.55      $264.71
                               tendon.
   27654  T                   Repair of achilles             253      25.74  $1,323.55      $684.55      $264.71
                               tendon.
   27656  T                   Repair leg fascia              251      13.88    $713.71      $365.89      $142.74
                               defect.
   27658  T                   Repair of leg tendon,          251      13.88    $713.71      $365.89      $142.74
                               each.
   27659  T                   Repair of leg tendon,          251      13.88    $713.71      $365.89      $142.74
                               each.
   27664  T                   Repair of leg tendon,          251      13.88    $713.71      $365.89      $142.74
                               each.
   27665  T                   Repair of leg tendon,          252      19.24    $989.32      $512.34      $197.86
                               each.
   27675  T                   Repair lower leg               251      13.88    $713.71      $365.89      $142.74
                               tendons.
   27676  T                   Repair lower leg               252      19.24    $989.32      $512.34      $197.86
                               tendons.
   27680  T                   Release of lower leg           252      19.24    $989.32      $512.34      $197.86
                               tendon.
   27681  T                   Release of lower leg           252      19.24    $989.32      $512.34      $197.86
                               tendons.
   27685  T                   Revision of lower leg          252      19.24    $989.32      $512.34      $197.86
                               tendon.
   27686  T                   Revise lower leg               252      19.24    $989.32      $512.34      $197.86
                               tendons.
   27687  T                   Revision of calf tendon        252      19.24    $989.32      $512.34      $197.86
   27690  T                   Revise lower leg tendon        253      25.74  $1,323.55      $684.55      $264.71
   27691  T                   Revise lower leg tendon        253      25.74  $1,323.55      $684.55      $264.71
   27692  T                   Revise additional leg          253      25.74  $1,323.55      $684.55      $264.71
                               tendon.
   27695  T                   Repair of ankle                252      19.24    $989.32      $512.34      $197.86
                               ligament.
   27696  T                   Repair of ankle                252      19.24    $989.32      $512.34      $197.86
                               ligaments.
   27698  T                   Repair of ankle                252      19.24    $989.32      $512.34      $197.86
                               ligament.
   27700  T                   Revision of ankle joint        217      20.54  $1,056.17      $530.42      $211.23
   27702  C                   Reconstruct ankle joint  .........  .........  .........  ...........  ...........
   27703  C                   Reconstruction, ankle    .........  .........  .........  ...........  ...........
                               joint.
   27704  T                   Removal of ankle               251      13.88    $713.71      $365.89      $142.74
                               implant.
   27705  T                   Incision of tibia......        253      25.74  $1,323.55      $684.55      $264.71
   27707  T                   Incision of fibula.....        251      13.88    $713.71      $365.89      $142.74
   27709  T                   Incision of tibia &            252      19.24    $989.32      $512.34      $197.86
                               fibula.
   27712  C                   Realignment of lower     .........  .........  .........  ...........  ...........
                               leg.
   27715  C                   Revision of lower leg..  .........  .........  .........  ...........  ...........
   27720  C                   Repair of tibia........  .........  .........  .........  ...........  ...........
   27722  C                   Repair/graft of tibia..  .........  .........  .........  ...........  ...........
   27724  C                   Repair/graft of tibia..  .........  .........  .........  ...........  ...........
   27725  C                   Repair of lower leg....  .........  .........  .........  ...........  ...........
   27727  C                   Repair of lower leg....  .........  .........  .........  ...........  ...........
   27730  T                   Repair of tibia                252      19.24    $989.32      $512.34      $197.86
                               epiphysis.
   27732  T                   Repair of fibula               252      19.24    $989.32      $512.34      $197.86
                               epiphysis.
   27734  T                   Repair lower leg               252      19.24    $989.32      $512.34      $197.86
                               epiphyses.
   27740  T                   Repair of leg epiphyses        252      19.24    $989.32      $512.34      $197.86
   27742  T                   Repair of leg epiphyses        253      25.74  $1,323.55      $684.55      $264.71
   27745  T                   Reinforce tibia........        253      25.74  $1,323.55      $684.55      $264.71
   27750  T                   Treatment of tibia             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27752  T                   Treatment of tibia             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27756  T                   Repair of tibia                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27758  T                   Repair of tibia                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27759  T                   Repair of tibia                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27760  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27762  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27766  T                   Repair of ankle                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27780  T                   Treatment of fibula            209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27781  T                   Treatment of fibula            209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27784  T                   Repair of fibula               216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27786  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27788  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27792  T                   Repair of ankle                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27808  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27810  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.

[[Page 35296]]

 
   27814  T                   Repair of ankle                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27816  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27818  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27822  T                   Repair of ankle                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27823  T                   Repair of ankle                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27824  T                   Treat lower leg                209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27825  T                   Treat lower leg                209       1.94     $99.75       $37.74       $19.95
                               fracture.
   27826  T                   Treat lower leg                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27827  T                   Treat lower leg                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27828  T                   Treat lower leg                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   27829  T                   Treat lower leg joint..        216      20.09  $1,033.03      $524.09      $206.61
   27830  T                   Treat lower leg                209       1.94     $99.75       $37.74       $19.95
                               dislocation.
   27831  T                   Treat lower leg                210      10.06    $517.29      $279.34      $103.46
                               dislocation.
   27832  T                   Repair lower leg               216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   27840  T                   Treat ankle dislocation        209       1.94     $99.75       $37.74       $19.95
   27842  T                   Treat ankle dislocation        210      10.06    $517.29      $279.34      $103.46
   27846  T                   Repair ankle                   216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   27848  T                   Repair ankle                   216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   27860  T                   Fixation of ankle joint        210      10.06    $517.29      $279.34      $103.46
   27870  T                   Fusion of ankle joint..        253      25.74  $1,323.55      $684.55      $264.71
   27871  T                   Fusion of tibiofibular         253      25.74  $1,323.55      $684.55      $264.71
                               joint.
   27880  C                   Amputation of lower leg  .........  .........  .........  ...........  ...........
   27881  C                   Amputation of lower leg  .........  .........  .........  ...........  ...........
   27882  C                   Amputation of lower leg  .........  .........  .........  ...........  ...........
   27884  T                   Amputation follow-up           251      13.88    $713.71      $365.89      $142.74
                               surgery.
   27886  C                   Amputation follow-up     .........  .........  .........  ...........  ...........
                               surgery.
   27888  C                   Amputation of foot at    .........  .........  .........  ...........  ...........
                               ankle.
   27889  T                   Amputation of foot at          252      19.24    $989.32      $512.34      $197.86
                               ankle.
   27892  T                   Decompression of leg...        251      13.88    $713.71      $365.89      $142.74
   27893  T                   Decompression of leg...        251      13.88    $713.71      $365.89      $142.74
   27894  T                   Decompression of leg...        251      13.88    $713.71      $365.89      $142.74
   27899  T                   Leg/ankle surgery              209       1.94     $99.75       $37.74       $19.95
                               procedure.
   28001  T                   Drainage of bursa of           132       5.63    $289.49      $132.89       $57.90
                               foot.
   28002  T                   Treatment of foot              251      13.88    $713.71      $365.89      $142.74
                               infection.
   28003  T                   Treatment of foot              251      13.88    $713.71      $365.89      $142.74
                               infection.
   28005  T                   Treat foot bone lesion.        271      14.12    $726.05      $365.44      $145.21
   28008  T                   Incision of foot fascia        271      14.12    $726.05      $365.44      $145.21
   28010  T                   Incision of toe tendon.        271      14.12    $726.05      $365.44      $145.21
   28011  T                   Incision of toe tendons        271      14.12    $726.05      $365.44      $145.21
   28020  T                   Exploration of a foot          271      14.12    $726.05      $365.44      $145.21
                               joint.
   28022  T                   Exploration of a foot          271      14.12    $726.05      $365.44      $145.21
                               joint.
   28024  T                   Exploration of a toe           271      14.12    $726.05      $365.44      $145.21
                               joint.
   28030  T                   Removal of foot nerve..        631      12.70    $653.03      $329.06      $130.61
   28035  T                   Decompression of tibia         631      12.70    $653.03      $329.06      $130.61
                               nerve.
   28043  T                   Excision of foot lesion        162       5.59    $287.44      $125.66       $57.49
   28045  T                   Excision of foot lesion        271      14.12    $726.05      $365.44      $145.21
   28046  T                   Resection of tumor,            271      14.12    $726.05      $365.44      $145.21
                               foot.
   28050  T                   Biopsy of foot joint           271      14.12    $726.05      $365.44      $145.21
                               lining.
   28052  T                   Biopsy of foot joint           271      14.12    $726.05      $365.44      $145.21
                               lining.
   28054  T                   Biopsy of toe joint            271      14.12    $726.05      $365.44      $145.21
                               lining.
   28060  T                   Partial removal foot           272      16.11    $828.38      $411.09      $165.68
                               fascia.
   28062  T                   Removal of foot fascia.        272      16.11    $828.38      $411.09      $165.68
   28070  T                   Removal of foot joint          272      16.11    $828.38      $411.09      $165.68
                               lining.
   28072  T                   Removal of foot joint          272      16.11    $828.38      $411.09      $165.68
                               lining.
   28080  T                   Removal of foot lesion.        271      14.12    $726.05      $365.44      $145.21
   28086  T                   Excise foot tendon             271      14.12    $726.05      $365.44      $145.21
                               sheath.
   28088  T                   Excise foot tendon             271      14.12    $726.05      $365.44      $145.21
                               sheath.
   28090  T                   Removal of foot lesion.        271      14.12    $726.05      $365.44      $145.21
   28092  T                   Removal of toe lesions.        271      14.12    $726.05      $365.44      $145.21
   28100  T                   Removal of ankle/heel          271      14.12    $726.05      $365.44      $145.21
                               lesion.
   28102  T                   Remove/graft foot              272      16.11    $828.38      $411.09      $165.68
                               lesion.
   28103  T                   Remove/graft foot              272      16.11    $828.38      $411.09      $165.68
                               lesion.
   28104  T                   Removal of foot lesion.        271      14.12    $726.05      $365.44      $145.21
   28106  T                   Remove/graft foot              272      16.11    $828.38      $411.09      $165.68
                               lesion.
   28107  T                   Remove/graft foot              272      16.11    $828.38      $411.09      $165.68
                               lesion.
   28108  T                   Removal of toe lesions.        271      14.12    $726.05      $365.44      $145.21
   28110  T                   Part removal of                276      19.00    $976.98      $495.39      $195.40
                               metatarsal.
   28111  T                   Part removal of                271      14.12    $726.05      $365.44      $145.21
                               metatarsal.
   28112  T                   Part removal of                271      14.12    $726.05      $365.44      $145.21
                               metatarsal.
   28113  T                   Part removal of                271      14.12    $726.05      $365.44      $145.21
                               metatarsal.
   28114  T                   Removal of metatarsal          271      14.12    $726.05      $365.44      $145.21
                               heads.
   28116  T                   Revision of foot.......        271      14.12    $726.05      $365.44      $145.21
   28118  T                   Removal of heel bone...        271      14.12    $726.05      $365.44      $145.21
   28119  T                   Removal of heel spur...        271      14.12    $726.05      $365.44      $145.21
   28120  T                   Part removal of ankle/         271      14.12    $726.05      $365.44      $145.21
                               heel.

[[Page 35297]]

 
   28122  T                   Partial removal of foot        271      14.12    $726.05      $365.44      $145.21
                               bone.
   28124  T                   Partial removal of toe.        271      14.12    $726.05      $365.44      $145.21
   28126  T                   Partial removal of toe.        271      14.12    $726.05      $365.44      $145.21
   28130  T                   Removal of ankle bone..        271      14.12    $726.05      $365.44      $145.21
   28140  T                   Removal of metatarsal..        271      14.12    $726.05      $365.44      $145.21
   28150  T                   Removal of toe.........        271      14.12    $726.05      $365.44      $145.21
   28153  T                   Partial removal of toe.        271      14.12    $726.05      $365.44      $145.21
   28160  T                   Partial removal of toe.        271      14.12    $726.05      $365.44      $145.21
   28171  T                   Extensive foot surgery.        271      14.12    $726.05      $365.44      $145.21
   28173  T                   Extensive foot surgery.        271      14.12    $726.05      $365.44      $145.21
   28175  T                   Extensive foot surgery.        271      14.12    $726.05      $365.44      $145.21
   28190  T                   Removal of foot foreign        161       3.43    $176.37       $75.71       $35.27
                               body.
   28192  T                   Removal of foot foreign        163      10.48    $538.88      $260.80      $107.78
                               body.
   28193  T                   Removal of foot foreign        163      10.48    $538.88      $260.80      $107.78
                               body.
   28200  T                   Repair of foot tendon..        271      14.12    $726.05      $365.44      $145.21
   28202  T                   Repair/graft of foot           272      16.11    $828.38      $411.09      $165.68
                               tendon.
   28208  T                   Repair of foot tendon..        271      14.12    $726.05      $365.44      $145.21
   28210  T                   Repair/graft of foot           271      14.12    $726.05      $365.44      $145.21
                               tendon.
   28220  T                   Release of foot tendon.        271      14.12    $726.05      $365.44      $145.21
   28222  T                   Release of foot tendons        271      14.12    $726.05      $365.44      $145.21
   28225  T                   Release of foot tendon.        271      14.12    $726.05      $365.44      $145.21
   28226  T                   Release of foot tendons        271      14.12    $726.05      $365.44      $145.21
   28230  T                   Incision of foot               271      14.12    $726.05      $365.44      $145.21
                               tendon(s).
   28232  T                   Incision of toe tendon.        271      14.12    $726.05      $365.44      $145.21
   28234  T                   Incision of foot tendon        271      14.12    $726.05      $365.44      $145.21
   28238  T                   Revision of foot tendon        272      16.11    $828.38      $411.09      $165.68
   28240  T                   Release of big toe.....        271      14.12    $726.05      $365.44      $145.21
   28250  T                   Revision of foot fascia        272      16.11    $828.38      $411.09      $165.68
   28260  T                   Release of midfoot             272      16.11    $828.38      $411.09      $165.68
                               joint.
   28261  T                   Revision of foot tendon        272      16.11    $828.38      $411.09      $165.68
   28262  T                   Revision of foot and           272      16.11    $828.38      $411.09      $165.68
                               ankle.
   28264  T                   Release of midfoot             272      16.11    $828.38      $411.09      $165.68
                               joint.
   28270  T                   Release of foot                271      14.12    $726.05      $365.44      $145.21
                               contracture.
   28272  T                   Release of toe joint,          271      14.12    $726.05      $365.44      $145.21
                               each.
   28280  T                   Fusion of toes.........        271      14.12    $726.05      $365.44      $145.21
   28285  T                   Repair of hammertoe....        271      14.12    $726.05      $365.44      $145.21
   28286  T                   Repair of hammertoe....        271      14.12    $726.05      $365.44      $145.21
   28288  T                   Partial removal of foot        272      16.11    $828.38      $411.09      $165.68
                               bone.
   28290  T                   Correction of bunion...        276      19.00    $976.98      $495.39      $195.40
   28292  T                   Correction of bunion...        276      19.00    $976.98      $495.39      $195.40
   28293  T                   Correction of bunion...        276      19.00    $976.98      $495.39      $195.40
   28294  T                   Correction of bunion...        276      19.00    $976.98      $495.39      $195.40
   28296  T                   Correction of bunion...        276      19.00    $976.98      $495.39      $195.40
   28297  T                   Correction of bunion...        276      19.00    $976.98      $495.39      $195.40
   28298  T                   Correction of bunion...        276      19.00    $976.98      $495.39      $195.40
   28299  T                   Correction of bunion...        276      19.00    $976.98      $495.39      $195.40
   28300  T                   Incision of heel bone..        272      16.11    $828.38      $411.09      $165.68
   28302  T                   Incision of ankle bone.        272      16.11    $828.38      $411.09      $165.68
   28304  T                   Incision of midfoot            272      16.11    $828.38      $411.09      $165.68
                               bones.
   28305  T                   Incise/graft midfoot           272      16.11    $828.38      $411.09      $165.68
                               bones.
   28306  T                   Incision of metatarsal.        272      16.11    $828.38      $411.09      $165.68
   28307  T                   Incision of metatarsal.        272      16.11    $828.38      $411.09      $165.68
   28308  T                   Incision of metatarsal.        272      16.11    $828.38      $411.09      $165.68
   28309  T                   Incision of metatarsals        272      16.11    $828.38      $411.09      $165.68
   28310  T                   Revision of big toe....        271      14.12    $726.05      $365.44      $145.21
   28312  T                   Revision of toe........        271      14.12    $726.05      $365.44      $145.21
   28313  T                   Repair deformity of toe        271      14.12    $726.05      $365.44      $145.21
   28315  T                   Removal of sesamoid            271      14.12    $726.05      $365.44      $145.21
                               bone.
   28320  T                   Repair of foot bones...        272      16.11    $828.38      $411.09      $165.68
   28322  T                   Repair of metatarsals..        272      16.11    $828.38      $411.09      $165.68
   28340  T                   Resect enlarged toe            271      14.12    $726.05      $365.44      $145.21
                               tissue.
   28341  T                   Resect enlarged toe....        271      14.12    $726.05      $365.44      $145.21
   28344  T                   Repair extra toe(s)....        272      16.11    $828.38      $411.09      $165.68
   28345  T                   Repair webbed toe(s)...        272      16.11    $828.38      $411.09      $165.68
   28360  T                   Reconstruct cleft foot.        272      16.11    $828.38      $411.09      $165.68
   28400  T                   Treatment of heel              209       1.94     $99.75       $37.74       $19.95
                               fracture.
   28405  T                   Treatment of heel              209       1.94     $99.75       $37.74       $19.95
                               fracture.
   28406  T                   Treatment of heel              216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   28415  T                   Repair of heel fracture        216      20.09  $1,033.03      $524.09      $206.61
   28420  T                   Repair/graft heel              216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   28430  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   28435  T                   Treatment of ankle             209       1.94     $99.75       $37.74       $19.95
                               fracture.
   28436  T                   Treatment of ankle             216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   28445  T                   Repair of ankle                216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   28450  T                   Treat midfoot fracture,        209       1.94     $99.75       $37.74       $19.95
                               each.

[[Page 35298]]

 
   28455  T                   Treat midfoot fracture,        209       1.94     $99.75       $37.74       $19.95
                               each.
   28456  T                   Repair midfoot fracture        216      20.09  $1,033.03      $524.09      $206.61
   28465  T                   Repair midfoot                 216      20.09  $1,033.03      $524.09      $206.61
                               fracture,each.
   28470  T                   Treat metatarsal               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   28475  T                   Treat metatarsal               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   28476  T                   Repair metatarsal              216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   28485  T                   Repair metatarsal              216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   28490  T                   Treat big toe fracture.        207       1.70     $87.41       $32.32       $17.48
   28495  T                   Treat big toe fracture.        207       1.70     $87.41       $32.32       $17.48
   28496  T                   Repair big toe fracture        216      20.09  $1,033.03      $524.09      $206.61
   28505  T                   Repair big toe fracture        216      20.09  $1,033.03      $524.09      $206.61
   28510  T                   Treatment of toe               207       1.70     $87.41       $32.32       $17.48
                               fracture.
   28515  T                   Treatment of toe               207       1.70     $87.41       $32.32       $17.48
                               fracture.
   28525  T                   Repair of toe fracture.        216      20.09  $1,033.03      $524.09      $206.61
   28530  T                   Treat sesamoid bone            209       1.94     $99.75       $37.74       $19.95
                               fracture.
   28531  T                   Treat sesamoid bone            216      20.09  $1,033.03      $524.09      $206.61
                               fracture.
   28540  T                   Treat foot dislocation.        209       1.94     $99.75       $37.74       $19.95
   28545  T                   Treat foot dislocation.        210      10.06    $517.29      $279.34      $103.46
   28546  T                   Treat foot dislocation.        216      20.09  $1,033.03      $524.09      $206.61
   28555  T                   Repair foot dislocation        216      20.09  $1,033.03      $524.09      $206.61
   28570  T                   Treat foot dislocation.        209       1.94     $99.75       $37.74       $19.95
   28575  T                   Treat foot dislocation.        210      10.06    $517.29      $279.34      $103.46
   28576  T                   Treat foot dislocation.        216      20.09  $1,033.03      $524.09      $206.61
   28585  T                   Repair foot dislocation        216      20.09  $1,033.03      $524.09      $206.61
   28600  T                   Treat foot dislocation.        209       1.94     $99.75       $37.74       $19.95
   28605  T                   Treat foot dislocation.        210      10.06    $517.29      $279.34      $103.46
   28606  T                   Treat foot dislocation.        216      20.09  $1,033.03      $524.09      $206.61
   28615  T                   Repair foot dislocation        216      20.09  $1,033.03      $524.09      $206.61
   28630  T                   Treat toe dislocation..        207       1.70     $87.41       $32.32       $17.48
   28635  T                   Treat toe dislocation..        210      10.06    $517.29      $279.34      $103.46
   28636  T                   Treat toe dislocation..        216      20.09  $1,033.03      $524.09      $206.61
   28645  T                   Repair toe dislocation.        216      20.09  $1,033.03      $524.09      $206.61
   28660  T                   Treat toe dislocation..        207       1.70     $87.41       $32.32       $17.48
   28665  T                   Treat toe dislocation..        210      10.06    $517.29      $279.34      $103.46
   28666  T                   Treat toe dislocation..        216      20.09  $1,033.03      $524.09      $206.61
   28675  T                   Repair of toe                  216      20.09  $1,033.03      $524.09      $206.61
                               dislocation.
   28705  T                   Fusion of foot bones...        272      16.11    $828.38      $411.09      $165.68
   28715  T                   Fusion of foot bones...        272      16.11    $828.38      $411.09      $165.68
   28725  T                   Fusion of foot bones...        272      16.11    $828.38      $411.09      $165.68
   28730  T                   Fusion of foot bones...        272      16.11    $828.38      $411.09      $165.68
   28735  T                   Fusion of foot bones...        272      16.11    $828.38      $411.09      $165.68
   28737  T                   Revision of foot bones.        271      14.12    $726.05      $365.44      $145.21
   28740  T                   Fusion of foot bones...        272      16.11    $828.38      $411.09      $165.68
   28750  T                   Fusion of big toe joint        271      14.12    $726.05      $365.44      $145.21
   28755  T                   Fusion of big toe joint        271      14.12    $726.05      $365.44      $145.21
   28760  T                   Fusion of big toe joint        272      16.11    $828.38      $411.09      $165.68
   28800  C                   Amputation of midfoot..  .........  .........  .........  ...........  ...........
   28805  C                   Amputation thru          .........  .........  .........  ...........  ...........
                               metatarsal.
   28810  T                   Amputation toe &               271      14.12    $726.05      $365.44      $145.21
                               metatarsal.
   28820  T                   Amputation of toe......        271      14.12    $726.05      $365.44      $145.21
   28825  T                   Partial amputation of          271      14.12    $726.05      $365.44      $145.21
                               toe.
   28899  T                   Foot/toes surgery              207       1.70     $87.41       $32.32       $17.48
                               procedure.
   29000  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29010  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29015  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29020  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29025  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29035  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29040  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29044  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29046  N                   Application of body      .........  .........  .........  ...........  ...........
                               cast.
   29049  N                   Application of figure    .........  .........  .........  ...........  ...........
                               eight.
   29055  N                   Application of shoulder  .........  .........  .........  ...........  ...........
                               cast.
   29058  N                   Application of shoulder  .........  .........  .........  ...........  ...........
                               cast.
   29065  N                   Application of long arm  .........  .........  .........  ...........  ...........
                               cast.
   29075  N                   Application of forearm   .........  .........  .........  ...........  ...........
                               cast.
   29085  N                   Apply hand/wrist cast..  .........  .........  .........  ...........  ...........
   29105  N                   Apply long arm splint..  .........  .........  .........  ...........  ...........
   29125  N                   Apply forearm splint...  .........  .........  .........  ...........  ...........
   29126  N                   Apply forearm splint...  .........  .........  .........  ...........  ...........
   29130  N                   Application of finger    .........  .........  .........  ...........  ...........
                               splint.
   29131  N                   Application of finger    .........  .........  .........  ...........  ...........
                               splint.
   29200  N                   Strapping of chest.....  .........  .........  .........  ...........  ...........
   29220  N                   Strapping of low back..  .........  .........  .........  ...........  ...........
   29240  N                   Strapping of shoulder..  .........  .........  .........  ...........  ...........

[[Page 35299]]

 
   29260  N                   Strapping of elbow or    .........  .........  .........  ...........  ...........
                               wrist.
   29280  N                   Strapping of hand or     .........  .........  .........  ...........  ...........
                               finger.
   29305  N                   Application of hip cast  .........  .........  .........  ...........  ...........
   29325  N                   Application of hip       .........  .........  .........  ...........  ...........
                               casts.
   29345  N                   Application of long leg  .........  .........  .........  ...........  ...........
                               cast.
   29355  N                   Application of long leg  .........  .........  .........  ...........  ...........
                               cast.
   29358  N                   Apply long leg cast      .........  .........  .........  ...........  ...........
                               brace.
   29365  N                   Application of long leg  .........  .........  .........  ...........  ...........
                               cast.
   29405  N                   Apply short leg cast...  .........  .........  .........  ...........  ...........
   29425  N                   Apply short leg cast...  .........  .........  .........  ...........  ...........
   29435  N                   Apply short leg cast...  .........  .........  .........  ...........  ...........
   29440  N                   Addition of walker to    .........  .........  .........  ...........  ...........
                               cast.
   29445  N                   Apply rigid leg cast...  .........  .........  .........  ...........  ...........
   29450  N                   Application of leg cast  .........  .........  .........  ...........  ...........
   29505  N                   Application long leg     .........  .........  .........  ...........  ...........
                               splint.
   29515  N                   Application lower leg    .........  .........  .........  ...........  ...........
                               splint.
   29520  N                   Strapping of hip.......  .........  .........  .........  ...........  ...........
   29530  N                   Strapping of knee......  .........  .........  .........  ...........  ...........
   29540  N                   Strapping of ankle.....  .........  .........  .........  ...........  ...........
   29550  N                   Strapping of toes......  .........  .........  .........  ...........  ...........
   29580  N                   Application of paste     .........  .........  .........  ...........  ...........
                               boot.
   29590  N                   Application of foot      .........  .........  .........  ...........  ...........
                               splint.
   29700  N                   Removal/revision of      .........  .........  .........  ...........  ...........
                               cast.
   29705  N                   Removal/revision of      .........  .........  .........  ...........  ...........
                               cast.
   29710  N                   Removal/revision of      .........  .........  .........  ...........  ...........
                               cast.
   29715  N                   Removal/revision of      .........  .........  .........  ...........  ...........
                               cast.
   29720  N                   Repair of body cast....  .........  .........  .........  ...........  ...........
   29730  N                   Windowing of cast......  .........  .........  .........  ...........  ...........
   29740  N                   Wedging of cast........  .........  .........  .........  ...........  ...........
   29750  N                   Wedging of clubfoot      .........  .........  .........  ...........  ...........
                               cast.
   29799  N                   Casting/strapping        .........  .........  .........  ...........  ...........
                               procedure.
   29800  T                   Jaw arthroscopy/surgery        280      22.15  $1,138.95      $581.72      $227.79
   29804  T                   Jaw arthroscopy/surgery        281      22.37  $1,150.27      $589.18      $230.05
   29815  T                   Shoulder arthroscopy...        280      22.15  $1,138.95      $581.72      $227.79
   29819  T                   Shoulder arthroscopy/          281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29820  T                   Shoulder arthroscopy/          281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29821  T                   Shoulder arthroscopy/          281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29822  T                   Shoulder arthroscopy/          281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29823  T                   Shoulder arthroscopy/          281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29825  T                   Shoulder arthroscopy/          281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29826  T                   Shoulder arthroscopy/          281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29830  T                   Elbow arthroscopy......        280      22.15  $1,138.95      $581.72      $227.79
   29834  T                   Elbow arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29835  T                   Elbow arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29836  T                   Elbow arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29837  T                   Elbow arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29838  T                   Elbow arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29840  T                   Wrist arthroscopy......        280      22.15  $1,138.95      $581.72      $227.79
   29843  T                   Wrist arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29844  T                   Wrist arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29845  T                   Wrist arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29846  T                   Wrist arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29847  T                   Wrist arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29848  T                   Wrist endoscopy/surgery        281      22.37  $1,150.27      $589.18      $230.05
   29850  T                   Knee arthroscopy/              286      27.69  $1,423.82      $791.90      $284.76
                               surgery.
   29851  T                   Knee arthroscopy/              286      27.69  $1,423.82      $791.90      $284.76
                               surgery.
   29855  T                   Tibial arthroscopy/            286      27.69  $1,423.82      $791.90      $284.76
                               surgery.
   29856  T                   Tibial arthroscopy/            286      27.69  $1,423.82      $791.90      $284.76
                               surgery.
   29860  T                   Hip arthroscopy, dx....        281      22.37  $1,150.27      $589.18      $230.05
   29861  T                   Hip arthroscopy/surgery        281      22.37  $1,150.27      $589.18      $230.05
   29862  T                   Hip arthroscopy/surgery        281      22.37  $1,150.27      $589.18      $230.05
   29863  T                   Hip arthroscopy/surgery        281      22.37  $1,150.27      $589.18      $230.05
   29870  T                   Knee arthroscopy,              280      22.15  $1,138.95      $581.72      $227.79
                               diagnostic.
   29871  T                   Knee arthroscopy/              282      23.65  $1,216.08      $609.97      $243.22
                               drainage.
   29874  T                   Knee arthroscopy/              281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29875  T                   Knee arthroscopy/              281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29876  T                   Knee arthroscopy/              282      23.65  $1,216.08      $609.97      $243.22
                               surgery.
   29877  T                   Knee arthroscopy/              281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29879  T                   Knee arthroscopy/              281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29880  T                   Knee arthroscopy/              281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29881  T                   Knee arthroscopy/              281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29882  T                   Knee arthroscopy/              282      23.65  $1,216.08      $609.97      $243.22
                               surgery.
   29883  T                   Knee arthroscopy/              282      23.65  $1,216.08      $609.97      $243.22
                               surgery.
   29884  T                   Knee arthroscopy/              281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29885  T                   Knee arthroscopy/              282      23.65  $1,216.08      $609.97      $243.22
                               surgery.

[[Page 35300]]

 
   29886  T                   Knee arthroscopy/              281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29887  T                   Knee arthroscopy/              282      23.65  $1,216.08      $609.97      $243.22
                               surgery.
   29888  T                   Knee arthroscopy/              286      27.69  $1,423.82      $791.90      $284.76
                               surgery.
   29889  T                   Knee arthroscopy/              286      27.69  $1,423.82      $791.90      $284.76
                               surgery.
   29891  T                   Ankle arthroscopy/             282      23.65  $1,216.08      $609.97      $243.22
                               surgery.
   29892  T                   Ankle arthroscopy/             286      27.69  $1,423.82      $791.90      $284.76
                               surgery.
   29893  T                   Scope, plantar                 271      14.12    $726.05      $365.44      $145.21
                               fasciotomy.
   29894  T                   Ankle arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29895  T                   Ankle arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29897  T                   Ankle arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29898  T                   Ankle arthroscopy/             281      22.37  $1,150.27      $589.18      $230.05
                               surgery.
   29909  T                   Arthroscopy of joint...        280      22.15  $1,138.95      $581.72      $227.79
   30000  T                   Drainage of nose lesion        311       1.41     $72.50       $20.57       $14.50
   30020  T                   Drainage of nose lesion        311       1.41     $72.50       $20.57       $14.50
   30100  T                   Intranasal biopsy......        311       1.41     $72.50       $20.57       $14.50
   30110  T                   Removal of nose                311       1.41     $72.50       $20.57       $14.50
                               polyp(s).
   30115  T                   Removal of nose                313      15.46    $794.95      $407.70      $158.99
                               polyp(s).
   30117  T                   Removal of intranasal          311       1.41     $72.50       $20.57       $14.50
                               lesion.
   30118  T                   Removal of intranasal          313      15.46    $794.95      $407.70      $158.99
                               lesion.
   30120  T                   Revision of nose.......        313      15.46    $794.95      $407.70      $158.99
   30124  T                   Removal of nose lesion.        311       1.41     $72.50       $20.57       $14.50
   30125  T                   Removal of nose lesion.        313      15.46    $794.95      $407.70      $158.99
   30130  T                   Removal of turbinate           313      15.46    $794.95      $407.70      $158.99
                               bones.
   30140  T                   Removal of turbinate           313      15.46    $794.95      $407.70      $158.99
                               bones.
   30150  T                   Partial removal of nose        313      15.46    $794.95      $407.70      $158.99
   30160  T                   Removal of nose........        313      15.46    $794.95      $407.70      $158.99
   30200  T                   Injection treatment of         347       2.57    $132.15       $62.38       $26.43
                               nose.
   30210  T                   Nasal sinus therapy....        311       1.41     $72.50       $20.57       $14.50
   30220  T                   Insert nasal septal            311       1.41     $72.50       $20.57       $14.50
                               button.
   30300  T                   Remove nasal foreign           311       1.41     $72.50       $20.57       $14.50
                               body.
   30310  T                   Remove nasal foreign           313      15.46    $794.95      $407.70      $158.99
                               body.
   30320  T                   Remove nasal foreign           313      15.46    $794.95      $407.70      $158.99
                               body.
   30400  T                   Reconstruction of nose.        314      25.15  $1,293.21      $687.72      $258.64
   30410  T                   Reconstruction of nose.        314      25.15  $1,293.21      $687.72      $258.64
   30420  T                   Reconstruction of nose.        314      25.15  $1,293.21      $687.72      $258.64
   30430  T                   Revision of nose.......        313      15.46    $794.95      $407.70      $158.99
   30435  T                   Revision of nose.......        314      25.15  $1,293.21      $687.72      $258.64
   30450  T                   Revision of nose.......        314      25.15  $1,293.21      $687.72      $258.64
   30460  T                   Revision of nose.......        314      25.15  $1,293.21      $687.72      $258.64
   30462  T                   Revision of nose.......        314      25.15  $1,293.21      $687.72      $258.64
   30520  T                   Repair of nasal septum.        313      15.46    $794.95      $407.70      $158.99
   30540  T                   Repair nasal defect....        313      15.46    $794.95      $407.70      $158.99
   30545  T                   Repair nasal defect....        314      25.15  $1,293.21      $687.72      $258.64
   30560  T                   Release of nasal               311       1.41     $72.50       $20.57       $14.50
                               adhesions.
   30580  T                   Repair upper jaw               313      15.46    $794.95      $407.70      $158.99
                               fistula.
   30600  T                   Repair mouth/nose              313      15.46    $794.95      $407.70      $158.99
                               fistula.
   30620  T                   Intranasal                     313      15.46    $794.95      $407.70      $158.99
                               reconstruction.
   30630  T                   Repair nasal septum            313      15.46    $794.95      $407.70      $158.99
                               defect.
   30801  T                   Cauterization inner            312       7.07    $363.54      $170.86       $72.71
                               nose.
   30802  T                   Cauterization inner            312       7.07    $363.54      $170.86       $72.71
                               nose.
   30901  T                   Control of nosebleed...        318       2.07    $106.44       $38.87       $21.29
   30903  T                   Control of nosebleed...        318       2.07    $106.44       $38.87       $21.29
   30905  T                   Control of nosebleed...        318       2.07    $106.44       $38.87       $21.29
   30906  T                   Repeat control of              318       2.07    $106.44       $38.87       $21.29
                               nosebleed.
   30915  T                   Ligation nasal sinus           367      17.02    $875.17      $441.15      $175.03
                               artery.
   30920  T                   Ligation upper jaw             367      17.02    $875.17      $441.15      $175.03
                               artery.
   30930  T                   Therapy fracture of            312       7.07    $363.54      $170.86       $72.71
                               nose.
   30999  T                   Nasal surgery procedure        318       2.07    $106.44       $38.87       $21.29
   31000  T                   Irrigation maxillary           311       1.41     $72.50       $20.57       $14.50
                               sinus.
   31002  T                   Irrigation sphenoid            311       1.41     $72.50       $20.57       $14.50
                               sinus.
   31020  T                   Exploration maxillary          313      15.46    $794.95      $407.70      $158.99
                               sinus.
   31030  T                   Exploration maxillary          313      15.46    $794.95      $407.70      $158.99
                               sinus.
   31032  T                   Explore sinus,remove           313      15.46    $794.95      $407.70      $158.99
                               polyps.
   31040  T                   Exploration behind             314      25.15  $1,293.21      $687.72      $258.64
                               upper jaw.
   31050  T                   Exploration sphenoid           313      15.46    $794.95      $407.70      $158.99
                               sinus.
   31051  T                   Sphenoid sinus surgery.        313      15.46    $794.95      $407.70      $158.99
   31070  T                   Exploration of frontal         313      15.46    $794.95      $407.70      $158.99
                               sinus.
   31075  T                   Exploration of frontal         314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31080  T                   Removal of frontal             314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31081  T                   Removal of frontal             314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31084  T                   Removal of frontal             314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31085  T                   Removal of frontal             314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31086  T                   Removal of frontal             314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31087  T                   Removal of frontal             314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31090  T                   Exploration of sinuses.        314      25.15  $1,293.21      $687.72      $258.64

[[Page 35301]]

 
   31200  T                   Removal of ethmoid             313      15.46    $794.95      $407.70      $158.99
                               sinus.
   31201  T                   Removal of ethmoid             314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31205  T                   Removal of ethmoid             314      25.15  $1,293.21      $687.72      $258.64
                               sinus.
   31225  C                   Removal of upper jaw...  .........  .........  .........  ...........  ...........
   31230  C                   Removal of upper jaw...  .........  .........  .........  ...........  ...........
   31231  T                   Nasal endoscopy, dx....        331       0.57     $29.31       $14.01        $5.86
   31233  T                   Nasal/sinus endoscopy,         332       9.67    $497.23      $242.72       $99.45
                               dx.
   31235  T                   Nasal/sinus endoscopy,         332       9.67    $497.23      $242.72       $99.45
                               dx.
   31237  T                   Nasal/sinus endoscopy,         332       9.67    $497.23      $242.72       $99.45
                               surg.
   31238  T                   Nasal/sinus endoscopy,         332       9.67    $497.23      $242.72       $99.45
                               surg.
   31239  T                   Nasal/sinus endoscopy,         333      16.81    $864.37      $461.04      $172.87
                               surg.
   31240  T                   Nasal/sinus endoscopy,         332       9.67    $497.23      $242.72       $99.45
                               surg.
   31254  T                   Revision of ethmoid            333      16.81    $864.37      $461.04      $172.87
                               sinus.
   31255  T                   Removal of ethmoid             333      16.81    $864.37      $461.04      $172.87
                               sinus.
   31256  T                   Exploration maxillary          333      16.81    $864.37      $461.04      $172.87
                               sinus.
   31267  T                   Endoscopy, maxillary           333      16.81    $864.37      $461.04      $172.87
                               sinus.
   31276  T                   Sinus surgical                 333      16.81    $864.37      $461.04      $172.87
                               endoscopy.
   31287  T                   Nasal/sinus endoscopy,         333      16.81    $864.37      $461.04      $172.87
                               surg.
   31288  T                   Nasal/sinus endoscopy,         333      16.81    $864.37      $461.04      $172.87
                               surg.
   31290  C                   Nasal/sinus endoscopy,   .........  .........  .........  ...........  ...........
                               surg.
   31291  C                   Nasal/sinus endoscopy,   .........  .........  .........  ...........  ...........
                               surg.
   31292  C                   Nasal/sinus endoscopy,   .........  .........  .........  ...........  ...........
                               surg.
   31293  C                   Nasal/sinus endoscopy,   .........  .........  .........  ...........  ...........
                               surg.
   31294  C                   Nasal/sinus endoscopy,   .........  .........  .........  ...........  ...........
                               surg.
   31299  T                   Sinus surgery procedure        331       0.57     $29.31       $14.01        $5.86
   31300  T                   Removal of larynx              314      25.15  $1,293.21      $687.72      $258.64
                               lesion.
   31320  T                   Diagnostic incision            313      15.46    $794.95      $407.70      $158.99
                               larynx.
   31360  C                   Removal of larynx......  .........  .........  .........  ...........  ...........
   31365  C                   Removal of larynx......  .........  .........  .........  ...........  ...........
   31367  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               larynx.
   31368  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               larynx.
   31370  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               larynx.
   31375  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               larynx.
   31380  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               larynx.
   31382  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               larynx.
   31390  C                   Removal of larynx &      .........  .........  .........  ...........  ...........
                               pharynx.
   31395  C                   Reconstruct larynx &     .........  .........  .........  ...........  ...........
                               pharynx.
   31400  T                   Revision of larynx.....        314      25.15  $1,293.21      $687.72      $258.64
   31420  T                   Removal of epiglottis..        314      25.15  $1,293.21      $687.72      $258.64
   31500  S                   Insert emergency airway        947       4.11    $211.34      $106.22       $42.27
   31502  T                   Change of windpipe             470       2.19    $112.61       $54.92       $22.52
                               airway.
   31505  T                   Diagnostic laryngoscopy        331       0.57     $29.31       $14.01        $5.86
   31510  T                   Laryngoscopy with              332       9.67    $497.23      $242.72       $99.45
                               biopsy.
   31511  T                   Remove foreign body,           332       9.67    $497.23      $242.72       $99.45
                               larynx.
   31512  T                   Removal of larynx              332       9.67    $497.23      $242.72       $99.45
                               lesion.
   31513  T                   Injection into vocal           332       9.67    $497.23      $242.72       $99.45
                               cord.
   31515  T                   Laryngoscopy for               332       9.67    $497.23      $242.72       $99.45
                               aspiration.
   31520  T                   Diagnostic laryngoscopy        332       9.67    $497.23      $242.72       $99.45
   31525  T                   Diagnostic laryngoscopy        332       9.67    $497.23      $242.72       $99.45
   31526  T                   Diagnostic laryngoscopy        332       9.67    $497.23      $242.72       $99.45
   31527  T                   Laryngoscopy for               333      16.81    $864.37      $461.04      $172.87
                               treatment.
   31528  T                   Laryngoscopy and               332       9.67    $497.23      $242.72       $99.45
                               dilatation.
   31529  T                   Laryngoscopy and               332       9.67    $497.23      $242.72       $99.45
                               dilatation.
   31530  T                   Operative laryngoscopy.        333      16.81    $864.37      $461.04      $172.87
   31531  T                   Operative laryngoscopy.        333      16.81    $864.37      $461.04      $172.87
   31535  T                   Operative laryngoscopy.        333      16.81    $864.37      $461.04      $172.87
   31536  T                   Operative laryngoscopy.        333      16.81    $864.37      $461.04      $172.87
   31540  T                   Operative laryngoscopy.        333      16.81    $864.37      $461.04      $172.87
   31541  T                   Operative laryngoscopy.        333      16.81    $864.37      $461.04      $172.87
   31560  T                   Operative laryngoscopy.        333      16.81    $864.37      $461.04      $172.87
   31561  T                   Operative laryngoscopy.        333      16.81    $864.37      $461.04      $172.87
   31570  T                   Laryngoscopy with              333      16.81    $864.37      $461.04      $172.87
                               injection.
   31571  T                   Laryngoscopy with              333      16.81    $864.37      $461.04      $172.87
                               injection.
   31575  T                   Diagnostic laryngoscopy        331       0.57     $29.31       $14.01        $5.86
   31576  T                   Laryngoscopy with              332       9.67    $497.23      $242.72       $99.45
                               biopsy.
   31577  T                   Remove foreign body,           332       9.67    $497.23      $242.72       $99.45
                               larynx.
   31578  T                   Removal of larynx              332       9.67    $497.23      $242.72       $99.45
                               lesion.
   31579  T                   Diagnostic laryngoscopy        331       0.57     $29.31       $14.01        $5.86
   31580  C                   Revision of larynx.....  .........  .........  .........  ...........  ...........
   31582  C                   Revision of larynx.....  .........  .........  .........  ...........  ...........
   31584  C                   Repair of larynx         .........  .........  .........  ...........  ...........
                               fracture.
   31585  T                   Repair of larynx               207       1.70     $87.41       $32.32       $17.48
                               fracture.
   31586  T                   Repair of larynx               209       1.94     $99.75       $37.74       $19.95
                               fracture.
   31587  C                   Revision of larynx.....  .........  .........  .........  ...........  ...........
   31588  T                   Revision of larynx.....        314      25.15  $1,293.21      $687.72      $258.64

[[Page 35302]]

 
   31590  T                   Reinnervate larynx.....        314      25.15  $1,293.21      $687.72      $258.64
   31595  T                   Larynx nerve surgery...        313      15.46    $794.95      $407.70      $158.99
   31599  T                   Larynx surgery                 207       1.70     $87.41       $32.32       $17.48
                               procedure.
   31600  C                   Incision of windpipe...  .........  .........  .........  ...........  ...........
   31601  C                   Incision of windpipe...  .........  .........  .........  ...........  ...........
   31603  T                   Incision of windpipe...        311       1.41     $72.50       $20.57       $14.50
   31605  T                   Incision of windpipe...        311       1.41     $72.50       $20.57       $14.50
   31610  C                   Incision of windpipe...  .........  .........  .........  ...........  ...........
   31611  T                   Surgery/speech                 313      15.46    $794.95      $407.70      $158.99
                               prosthesis.
   31612  T                   Puncture/clear windpipe        312       7.07    $363.54      $170.86       $72.71
   31613  T                   Repair windpipe opening        313      15.46    $794.95      $407.70      $158.99
   31614  T                   Repair windpipe opening        313      15.46    $794.95      $407.70      $158.99
   31615  T                   Visualization of               336       7.24    $372.28      $195.49       $74.46
                               windpipe.
   31622  T                   Dx bronchoscope/wash...        336       7.24    $372.28      $195.49       $74.46
   31625  T                   Bronchoscopy with              336       7.24    $372.28      $195.49       $74.46
                               biopsy.
   31628  T                   Bronchoscopy with              336       7.24    $372.28      $195.49       $74.46
                               biopsy.
   31629  T                   Bronchoscopy with              336       7.24    $372.28      $195.49       $74.46
                               biopsy.
   31630  T                   Bronchoscopy with              336       7.24    $372.28      $195.49       $74.46
                               repair.
   31631  T                   Bronchoscopy with              336       7.24    $372.28      $195.49       $74.46
                               dilation.
   31635  T                   Remove foreign body,           336       7.24    $372.28      $195.49       $74.46
                               airway.
   31640  T                   Bronchoscopy & remove          336       7.24    $372.28      $195.49       $74.46
                               lesion.
   31641  T                   Bronchoscopy, treat            336       7.24    $372.28      $195.49       $74.46
                               blockage.
   31645  T                   Bronchoscopy, clear            336       7.24    $372.28      $195.49       $74.46
                               airways.
   31646  T                   Bronchoscopy,reclear           336       7.24    $372.28      $195.49       $74.46
                               airways.
   31656  T                   Bronchoscopy,inject for        336       7.24    $372.28      $195.49       $74.46
                               xray.
   31700  T                   Insertion of airway            332       9.67    $497.23      $242.72       $99.45
                               catheter.
   31708  T                   Instill airway contrast        347       2.57    $132.15       $62.38       $26.43
                               dye.
   31710  T                   Insertion of airway            347       2.57    $132.15       $62.38       $26.43
                               catheter.
   31715  T                   Injection for bronchus         347       2.57    $132.15       $62.38       $26.43
                               x-ray.
   31717  T                   Bronchial brush biopsy.        332       9.67    $497.23      $242.72       $99.45
   31720  T                   Clearance of airways...        332       9.67    $497.23      $242.72       $99.45
   31725  C                   Clearance of airways...  .........  .........  .........  ...........  ...........
   31730  T                   Intro windpipe wire/           332       9.67    $497.23      $242.72       $99.45
                               tube.
   31750  T                   Repair of windpipe.....        314      25.15  $1,293.21      $687.72      $258.64
   31755  T                   Repair of windpipe.....        314      25.15  $1,293.21      $687.72      $258.64
   31760  C                   Repair of windpipe.....  .........  .........  .........  ...........  ...........
   31766  C                   Reconstruction of        .........  .........  .........  ...........  ...........
                               windpipe.
   31770  C                   Repair/graft of          .........  .........  .........  ...........  ...........
                               bronchus.
   31775  C                   Reconstruct bronchus...  .........  .........  .........  ...........  ...........
   31780  C                   Reconstruct windpipe...  .........  .........  .........  ...........  ...........
   31781  C                   Reconstruct windpipe...  .........  .........  .........  ...........  ...........
   31785  C                   Remove windpipe lesion.  .........  .........  .........  ...........  ...........
   31786  C                   Remove windpipe lesion.  .........  .........  .........  ...........  ...........
   31800  C                   Repair of windpipe       .........  .........  .........  ...........  ...........
                               injury.
   31805  C                   Repair of windpipe       .........  .........  .........  ...........  ...........
                               injury.
   31820  T                   Closure of windpipe            313      15.46    $794.95      $407.70      $158.99
                               lesion.
   31825  T                   Repair of windpipe             313      15.46    $794.95      $407.70      $158.99
                               defect.
   31830  T                   Revise windpipe scar...        313      15.46    $794.95      $407.70      $158.99
   31899  T                   Airways surgical               336       7.24    $372.28      $195.49       $74.46
                               procedure.
   32000  T                   Drainage of chest......        320       3.09    $158.89       $80.91       $31.78
   32002  T                   Treatment of collapsed         320       3.09    $158.89       $80.91       $31.78
                               lung.
   32005  C                   Treat lung lining        .........  .........  .........  ...........  ...........
                               chemically.
   32020  T                   Insertion of chest tube        320       3.09    $158.89       $80.91       $31.78
   32035  C                   Exploration of chest...  .........  .........  .........  ...........  ...........
   32036  C                   Exploration of chest...  .........  .........  .........  ...........  ...........
   32095  C                   Biopsy through chest     .........  .........  .........  ...........  ...........
                               wall.
   32100  C                   Exploration/biopsy of    .........  .........  .........  ...........  ...........
                               chest.
   32110  C                   Explore/repair chest...  .........  .........  .........  ...........  ...........
   32120  C                   Re-exploration of chest  .........  .........  .........  ...........  ...........
   32124  C                   Explore chest,free       .........  .........  .........  ...........  ...........
                               adhesions.
   32140  C                   Removal of lung          .........  .........  .........  ...........  ...........
                               lesion(s).
   32141  C                   Remove/treat lung        .........  .........  .........  ...........  ...........
                               lesions.
   32150  C                   Removal of lung          .........  .........  .........  ...........  ...........
                               lesion(s).
   32151  C                   Remove lung foreign      .........  .........  .........  ...........  ...........
                               body.
   32160  C                   Open chest heart         .........  .........  .........  ...........  ...........
                               massage.
   32200  C                   Open drainage, lung      .........  .........  .........  ...........  ...........
                               lesion.
   32201  C                   Percut drainage, lung    .........  .........  .........  ...........  ...........
                               lesion.
   32215  C                   Treat chest lining.....  .........  .........  .........  ...........  ...........
   32220  C                   Release of lung........  .........  .........  .........  ...........  ...........
   32225  C                   Partial release of lung  .........  .........  .........  ...........  ...........
   32310  C                   Removal of chest lining  .........  .........  .........  ...........  ...........
   32320  C                   Free/remove chest        .........  .........  .........  ...........  ...........
                               lining.
   32400  T                   Needle biopsy chest            122       4.59    $236.02      $113.00       $47.20
                               lining.
   32402  C                   Open biopsy chest        .........  .........  .........  ...........  ...........
                               lining.
   32405  T                   Biopsy, lung or                122       4.59    $236.02      $113.00       $47.20
                               mediastinum.

[[Page 35303]]

 
   32420  T                   Puncture/clear lung....        320       3.09    $158.89       $80.91       $31.78
   32440  C                   Removal of lung........  .........  .........  .........  ...........  ...........
   32442  C                   Sleeve pneumonectomy...  .........  .........  .........  ...........  ...........
   32445  C                   Removal of lung........  .........  .........  .........  ...........  ...........
   32480  C                   Partial removal of lung  .........  .........  .........  ...........  ...........
   32482  C                   Bilobectomy............  .........  .........  .........  ...........  ...........
   32484  C                   Segmentectomy..........  .........  .........  .........  ...........  ...........
   32486  C                   Sleeve lobectomy.......  .........  .........  .........  ...........  ...........
   32488  C                   Completion               .........  .........  .........  ...........  ...........
                               pneumonectomy.
   32491  C                   Lung volume reduction..  .........  .........  .........  ...........  ...........
   32500  C                   Partial removal of lung  .........  .........  .........  ...........  ...........
   32501  C                   Repair bronchus (add-    .........  .........  .........  ...........  ...........
                               on).
   32520  C                   Remove lung & revise     .........  .........  .........  ...........  ...........
                               chest.
   32522  C                   Remove lung & revise     .........  .........  .........  ...........  ...........
                               chest.
   32525  C                   Remove lung & revise     .........  .........  .........  ...........  ...........
                               chest.
   32540  C                   Removal of lung lesion.  .........  .........  .........  ...........  ...........
   32601  C                   Thoracoscopy,            .........  .........  .........  ...........  ...........
                               diagnostic.
   32602  C                   Thoracoscopy,            .........  .........  .........  ...........  ...........
                               diagnostic.
   32603  C                   Thoracoscopy,            .........  .........  .........  ...........  ...........
                               diagnostic.
   32604  C                   Thoracoscopy,            .........  .........  .........  ...........  ...........
                               diagnostic.
   32605  C                   Thoracoscopy,            .........  .........  .........  ...........  ...........
                               diagnostic.
   32606  C                   Thoracoscopy,            .........  .........  .........  ...........  ...........
                               diagnostic.
   32650  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32651  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32652  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32653  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32654  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32655  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32656  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32657  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32658  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32659  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32660  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32661  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32662  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32663  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32664  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32665  C                   Thoracoscopy, surgical.  .........  .........  .........  ...........  ...........
   32800  C                   Repair lung hernia.....  .........  .........  .........  ...........  ...........
   32810  C                   Close chest after        .........  .........  .........  ...........  ...........
                               drainage.
   32815  C                   Close bronchial fistula  .........  .........  .........  ...........  ...........
   32820  C                   Reconstruct injured      .........  .........  .........  ...........  ...........
                               chest.
   32850  C                   Donor pneumonectomy....  .........  .........  .........  ...........  ...........
   32851  C                   Lung transplant, single  .........  .........  .........  ...........  ...........
   32852  C                   Lung transplant w/       .........  .........  .........  ...........  ...........
                               bypass.
   32853  C                   Lung transplant, double  .........  .........  .........  ...........  ...........
   32854  C                   Lung transplant w/       .........  .........  .........  ...........  ...........
                               bypass.
   32900  C                   Removal of rib(s)......  .........  .........  .........  ...........  ...........
   32905  C                   Revise & repair chest    .........  .........  .........  ...........  ...........
                               wall.
   32906  C                   Revise & repair chest    .........  .........  .........  ...........  ...........
                               wall.
   32940  C                   Revision of lung.......  .........  .........  .........  ...........  ...........
   32960  T                   Therapeutic                    320       3.09    $158.89       $80.91       $31.78
                               pneumothorax.
   32999  T                   Chest surgery procedure        320       3.09    $158.89       $80.91       $31.78
   33010  T                   Drainage of heart sac..        320       3.09    $158.89       $80.91       $31.78
   33011  T                   Repeat drainage of             320       3.09    $158.89       $80.91       $31.78
                               heart sac.
   33015  C                   Incision of heart sac..  .........  .........  .........  ...........  ...........
   33020  C                   Incision of heart sac..  .........  .........  .........  ...........  ...........
   33025  C                   Incision of heart sac..  .........  .........  .........  ...........  ...........
   33030  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               heart sac.
   33031  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               heart sac.
   33050  C                   Removal of heart sac     .........  .........  .........  ...........  ...........
                               lesion.
   33120  C                   Removal of heart lesion  .........  .........  .........  ...........  ...........
   33130  C                   Removal of heart lesion  .........  .........  .........  ...........  ...........
   33200  C                   Insertion of heart       .........  .........  .........  ...........  ...........
                               pacemaker.
   33201  C                   Insertion of heart       .........  .........  .........  ...........  ...........
                               pacemaker.
   33206  C                   Insertion of heart       .........  .........  .........  ...........  ...........
                               pacemaker.
   33207  C                   Insertion of heart       .........  .........  .........  ...........  ...........
                               pacemaker.
   33208  C                   Insertion of heart       .........  .........  .........  ...........  ...........
                               pacemaker.
   33210  C                   Insertion of heart       .........  .........  .........  ...........  ...........
                               electrode.
   33211  C                   Insertion of heart       .........  .........  .........  ...........  ...........
                               electrode.
   33212  C                   Insertion of pulse       .........  .........  .........  ...........  ...........
                               generator.
   33213  C                   Insertion of pulse       .........  .........  .........  ...........  ...........
                               generator.
   33214  C                   Upgrade of pacemaker     .........  .........  .........  ...........  ...........
                               system.
   33216  C                   Revision implanted       .........  .........  .........  ...........  ...........
                               electrode.
   33217  C                   Insert/revise electrode  .........  .........  .........  ...........  ...........

[[Page 35304]]

 
   33218  C                   Repair pacemaker         .........  .........  .........  ...........  ...........
                               electrodes.
   33220  C                   Repair pacemaker         .........  .........  .........  ...........  ...........
                               electrode.
   33222  T                   Pacemaker aicd pocket..        360       6.04    $310.58      $138.54       $62.12
   33223  T                   Pacemaker aicd pocket..        360       6.04    $310.58      $138.54       $62.12
   33233  C                   Removal of pacemaker     .........  .........  .........  ...........  ...........
                               system.
   33234  C                   Removal of pacemaker     .........  .........  .........  ...........  ...........
                               system.
   33235  C                   Removal pacemaker        .........  .........  .........  ...........  ...........
                               electrode.
   33236  C                   Remove electrode/        .........  .........  .........  ...........  ...........
                               thoracotomy.
   33237  C                   Remove electrode/        .........  .........  .........  ...........  ...........
                               thoracotomy.
   33238  C                   Remove electrode/        .........  .........  .........  ...........  ...........
                               thoracotomy.
   33240  C                   Insert/replace pulse     .........  .........  .........  ...........  ...........
                               gener.
   33241  C                   Remove pulse generator   .........  .........  .........  ...........  ...........
                               only.
   33242  C                   Repair pulse generator/  .........  .........  .........  ...........  ...........
                               leads.
   33243  C                   Remove generator/        .........  .........  .........  ...........  ...........
                               thoracotomy.
   33244  C                   Remove generator.......  .........  .........  .........  ...........  ...........
   33245  C                   Implant heart            .........  .........  .........  ...........  ...........
                               defibrillator.
   33246  C                   Implant heart            .........  .........  .........  ...........  ...........
                               defibrillator.
   33247  C                   Insert/replace leads...  .........  .........  .........  ...........  ...........
   33249  C                   Insert/replace leads/    .........  .........  .........  ...........  ...........
                               gener.
   33250  C                   Ablate heart dysrhythm   .........  .........  .........  ...........  ...........
                               focus.
   33251  C                   Ablate heart dysrhythm   .........  .........  .........  ...........  ...........
                               focus.
   33253  C                   Reconstruct atria......  .........  .........  .........  ...........  ...........
   33261  C                   Ablate heart dysrhythm   .........  .........  .........  ...........  ...........
                               focus.
   33300  C                   Repair of heart wound..  .........  .........  .........  ...........  ...........
   33305  C                   Repair of heart wound..  .........  .........  .........  ...........  ...........
   33310  C                   Exploratory heart        .........  .........  .........  ...........  ...........
                               surgery.
   33315  C                   Exploratory heart        .........  .........  .........  ...........  ...........
                               surgery.
   33320  C                   Repair major blood       .........  .........  .........  ...........  ...........
                               vessel(s).
   33321  C                   Repair major vessel....  .........  .........  .........  ...........  ...........
   33322  C                   Repair major blood       .........  .........  .........  ...........  ...........
                               vessel(s).
   33330  C                   Insert major vessel      .........  .........  .........  ...........  ...........
                               graft.
   33332  C                   Insert major vessel      .........  .........  .........  ...........  ...........
                               graft.
   33335  C                   Insert major vessel      .........  .........  .........  ...........  ...........
                               graft.
   33400  C                   Repair of aortic valve.  .........  .........  .........  ...........  ...........
   33401  C                   Valvuloplasty, open....  .........  .........  .........  ...........  ...........
   33403  C                   Valvuloplasty, w/cp      .........  .........  .........  ...........  ...........
                               bypass.
   33404  C                   Prepare heart-aorta      .........  .........  .........  ...........  ...........
                               conduit.
   33405  C                   Replacement of aortic    .........  .........  .........  ...........  ...........
                               valve.
   33406  C                   Replacement, aortic      .........  .........  .........  ...........  ...........
                               valve.
   33411  C                   Replacement of aortic    .........  .........  .........  ...........  ...........
                               valve.
   33412  C                   Replacement of aortic    .........  .........  .........  ...........  ...........
                               valve.
   33413  C                   Replacement, aortic      .........  .........  .........  ...........  ...........
                               valve.
   33414  C                   Repair, aortic valve...  .........  .........  .........  ...........  ...........
   33415  C                   Revision, subvalvular    .........  .........  .........  ...........  ...........
                               tissue.
   33416  C                   Revise ventricle muscle  .........  .........  .........  ...........  ...........
   33417  C                   Repair of aortic valve.  .........  .........  .........  ...........  ...........
   33420  C                   Revision of mitral       .........  .........  .........  ...........  ...........
                               valve.
   33422  C                   Revision of mitral       .........  .........  .........  ...........  ...........
                               valve.
   33425  C                   Repair of mitral valve.  .........  .........  .........  ...........  ...........
   33426  C                   Repair of mitral valve.  .........  .........  .........  ...........  ...........
   33427  C                   Repair of mitral valve.  .........  .........  .........  ...........  ...........
   33430  C                   Replacement of mitral    .........  .........  .........  ...........  ...........
                               valve.
   33460  C                   Revision of tricuspid    .........  .........  .........  ...........  ...........
                               valve.
   33463  C                   Valvuloplasty,           .........  .........  .........  ...........  ...........
                               tricuspid.
   33464  C                   Valvuloplasty,           .........  .........  .........  ...........  ...........
                               tricuspid.
   33465  C                   Replace tricuspid valve  .........  .........  .........  ...........  ...........
   33468  C                   Revision of tricuspid    .........  .........  .........  ...........  ...........
                               valve.
   33470  C                   Revision of pulmonary    .........  .........  .........  ...........  ...........
                               valve.
   33471  C                   Valvotomy, pulmonary     .........  .........  .........  ...........  ...........
                               valve.
   33472  C                   Revision of pulmonary    .........  .........  .........  ...........  ...........
                               valve.
   33474  C                   Revision of pulmonary    .........  .........  .........  ...........  ...........
                               valve.
   33475  C                   Replacement, pulmonary   .........  .........  .........  ...........  ...........
                               valve.
   33476  C                   Revision of heart        .........  .........  .........  ...........  ...........
                               chamber.
   33478  C                   Revision of heart        .........  .........  .........  ...........  ...........
                               chamber.
   33496  C                   Repair, prosth valve     .........  .........  .........  ...........  ...........
                               clot.
   33500  C                   Repair heart vessel      .........  .........  .........  ...........  ...........
                               fistula.
   33501  C                   Repair heart vessel      .........  .........  .........  ...........  ...........
                               fistula.
   33502  C                   Coronary artery          .........  .........  .........  ...........  ...........
                               correction.
   33503  C                   Coronary artery graft..  .........  .........  .........  ...........  ...........
   33504  C                   Coronary artery graft..  .........  .........  .........  ...........  ...........
   33505  C                   Repair artery w/tunnel.  .........  .........  .........  ...........  ...........
   33506  C                   Repair artery,           .........  .........  .........  ...........  ...........
                               translocation.
   33510  C                   CABG, vein, single.....  .........  .........  .........  ...........  ...........
   33511  C                   CABG, vein, two........  .........  .........  .........  ...........  ...........
   33512  C                   CABG, vein, three......  .........  .........  .........  ...........  ...........

[[Page 35305]]

 
   33513  C                   CABG, vein, four.......  .........  .........  .........  ...........  ...........
   33514  C                   CABG, vein, five.......  .........  .........  .........  ...........  ...........
   33516  C                   CABG, vein, six+.......  .........  .........  .........  ...........  ...........
   33517  C                   CABG, artery-vein,       .........  .........  .........  ...........  ...........
                               single.
   33518  C                   CABG, artery-vein, two.  .........  .........  .........  ...........  ...........
   33519  C                   CABG, artery-vein,       .........  .........  .........  ...........  ...........
                               three.
   33521  C                   CABG, artery-vein, four  .........  .........  .........  ...........  ...........
   33522  C                   CABG, artery-vein, five  .........  .........  .........  ...........  ...........
   33523  C                   CABG, artery-vein, six+  .........  .........  .........  ...........  ...........
   33530  C                   Coronary artery, bypass/ .........  .........  .........  ...........  ...........
                               reop.
   33533  C                   CABG, arterial, single.  .........  .........  .........  ...........  ...........
   33534  C                   CABG, arterial, two....  .........  .........  .........  ...........  ...........
   33535  C                   CABG, arterial, three..  .........  .........  .........  ...........  ...........
   33536  C                   CABG, arterial, four+..  .........  .........  .........  ...........  ...........
   33542  C                   Removal of heart lesion  .........  .........  .........  ...........  ...........
   33545  C                   Repair of heart damage.  .........  .........  .........  ...........  ...........
   33572  C                   Open coronary            .........  .........  .........  ...........  ...........
                               endarterectomy.
   33600  C                   Closure of valve.......  .........  .........  .........  ...........  ...........
   33602  C                   Closure of valve.......  .........  .........  .........  ...........  ...........
   33606  C                   Anastomosis/artery-      .........  .........  .........  ...........  ...........
                               aorta.
   33608  C                   Repair anomaly w/        .........  .........  .........  ...........  ...........
                               conduit.
   33610  C                   Repair by enlargement..  .........  .........  .........  ...........  ...........
   33611  C                   Repair double ventricle  .........  .........  .........  ...........  ...........
   33612  C                   Repair double ventricle  .........  .........  .........  ...........  ...........
   33615  C                   Repair (simple fontan).  .........  .........  .........  ...........  ...........
   33617  C                   Repair by modified       .........  .........  .........  ...........  ...........
                               fontan.
   33619  C                   Repair single ventricle  .........  .........  .........  ...........  ...........
   33641  C                   Repair heart septum      .........  .........  .........  ...........  ...........
                               defect.
   33645  C                   Revision of heart veins  .........  .........  .........  ...........  ...........
   33647  C                   Repair heart septum      .........  .........  .........  ...........  ...........
                               defects.
   33660  C                   Repair of heart defects  .........  .........  .........  ...........  ...........
   33665  C                   Repair of heart defects  .........  .........  .........  ...........  ...........
   33670  C                   Repair of heart          .........  .........  .........  ...........  ...........
                               chambers.
   33681  C                   Repair heart septum      .........  .........  .........  ...........  ...........
                               defect.
   33684  C                   Repair heart septum      .........  .........  .........  ...........  ...........
                               defect.
   33688  C                   Repair heart septum      .........  .........  .........  ...........  ...........
                               defect.
   33690  C                   Reinforce pulmonary      .........  .........  .........  ...........  ...........
                               artery.
   33692  C                   Repair of heart defects  .........  .........  .........  ...........  ...........
   33694  C                   Repair of heart defects  .........  .........  .........  ...........  ...........
   33697  C                   Repair of heart defects  .........  .........  .........  ...........  ...........
   33702  C                   Repair of heart defects  .........  .........  .........  ...........  ...........
   33710  C                   Repair of heart defects  .........  .........  .........  ...........  ...........
   33720  C                   Repair of heart defect.  .........  .........  .........  ...........  ...........
   33722  C                   Repair of heart defect.  .........  .........  .........  ...........  ...........
   33730  C                   Repair heart-vein        .........  .........  .........  ...........  ...........
                               defect(s).
   33732  C                   Repair heart-vein        .........  .........  .........  ...........  ...........
                               defect.
   33735  C                   Revision of heart        .........  .........  .........  ...........  ...........
                               chamber.
   33736  C                   Revision of heart        .........  .........  .........  ...........  ...........
                               chamber.
   33737  C                   Revision of heart        .........  .........  .........  ...........  ...........
                               chamber.
   33750  C                   Major vessel shunt.....  .........  .........  .........  ...........  ...........
   33755  C                   Major vessel shunt.....  .........  .........  .........  ...........  ...........
   33762  C                   Major vessel shunt.....  .........  .........  .........  ...........  ...........
   33764  C                   Major vessel shunt &     .........  .........  .........  ...........  ...........
                               graft.
   33766  C                   Major vessel shunt.....  .........  .........  .........  ...........  ...........
   33767  C                   Major vessel shunt.....  .........  .........  .........  ...........  ...........
   33770  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33771  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33774  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33775  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33776  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33777  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33778  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33779  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33780  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33781  C                   Repair great vessels     .........  .........  .........  ...........  ...........
                               defect.
   33786  C                   Repair arterial trunk..  .........  .........  .........  ...........  ...........
   33788  C                   Revision of pulmonary    .........  .........  .........  ...........  ...........
                               artery.
   33800  C                   Aortic suspension......  .........  .........  .........  ...........  ...........
   33802  C                   Repair vessel defect...  .........  .........  .........  ...........  ...........
   33803  C                   Repair vessel defect...  .........  .........  .........  ...........  ...........
   33813  C                   Repair septal defect...  .........  .........  .........  ...........  ...........
   33814  C                   Repair septal defect...  .........  .........  .........  ...........  ...........
   33820  C                   Revise major vessel....  .........  .........  .........  ...........  ...........
   33822  C                   Revise major vessel....  .........  .........  .........  ...........  ...........
   33824  C                   Revise major vessel....  .........  .........  .........  ...........  ...........

[[Page 35306]]

 
   33840  C                   Remove aorta             .........  .........  .........  ...........  ...........
                               constriction.
   33845  C                   Remove aorta             .........  .........  .........  ...........  ...........
                               constriction.
   33851  C                   Remove aorta             .........  .........  .........  ...........  ...........
                               constriction.
   33852  C                   Repair septal defect...  .........  .........  .........  ...........  ...........
   33853  C                   Repair septal defect...  .........  .........  .........  ...........  ...........
   33860  C                   Ascending aorta graft..  .........  .........  .........  ...........  ...........
   33861  C                   Ascending aorta graft..  .........  .........  .........  ...........  ...........
   33863  C                   Ascending aorta graft..  .........  .........  .........  ...........  ...........
   33870  C                   Transverse aortic arch   .........  .........  .........  ...........  ...........
                               graft.
   33875  C                   Thoracic aorta graft...  .........  .........  .........  ...........  ...........
   33877  C                   Thoracoabdominal graft.  .........  .........  .........  ...........  ...........
   33910  C                   Remove lung artery       .........  .........  .........  ...........  ...........
                               emboli.
   33915  C                   Remove lung artery       .........  .........  .........  ...........  ...........
                               emboli.
   33916  C                   Surgery of great vessel  .........  .........  .........  ...........  ...........
   33917  C                   Repair pulmonary artery  .........  .........  .........  ...........  ...........
   33918  C                   Repair pulmonary         .........  .........  .........  ...........  ...........
                               atresia.
   33919  C                   Repair pulmonary         .........  .........  .........  ...........  ...........
                               atresia.
   33920  C                   Repair pulmonary         .........  .........  .........  ...........  ...........
                               atresia.
   33922  C                   Transect pulmonary       .........  .........  .........  ...........  ...........
                               artery.
   33924  C                   Remove pulmonary shunt.  .........  .........  .........  ...........  ...........
   33930  C                   Removal of donor heart/  .........  .........  .........  ...........  ...........
                               lung.
   33935  C                   Transplantation, heart/  .........  .........  .........  ...........  ...........
                               lung.
   33940  C                   Removal of donor heart.  .........  .........  .........  ...........  ...........
   33945  C                   Transplantation of       .........  .........  .........  ...........  ...........
                               heart.
   33960  C                   External circulation     .........  .........  .........  ...........  ...........
                               assist.
   33961  C                   External circulation     .........  .........  .........  ...........  ...........
                               assist.
   33970  C                   Aortic circulation       .........  .........  .........  ...........  ...........
                               assist.
   33971  C                   Aortic circulation       .........  .........  .........  ...........  ...........
                               assist.
   33973  C                   Insert balloon device..  .........  .........  .........  ...........  ...........
   33974  C                   Remove intra-aortic      .........  .........  .........  ...........  ...........
                               balloon.
   33975  C                   Implant ventricular      .........  .........  .........  ...........  ...........
                               device.
   33976  C                   Implant ventricular      .........  .........  .........  ...........  ...........
                               device.
   33977  C                   Remove ventricular       .........  .........  .........  ...........  ...........
                               device.
   33978  C                   Remove ventricular       .........  .........  .........  ...........  ...........
                               device.
   33999  T                   Cardiac surgery                320       3.09    $158.89       $80.91       $31.78
                               procedure.
   34001  C                   Removal of artery clot.  .........  .........  .........  ...........  ...........
   34051  C                   Removal of artery clot.  .........  .........  .........  ...........  ...........
   34101  C                   Removal of artery clot.  .........  .........  .........  ...........  ...........
   34111  C                   Removal of arm artery    .........  .........  .........  ...........  ...........
                               clot.
   34151  C                   Removal of artery clot.  .........  .........  .........  ...........  ...........
   34201  C                   Removal of artery clot.  .........  .........  .........  ...........  ...........
   34203  C                   Removal of leg artery    .........  .........  .........  ...........  ...........
                               clot.
   34401  C                   Removal of vein clot...  .........  .........  .........  ...........  ...........
   34421  C                   Removal of vein clot...  .........  .........  .........  ...........  ...........
   34451  C                   Removal of vein clot...  .........  .........  .........  ...........  ...........
   34471  C                   Removal of vein clot...  .........  .........  .........  ...........  ...........
   34490  C                   Removal of vein clot...  .........  .........  .........  ...........  ...........
   34501  C                   Repair valve, femoral    .........  .........  .........  ...........  ...........
                               vein.
   34502  C                   Reconstruct, vena cava.  .........  .........  .........  ...........  ...........
   34510  C                   Transposition of vein    .........  .........  .........  ...........  ...........
                               valve.
   34520  C                   Cross-over vein graft..  .........  .........  .........  ...........  ...........
   34530  C                   Leg vein fusion........  .........  .........  .........  ...........  ...........
   35001  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35002  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               neck.
   35005  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35011  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35013  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               arm.
   35021  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35022  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               chest.
   35045  C                   Repair defect of arm     .........  .........  .........  ...........  ...........
                               artery.
   35081  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35082  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               aorta.
   35091  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35092  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               aorta.
   35102  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35103  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               groin.
   35111  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35112  C                   Repair artery            .........  .........  .........  ...........  ...........
                               rupture,spleen.
   35121  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35122  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               belly.
   35131  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35132  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               groin.
   35141  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35142  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               thigh.
   35151  C                   Repair defect of artery  .........  .........  .........  ...........  ...........

[[Page 35307]]

 
   35152  C                   Repair artery rupture,   .........  .........  .........  ...........  ...........
                               knee.
   35161  C                   Repair defect of artery  .........  .........  .........  ...........  ...........
   35162  C                   Repair artery rupture..  .........  .........  .........  ...........  ...........
   35180  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35182  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35184  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35188  T                   Repair blood vessel            368      22.59  $1,161.58      $647.49      $232.32
                               lesion.
   35189  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35190  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35201  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35206  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35207  T                   Repair blood vessel            368      22.59  $1,161.58      $647.49      $232.32
                               lesion.
   35211  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35216  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35221  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35226  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35231  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35236  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35241  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35246  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35251  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35256  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35261  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35266  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35271  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35276  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35281  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35286  C                   Repair blood vessel      .........  .........  .........  ...........  ...........
                               lesion.
   35301  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35311  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35321  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35331  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35341  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35351  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35355  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35361  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35363  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35371  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35372  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35381  C                   Rechanneling of artery.  .........  .........  .........  ...........  ...........
   35390  C                   Reoperation, carotid     .........  .........  .........  ...........  ...........
                               add-on.
   35400  C                   Angioscopy.............  .........  .........  .........  ...........  ...........
   35450  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35452  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35454  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35456  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35458  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35459  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35460  C                   Repair venous blockage.  .........  .........  .........  ...........  ...........
   35470  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35471  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35472  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35473  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35474  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35475  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   35476  C                   Repair venous blockage.  .........  .........  .........  ...........  ...........
   35480  C                   Atherectomy, open......  .........  .........  .........  ...........  ...........
   35481  C                   Atherectomy, open......  .........  .........  .........  ...........  ...........
   35482  C                   Atherectomy, open......  .........  .........  .........  ...........  ...........
   35483  C                   Atherectomy, open......  .........  .........  .........  ...........  ...........
   35484  C                   Atherectomy, open......  .........  .........  .........  ...........  ...........
   35485  C                   Atherectomy, open......  .........  .........  .........  ...........  ...........
   35490  C                   Atherectomy,             .........  .........  .........  ...........  ...........
                               percutaneous.
   35491  C                   Atherectomy,             .........  .........  .........  ...........  ...........
                               percutaneous.
   35492  C                   Atherectomy,             .........  .........  .........  ...........  ...........
                               percutaneous.
   35493  C                   Atherectomy,             .........  .........  .........  ...........  ...........
                               percutaneous.
   35494  C                   Atherectomy,             .........  .........  .........  ...........  ...........
                               percutaneous.
   35495  C                   Atherectomy,             .........  .........  .........  ...........  ...........
                               percutaneous.
   35501  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35506  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35507  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35508  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35509  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35511  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35515  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........

[[Page 35308]]

 
   35516  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35518  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35521  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35526  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35531  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35533  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35536  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35541  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35546  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35548  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35549  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35551  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35556  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35558  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35560  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35563  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35565  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35566  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35571  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35582  C                   Vein bypass graft......  .........  .........  .........  ...........  ...........
   35583  C                   Vein bypass graft......  .........  .........  .........  ...........  ...........
   35585  C                   Vein bypass graft......  .........  .........  .........  ...........  ...........
   35587  C                   Vein bypass graft......  .........  .........  .........  ...........  ...........
   35601  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35606  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35612  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35616  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35621  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35623  C                   Bypass graft, not vein.  .........  .........  .........  ...........  ...........
   35626  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35631  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35636  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35641  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35642  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35645  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35646  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35650  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35651  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35654  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35656  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35661  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35663  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35665  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35666  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35671  C                   Artery bypass graft....  .........  .........  .........  ...........  ...........
   35681  C                   Composite bypass graft.  .........  .........  .........  ...........  ...........
   35691  C                   Arterial transposition.  .........  .........  .........  ...........  ...........
   35693  C                   Arterial transposition.  .........  .........  .........  ...........  ...........
   35694  C                   Arterial transposition.  .........  .........  .........  ...........  ...........
   35695  C                   Arterial transposition.  .........  .........  .........  ...........  ...........
   35700  C                   Reoperation, bypass      .........  .........  .........  ...........  ...........
                               graft.
   35701  C                   Exploration, carotid     .........  .........  .........  ...........  ...........
                               artery.
   35721  C                   Exploration, femoral     .........  .........  .........  ...........  ...........
                               artery.
   35741  C                   Exploration popliteal    .........  .........  .........  ...........  ...........
                               artery.
   35761  C                   Exploration of artery/   .........  .........  .........  ...........  ...........
                               vein.
   35800  C                   Explore neck vessels...  .........  .........  .........  ...........  ...........
   35820  C                   Explore chest vessels..  .........  .........  .........  ...........  ...........
   35840  C                   Explore abdominal        .........  .........  .........  ...........  ...........
                               vessels.
   35860  C                   Explore limb vessels...  .........  .........  .........  ...........  ...........
   35870  C                   Repair vessel graft      .........  .........  .........  ...........  ...........
                               defect.
   35875  T                   Removal of clot in             368      22.59  $1,161.58      $647.49      $232.32
                               graft.
   35876  T                   Removal of clot in             368      22.59  $1,161.58      $647.49      $232.32
                               graft.
   35901  C                   Excision, graft, neck..  .........  .........  .........  ...........  ...........
   35903  C                   Excision, graft,         .........  .........  .........  ...........  ...........
                               extremity.
   35905  C                   Excision, graft, thorax  .........  .........  .........  ...........  ...........
   35907  C                   Excision, graft,         .........  .........  .........  ...........  ...........
                               abdomen.
   36000  N                   Place needle in vein...  .........  .........  .........  ...........  ...........
   36005  T                   Injection, venography..        347       2.57    $132.15       $62.38       $26.43
   36010  T                   Place catheter in vein.        342       2.61    $134.21       $68.70       $26.84
   36011  T                   Place catheter in vein.        342       2.61    $134.21       $68.70       $26.84
   36012  T                   Place catheter in vein.        342       2.61    $134.21       $68.70       $26.84
   36013  T                   Place catheter in              342       2.61    $134.21       $68.70       $26.84
                               artery.
   36014  T                   Place catheter in              342       2.61    $134.21       $68.70       $26.84
                               artery.
   36015  T                   Place catheter in              342       2.61    $134.21       $68.70       $26.84
                               artery.
   36100  T                   Establish access to            342       2.61    $134.21       $68.70       $26.84
                               artery.

[[Page 35309]]

 
   36120  T                   Establish access to            342       2.61    $134.21       $68.70       $26.84
                               artery.
   36140  T                   Establish access to            342       2.61    $134.21       $68.70       $26.84
                               artery.
   36145  N                   Artery to vein shunt...  .........  .........  .........  ...........  ...........
   36160  T                   Establish access to            342       2.61    $134.21       $68.70       $26.84
                               aorta.
   36200  T                   Place catheter in aorta        342       2.61    $134.21       $68.70       $26.84
   36215  T                   Place catheter in              343       8.76    $450.44      $240.24       $90.09
                               artery.
   36216  T                   Place catheter in              343       8.76    $450.44      $240.24       $90.09
                               artery.
   36217  T                   Place catheter in              343       8.76    $450.44      $240.24       $90.09
                               artery.
   36218  T                   Place catheter in              343       8.76    $450.44      $240.24       $90.09
                               artery.
   36245  T                   Place catheter in              343       8.76    $450.44      $240.24       $90.09
                               artery.
   36246  T                   Place catheter in              343       8.76    $450.44      $240.24       $90.09
                               artery.
   36247  T                   Place catheter in              343       8.76    $450.44      $240.24       $90.09
                               artery.
   36248  T                   Place catheter in              343       8.76    $450.44      $240.24       $90.09
                               artery.
   36260  T                   Insertion of infusion          368      22.59  $1,161.58      $647.49      $232.32
                               pump.
   36261  T                   Revision of infusion           360       6.04    $310.58      $138.54       $62.12
                               pump.
   36262  T                   Removal of infusion            360       6.04    $310.58      $138.54       $62.12
                               pump.
   36299  T                   Vessel injection               360       6.04    $310.58      $138.54       $62.12
                               procedure.
   36400  N                   Drawing blood..........  .........  .........  .........  ...........  ...........
   36405  N                   Drawing blood..........  .........  .........  .........  ...........  ...........
   36406  N                   Drawing blood..........  .........  .........  .........  ...........  ...........
   36410  T                   Drawing blood..........        341       0.09      $4.63        $2.49        $0.93
   36415  E                   Drawing blood..........  .........  .........  .........  ...........  ...........
   36420  T                   Establish access to            341       0.09      $4.63        $2.49        $0.93
                               vein.
   36425  T                   Establish access to            341       0.09      $4.63        $2.49        $0.93
                               vein.
   36430  T                   Blood transfusion              369       6.33    $325.49      $155.49       $65.10
                               service.
   36440  T                   Blood transfusion              369       6.33    $325.49      $155.49       $65.10
                               service.
   36450  T                   Exchange transfusion           369       6.33    $325.49      $155.49       $65.10
                               service.
   36455  T                   Exchange transfusion           369       6.33    $325.49      $155.49       $65.10
                               service.
   36460  T                   Transfusion service,           369       6.33    $325.49      $155.49       $65.10
                               fetal.
   36468  T                   Injection(s); spider           339       0.98     $50.39       $19.66       $10.08
                               veins.
   36469  T                   Injection(s); spider           339       0.98     $50.39       $19.66       $10.08
                               veins.
   36470  T                   Injection therapy of           339       0.98     $50.39       $19.66       $10.08
                               vein.
   36471  T                   Injection therapy of           339       0.98     $50.39       $19.66       $10.08
                               veins.
   36481  T                   Insertion of catheter,         343       8.76    $450.44      $240.24       $90.09
                               vein.
   36488  T                   Insertion of catheter,         346       4.63    $238.07      $121.59       $47.61
                               vein.
   36489  T                   Insertion of catheter,         346       4.63    $238.07      $121.59       $47.61
                               vein.
   36490  T                   Insertion of catheter,         346       4.63    $238.07      $121.59       $47.61
                               vein.
   36491  T                   Insertion of catheter,         346       4.63    $238.07      $121.59       $47.61
                               vein.
   36493  T                   Repositioning of cvc...        346       4.63    $238.07      $121.59       $47.61
   36500  T                   Insertion of catheter,         342       2.61    $134.21       $68.70       $26.84
                               vein.
   36510  C                   Insertion of catheter,   .........  .........  .........  ...........  ...........
                               vein.
   36520  T                   Plasma and/or cell             369       6.33    $325.49      $155.49       $65.10
                               exchange.
   36522  T                   Photopheresis..........        369       6.33    $325.49      $155.49       $65.10
   36530  T                   Insertion of infusion          368      22.59  $1,161.58      $647.49      $232.32
                               pump.
   36531  T                   Revision of infusion           360       6.04    $310.58      $138.54       $62.12
                               pump.
   36532  T                   Removal of infusion            360       6.04    $310.58      $138.54       $62.12
                               pump.
   36533  T                   Insertion of access            368      22.59  $1,161.58      $647.49      $232.32
                               port.
   36534  T                   Revision of access port        360       6.04    $310.58      $138.54       $62.12
   36535  T                   Removal of access port.        360       6.04    $310.58      $138.54       $62.12
   36600  N                   Withdrawal of arterial   .........  .........  .........  ...........  ...........
                               blood.
   36620  T                   Insertion catheter,            342       2.61    $134.21       $68.70       $26.84
                               artery.
   36625  T                   Insertion catheter,            342       2.61    $134.21       $68.70        $6.84
                               artery.
   36640  T                   Insertion catheter,            346       4.63    $238.07      $121.59       $47.61
                               artery.
   36660  C                   Insertion catheter,      .........  .........  .........  ...........  ...........
                               artery.
   36680  X                   Insert needle, bone            906       1.93     $99.24       $57.18       $19.85
                               cavity.
   36800  T                   Insertion of cannula...        368      22.59  $1,161.58      $647.49      $232.32
   36810  T                   Insertion of cannula...        368      22.59  $1,161.58      $647.49      $232.32
   36815  T                   Insertion of cannula...        368      22.59  $1,161.58      $647.49      $232.32
   36821  T                   Artery-vein fusion.....        368      22.59  $1,161.58      $647.49      $232.32
   36822  C                   Insertion of cannula(s)  .........  .........  .........  ...........  ...........
   36825  T                   Artery-vein graft......        368      22.59  $1,161.58      $647.49      $232.32
   36830  T                   Artery-vein graft......        368      22.59  $1,161.58      $647.49      $232.32
   36832  T                   Av fistula revision....        368      22.59  $1,161.58      $647.49      $232.32
   36834  C                   Repair A-V aneurysm....  .........  .........  .........  ...........  ...........
   36835  T                   Artery to vein shunt...        368      22.59  $1,161.58      $647.49      $232.32
   36860  T                   External cannula               368      22.59  $1,161.58      $647.49      $232.32
                               declotting.
   36861  T                   Cannula declotting.....        368      22.59  $1,161.58      $647.49      $232.32
   37140  C                   Revision of circulation  .........  .........  .........  ...........  ...........
   37145  C                   Revision of circulation  .........  .........  .........  ...........  ...........
   37160  C                   Revision of circulation  .........  .........  .........  ...........  ...........
   37180  C                   Revision of circulation  .........  .........  .........  ...........  ...........
   37181  C                   Splice spleen/kidney     .........  .........  .........  ...........  ...........
                               veins.
   37195  C                   Thrombolytic therapy,    .........  .........  .........  ...........  ...........
                               stroke.
   37200  C                   Transcatheter biopsy...  .........  .........  .........  ...........  ...........
   37201  C                   Transcatheter therapy    .........  .........  .........  ...........  ...........
                               infuse.

[[Page 35310]]

 
   37202  C                   Transcatheter therapy    .........  .........  .........  ...........  ...........
                               infuse.
   37203  T                   Transcatheter retrieval        360       6.04    $310.58      $138.54       $62.12
   37204  C                   Transcatheter occlusion  .........  .........  .........  ...........  ...........
   37205  C                   Transcatheter stent....  .........  .........  .........  ...........  ...........
   37206  C                   Transcatheter stent add- .........  .........  .........  ...........  ...........
                               on.
   37207  C                   Transcatheter stent....  .........  .........  .........  ...........  ...........
   37208  C                   Transcatheter stent add- .........  .........  .........  ...........  ...........
                               on.
   37209  C                   Exchange arterial        .........  .........  .........  ...........  ...........
                               catheter.
   37250  C                   Intravascular us.......  .........  .........  .........  ...........  ...........
   37251  C                   Intravascular us.......  .........  .........  .........  ...........  ...........
   37565  C                   Ligation of neck vein..  .........  .........  .........  ...........  ...........
   37600  C                   Ligation of neck artery  .........  .........  .........  ...........  ...........
   37605  C                   Ligation of neck artery  .........  .........  .........  ...........  ...........
   37606  C                   Ligation of neck artery  .........  .........  .........  ...........  ...........
   37607  T                   Ligation of fistula....        368      22.59  $1,161.58      $647.49      $232.32
   37609  T                   Temporal artery                162       5.59    $287.44      $125.66       $57.49
                               procedure.
   37615  C                   Ligation of neck artery  .........  .........  .........  ...........  ...........
   37616  C                   Ligation of chest        .........  .........  .........  ...........  ...........
                               artery.
   37617  C                   Ligation of abdomen      .........  .........  .........  ...........  ...........
                               artery.
   37618  T                   Ligation of extremity          367      17.02    $875.17      $441.15      $175.03
                               artery.
   37620  C                   Revision of major vein.  .........  .........  .........  ...........  ...........
   37650  T                   Revision of major vein.        367      17.02    $875.17      $441.15      $175.03
   37660  C                   Revision of major vein.  .........  .........  .........  ...........  ...........
   37700  T                   Revise leg vein........        367      17.02    $875.17      $441.15      $175.03
   37720  T                   Removal of leg vein....        367      17.02    $875.17      $441.15      $175.03
   37730  T                   Removal of leg veins...        367      17.02    $875.17      $441.15      $175.03
   37735  T                   Removal of leg veins/          367      17.02    $875.17      $441.15      $175.03
                               lesion.
   37760  T                   Revision of leg veins..        367      17.02    $875.17      $441.15      $175.03
   37780  T                   Revision of leg vein...        367      17.02    $875.17      $441.15      $175.03
   37785  T                   Revise secondary               367      17.02    $875.17      $441.15      $175.03
                               varicosity.
   37788  C                   Revascularization,       .........  .........  .........  ...........  ...........
                               penis.
   37790  T                   Penile venous occlusion        537      28.65  $1,473.18      $872.36      $294.64
   37799  T                   Vascular surgery               162       5.59    $287.44      $125.66       $57.49
                               procedure.
   38100  C                   Removal of spleen,       .........  .........  .........  ...........  ...........
                               total.
   38101  C                   Removal of spleen,       .........  .........  .........  ...........  ...........
                               partial.
   38102  C                   Removal of spleen,       .........  .........  .........  ...........  ...........
                               total.
   38115  C                   Repair of ruptured       .........  .........  .........  ...........  ...........
                               spleen.
   38200  T                   Injection for spleen x-        347       2.57    $132.15       $62.38       $26.43
                               ray.
   38230  T                   Bone marrow collection.        369       6.33    $325.49      $155.49       $65.10
   38231  T                   Stem cell collection...        369       6.33    $325.49      $155.49       $65.10
   38240  C                   Bone marrow/stem         .........  .........  .........  ...........  ...........
                               transplant.
   38241  C                   Bone marrow/stem         .........  .........  .........  ...........  ...........
                               transplant.
   38300  T                   Drainage lymph node            132       5.63    $289.49      $132.89       $57.90
                               lesion.
   38305  T                   Drainage lymph node            132       5.63    $289.49      $132.89       $57.90
                               lesion.
   38308  T                   Incision of lymph              396      12.98    $667.43      $334.48      $133.49
                               channels.
   38380  C                   Thoracic duct procedure  .........  .........  .........  ...........  ...........
   38381  C                   Thoracic duct procedure  .........  .........  .........  ...........  ...........
   38382  C                   Thoracic duct procedure  .........  .........  .........  ...........  ...........
   38500  T                   Biopsy/removal,lymph           396      12.98    $667.43      $334.48      $133.49
                               node(s).
   38505  T                   Needle biopsy, lymph           122       4.59    $236.02      $113.00       $47.20
                               node(s).
   38510  T                   Biopsy/removal,lymph           396      12.98    $667.43      $334.48      $133.49
                               node(s).
   38520  T                   Biopsy/removal,lymph           396      12.98    $667.43      $334.48      $133.49
                               node(s).
   38525  T                   Biopsy/removal,lymph           396      12.98    $667.43      $334.48      $133.49
                               node(s).
   38530  T                   Biopsy/removal,lymph           396      12.98    $667.43      $334.48      $133.49
                               node(s).
   38542  T                   Explore deep node(s),          397      19.12    $983.15      $542.17      $196.63
                               neck.
   38550  T                   Removal neck/armpit            396      12.98    $667.43      $334.48      $133.49
                               lesion.
   38555  T                   Removal neck/armpit            397      19.12    $983.15      $542.17      $196.63
                               lesion.
   38562  C                   Removal, pelvic lymph    .........  .........  .........  ...........  ...........
                               nodes.
   38564  C                   Removal, abdomen lymph   .........  .........  .........  ...........  ...........
                               nodes.
   38700  C                   Removal of lymph nodes,  .........  .........  .........  ...........  ...........
                               neck.
   38720  C                   Removal of lymph nodes,  .........  .........  .........  ...........  ...........
                               neck.
   38724  C                   Removal of lymph nodes,  .........  .........  .........  ...........  ...........
                               neck.
   38740  T                   Remove armpit lymph            397      19.12    $983.15      $542.17      $196.63
                               nodes.
   38745  T                   Remove armpits lymph           397      19.12    $983.15      $542.17      $196.63
                               nodes.
   38746  C                   Remove thoracic lymph    .........  .........  .........  ...........  ...........
                               nodes.
   38747  C                   Remove abdominal lymph   .........  .........  .........  ...........  ...........
                               nodes.
   38760  T                   Remove groin lymph             397      19.12    $983.15      $542.17      $196.63
                               nodes.
   38765  C                   Remove groin lymph       .........  .........  .........  ...........  ...........
                               nodes.
   38770  C                   Remove pelvis lymph      .........  .........  .........  ...........  ...........
                               nodes.
   38780  C                   Remove abdomen lymph     .........  .........  .........  ...........  ...........
                               nodes.
   38790  T                   Injection for lymphatic        347       2.57    $132.15       $62.38       $26.43
                               xray.
   38794  T                   Access thoracic lymph          342       2.61    $134.21       $68.70       $26.84
                               duct.
   38999  T                   Blood/lymph system             132       5.63    $289.49      $132.89       $57.90
                               procedure.
   39000  C                   Exploration of chest...  .........  .........  .........  ...........  ...........
   39010  C                   Exploration of chest...  .........  .........  .........  ...........  ...........

[[Page 35311]]

 
   39200  C                   Removal chest lesion...  .........  .........  .........  ...........  ...........
   39220  C                   Removal chest lesion...  .........  .........  .........  ...........  ...........
   39400  C                   Visualization of chest.  .........  .........  .........  ...........  ...........
   39499  C                   Chest procedure........  .........  .........  .........  ...........  ...........
   39501  C                   Repair diaphragm         .........  .........  .........  ...........  ...........
                               laceration.
   39502  C                   Repair paraesophageal    .........  .........  .........  ...........  ...........
                               hernia.
   39503  C                   Repair of diaphragm      .........  .........  .........  ...........  ...........
                               hernia.
   39520  C                   Repair of diaphragm      .........  .........  .........  ...........  ...........
                               hernia.
   39530  C                   Repair of diaphragm      .........  .........  .........  ...........  ...........
                               hernia.
   39531  C                   Repair of diaphragm      .........  .........  .........  ...........  ...........
                               hernia.
   39540  C                   Repair of diaphragm      .........  .........  .........  ...........  ...........
                               hernia.
   39541  C                   Repair of diaphragm      .........  .........  .........  ...........  ...........
                               hernia.
   39545  C                   Revision of diaphragm..  .........  .........  .........  ...........  ...........
   39599  C                   Diaphragm surgery        .........  .........  .........  ...........  ...........
                               procedure.
   40490  T                   Biopsy of lip..........        311       1.41     $72.50       $20.57       $14.50
   40500  T                   Partial excision of lip        313      15.46    $794.95      $407.70      $158.99
   40510  T                   Partial excision of lip        313      15.46    $794.95      $407.70      $158.99
   40520  T                   Partial excision of lip        313      15.46    $794.95      $407.70      $158.99
   40525  T                   Reconstruct lip with           313      15.46    $794.95      $407.70      $158.99
                               flap.
   40527  T                   Reconstruct lip with           313      15.46    $794.95      $407.70      $158.99
                               flap.
   40530  T                   Partial removal of lip.        313      15.46    $794.95      $407.70      $158.99
   40650  T                   Repair lip.............        313      15.46    $794.95      $407.70      $158.99
   40652  T                   Repair lip.............        313      15.46    $794.95      $407.70      $158.99
   40654  T                   Repair lip.............        313      15.46    $794.95      $407.70      $158.99
   40700  T                   Repair cleft lip/nasal.        314      25.15  $1,293.21      $687.72      $258.64
   40701  T                   Repair cleft lip/nasal.        314      25.15  $1,293.21      $687.72      $258.64
   40702  T                   Repair cleft lip/nasal.        314      25.15  $1,293.21      $687.72      $258.64
   40720  T                   Repair cleft lip/nasal.        314      25.15  $1,293.21      $687.72      $258.64
   40761  T                   Repair cleft lip/nasal.        314      25.15  $1,293.21      $687.72      $258.64
   40799  T                   Lip surgery procedure..        311       1.41     $72.50       $20.57       $14.50
   40800  T                   Drainage of mouth              311       1.41     $72.50       $20.57       $14.50
                               lesion.
   40801  T                   Drainage of mouth              311       1.41     $72.50       $20.57       $14.50
                               lesion.
   40804  T                   Removal foreign body,          311       1.41     $72.50       $20.57       $14.50
                               mouth.
   40805  T                   Removal foreign body,          311       1.41     $72.50       $20.57       $14.50
                               mouth.
   40806  T                   Incision of lip fold...        311       1.41     $72.50       $20.57       $14.50
   40808  T                   Biopsy of mouth lesion.        311       1.41     $72.50       $20.57       $14.50
   40810  T                   Excision of mouth              311       1.41     $72.50       $20.57       $14.50
                               lesion.
   40812  T                   Excise/repair mouth            311       1.41     $72.50       $20.57       $14.50
                               lesion.
   40814  T                   Excise/repair mouth            313      15.46    $794.95      $407.70      $158.99
                               lesion.
   40816  T                   Excision of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   40818  T                   Excise oral mucosa for         313      15.46    $794.95      $407.70      $158.99
                               graft.
   40819  T                   Excise lip or cheek            313      15.46    $794.95      $407.70      $158.99
                               fold.
   40820  T                   Treatment of mouth             311       1.41     $72.50       $20.57       $14.50
                               lesion.
   40830  T                   Repair mouth laceration        312       7.07    $363.54      $170.86       $72.71
   40831  T                   Repair mouth laceration        312       7.07    $363.54      $170.86       $72.71
   40840  T                   Reconstruction of mouth        313      15.46    $794.95      $407.70      $158.99
   40842  T                   Reconstruction of mouth        313      15.46    $794.95      $407.70      $158.99
   40843  T                   Reconstruction of mouth        314      25.15  $1,293.21      $687.72      $258.64
   40844  T                   Reconstruction of mouth        314      25.15  $1,293.21      $687.72      $258.64
   40845  T                   Reconstruction of mouth        314      25.15  $1,293.21      $687.72      $258.64
   40899  T                   Mouth surgery procedure        311       1.41     $72.50       $20.57       $14.50
   41000  T                   Drainage of mouth              311       1.41     $72.50       $20.57       $14.50
                               lesion.
   41005  T                   Drainage of mouth              311       1.41     $72.50       $20.57       $14.50
                               lesion.
   41006  T                   Drainage of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41007  T                   Drainage of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41008  T                   Drainage of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41009  T                   Drainage of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41010  T                   Incision of tongue fold        313      15.46    $794.95      $407.70      $158.99
   41015  T                   Drainage of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41016  T                   Drainage of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41017  T                   Drainage of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41018  T                   Drainage of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41100  T                   Biopsy of tongue.......        311       1.41     $72.50       $20.57       $14.50
   41105  T                   Biopsy of tongue.......        311       1.41     $72.50       $20.57       $14.50
   41108  T                   Biopsy of floor of             311       1.41     $72.50       $20.57       $14.50
                               mouth.
   41110  T                   Excision of tongue             311       1.41     $72.50       $20.57       $14.50
                               lesion.
   41112  T                   Excision of tongue             313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41113  T                   Excision of tongue             313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41114  T                   Excision of tongue             313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41115  T                   Excision of tongue fold        311       1.41     $72.50       $20.57       $14.50
   41116  T                   Excision of mouth              313      15.46    $794.95      $407.70      $158.99
                               lesion.
   41120  T                   Partial removal of             313      15.46    $794.95      $407.70      $158.99
                               tongue.
   41130  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               tongue.
   41135  C                   Tongue and neck surgery  .........  .........  .........  ...........  ...........
   41140  C                   Removal of tongue......  .........  .........  .........  ...........  ...........

[[Page 35312]]

 
   41145  C                   Tongue removal; neck     .........  .........  .........  ...........  ...........
                               surgery.
   41150  C                   Tongue, mouth, jaw       .........  .........  .........  ...........  ...........
                               surgery.
   41153  C                   Tongue, mouth, neck      .........  .........  .........  ...........  ...........
                               surgery.
   41155  C                   Tongue, jaw, & neck      .........  .........  .........  ...........  ...........
                               surgery.
   41250  T                   Repair tongue                  312       7.07    $363.54      $170.86       $72.71
                               laceration.
   41251  T                   Repair tongue                  312       7.07    $363.54      $170.86       $72.71
                               laceration.
   41252  T                   Repair tongue                  312       7.07    $363.54      $170.86       $72.71
                               laceration.
   41500  T                   Fixation of tongue.....        312       7.07    $363.54      $170.86       $72.71
   41510  T                   Tongue to lip surgery..        312       7.07    $363.54      $170.86       $72.71
   41520  T                   Reconstruction, tongue         313      15.46    $794.95      $407.70      $158.99
                               fold.
   41599  T                   Tongue and mouth               311       1.41     $72.50       $20.57       $14.50
                               surgery.
   41800  T                   Drainage of gum lesion.        312       7.07    $363.54      $170.86       $72.71
   41805  T                   Removal foreign body,          311       1.41     $72.50       $20.57       $14.50
                               gum.
   41806  T                   Removal foreign                311       1.41     $72.50       $20.57       $14.50
                               body,jawbone.
   41820  T                   Excision, gum, each            311       1.41     $72.50       $20.57       $14.50
                               quadrant.
   41821  T                   Excision of gum flap...        311       1.41     $72.50       $20.57       $14.50
   41822  T                   Excision of gum lesion.        231      11.31    $581.56      $286.79      $116.31
   41823  T                   Excision of gum lesion.        231      11.31    $581.56      $286.79      $116.31
   41825  T                   Excision of gum lesion.        311       1.41     $72.50       $20.57       $14.50
   41826  T                   Excision of gum lesion.        311       1.41     $72.50       $20.57       $14.50
   41827  T                   Excision of gum lesion.        313      15.46    $794.95      $407.70      $158.99
   41828  T                   Excision of gum lesion.        311       1.41     $72.50       $20.57       $14.50
   41830  T                   Removal of gum tissue..        311       1.41     $72.50       $20.57       $14.50
   41850  T                   Treatment of gum lesion        311       1.41     $72.50       $20.57       $14.50
   41870  T                   Gum graft..............        311       1.41     $72.50       $20.57       $14.50
   41872  T                   Repair gum.............        311       1.41     $72.50       $20.57       $14.50
   41874  T                   Repair tooth socket....        311       1.41     $72.50       $20.57       $14.50
   41899  T                   Dental surgery                 311       1.41     $72.50       $20.57       $14.50
                               procedure.
   42000  T                   Drainage mouth roof            311       1.41     $72.50       $20.57       $14.50
                               lesion.
   42100  T                   Biopsy roof of mouth...        311       1.41     $72.50       $20.57       $14.50
   42104  T                   Excision lesion, mouth         311       1.41     $72.50       $20.57       $14.50
                               roof.
   42106  T                   Excision lesion, mouth         311       1.41     $72.50       $20.57       $14.50
                               roof.
   42107  T                   Excision lesion, mouth         313      15.46    $794.95      $407.70      $158.99
                               roof.
   42120  T                   Remove palate/lesion...        313      15.46    $794.95      $407.70      $158.99
   42140  T                   Excision of uvula......        311       1.41     $72.50       $20.57       $14.50
   42145  C                   Repair, palate,pharynx/  .........  .........  .........  ...........  ...........
                               uvula.
   42160  T                   Treatment mouth roof           311       1.41     $72.50       $20.57       $14.50
                               lesion.
   42180  T                   Repair palate..........        313      15.46    $794.95      $407.70      $158.99
   42182  T                   Repair palate..........        313      15.46    $794.95      $407.70      $158.99
   42200  T                   Reconstruct cleft              313      15.46    $794.95      $407.70      $158.99
                               palate.
   42205  T                   Reconstruct cleft              313      15.46    $794.95      $407.70      $158.99
                               palate.
   42210  T                   Reconstruct cleft              314      25.15  $1,293.21      $687.72      $258.64
                               palate.
   42215  T                   Reconstruct cleft              313      15.46    $794.95      $407.70      $158.99
                               palate.
   42220  T                   Reconstruct cleft              313      15.46    $794.95      $407.70      $158.99
                               palate.
   42225  T                   Reconstruct cleft              314      25.15  $1,293.21      $687.72      $258.64
                               palate.
   42226  T                   Lengthening of palate..        314      25.15  $1,293.21      $687.72      $258.64
   42227  T                   Lengthening of palate..        314      25.15  $1,293.21      $687.72      $258.64
   42235  T                   Repair palate..........        313      15.46    $794.95      $407.70      $158.99
   42260  T                   Repair nose to lip             313      15.46    $794.95      $407.70      $158.99
                               fistula.
   42280  T                   Preparation, palate            311       1.41     $72.50       $20.57       $14.50
                               mold.
   42281  T                   Insertion, palate              311       1.41     $72.50       $20.57       $14.50
                               prosthesis.
   42299  T                   Palate/uvula surgery...        311       1.41     $72.50       $20.57       $14.50
   42300  T                   Drainage of salivary           312       7.07    $363.54      $170.86       $72.71
                               gland.
   42305  T                   Drainage of salivary           312       7.07    $363.54      $170.86       $72.71
                               gland.
   42310  T                   Drainage of salivary           312       7.07    $363.54      $170.86       $72.71
                               gland.
   42320  T                   Drainage of salivary           312       7.07    $363.54      $170.86       $72.71
                               gland.
   42325  T                   Create salivary cyst           313      15.46    $794.95      $407.70      $158.99
                               drain.
   42326  T                   Create salivary cyst           313      15.46    $794.95      $407.70      $158.99
                               drain.
   42330  T                   Removal of salivary            311       1.41     $72.50       $20.57       $14.50
                               stone.
   42335  T                   Removal of salivary            311       1.41     $72.50       $20.57       $14.50
                               stone.
   42340  T                   Removal of salivary            313      15.46    $794.95      $407.70      $158.99
                               stone.
   42400  T                   Biopsy of salivary             122       4.59    $236.02      $113.00       $47.20
                               gland.
   42405  T                   Biopsy of salivary             312       7.07    $363.54      $170.86       $72.71
                               gland.
   42408  T                   Excision of salivary           313      15.46    $794.95      $407.70      $158.99
                               cyst.
   42409  T                   Drainage of salivary           313      15.46    $794.95      $407.70      $158.99
                               cyst.
   42410  T                   Excise parotid gland/          313      15.46    $794.95      $407.70      $158.99
                               lesion.
   42415  T                   Excise parotid gland/          314      25.15  $1,293.21      $687.72      $258.64
                               lesion.
   42420  T                   Excise parotid gland/          314      25.15  $1,293.21      $687.72      $258.64
                               lesion.
   42425  T                   Excise parotid gland/          314      25.15  $1,293.21      $687.72      $258.64
                               lesion.
   42426  C                   Excise parotid gland/    .........  .........  .........  ...........  ...........
                               lesion.
   42440  T                   Excision submaxillary          313      15.46    $794.95      $407.70      $158.99
                               gland.
   42450  T                   Excision sublingual            313      15.46    $794.95      $407.70      $158.99
                               gland.
   42500  T                   Repair salivary duct...        313      15.46    $794.95      $407.70      $158.99
   42505  T                   Repair salivary duct...        313      15.46    $794.95      $407.70      $158.99
   42507  T                   Parotid duct diversion.        313      15.46    $794.95      $407.70      $158.99

[[Page 35313]]

 
   42508  T                   Parotid duct diversion.        313      15.46    $794.95      $407.70      $158.99
   42509  T                   Parotid duct diversion.        314      25.15  $1,293.21      $687.72      $258.64
   42510  T                   Parotid duct diversion.        313      15.46    $794.95      $407.70      $158.99
   42550  T                   Injection for salivary         347       2.57    $132.15       $62.38       $26.43
                               x-ray.
   42600  T                   Closure of salivary            313      15.46    $794.95      $407.70      $158.99
                               fistula.
   42650  T                   Dilation of salivary           311       1.41     $72.50       $20.57       $14.50
                               duct.
   42660  T                   Dilation of salivary           311       1.41     $72.50       $20.57       $14.50
                               duct.
   42665  T                   Ligation of salivary           311       1.41     $72.50       $20.57       $14.50
                               duct.
   42699  T                   Salivary surgery               311       1.41     $72.50       $20.57       $14.50
                               procedure.
   42700  T                   Drainage of tonsil             312       7.07    $363.54      $170.86       $72.71
                               abscess.
   42720  T                   Drainage of throat             312       7.07    $363.54      $170.86       $72.71
                               abscess.
   42725  T                   Drainage of throat             313      15.46    $794.95      $407.70      $158.99
                               abscess.
   42800  T                   Biopsy of throat.......        312       7.07    $363.54      $170.86       $72.71
   42802  T                   Biopsy of throat.......        312       7.07    $363.54      $170.86       $72.71
   42804  T                   Biopsy of upper nose/          312       7.07    $363.54      $170.86       $72.71
                               throat.
   42806  T                   Biopsy of upper nose/          312       7.07    $363.54      $170.86       $72.71
                               throat.
   42808  T                   Excise pharynx lesion..        312       7.07    $363.54      $170.86       $72.71
   42809  T                   Remove pharynx foreign         151       1.63     $83.81       $33.22       $16.76
                               body.
   42810  T                   Excision of neck cyst..        313      15.46    $794.95      $407.70      $158.99
   42815  T                   Excision of neck cyst..        313      15.46    $794.95      $407.70      $158.99
   42820  T                   Remove tonsils and             319      16.20    $833.00      $463.53      $166.60
                               adenoids.
   42821  T                   Remove tonsils and             319      16.20    $833.00      $463.53      $166.60
                               adenoids.
   42825  T                   Removal of tonsils.....        319      16.20    $833.00      $463.53      $166.60
   42826  T                   Removal of tonsils.....        319      16.20    $833.00      $463.53      $166.60
   42830  T                   Removal of adenoids....        319      16.20    $833.00      $463.53      $166.60
   42831  T                   Removal of adenoids....        319      16.20    $833.00      $463.53      $166.60
   42835  T                   Removal of adenoids....        319      16.20    $833.00      $463.53      $166.60
   42836  T                   Removal of adenoids....        319      16.20    $833.00      $463.53      $166.60
   42842  T                   Extensive surgery of           314      25.15  $1,293.21      $687.72      $258.64
                               throat.
   42844  T                   Extensive surgery of           314      25.15  $1,293.21      $687.72      $258.64
                               throat.
   42845  C                   Extensive surgery of     .........  .........  .........  ...........  ...........
                               throat.
   42860  T                   Excision of tonsil tags        319      16.20    $833.00      $463.53      $166.60
   42870  T                   Excision of lingual            319      16.20    $833.00      $463.53      $166.60
                               tonsil.
\2\ 4288  C                   Excise nose/throat       .........  .........  .........  ...........  ...........
        0                      lesion.
   42890  T                   Partial removal of             314      25.15  $1,293.21      $687.72      $258.64
                               pharynx.
   42892  T                   Revision of pharyngeal         314      25.15  $1,293.21      $687.72      $258.64
                               walls.
   42894  C                   Revision of pharyngeal   .........  .........  .........  ...........  ...........
                               walls.
   42900  T                   Repair throat wound....        313      15.46    $794.95      $407.70      $158.99
   42950  T                   Reconstruction of              313      15.46    $794.95      $407.70      $158.99
                               throat.
   42953  C                   Repair throat,           .........  .........  .........  ...........  ...........
                               esophagus.
   42955  T                   Surgical opening of            313      15.46    $794.95      $407.70      $158.99
                               throat.
   42960  T                   Control throat bleeding        318       2.07    $106.44       $38.87       $21.29
   42961  C                   Control throat bleeding  .........  .........  .........  ...........  ...........
   42962  T                   Control throat bleeding        313      15.46    $794.95      $407.70      $158.99
   42970  T                   Control nose/throat            318       2.07    $106.44       $38.87       $21.29
                               bleeding.
   42971  C                   Control nose/throat      .........  .........  .........  ...........  ...........
                               bleeding.
   42972  T                   Control nose/throat            313      15.46    $794.95      $407.70      $158.99
                               bleeding.
   42999  T                   Throat surgery                 318       2.07    $106.44       $38.87       $21.29
                               procedure.
   43020  T                   Incision of esophagus..        313      15.46    $794.95      $407.70      $158.99
   43030  T                   Throat muscle surgery..        313      15.46    $794.95      $407.70      $158.99
   43045  C                   Incision of esophagus..  .........  .........  .........  ...........  ...........
   43100  C                   Excision of esophagus    .........  .........  .........  ...........  ...........
                               lesion.
   43101  C                   Excision of esophagus    .........  .........  .........  ...........  ...........
                               lesion.
   43107  C                   Removal of esophagus...  .........  .........  .........  ...........  ...........
   43108  C                   Removal of esophagus...  .........  .........  .........  ...........  ...........
   43112  C                   Removal of esophagus...  .........  .........  .........  ...........  ...........
   43113  C                   Removal of esophagus...  .........  .........  .........  ...........  ...........
   43116  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               esophagus.
   43117  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               esophagus.
   43118  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               esophagus.
   43121  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               esophagus.
   43122  C                   Parital removal of       .........  .........  .........  ...........  ...........
                               esophagus.
   43123  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               esophagus.
   43124  C                   Removal of esophagus...  .........  .........  .........  ...........  ...........
   43130  C                   Removal of esophagus     .........  .........  .........  ...........  ...........
                               pouch.
   43135  C                   Removal of esophagus     .........  .........  .........  ...........  ...........
                               pouch.
   43200  T                   Esophagus endoscopy....        417       6.35    $326.52      $179.22       $65.30
   43202  T                   Esophagus endoscopy,           417       6.35    $326.52      $179.22       $65.30
                               biopsy.
   43204  T                   Esophagus endoscopy &          407       6.89    $354.28      $189.39       $70.86
                               inject.
   43205  T                   Esophagus endoscopy/           407       6.89    $354.28      $189.39       $70.86
                               ligation.
   43215  T                   Esophagus endoscopy....        407       6.89    $354.28      $189.39       $70.86
   43216  T                   Esophagus endoscopy/           407       6.89    $354.28      $189.39       $70.86
                               lesion.
   43217  T                   Esophagus endoscopy....        407       6.89    $354.28      $189.39       $70.86
   43219  T                   Esophagus endoscopy....        449       7.63    $392.33      $213.57       $78.47
   43220  T                   Esophagus                      407       6.89    $354.28      $189.39       $70.86
                               endoscopy,dilation.

[[Page 35314]]

 
   43226  T                   Esophagus                      407       6.89    $354.28      $189.39       $70.86
                               endoscopy,dilation.
   43227  T                   Esophagus endoscopy,           407       6.89    $354.28      $189.39       $70.86
                               repair.
   43228  T                   Esophagus                      449       7.63    $392.33      $213.57       $78.47
                               endoscopy,ablation.
   43234  T                   Upper GI endoscopy,            417       6.35    $326.52      $179.22       $65.30
                               exam.
   43235  T                   Upper gi                       417       6.35    $326.52      $179.22       $65.30
                               endoscopy,diagnosis.
   43239  T                   Upper GI endoscopy,            417       6.35    $326.52      $179.22       $65.30
                               biopsy.
   43241  T                   Upper GI endoscopy with        418       7.44    $382.56      $213.57       $76.51
                               tube.
   43243  T                   Upper GI endoscopy &           418       7.44    $382.56      $213.57       $76.51
                               inject..
   43244  T                   Upper GI endoscopy/            418       7.44    $382.56      $213.57       $76.51
                               ligation.
   43245  T                   Operative upper GI             418       7.44    $382.56      $213.57       $76.51
                               endoscopy.
   43246  T                   Place gastrostomy tube.        418       7.44    $382.56      $213.57       $76.51
   43247  T                   Operative upper GI             418       7.44    $382.56      $213.57       $76.51
                               endoscopy.
   43248  T                   Upper GI endoscopy/            418       7.44    $382.56      $213.57       $76.51
                               guidewire.
   43249  T                   Esophagus                      418       7.44    $382.56      $213.57       $76.51
                               endoscopy,dilation.
   43250  T                   Upper GI endoscopy/            418       7.44    $382.56      $213.57       $76.51
                               tumor.
   43251  T                   Operative upper GI             418       7.44    $382.56      $213.57       $76.51
                               endoscopy.
   43255  T                   Operative upper GI             418       7.44    $382.56      $213.57       $76.51
                               endoscopy.
   43258  T                   Operative upper GI             449       7.63    $392.33      $213.57       $78.47
                               endoscopy.
   43259  T                   Endoscopic ultrasound          449       7.63    $392.33      $213.57       $78.47
                               exam.
   43260  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43261  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43262  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43263  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43264  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43265  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43267  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43268  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43269  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43271  T                   Endoscopy,bile duct/           456       9.61    $494.15      $249.05       $98.83
                               pancreas.
   43272  T                   Endoscopy,bile duct/           449       7.63    $392.33      $213.57       $78.47
                               pancreas.
   43300  C                   Repair of esophagus....  .........  .........  .........  ...........  ...........
   43305  C                   Repair esophagus and     .........  .........  .........  ...........  ...........
                               fistula.
   43310  C                   Repair of esophagus....  .........  .........  .........  ...........  ...........
   43312  C                   Repair esophagus and     .........  .........  .........  ...........  ...........
                               fistula.
   43320  C                   Fuse esophagus &         .........  .........  .........  ...........  ...........
                               stomach.
   43324  C                   Revise esophagus &       .........  .........  .........  ...........  ...........
                               stomach.
   43325  C                   Revise esophagus &       .........  .........  .........  ...........  ...........
                               stomach.
   43326  C                   Revise esophagus &       .........  .........  .........  ...........  ...........
                               stomach.
   43330  C                   Repair of esophagus....  .........  .........  .........  ...........  ...........
   43331  C                   Repair of esophagus....  .........  .........  .........  ...........  ...........
   43340  C                   Fuse esophagus &         .........  .........  .........  ...........  ...........
                               intestine.
   43341  C                   Fuse esophagus &         .........  .........  .........  ...........  ...........
                               intestine.
   43350  C                   Surgical opening,        .........  .........  .........  ...........  ...........
                               esophagus.
   43351  C                   Surgical opening,        .........  .........  .........  ...........  ...........
                               esophagus.
   43352  C                   Surgical opening,        .........  .........  .........  ...........  ...........
                               esophagus.
   43360  C                   Gastrointestinal repair  .........  .........  .........  ...........  ...........
   43361  C                   Gastrointestinal repair  .........  .........  .........  ...........  ...........
   43400  C                   Ligate esophagus veins.  .........  .........  .........  ...........  ...........
   43401  C                   Esophagus surgery for    .........  .........  .........  ...........  ...........
                               veins.
   43405  C                   Ligate/staple esophagus  .........  .........  .........  ...........  ...........
   43410  C                   Repair esophagus wound.  .........  .........  .........  ...........  ...........
   43415  C                   Repair esophagus wound.  .........  .........  .........  ...........  ...........
   43420  C                   Repair esophagus         .........  .........  .........  ...........  ...........
                               opening.
   43425  C                   Repair esophagus         .........  .........  .........  ...........  ...........
                               opening.
   43450  T                   Dilate esophagus.......        406       4.17    $214.42      $106.67       $42.88
   43453  T                   Dilate esophagus.......        406       4.17    $214.42      $106.67       $42.88
   43456  T                   Dilate esophagus.......        406       4.17    $214.42      $106.67       $42.88
   43458  T                   Dilation of esophagus..        406       4.17    $214.42      $106.67       $42.88
   43460  C                   Pressure treatment       .........  .........  .........  ...........  ...........
                               esophagus.
   43496  C                   Free jejunum flap,       .........  .........  .........  ...........  ...........
                               microvasc.
   43499  T                   Esophagus surgery              406       4.17    $214.42      $106.67       $42.88
                               procedure.
   43500  C                   Surgical opening of      .........  .........  .........  ...........  ...........
                               stomach.
   43501  C                   Surgical repair of       .........  .........  .........  ...........  ...........
                               stomach.
   43502  C                   Surgical repair of       .........  .........  .........  ...........  ...........
                               stomach.
   43510  C                   Surgical opening of      .........  .........  .........  ...........  ...........
                               stomach.
   43520  C                   Incision of pyloric      .........  .........  .........  ...........  ...........
                               muscle.
   43600  T                   Biopsy of stomach......        417       6.35    $326.52      $179.22       $65.30
   43605  C                   Biopsy of stomach......  .........  .........  .........  ...........  ...........
   43610  C                   Excision of stomach      .........  .........  .........  ...........  ...........
                               lesion.
   43611  C                   Excision of stomach      .........  .........  .........  ...........  ...........
                               lesion.
   43620  C                   Removal of stomach.....  .........  .........  .........  ...........  ...........
   43621  C                   Removal of stomach.....  .........  .........  .........  ...........  ...........
   43622  C                   Removal of stomach.....  .........  .........  .........  ...........  ...........
   43631  C                   Removal of stomach,      .........  .........  .........  ...........  ...........
                               partial.
   43632  C                   Removal stomach,         .........  .........  .........  ...........  ...........
                               partial.

[[Page 35315]]

 
   43633  C                   Removal stomach,         .........  .........  .........  ...........  ...........
                               partial.
   43634  C                   Removal stomach,         .........  .........  .........  ...........  ...........
                               partial.
   43635  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               stomach.
   43638  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               stomach.
   43639  C                   Removal stomach,         .........  .........  .........  ...........  ...........
                               partial.
   43640  C                   Vagotomy & pylorus       .........  .........  .........  ...........  ...........
                               repair.
   43641  C                   Vagotomy & pylorus       .........  .........  .........  ...........  ...........
                               repair.
   43750  T                   Place gastrostomy tube.        418       7.44    $382.56      $213.57       $76.51
   43760  T                   Change gastrostomy tube        470       2.19    $112.61       $54.92       $22.52
   43761  T                   Reposition gastrostomy         470       2.19    $112.61       $54.92       $22.52
                               tube.
   43800  C                   Reconstruction of        .........  .........  .........  ...........  ...........
                               pylorus.
   43810  C                   Fusion of stomach and    .........  .........  .........  ...........  ...........
                               bowel.
   43820  C                   Fusion of stomach and    .........  .........  .........  ...........  ...........
                               bowel.
   43825  C                   Fusion of stomach and    .........  .........  .........  ...........  ...........
                               bowel.
   43830  C                   Place gastrostomy tube.  .........  .........  .........  ...........  ...........
   43831  C                   Place gastrostomy tube.  .........  .........  .........  ...........  ...........
   43832  C                   Place gastrostomy tube.  .........  .........  .........  ...........  ...........
   43840  C                   Repair of stomach        .........  .........  .........  ...........  ...........
                               lesion.
   43842  C                   Gastroplasty for         .........  .........  .........  ...........  ...........
                               obesity.
   43843  C                   Gastroplasty for         .........  .........  .........  ...........  ...........
                               obesity.
   43846  C                   Gastric bypass for       .........  .........  .........  ...........  ...........
                               obesity.
   43847  C                   Gastric bypass for       .........  .........  .........  ...........  ...........
                               obesity.
   43848  C                   Revision gastroplasty..  .........  .........  .........  ...........  ...........
   43850  C                   Revise stomach-bowel     .........  .........  .........  ...........  ...........
                               fusion.
   43855  C                   Revise stomach-bowel     .........  .........  .........  ...........  ...........
                               fusion.
   43860  C                   Revise stomach-bowel     .........  .........  .........  ...........  ...........
                               fusion.
   43865  C                   Revise stomach-bowel     .........  .........  .........  ...........  ...........
                               fusion.
   43870  T                   Repair stomach opening.        182       4.11    $211.34       $92.43       $42.27
   43880  C                   Repair stomach-bowel     .........  .........  .........  ...........  ...........
                               fistula.
   43999  T                   Stomach surgery                470       2.19    $112.61       $54.92       $22.52
                               procedure.
   44005  C                   Freeing of bowel         .........  .........  .........  ...........  ...........
                               adhesion.
   44010  C                   Incision of small bowel  .........  .........  .........  ...........  ...........
   44015  C                   Insert needle catheter,  .........  .........  .........  ...........  ...........
                               bowel.
   44020  C                   Exploration of small     .........  .........  .........  ...........  ...........
                               bowel.
   44021  C                   Decompress small bowel.  .........  .........  .........  ...........  ...........
   44025  C                   Incision of large bowel  .........  .........  .........  ...........  ...........
   44050  C                   Reduce bowel             .........  .........  .........  ...........  ...........
                               obstruction.
   44055  C                   Correct malrotation of   .........  .........  .........  ...........  ...........
                               bowel.
   44100  T                   Biopsy of bowel........        417       6.35    $326.52      $179.22       $65.30
   44110  C                   Excision of bowel        .........  .........  .........  ...........  ...........
                               lesion(s).
   44111  C                   Excision of bowel        .........  .........  .........  ...........  ...........
                               lesion(s).
   44120  C                   Removal of small         .........  .........  .........  ...........  ...........
                               intestine.
   44121  C                   Removal of small         .........  .........  .........  ...........  ...........
                               intestine.
   44125  C                   Removal of small         .........  .........  .........  ...........  ...........
                               intestine.
   44130  C                   Bowel to bowel fusion..  .........  .........  .........  ...........  ...........
   44139  C                   Mobilization of colon..  .........  .........  .........  ...........  ...........
   44140  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               colon.
   44141  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               colon.
   44143  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               colon.
   44144  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               colon.
   44145  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               colon.
   44146  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               colon.
   44147  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               colon.
   44150  C                   Removal of colon.......  .........  .........  .........  ...........  ...........
   44151  C                   Removal of colon/        .........  .........  .........  ...........  ...........
                               ileostomy.
   44152  C                   Removal of colon/        .........  .........  .........  ...........  ...........
                               ileostomy.
   44153  C                   Removal of colon/        .........  .........  .........  ...........  ...........
                               ileostomy.
   44155  C                   Removal of colon.......  .........  .........  .........  ...........  ...........
   44156  C                   Removal of colon/        .........  .........  .........  ...........  ...........
                               ileostomy.
   44160  C                   Removal of colon.......  .........  .........  .........  ...........  ...........
   44300  C                   Open bowel to skin.....  .........  .........  .........  ...........  ...........
   44310  C                   Ileostomy/jejunostomy..  .........  .........  .........  ...........  ...........
   44312  T                   Revision of ileostomy..        183      11.04    $567.68      $283.18      $113.54
   44314  C                   Revision of ileostomy..  .........  .........  .........  ...........  ...........
   44316  C                   Devise bowel pouch.....  .........  .........  .........  ...........  ...........
   44320  C                   Colostomy..............  .........  .........  .........  ...........  ...........
   44322  C                   Colostomy with biopsies  .........  .........  .........  ...........  ...........
   44340  T                   Revision of colostomy..        183      11.04    $567.68      $283.18      $113.54
   44345  C                   Revision of colostomy..  .........  .........  .........  ...........  ...........
   44346  C                   Revision of colostomy..  .........  .........  .........  ...........  ...........
   44360  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44361  T                   Small bowel                    419       6.83    $351.20      $164.08       $70.24
                               endoscopy,biopsy.
   44363  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44364  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44365  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24

[[Page 35316]]

 
   44366  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44369  T                   Small bowel endoscopy..        449       7.63    $392.33      $213.57       $78.47
   44372  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44373  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44376  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44377  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44378  T                   Small bowel endoscopy..        419       6.83    $351.20      $164.08       $70.24
   44380  T                   Small bowel endoscopy..        426       6.74    $346.57      $185.32       $69.31
   44382  T                   Small bowel endoscopy..        426       6.74    $346.57      $185.32       $69.31
   44385  T                   Endoscopy of bowel             426       6.74    $346.57      $185.32       $69.31
                               pouch.
   44386  T                   Endoscopy,bowel pouch,         426       6.74    $346.57      $185.32       $69.31
                               biopsy.
   44388  T                   Colon endoscopy........        426       6.74    $346.57      $185.32       $69.31
   44389  T                   Colonoscopy with biopsy        426       6.74    $346.57      $185.32       $69.31
   44390  T                   Colonoscopy for foreign        427       8.09    $415.99      $222.84       $83.20
                               body.
   44391  T                   Colonoscopy for                427       8.09    $415.99      $222.84       $83.20
                               bleeding.
   44392  T                   Colonoscopy &                  427       8.09    $415.99      $222.84       $83.20
                               polypectomy.
   44393  T                   Colonoscopy, lesion            449       7.63    $392.33      $213.57       $78.47
                               removal.
   44394  T                   Colonoscopy w/snare....        427       8.09    $415.99      $222.84       $83.20
   44500  C                   Intro, gastrointestinal  .........  .........  .........  ...........  ...........
                               tube.
   44602  C                   Suture, small intestine  .........  .........  .........  ...........  ...........
   44603  C                   Suture, small intestine  .........  .........  .........  ...........  ...........
   44604  C                   Suture, large intestine  .........  .........  .........  ...........  ...........
   44605  C                   Repair of bowel lesion.  .........  .........  .........  ...........  ...........
   44615  C                   Intestinal               .........  .........  .........  ...........  ...........
                               stricturoplasty.
   44620  C                   Repair bowel opening...  .........  .........  .........  ...........  ...........
   44625  C                   Repair bowel opening...  .........  .........  .........  ...........  ...........
   44626  C                   Repair bowel opening...  .........  .........  .........  ...........  ...........
   44640  C                   Repair bowel-skin        .........  .........  .........  ...........  ...........
                               fistula.
   44650  C                   Repair bowel fistula...  .........  .........  .........  ...........  ...........
   44660  C                   Repair bowel-bladder     .........  .........  .........  ...........  ...........
                               fistula.
   44661  C                   Repair bowel-bladder     .........  .........  .........  ...........  ...........
                               fistula.
   44680  C                   Surgical revision,       .........  .........  .........  ...........  ...........
                               intestine.
   44700  C                   Suspend bowel w/         .........  .........  .........  ...........  ...........
                               prosthesis.
   44799  T                   Intestine surgery              419       6.83    $351.20      $164.08       $70.24
                               procedure.
   44800  C                   Excision of bowel pouch  .........  .........  .........  ...........  ...........
   44820  C                   Excision of mesentery    .........  .........  .........  ...........  ...........
                               lesion.
   44850  C                   Repair of mesentery....  .........  .........  .........  ...........  ...........
   44899  C                   Bowel surgery procedure  .........  .........  .........  ...........  ...........
   44900  C                   Drain, app abscess,      .........  .........  .........  ...........  ...........
                               open.
   44901  C                   Drain, app abscess,      .........  .........  .........  ...........  ...........
                               perc.
   44950  C                   Appendectomy...........  .........  .........  .........  ...........  ...........
   44955  C                   Appendectomy add-on....  .........  .........  .........  ...........  ...........
   44960  C                   Appendectomy...........  .........  .........  .........  ...........  ...........
   45000  T                   Drainage of pelvic             452       4.52    $232.42      $103.06       $46.48
                               abscess.
   45005  T                   Drainage of rectal             452       4.52    $232.42      $103.06       $46.48
                               abscess.
   45020  T                   Drainage of rectal             452       4.52    $232.42      $103.06       $46.48
                               abscess.
   45100  T                   Biopsy of rectum.......        452       4.52    $232.42      $103.06       $46.48
   45108  T                   Removal of anorectal           453      16.26    $836.09      $440.47      $167.22
                               lesion.
   45110  C                   Removal of rectum......  .........  .........  .........  ...........  ...........
   45111  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               rectum.
   45112  C                   Removal of rectum......  .........  .........  .........  ...........  ...........
   45113  C                   Partial proctectomy....  .........  .........  .........  ...........  ...........
   45114  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               rectum.
   45116  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               rectum.
   45119  C                   Remove, rectum w/        .........  .........  .........  ...........  ...........
                               reservoir.
   45120  C                   Removal of rectum......  .........  .........  .........  ...........  ...........
   45121  C                   Removal of rectum and    .........  .........  .........  ...........  ...........
                               colon.
   45123  C                   Partial proctectomy....  .........  .........  .........  ...........  ...........
   45130  C                   Excision of rectal       .........  .........  .........  ...........  ...........
                               prolapse.
   45135  C                   Excision of rectal       .........  .........  .........  ...........  ...........
                               prolapse.
   45150  T                   Excision of rectal             453      16.26    $836.09      $440.47      $167.22
                               stricture.
   45160  T                   Excision of rectal             453      16.26    $836.09      $440.47      $167.22
                               lesion.
   45170  T                   Excision of rectal             453      16.26    $836.09      $440.47      $167.22
                               lesion.
   45190  T                   Destruction, rectal            453      16.26    $836.09      $440.47      $167.22
                               tumor.
   45300  T                   Proctosigmoidoscopy....        446       2.54    $130.61       $64.86       $26.12
   45303  T                   Proctosigmoidoscopy....        447       7.06    $363.03      $191.87       $72.61
   45305  T                   Proctosigmoidoscopy;           446       2.54    $130.61       $64.86       $26.12
                               biopsy.
   45307  T                   Proctosigmoidoscopy....        447       7.06    $363.03      $191.87       $72.61
   45308  T                   Proctosigmoidoscopy....        447       7.06    $363.03      $191.87       $72.61
   45309  T                   Proctosigmoidoscopy....        447       7.06    $363.03      $191.87       $72.61
   45315  T                   Proctosigmoidoscopy....        447       7.06    $363.03      $191.87       $72.61
   45317  T                   Proctosigmoidoscopy....        447       7.06    $363.03      $191.87       $72.61
   45320  T                   Proctosigmoidoscopy....        447       7.06    $363.03      $191.87       $72.61
   45321  T                   Proctosigmoidoscopy....        447       7.06    $363.03      $191.87       $72.61
   45330  T                   Sigmoidoscopy,                 446       2.54    $130.61       $64.86       $26.12
                               diagnostic.

[[Page 35317]]

 
   45331  T                   Sigmoidoscopy and              446       2.54    $130.61       $64.86       $26.12
                               biopsy.
   45332  T                   Sigmoidoscopy..........        448       5.28    $271.50      $139.22       $54.30
   45333  T                   Sigmoidoscopy &                448       5.28    $271.50      $139.22       $54.30
                               polypectomy.
   45334  T                   Sigmoidoscopy for              448       5.28    $271.50      $139.22       $54.30
                               bleeding.
   45337  T                   Sigmoidoscopy,                 458       5.28    $271.50      $139.22       $54.30
                               decompression.
   45338  T                   Sigmoidoscopy..........        448       5.28    $271.50      $139.22       $54.30
   45339  T                   Sigmoidoscopy..........        449       7.63    $392.33      $213.57       $78.47
   45355  T                   Surgical colonoscopy...        427       8.09    $415.99      $222.84       $83.20
   45378  T                   Diagnostic colonoscopy.        426       6.74    $346.57      $185.32       $69.31
   45379  T                   Colonoscopy............        427       8.09    $415.99      $222.84       $83.20
   45380  T                   Colonoscopy and biopsy.        426       6.74    $346.57      $185.32       $69.31
   45382  T                   Colonoscopy,control            427       8.09    $415.99      $222.84       $83.20
                               bleeding.
   45383  T                   Colonoscopy, lesion            449       7.63    $392.33      $213.57       $78.47
                               removal.
   45384  T                   Colonoscopy............        427       8.09    $415.99      $222.84       $83.20
   45385  T                   Colonoscopy, lesion            427       8.09    $415.99      $222.84       $83.20
                               removal.
   45500  T                   Repair of rectum.......        453      16.26    $836.09      $440.47      $167.22
   45505  T                   Repair of rectum.......        453      16.26    $836.09      $440.47      $167.22
   45520  T                   Treatment of rectal            339       0.98     $50.39       $19.66       $10.08
                               prolapse.
   45540  C                   Correct rectal prolapse  .........  .........  .........  ...........  ...........
   45541  C                   Correct rectal prolapse  .........  .........  .........  ...........  ...........
   45550  C                   Repair rectum;remove     .........  .........  .........  ...........  ...........
                               sigmoid.
   45560  T                   Repair of rectocele....        453      16.26    $836.09      $440.47      $167.22
   45562  C                   Exploration/repair of    .........  .........  .........  ...........  ...........
                               rectum.
   45563  C                   Exploration/repair of    .........  .........  .........  ...........  ...........
                               rectum.
   45800  C                   Repair rectumbladder     .........  .........  .........  ...........  ...........
                               fistula.
   45805  C                   Repair fistula;          .........  .........  .........  ...........  ...........
                               colostomy.
   45820  C                   Repair rectourethral     .........  .........  .........  ...........  ...........
                               fistula.
   45825  C                   Repair fistula;          .........  .........  .........  ...........  ...........
                               colostomy.
   45900  T                   Reduction of rectal            452       4.52    $232.42      $103.06       $46.48
                               prolapse.
   45905  T                   Dilation of anal               452       4.52    $232.42      $103.06       $46.48
                               sphincter.
   45910  T                   Dilation of rectal             452       4.52    $232.42      $103.06       $46.48
                               narrowing.
   45915  T                   Remove rectal                  452       4.52    $232.42      $103.06       $46.48
                               obstruction.
   45999  T                   Rectum surgery                 452       4.52    $232.42      $103.06       $46.48
                               procedure.
   46030  T                   Removal of rectal              452       4.52    $232.42      $103.06       $46.48
                               marker.
   46040  T                   Incision of rectal             452       4.52    $232.42      $103.06       $46.48
                               abscess.
   46045  T                   Incision of rectal             453      16.26    $836.09      $440.47      $167.22
                               abscess.
   46050  T                   Incision of anal               452       4.52    $232.42      $103.06       $46.48
                               abscess.
   46060  T                   Incision of rectal             453      16.26    $836.09      $440.47      $167.22
                               abscess.
   46070  T                   Incision of anal septum        451       2.42    $124.44       $53.56       $24.89
   46080  T                   Incision of anal               452       4.52    $232.42      $103.06       $46.48
                               sphincter.
   46083  T                   Incise external                451       2.42    $124.44       $53.56       $24.89
                               hemorrhoid.
   46200  T                   Removal of anal fissure        453      16.26    $836.09      $440.47      $167.22
   46210  T                   Removal of anal crypt..        452       4.52    $232.42      $103.06       $46.48
   46211  T                   Removal of anal crypts.        453      16.26    $836.09      $440.47      $167.22
   46220  T                   Removal of anal tab....        451       2.42    $124.44       $53.56       $24.89
   46221  T                   Ligation of                    451       2.42    $124.44       $53.56       $24.89
                               hemorrhoid(s).
   46230  T                   Removal of anal tabs...        451       2.42    $124.44       $53.56       $24.89
   46250  T                   Hemorrhoidectomy.......        453      16.26    $836.09      $440.47      $167.22
   46255  T                   Hemorrhoidectomy.......        453      16.26    $836.09      $440.47      $167.22
   46257  T                   Remove hemorrhoids &           453      16.26    $836.09      $440.47      $167.22
                               fissure.
   46258  T                   Remove hemorrhoids &           453      16.26    $836.09      $440.47      $167.22
                               fistula.
   46260  T                   Hemorrhoidectomy.......        453      16.26    $836.09      $440.47      $167.22
   46261  T                   Remove hemorrhoids &           453      16.26    $836.09      $440.47      $167.22
                               fissure.
   46262  T                   Remove hemorrhoids &           453      16.26    $836.09      $440.47      $167.22
                               fistula.
   46270  T                   Removal of anal fistula        453      16.26    $836.09      $440.47      $167.22
   46275  T                   Removal of anal fistula        453      16.26    $836.09      $440.47      $167.22
   46280  T                   Removal of anal fistula        453      16.26    $836.09      $440.47      $167.22
   46285  T                   Removal of anal fistula        453      16.26    $836.09      $440.47      $167.22
   46288  T                   Repair anal fistula....        453      16.26    $836.09      $440.47      $167.22
   46320  T                   Removal of hemorrhoid          451       2.42    $124.44       $53.56       $24.89
                               clot.
   46500  T                   Injection into                 451       2.42    $124.44       $53.56       $24.89
                               hemorrhoids.
   46600  N                   Diagnostic anoscopy....  .........  .........  .........  ...........  ...........
   46604  N                   Anoscopy and dilation..  .........  .........  .........  ...........  ...........
   46606  T                   Anoscopy and biopsy....        437       6.54    $336.29      $173.79       $67.26
   46608  T                   Anoscopy;remove foreign        437       6.54    $336.29      $173.79       $67.26
                               body.
   46610  T                   Anoscopy; remove lesion        437       6.54    $336.29      $173.79       $67.26
   46611  T                   Anoscopy...............        437       6.54    $336.29      $173.79       $67.26
   46612  T                   Anoscopy; remove               437       6.54    $336.29      $173.79       $67.26
                               lesions.
   46614  T                   Anoscopy; control              437       6.54    $336.29      $173.79       $67.26
                               bleeding.
   46615  T                   Anoscopy...............        437       6.54    $336.29      $173.79       $67.26
   46700  T                   Repair of anal                 453      16.26    $836.09      $440.47      $167.22
                               stricture.
   46705  C                   Repair of anal           .........  .........  .........  ...........  ...........
                               stricture.
   46715  C                   Repair of anovaginal     .........  .........  .........  ...........  ...........
                               fistula.
   46716  C                   Repair of anovaginal     .........  .........  .........  ...........  ...........
                               fistula.
   46730  C                   Construction of absent   .........  .........  .........  ...........  ...........
                               anus.

[[Page 35318]]

 
   46735  C                   Construction of absent   .........  .........  .........  ...........  ...........
                               anus.
   46740  C                   Construction of absent   .........  .........  .........  ...........  ...........
                               anus.
   46742  C                   Repair, imperforated     .........  .........  .........  ...........  ...........
                               anus.
   46744  C                   Repair, cloacal anomaly  .........  .........  .........  ...........  ...........
   46746  C                   Repair, cloacal anomaly  .........  .........  .........  ...........  ...........
   46748  C                   Repair, cloacal anomaly  .........  .........  .........  ...........  ...........
   46750  T                   Repair of anal                 453      16.26    $836.09      $440.47      $167.22
                               sphincter.
   46751  C                   Repair of anal           .........  .........  .........  ...........  ...........
                               sphincter.
   46753  T                   Reconstruction of anus.        453      16.26    $836.09      $440.47      $167.22
   46754  T                   Removal of suture from         452       4.52    $232.42      $103.06       $46.48
                               anus.
   46760  T                   Repair of anal                 453      16.26    $836.09      $440.47      $167.22
                               sphincter.
   46761  T                   Repair of anal                 453      16.26    $836.09      $440.47      $167.22
                               sphincter.
   46762  T                   Implant artificial             453      16.26    $836.09      $440.47      $167.22
                               sphincter.
   46900  T                   Destruction, anal              152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   46910  T                   Destruction, anal              152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   46916  T                   Cryosurgery, anal              152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   46917  T                   Laser surgery,anal             152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   46922  T                   Excision of anal               152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   46924  T                   Destruction, anal              152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   46934  T                   Destruction of                 451       2.42    $124.44       $53.56       $24.89
                               hemorrhoids.
   46935  T                   Destruction of                 451       2.42    $124.44       $53.56       $24.89
                               hemorrhoids.
   46936  T                   Destruction of                 451       2.42    $124.44       $53.56       $24.89
                               hemorrhoids.
   46937  T                   Cryotherapy of rectal          453      16.26    $836.09      $440.47      $167.22
                               lesion.
   46938  T                   Cryotherapy of rectal          453      16.26    $836.09      $440.47      $167.22
                               lesion.
   46940  T                   Treatment of anal              451       2.42    $124.44       $53.56       $24.89
                               fissure.
   46942  T                   Treatment of anal              451       2.42    $124.44       $53.56       $24.89
                               fissure.
   46945  T                   Ligation of hemorrhoids        451       2.42    $124.44       $53.56       $24.89
   46946  T                   Ligation of hemorrhoids        451       2.42    $124.44       $53.56       $24.89
   46999  T                   Anus surgery procedure.        452       4.52    $232.42      $103.06       $46.48
   47000  T                   Needle biopsy of liver.        122       4.59    $236.02      $113.00       $47.20
   47001  C                   Needle biopsy, liver     .........  .........  .........  ...........  ...........
                               add-on.
   47010  C                   Open drainage, liver     .........  .........  .........  ...........  ...........
                               lesion.
   47011  C                   Percut drain, liver      .........  .........  .........  ...........  ...........
                               lesion.
   47015  C                   Inject/aspirate liver    .........  .........  .........  ...........  ...........
                               cyst.
   47100  C                   Wedge biopsy of liver..  .........  .........  .........  ...........  ...........
   47120  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               liver.
   47122  C                   Extensive removal of     .........  .........  .........  ...........  ...........
                               liver.
   47125  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               liver.
   47130  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               liver.
   47133  C                   Removal of donor liver.  .........  .........  .........  ...........  ...........
   47134  C                   Partial removal, donor   .........  .........  .........  ...........  ...........
                               liver.
   47135  C                   Transplantation of       .........  .........  .........  ...........  ...........
                               liver.
   47136  C                   Transplantation of       .........  .........  .........  ...........  ...........
                               liver.
   47300  C                   Surgery for liver        .........  .........  .........  ...........  ...........
                               lesion.
   47350  C                   Repair liver wound.....  .........  .........  .........  ...........  ...........
   47360  C                   Repair liver wound.....  .........  .........  .........  ...........  ...........
   47361  C                   Repair liver wound.....  .........  .........  .........  ...........  ...........
   47362  C                   Repair liver wound.....  .........  .........  .........  ...........  ...........
   47399  T                   Liver surgery procedure        122       4.59    $236.02      $113.00       $47.20
   47400  C                   Incision of liver duct.  .........  .........  .........  ...........  ...........
   47420  C                   Incision of bile duct..  .........  .........  .........  ...........  ...........
   47425  C                   Incision of bile duct..  .........  .........  .........  ...........  ...........
   47460  C                   Incise bile duct         .........  .........  .........  ...........  ...........
                               sphincter.
   47480  C                   Incision of gallbladder  .........  .........  .........  ...........  ...........
   47490  C                   Incision of gallbladder  .........  .........  .........  ...........  ...........
   47500  T                   Injection for liver x-         347       2.57    $132.15       $62.38       $26.43
                               rays.
   47505  T                   Injection for liver x-         347       2.57    $132.15       $62.38       $26.43
                               rays.
   47510  T                   Insert catheter, bile          458       6.81    $350.17      $181.70       $70.03
                               duct.
   47511  T                   Insert bile duct drain.        458       6.81    $350.17      $181.70       $70.03
   47525  T                   Change bile duct               470       2.19    $112.61       $54.92       $22.52
                               catheter.
   47530  T                   Revise, reinsert bile          470       2.19    $112.61       $54.92       $22.52
                               tube.
   47550  C                   Bile duct endoscopy add- .........  .........  .........  ...........  ...........
                               on.
   47552  T                   Biliary endoscopy, thru        458       6.81    $350.17      $181.70       $70.03
                               skin.
   47553  T                   Biliary endoscopy, thru        458       6.81    $350.17      $181.70       $70.03
                               skin.
   47554  T                   Biliary endoscopy, thru        458       6.81    $350.17      $181.70       $70.03
                               skin.
   47555  T                   Biliary endoscopy, thru        458       6.81    $350.17      $181.70       $70.03
                               skin.
   47556  T                   Biliary endoscopy, thru        458       6.81    $350.17      $181.70       $70.03
                               skin.
   47600  C                   Removal of gallbladder.  .........  .........  .........  ...........  ...........
   47605  C                   Removal of gallbladder.  .........  .........  .........  ...........  ...........
   47610  C                   Removal of gallbladder.  .........  .........  .........  ...........  ...........
   47612  C                   Removal of gallbladder.  .........  .........  .........  ...........  ...........
   47620  C                   Removal of gallbladder.  .........  .........  .........  ...........  ...........
   47630  T                   Remove bile duct stone.        458       6.81    $350.17      $181.70       $70.03
   47700  C                   Exploration of bile      .........  .........  .........  ...........  ...........
                               ducts.
   47701  C                   Bile duct revision.....  .........  .........  .........  ...........  ...........

[[Page 35319]]

 
   47711  C                   Excision of bile duct    .........  .........  .........  ...........  ...........
                               tumor.
   47712  C                   Excision of bile duct    .........  .........  .........  ...........  ...........
                               tumor.
   47715  C                   Excision of bile duct    .........  .........  .........  ...........  ...........
                               cyst.
   47716  C                   Fusion of bile duct      .........  .........  .........  ...........  ...........
                               cyst.
   47720  C                   Fuse gallbladder &       .........  .........  .........  ...........  ...........
                               bowel.
   47721  C                   Fuse upper gi            .........  .........  .........  ...........  ...........
                               structures.
   47740  C                   Fuse gallbladder &       .........  .........  .........  ...........  ...........
                               bowel.
   47741  C                   Fuse gallbladder &       .........  .........  .........  ...........  ...........
                               bowel.
   47760  C                   Fuse bile ducts and      .........  .........  .........  ...........  ...........
                               bowel.
   47765  C                   Fuse liver ducts &       .........  .........  .........  ...........  ...........
                               bowel.
   47780  C                   Fuse bile ducts and      .........  .........  .........  ...........  ...........
                               bowel.
   47785  C                   Fuse bile ducts and      .........  .........  .........  ...........  ...........
                               bowel.
   47800  C                   Reconstruction of bile   .........  .........  .........  ...........  ...........
                               ducts.
   47801  C                   Placement, bile duct     .........  .........  .........  ...........  ...........
                               support.
   47802  C                   Fuse liver duct &        .........  .........  .........  ...........  ...........
                               intestine.
   47900  C                   Suture bile duct injury  .........  .........  .........  ...........  ...........
   47999  T                   Bile tract surgery             470       2.19    $112.61       $54.92       $22.52
                               procedure.
   48000  C                   Drainage of abdomen....  .........  .........  .........  ...........  ...........
   48001  C                   Placement of drain,      .........  .........  .........  ...........  ...........
                               pancreas.
   48005  C                   Resect/debride pancreas  .........  .........  .........  ...........  ...........
   48020  C                   Removal of pancreatic    .........  .........  .........  ...........  ...........
                               stone.
   48100  C                   Biopsy of pancreas.....  .........  .........  .........  ...........  ...........
   48102  T                   Needle biopsy, pancreas        122       4.59    $236.02      $113.00       $47.20
   48120  C                   Removal of pancreas      .........  .........  .........  ...........  ...........
                               lesion.
   48140  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               pancreas.
   48145  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               pancreas.
   48146  C                   Pancreatectomy.........  .........  .........  .........  ...........  ...........
   48148  C                   Removal of pancreatic    .........  .........  .........  ...........  ...........
                               duct.
   48150  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               pancreas.
   48152  C                   Pancreatectomy.........  .........  .........  .........  ...........  ...........
   48153  C                   Pancreatectomy.........  .........  .........  .........  ...........  ...........
   48154  C                   Pancreatectomy.........  .........  .........  .........  ...........  ...........
   48155  C                   Removal of pancreas....  .........  .........  .........  ...........  ...........
   48160  E                   Pancreas removal,        .........  .........  .........  ...........  ...........
                               transplant.
   48180  C                   Fuse pancreas and bowel  .........  .........  .........  ...........  ...........
   48400  C                   Injection, intraop add-  .........  .........  .........  ...........  ...........
                               on.
   48500  C                   Surgery of pancreas      .........  .........  .........  ...........  ...........
                               cyst.
   48510  C                   Drain pancreatic         .........  .........  .........  ...........  ...........
                               pseudocyst.
   48511  C                   Drain pancreatic         .........  .........  .........  ...........  ...........
                               pseudocyst.
   48520  C                   Fuse pancreas cyst and   .........  .........  .........  ...........  ...........
                               bowel.
   48540  C                   Fuse pancreas cyst and   .........  .........  .........  ...........  ...........
                               bowel.
   48545  C                   Pancreatorrhaphy.......  .........  .........  .........  ...........  ...........
   48547  C                   Duodenal exclusion.....  .........  .........  .........  ...........  ...........
   48550  E                   Donor pancreatectomy...  .........  .........  .........  ...........  ...........
   48554  E                   Transplantallograft      .........  .........  .........  ...........  ...........
                               pancreas.
   48556  C                   Removal, allograft       .........  .........  .........  ...........  ...........
                               pancreas.
   48999  T                   Pancreas surgery               122       4.59    $236.02      $113.00       $47.20
                               procedure.
   49000  C                   Exploration of abdomen.  .........  .........  .........  ...........  ...........
   49002  C                   Reopening of abdomen...  .........  .........  .........  ...........  ...........
   49010  C                   Exploration behind       .........  .........  .........  ...........  ...........
                               abdomen.
   49020  C                   Drain abdominal abscess  .........  .........  .........  ...........  ...........
   49021  C                   Drain abdominal abscess  .........  .........  .........  ...........  ...........
   49040  C                   Open drainage abdom      .........  .........  .........  ...........  ...........
                               abscess.
   49041  C                   Percut drain abdom       .........  .........  .........  ...........  ...........
                               abscess.
   49060  C                   Open drain retroper      .........  .........  .........  ...........  ...........
                               abscess.
   49061  C                   Percutdrain retroper     .........  .........  .........  ...........  ...........
                               abscess.
   49062  C                   Drain to peritoneal      .........  .........  .........  ...........  ...........
                               cavity.
   49080  T                   Puncture, peritoneal           320       3.09    $158.89       $80.91       $31.78
                               cavity.
   49081  T                   Removal of abdominal           320       3.09    $158.89       $80.91       $31.78
                               fluid.
   49085  T                   Remove abdomen foreign         459      17.85    $917.85      $497.88      $183.57
                               body.
   49180  T                   Biopsy, abdominal mass.        122       4.59    $236.02      $113.00       $47.20
   49200  C                   Removal of abdominal     .........  .........  .........  ...........  ...........
                               lesion.
   49201  C                   Removal of abdominal     .........  .........  .........  ...........  ...........
                               lesion.
   49215  C                   Excise sacral spine      .........  .........  .........  ...........  ...........
                               tumor.
   49220  C                   Multiple surgery,        .........  .........  .........  ...........  ...........
                               abdomen.
   49250  T                   Excision of umbilicus..        459      17.85    $917.85      $497.88      $183.57
   49255  C                   Removal of omentum.....  .........  .........  .........  ...........  ...........
   49400  T                   Air injection into             347       2.57    $132.15       $62.38       $26.43
                               abdomen.
   49420  T                   Insert abdominal drain.        459      17.85    $917.85      $497.88      $183.57
   49421  T                   Insert abdominal drain.        459      17.85    $917.85      $497.88      $183.57
   49422  T                   Remove perm cannula/           470       2.19    $112.61       $54.92       $22.52
                               catheter.
   49423  T                   Exchange drainage cath.        459      17.85    $917.85      $497.88      $183.57
   49424  T                   Assess cyst, contrast          347       2.57    $132.15       $62.38       $26.43
                               inj.
   49425  C                   Insert abdomen-venous    .........  .........  .........  ...........  ...........
                               drain.
   49426  T                   Revise abdomen-venous          459      17.85    $917.85      $497.88      $183.57
                               shunt.

[[Page 35320]]

 
   49427  T                   Injection, abdominal           347       2.57    $132.15       $62.38       $26.43
                               shunt.
   49428  C                   Ligation of shunt......  .........  .........  .........  ...........  ...........
   49429  T                   Removal of shunt.......        470       2.19    $112.61       $54.92       $22.52
   49495  T                   Repair inguinal hernia,        466      20.67  $1,062.85      $556.64      $212.57
                               init.
   49496  T                   Repair inguinal hernia,        466      20.67  $1,062.85      $556.64      $212.57
                               init.
   49500  T                   Repair inguinal hernia.        466      20.67  $1,062.85      $556.64      $212.57
   49501  T                   Repair inguinal hernia,        466      20.67  $1,062.85      $556.64      $212.57
                               init.
   49505  T                   Repair inguinal hernia.        466      20.67  $1,062.85      $556.64      $212.57
   49507  T                   Repair, inguinal hernia        466      20.67  $1,062.85      $556.64      $212.57
   49520  T                   Rerepair inguinal              466      20.67  $1,062.85      $556.64      $212.57
                               hernia.
   49521  T                   Repair inguinal hernia,        466      20.67  $1,062.85      $556.64      $212.57
                               rec.
   49525  T                   Repair inguinal hernia.        466      20.67  $1,062.85      $556.64      $212.57
   49540  T                   Repair lumbar hernia...        466      20.67  $1,062.85      $556.64      $212.57
   49550  T                   Repair femoral hernia..        466      20.67  $1,062.85      $556.64      $212.57
   49553  T                   Repair femoral hernia,         466      20.67  $1,062.85      $556.64      $212.57
                               init.
   49555  T                   Repair femoral hernia..        466      20.67  $1,062.85      $556.64      $212.57
   49557  T                   Repair femoral hernia,         466      20.67  $1,062.85      $556.64      $212.57
                               recur.
   49560  T                   Repair abdominal hernia        466      20.67  $1,062.85      $556.64      $212.57
   49561  T                   Repair incisional              466      20.67  $1,062.85      $556.64      $212.57
                               hernia.
   49565  T                   Rerepair abdominal             466      20.67  $1,062.85      $556.64      $212.57
                               hernia.
   49566  T                   Repair incisional              466      20.67  $1,062.85      $556.64      $212.57
                               hernia.
   49568  T                   Hernia repair w/mesh...        466      20.67  $1,062.85      $556.64      $212.57
   49570  T                   Repair epigastric              466      20.67  $1,062.85      $556.64      $212.57
                               hernia.
   49572  T                   Repair, epigastric             466      20.67  $1,062.85      $556.64      $212.57
                               hernia.
   49580  T                   Repair umbilical hernia        466      20.67  $1,062.85      $556.64      $212.57
   49582  T                   Repair umbilical hernia        466      20.67  $1,062.85      $556.64      $212.57
   49585  T                   Repair umbilical hernia        466      20.67  $1,062.85      $556.64      $212.57
   49587  T                   Repair umbilical hernia        466      20.67  $1,062.85      $556.64      $212.57
   49590  T                   Repair abdominal hernia        466      20.67  $1,062.85      $556.64      $212.57
   49600  T                   Repair umbilical lesion        466      20.67  $1,062.85      $556.64      $212.57
   49605  C                   Repair umbilical lesion  .........  .........  .........  ...........  ...........
   49606  C                   Repair umbilical lesion  .........  .........  .........  ...........  ...........
   49610  C                   Repair umbilical lesion  .........  .........  .........  ...........  ...........
   49611  C                   Repair umbilical lesion  .........  .........  .........  ...........  ...........
   49900  C                   Repair of abdominal      .........  .........  .........  ...........  ...........
                               wall.
   49905  C                   Omental flap...........  .........  .........  .........  ...........  ...........
   49906  C                   Free omental flap,       .........  .........  .........  ...........  ...........
                               microvasc.
   49999  T                   Abdomen surgery                470       2.19    $112.61       $54.92       $22.52
                               procedure.
   50010  C                   Exploration of kidney..  .........  .........  .........  ...........  ...........
   50020  C                   Open drain renal         .........  .........  .........  ...........  ...........
                               abscess.
   50021  C                   Percut drain renal       .........  .........  .........  ...........  ...........
                               abscess.
   50040  C                   Drainage of kidney.....  .........  .........  .........  ...........  ...........
   50045  C                   Exploration of kidney..  .........  .........  .........  ...........  ...........
   50060  C                   Removal of kidney stone  .........  .........  .........  ...........  ...........
   50065  C                   Incision of kidney.....  .........  .........  .........  ...........  ...........
   50070  C                   Incision of kidney.....  .........  .........  .........  ...........  ...........
   50075  C                   Removal of kidney stone  .........  .........  .........  ...........  ...........
   50080  C                   Removal of kidney stone  .........  .........  .........  ...........  ...........
   50081  C                   Removal of kidney stone  .........  .........  .........  ...........  ...........
   50100  C                   Revise kidney blood      .........  .........  .........  ...........  ...........
                               vessels.
   50120  C                   Exploration of kidney..  .........  .........  .........  ...........  ...........
   50125  C                   Explore and drain        .........  .........  .........  ...........  ...........
                               kidney.
   50130  C                   Removal of kidney stone  .........  .........  .........  ...........  ...........
   50135  C                   Exploration of kidney..  .........  .........  .........  ...........  ...........
   50200  T                   Biopsy of kidney.......        122       4.59    $236.02      $113.00       $47.20
   50205  C                   Biopsy of kidney.......  .........  .........  .........  ...........  ...........
   50220  C                   Removal of kidney......  .........  .........  .........  ...........  ...........
   50225  C                   Removal of kidney......  .........  .........  .........  ...........  ...........
   50230  C                   Removal of kidney......  .........  .........  .........  ...........  ...........
   50234  C                   Removal of kidney &      .........  .........  .........  ...........  ...........
                               ureter.
   50236  C                   Removal of kidney &      .........  .........  .........  ...........  ...........
                               ureter.
   50240  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               kidney.
   50280  C                   Removal of kidney        .........  .........  .........  ...........  ...........
                               lesion.
   50290  C                   Removal of kidney        .........  .........  .........  ...........  ...........
                               lesion.
   50300  C                   Removal of donor kidney  .........  .........  .........  ...........  ...........
   50320  C                   Removal of donor kidney  .........  .........  .........  ...........  ...........
   50340  C                   Removal of kidney......  .........  .........  .........  ...........  ...........
   50360  C                   Transplantation of       .........  .........  .........  ...........  ...........
                               kidney.
   50365  C                   Transplantation of       .........  .........  .........  ...........  ...........
                               kidney.
   50370  C                   Remove transplanted      .........  .........  .........  ...........  ...........
                               kidney.
   50380  C                   Reimplantation of        .........  .........  .........  ...........  ...........
                               kidney.
   50390  T                   Drainage of kidney             122       4.59    $236.02      $113.00       $47.20
                               lesion.
   50392  T                   Insert kidney drain....        347       2.57    $132.15       $62.38       $26.43
   50393  T                   Insert ureteral tube...        347       2.57    $132.15       $62.38       $26.43
   50394  T                   Injection for kidney x-        347       2.57    $132.15       $62.38       $26.43
                               ray.

[[Page 35321]]

 
   50395  T                   Create passage to              347       2.57    $132.15       $62.38       $26.43
                               kidney.
   50396  T                   Measure kidney pressure        529       2.33    $119.81       $59.66       $23.96
   50398  T                   Change kidney tube.....        521       4.89    $251.44      $110.06       $50.29
   50400  C                   Revision of kidney/      .........  .........  .........  ...........  ...........
                               ureter.
   50405  C                   Revision of kidney/      .........  .........  .........  ...........  ...........
                               ureter.
   50500  C                   Repair of kidney wound.  .........  .........  .........  ...........  ...........
   50520  C                   Close kidney-skin        .........  .........  .........  ...........  ...........
                               fistula.
   50525  C                   Repair renal-abdomen     .........  .........  .........  ...........  ...........
                               fistula.
   50526  C                   Repair renal-abdomen     .........  .........  .........  ...........  ...........
                               fistula.
   50540  C                   Revision of horseshoe    .........  .........  .........  ...........  ...........
                               kidney.
   50551  T                   Kidney endoscopy.......        522      10.15    $521.91      $259.45      $104.38
   50553  T                   Kidney endoscopy.......        522      10.15    $521.91      $259.45      $104.38
   50555  T                   Kidney endoscopy &             522      10.15    $521.91      $259.45      $104.38
                               biopsy.
   50557  T                   Kidney endoscopy &             522      10.15    $521.91      $259.45      $104.38
                               treatment.
   50559  T                   Renal endoscopy;               522      10.15    $521.91      $259.45      $104.38
                               radiotracer.
   50561  T                   Kidney endoscopy &             522      10.15    $521.91      $259.45      $104.38
                               treatment.
   50570  C                   Kidney endoscopy.......  .........  .........  .........  ...........  ...........
   50572  C                   Kidney endoscopy.......  .........  .........  .........  ...........  ...........
   50574  C                   Kidney endoscopy &       .........  .........  .........  ...........  ...........
                               biopsy.
   50575  C                   Kidney endoscopy.......  .........  .........  .........  ...........  ...........
   50576  C                   Kidney endoscopy &       .........  .........  .........  ...........  ...........
                               treatment.
   50578  C                   Renal endoscopy;         .........  .........  .........  ...........  ...........
                               radiotracer.
   50580  C                   Kidney endoscopy &       .........  .........  .........  ...........  ...........
                               treatment.
   50590  T                   Fragmenting of kidney          527      43.48  $2,235.74    $1,372.95      $447.15
                               stone.
   50600  C                   Exploration of ureter..  .........  .........  .........  ...........  ...........
   50605  C                   Insert ureteral support  .........  .........  .........  ...........  ...........
   50610  C                   Removal of ureter stone  .........  .........  .........  ...........  ...........
   50620  C                   Removal of ureter stone  .........  .........  .........  ...........  ...........
   50630  C                   Removal of ureter stone  .........  .........  .........  ...........  ...........
   50650  C                   Removal of ureter......  .........  .........  .........  ...........  ...........
   50660  C                   Removal of ureter......  .........  .........  .........  ...........  ...........
   50684  T                   Injection for ureter x-        347       2.57    $132.15       $62.38       $26.43
                               ray.
   50686  T                   Measure ureter pressure        529       2.33    $119.81       $59.66       $23.96
   50688  T                   Change of ureter tube..        470       2.19    $112.61       $54.92       $22.52
   50690  T                   Injection for ureter x-        347       2.57    $132.15       $62.38       $26.43
                               ray.
   50700  C                   Revision of ureter.....  .........  .........  .........  ...........  ...........
   50715  C                   Release of ureter......  .........  .........  .........  ...........  ...........
   50722  C                   Release of ureter......  .........  .........  .........  ...........  ...........
   50725  C                   Release/revise ureter..  .........  .........  .........  ...........  ...........
   50727  C                   Revise ureter..........  .........  .........  .........  ...........  ...........
   50728  C                   Revise ureter..........  .........  .........  .........  ...........  ...........
   50740  C                   Fusion of ureter &       .........  .........  .........  ...........  ...........
                               kidney.
   50750  C                   Fusion of ureter &       .........  .........  .........  ...........  ...........
                               kidney.
   50760  C                   Fusion of ureters......  .........  .........  .........  ...........  ...........
   50770  C                   Splicing of ureters....  .........  .........  .........  ...........  ...........
   50780  C                   Reimplant ureter in      .........  .........  .........  ...........  ...........
                               bladder.
   50782  C                   Reimplant ureter in      .........  .........  .........  ...........  ...........
                               bladder.
   50783  C                   Reimplant ureter in      .........  .........  .........  ...........  ...........
                               bladder.
   50785  C                   Reimplant ureter in      .........  .........  .........  ...........  ...........
                               bladder.
   50800  C                   Implant ureter in bowel  .........  .........  .........  ...........  ...........
   50810  C                   Fusion of ureter &       .........  .........  .........  ...........  ...........
                               bowel.
   50815  C                   Urine shunt to bowel...  .........  .........  .........  ...........  ...........
   50820  C                   Construct bowel bladder  .........  .........  .........  ...........  ...........
   50825  C                   Construct bowel bladder  .........  .........  .........  ...........  ...........
   50830  C                   Revise urine flow......  .........  .........  .........  ...........  ...........
   50840  C                   Replace ureter by bowel  .........  .........  .........  ...........  ...........
   50845  C                   Appendico-vesicostomy..  .........  .........  .........  ...........  ...........
   50860  C                   Transplant ureter to     .........  .........  .........  ...........  ...........
                               skin.
   50900  C                   Repair of ureter.......  .........  .........  .........  ...........  ...........
   50920  C                   Closure ureter/skin      .........  .........  .........  ...........  ...........
                               fistula.
   50930  C                   Closure ureter/bowel     .........  .........  .........  ...........  ...........
                               fistula.
   50940  C                   Release of ureter......  .........  .........  .........  ...........  ...........
   50951  T                   Endoscopy of ureter....        523      16.35    $840.72      $438.89      $168.14
   50953  T                   Endoscopy of ureter....        523      16.35    $840.72      $438.89      $168.14
   50955  T                   Ureter endoscopy &             523      16.35    $840.72      $438.89      $168.14
                               biopsy.
   50957  T                   Ureter endoscopy &             523      16.35    $840.72      $438.89      $168.14
                               treatment.
   50959  T                   Ureter endoscopy &             523      16.35    $840.72      $438.89      $168.14
                               tracer.
   50961  T                   Ureter endoscopy &             523      16.35    $840.72      $438.89      $168.14
                               treatment.
   50970  C                   Ureter endoscopy.......  .........  .........  .........  ...........  ...........
   50972  C                   Ureter endoscopy &       .........  .........  .........  ...........  ...........
                               catheter.
   50974  C                   Ureter endoscopy &       .........  .........  .........  ...........  ...........
                               biopsy.
   50976  C                   Ureter endoscopy &       .........  .........  .........  ...........  ...........
                               treatment.
   50978  C                   Ureter endoscopy &       .........  .........  .........  ...........  ...........
                               tracer.
   50980  C                   Ureter endoscopy &       .........  .........  .........  ...........  ...........
                               treatment.
   51000  T                   Drainage of bladder....        530       2.46    $126.49       $53.34       $25.30

[[Page 35322]]

 
   51005  T                   Drainage of bladder....        530       2.46    $126.49       $53.34       $25.30
   51010  T                   Drainage of bladder....        530       2.46    $126.49       $53.34       $25.30
   51020  T                   Incise & treat bladder.        523      16.35    $840.72      $438.89      $168.14
   51030  T                   Incise & treat bladder.        523      16.35    $840.72      $438.89      $168.14
   51040  T                   Incise & drain bladder.        523      16.35    $840.72      $438.89      $168.14
   51045  T                   Incise bladder, drain          523      16.35    $840.72      $438.89      $168.14
                               ureter.
   51050  T                   Removal of bladder             523      16.35    $840.72      $438.89      $168.14
                               stone.
   51060  C                   Removal of ureter stone  .........  .........  .........  ...........  ...........
   51065  T                   Removal of ureter stone        523      16.35    $840.72      $438.89      $168.14
   51080  T                   Drainage of bladder            132       5.63    $289.49      $132.89       $57.90
                               abscess.
   51500  T                   Removal of bladder cyst        466      20.67  $1,062.85      $556.64      $212.57
   51520  T                   Removal of bladder             523      16.35    $840.72      $438.89      $168.14
                               lesion.
   51525  C                   Removal of bladder       .........  .........  .........  ...........  ...........
                               lesion.
   51530  C                   Removal of bladder       .........  .........  .........  ...........  ...........
                               lesion.
   51535  C                   Repair of ureter lesion  .........  .........  .........  ...........  ...........
   51550  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               bladder.
   51555  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               bladder.
   51565  C                   Revise bladder &         .........  .........  .........  ...........  ...........
                               ureter(s).
   51570  C                   Removal of bladder.....  .........  .........  .........  ...........  ...........
   51575  C                   Removal of bladder &     .........  .........  .........  ...........  ...........
                               nodes.
   51580  C                   Remove bladder; revise   .........  .........  .........  ...........  ...........
                               tract.
   51585  C                   Removal of bladder &     .........  .........  .........  ...........  ...........
                               nodes.
   51590  C                   Remove bladder; revise   .........  .........  .........  ...........  ...........
                               tract.
   51595  C                   Remove bladder; revise   .........  .........  .........  ...........  ...........
                               tract.
   51596  C                   Remove bladder, create   .........  .........  .........  ...........  ...........
                               pouch.
   51597  C                   Removal of pelvic        .........  .........  .........  ...........  ...........
                               structures.
   51600  T                   Injection for bladder x-       347       2.57    $132.15       $62.38       $26.43
                               ray.
   51605  T                   Preparation for bladder        347       2.57    $132.15       $62.38       $26.43
                               x-ray.
   51610  T                   Injection for bladder x-       347       2.57    $132.15       $62.38       $26.43
                               ray.
   51700  T                   Irrigation of bladder..        530       2.46    $126.49       $53.34       $25.30
   51705  T                   Change of bladder tube.        470       2.19    $112.61       $54.92       $22.52
   51710  T                   Change of bladder tube.        470       2.19    $112.61       $54.92       $22.52
   51715  T                   Endoscopic injection/          531      18.59    $955.90      $531.55      $191.18
                               implant.
   51720  T                   Treatment of bladder           530       2.46    $126.49       $53.34       $25.30
                               lesion.
   51725  T                   Simple cystometrogram..        529       2.33    $119.81       $59.66       $23.96
   51726  T                   Complex cystometrogram.        529       2.33    $119.81       $59.66       $23.96
   51736  T                   Urine flow measurement.        529       2.33    $119.81       $59.66       $23.96
   51741  T                   Electro-uroflowmetry,          529       2.33    $119.81       $59.66       $23.96
                               first.
   51772  T                   Urethra pressure               529       2.33    $119.81       $59.66       $23.96
                               profile.
   51784  T                   Anal/urinary muscle            529       2.33    $119.81       $59.66       $23.96
                               study.
   51785  T                   Anal/urinary muscle            529       2.33    $119.81       $59.66       $23.96
                               study.
   51792  T                   Urinary reflex study...        529       2.33    $119.81       $59.66       $23.96
   51795  T                   Urine voiding pressure         529       2.33    $119.81       $59.66       $23.96
                               study.
   51797  T                   Intraabdominal pressure        529       2.33    $119.81       $59.66       $23.96
                               test.
   51800  C                   Revision of bladder/     .........  .........  .........  ...........  ...........
                               urethra.
   51820  C                   Revision of urinary      .........  .........  .........  ...........  ...........
                               tract.
   51840  C                   Attach bladder/urethra.  .........  .........  .........  ...........  ...........
   51841  C                   Attach bladder/urethra.  .........  .........  .........  ...........  ...........
   51845  C                   Repair bladder neck....  .........  .........  .........  ...........  ...........
   51860  C                   Repair of bladder wound  .........  .........  .........  ...........  ...........
   51865  C                   Repair of bladder wound  .........  .........  .........  ...........  ...........
   51880  T                   Repair of bladder              523      16.35    $840.72      $438.89      $168.14
                               opening.
   51900  C                   Repair bladder/vagina    .........  .........  .........  ...........  ...........
                               lesion.
   51920  C                   Close bladder-uterus     .........  .........  .........  ...........  ...........
                               fistula.
   51925  C                   Hysterectomy/bladder     .........  .........  .........  ...........  ...........
                               repair.
   51940  C                   Correction of bladder    .........  .........  .........  ...........  ...........
                               defect.
   51960  C                   Revision of bladder &    .........  .........  .........  ...........  ...........
                               bowel.
   51980  C                   Construct bladder        .........  .........  .........  ...........  ...........
                               opening.
   52000  T                   Cystoscopy.............        521       4.89    $251.44      $110.06       $50.29
   52005  T                   Cystoscopy & ureter            522      10.15    $521.91      $259.45      $104.38
                               catheter.
   52007  T                   Cystoscopy and biopsy..        522      10.15    $521.91      $259.45      $104.38
   52010  T                   Cystoscopy & duct              522      10.15    $521.91      $259.45      $104.38
                               catheter.
   52204  T                   Cystoscopy.............        522      10.15    $521.91      $259.45      $104.38
   52214  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52224  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52234  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52235  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52240  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52250  T                   Cystoscopy &                   523      16.35    $840.72      $438.89      $168.14
                               radiotracer.
   52260  T                   Cystoscopy & treatment.        522      10.15    $521.91      $259.45      $104.38
   52265  T                   Cystoscopy & treatment.        521       4.89    $251.44      $110.06       $50.29
   52270  T                   Cystoscopy & revise            522      10.15    $521.91      $259.45      $104.38
                               urethra.
   52275  T                   Cystoscopy & revise            522      10.15    $521.91      $259.45      $104.38
                               urethra.
   52276  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52277  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.

[[Page 35323]]

 
   52281  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52282  T                   Cystoscopy, implant            523      16.35    $840.72      $438.89      $168.14
                               stent.
   52283  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52285  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52290  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52300  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52301  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52305  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52310  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52315  T                   Cystoscopy and                 522      10.15    $521.91      $259.45      $104.38
                               treatment.
   52317  T                   Remove bladder stone...        523      16.35    $840.72      $438.89      $168.14
   52318  T                   Remove bladder stone...        523      16.35    $840.72      $438.89      $168.14
   52320  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52325  T                   Cystoscopy, stone              523      16.35    $840.72      $438.89      $168.14
                               removal.
   52327  T                   Cystoscopy, inject             522      10.15    $521.91      $259.45      $104.38
                               material.
   52330  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52332  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52334  T                   Create passage to              523      16.35    $840.72      $438.89      $168.14
                               kidney.
   52335  T                   Endoscopy of urinary           523      16.35    $840.72      $438.89      $168.14
                               tract.
   52336  T                   Cystoscopy, stone              523      16.35    $840.72      $438.89      $168.14
                               removal.
   52337  T                   Cystoscopy, stone              524      27.20  $1,398.62      $824.90      $279.72
                               removal.
   52338  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52339  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52340  T                   Cystoscopy and                 523      16.35    $840.72      $438.89      $168.14
                               treatment.
   52450  T                   Incision of prostate...        523      16.35    $840.72      $438.89      $168.14
   52500  T                   Revision of bladder            523      16.35    $840.72      $438.89      $168.14
                               neck.
   52510  T                   Dilation prostatic             522      10.15    $521.91      $259.45      $104.38
                               urethra.
   52601  T                   Prostatectomy (TURP)...        524      27.20  $1,398.62      $824.90      $279.72
   52606  T                   Control postop bleeding        523      16.35    $840.72      $438.89      $168.14
   52612  T                   Prostatectomy, first           524      27.20  $1,398.62      $824.90      $279.72
                               stage.
   52614  T                   Prostatectomy, second          524      27.20  $1,398.62      $824.90      $279.72
                               stage.
   52620  T                   Remove residual                524      27.20  $1,398.62      $824.90      $279.72
                               prostate.
   52630  T                   Remove prostate                524      27.20  $1,398.62      $824.90      $279.72
                               regrowth.
   52640  T                   Relieve bladder                523      16.35    $840.72      $438.89      $168.14
                               contracture.
   52647  T                   Laser surgery of               524      27.20  $1,398.62      $824.90      $279.72
                               prostate.
   52648  T                   Laser surgery of               524      27.20  $1,398.62      $824.90      $279.72
                               prostate.
   52700  T                   Drainage of prostate           523      16.35    $840.72      $438.89      $168.14
                               abscess.
   53000  T                   Incision of urethra....        531      18.59    $955.90      $531.55      $191.18
   53010  T                   Incision of urethra....        531      18.59    $955.90      $531.55      $191.18
   53020  T                   Incision of urethra....        531      18.59    $955.90      $531.55      $191.18
   53025  T                   Incision of urethra....        531      18.59    $955.90      $531.55      $191.18
   53040  T                   Drainage of urethra            531      18.59    $955.90      $531.55      $191.18
                               abscess.
   53060  T                   Drainage of urethra            531      18.59    $955.90      $531.55      $191.18
                               abscess.
   53080  T                   Drainage of urinary            531      18.59    $955.90      $531.55      $191.18
                               leakage.
   53085  C                   Drainage of urinary      .........  .........  .........  ...........  ...........
                               leakage.
   53200  T                   Biopsy of urethra......        531      18.59    $955.90      $531.55      $191.18
   53210  T                   Removal of urethra.....        532      23.02  $1,183.69      $588.50      $236.74
   53215  T                   Removal of urethra.....        532      23.02  $1,183.69      $588.50      $236.74
   53220  T                   Treatment of urethra           532      23.02  $1,183.69      $588.50      $236.74
                               lesion.
   53230  T                   Removal of urethra             532      23.02  $1,183.69      $588.50      $236.74
                               lesion.
   53235  T                   Removal of urethra             532      23.02  $1,183.69      $588.50      $236.74
                               lesion.
   53240  T                   Surgery for urethra            532      23.02  $1,183.69      $588.50      $236.74
                               pouch.
   53250  T                   Removal of urethra             531      18.59    $955.90      $531.55      $191.18
                               gland.
   53260  T                   Treatment of urethra           531      18.59    $955.90      $531.55      $191.18
                               lesion.
   53265  T                   Treatment of urethra           531      18.59    $955.90      $531.55      $191.18
                               lesion.
   53270  T                   Removal of urethra             531      18.59    $955.90      $531.55      $191.18
                               gland.
   53275  T                   Repair of urethra              531      18.59    $955.90      $531.55      $191.18
                               defect.
   53400  T                   Revise urethra, 1st            532      23.02  $1,183.69      $588.50      $236.74
                               stage.
   53405  T                   Revise urethra, 2nd            532      23.02  $1,183.69      $588.50      $236.74
                               stage.
   53410  T                   Reconstruction of              532      23.02  $1,183.69      $588.50      $236.74
                               urethra.
   53415  C                   Reconstruction of        .........  .........  .........  ...........  ...........
                               urethra.
   53420  T                   Reconstruct urethra,           532      23.02  $1,183.69      $588.50      $236.74
                               stage 1.
   53425  T                   Reconstruct urethra,           532      23.02  $1,183.69      $588.50      $236.74
                               stage 2.
   53430  T                   Reconstruction of              532      23.02  $1,183.69      $588.50      $236.74
                               urethra.
   53440  T                   Correct bladder                538      48.41  $2,489.24    $1,563.47      $497.85
                               function.
   53442  T                   Remove perineal                531      18.59    $955.90      $531.55      $191.18
                               prosthesis.
   53443  C                   Reconstruction of        .........  .........  .........  ...........  ...........
                               urethra.
   53445  T                   Correct urine flow             538      48.41  $2,489.24    $1,563.47      $497.85
                               control.
   53447  T                   Remove artificial              532      23.02  $1,183.69      $588.50      $236.74
                               sphincter.
   53449  T                   Correct artificial             532      23.02  $1,183.69      $588.50      $236.74
                               sphincter.
   53450  T                   Revision of urethra....        532      23.02  $1,183.69      $588.50      $236.74
   53460  T                   Revision of urethra....        532      23.02  $1,183.69      $588.50      $236.74
   53502  T                   Repair of urethra              531      18.59    $955.90      $531.55      $191.18
                               injury.
   53505  T                   Repair of urethra              531      18.59    $955.90      $531.55      $191.18
                               injury.
   53510  T                   Repair of urethra              531      18.59    $955.90      $531.55      $191.18
                               injury.

[[Page 35324]]

 
   53515  T                   Repair of urethra              532      23.02  $1,183.69      $588.50      $236.74
                               injury.
   53520  T                   Repair of urethra              532      23.02  $1,183.69      $588.50      $236.74
                               defect.
   53600  T                   Dilate urethra                 530       2.46    $126.49       $53.34       $25.30
                               stricture.
   53601  T                   Dilate urethra                 530       2.46    $126.49       $53.34       $25.30
                               stricture.
   53605  T                   Dilate urethra                 522      10.15    $521.91      $259.45      $104.38
                               stricture.
   53620  T                   Dilate urethra                 530       2.46    $126.49       $53.34       $25.30
                               stricture.
   53621  T                   Dilate urethra                 530       2.46    $126.49       $53.34       $25.30
                               stricture.
\2\ 5364  T                   Relieve bladder                530       2.46    $126.49       $53.34       $25.30
        0                      retention.
   53660  T                   Dilation of urethra....        530       2.46    $126.49       $53.34       $25.30
   53661  T                   Dilation of urethra....        530       2.46    $126.49       $53.34       $25.30
   53665  T                   Dilation of urethra....        531      18.59    $955.90      $531.55      $191.18
   53670  N                   Insert urinary catheter  .........  .........  .........  ...........  ...........
   53675  T                   Insert urinary catheter        530       2.46    $126.49       $53.34       $25.30
   53850  T                   Prostatic microwave            524      27.20  $1,398.62      $824.90      $279.72
                               thermotx.
   53852  T                   Prostatic rf thermotx..        524      27.20  $1,398.62      $824.90      $279.72
   53899  T                   Urology surgery                530       2.46    $126.49       $53.34       $25.30
                               procedure.
   54000  T                   Slitting of prepuce....        531      18.59    $955.90      $531.55      $191.18
   54001  T                   Slitting of prepuce....        531      18.59    $955.90      $531.55      $191.18
   54015  T                   Drain penis lesion.....        132       5.63    $289.49      $132.89       $57.90
   54050  T                   Destruction, penis             152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   54055  T                   Destruction, penis             152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   54056  T                   Cryosurgery, penis             152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   54057  T                   Laser surg, penis              152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   54060  T                   Excision of penis              152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   54065  T                   Destruction, penis             152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   54100  T                   Biopsy of penis........        162       5.59    $287.44      $125.66       $57.49
   54105  T                   Biopsy of penis........        162       5.59    $287.44      $125.66       $57.49
   54110  T                   Treatment of penis             537      28.65  $1,473.18      $872.36      $294.64
                               lesion.
   54111  T                   Treat penis lesion,            537      28.65  $1,473.18      $872.36      $294.64
                               graft.
   54112  T                   Treat penis lesion,            537      28.65  $1,473.18      $872.36      $294.64
                               graft.
   54115  T                   Treatment of penis             132       5.63    $289.49      $132.89       $57.90
                               lesion.
   54120  T                   Partial removal of             537      28.65  $1,473.18      $872.36      $294.64
                               penis.
   54125  C                   Removal of penis.......  .........  .........  .........  ...........  ...........
   54130  C                   Remove penis & nodes...  .........  .........  .........  ...........  ...........
   54135  C                   Remove penis & nodes...  .........  .........  .........  ...........  ...........
   54150  T                   Circumcision...........        536      12.89    $662.80      $321.60      $132.56
   54152  T                   Circumcision...........        536      12.89    $662.80      $321.60      $132.56
   54160  T                   Circumcision...........        536      12.89    $662.80      $321.60      $132.56
   54161  T                   Circumcision...........        536      12.89    $662.80      $321.60      $132.56
   54200  T                   Treatment of penis             530       2.46    $126.49       $53.34       $25.30
                               lesion.
   54205  T                   Treatment of penis             537      28.65  $1,473.18      $872.36      $294.64
                               lesion.
   54220  T                   Treatment of penis             530       2.46    $126.49       $53.34       $25.30
                               lesion.
   54230  T                   Prepare penis study....        347       2.57    $132.15       $62.38       $26.43
   54231  T                   Dynamic cavernosometry.        530       2.46    $126.49       $53.34       $25.30
   54235  T                   Penile injection.......        530       2.46    $126.49       $53.34       $25.30
   54240  T                   Penis study............        529       2.33    $119.81       $59.66       $23.96
   54250  T                   Penis study............        529       2.33    $119.81       $59.66       $23.96
   54300  T                   Revision of penis......        537      28.65  $1,473.18      $872.36      $294.64
   54304  T                   Revision of penis......        537      28.65  $1,473.18      $872.36      $294.64
   54308  T                   Reconstruction of              537      28.65  $1,473.18      $872.36      $294.64
                               urethra.
   54312  T                   Reconstruction of              537      28.65  $1,473.18      $872.36      $294.64
                               urethra.
   54316  T                   Reconstruction of              537      28.65  $1,473.18      $872.36      $294.64
                               urethra.
   54318  T                   Reconstruction of              537      28.65  $1,473.18      $872.36      $294.64
                               urethra.
   54322  T                   Reconstruction of              537      28.65  $1,473.18      $872.36      $294.64
                               urethra.
   54324  T                   Reconstruction of              537      28.65  $1,473.18      $872.36      $294.64
                               urethra.
   54326  T                   Reconstruction of              537      28.65  $1,473.18      $872.36      $294.64
                               urethra.
   54328  T                   Revise penis, urethra..        537      28.65  $1,473.18      $872.36      $294.64
   54332  C                   Revise penis, urethra..  .........  .........  .........  ...........  ...........
   54336  C                   Revise penis, urethra..  .........  .........  .........  ...........  ...........
   54340  T                   Secondary urethral             537      28.65  $1,473.18      $872.36      $294.64
                               surgery.
   54344  T                   Secondary urethral             537      28.65  $1,473.18      $872.36      $294.64
                               surgery.
   54348  T                   Secondary urethral             537      28.65  $1,473.18      $872.36      $294.64
                               surgery.
   54352  T                   Reconstruct urethra,           537      28.65  $1,473.18      $872.36      $294.64
                               penis.
   54360  T                   Penis plastic surgery..        537      28.65  $1,473.18      $872.36      $294.64
   54380  T                   Repair penis...........        537      28.65  $1,473.18      $872.36      $294.64
   54385  T                   Repair penis...........        537      28.65  $1,473.18      $872.36      $294.64
   54390  C                   Repair penis and         .........  .........  .........  ...........  ...........
                               bladder.
   54400  T                   Insert semi-rigid              538      48.41  $2,489.24    $1,563.47      $497.85
                               prosthesis.
   54401  T                   Insert self-contd              538      48.41  $2,489.24    $1,563.47      $497.85
                               prosthesis.
   54402  T                   Remove penis prosthesis        537      28.65  $1,473.18      $872.36      $294.64
   54405  T                   Insert multi-comp              538      48.41  $2,489.24    $1,563.47      $497.85
                               prosthesis.
   54407  T                   Remove multi-comp              537      28.65  $1,473.18      $872.36      $294.64
                               prosthesis.
   54409  T                   Revise penis prosthesis        537      28.65  $1,473.18      $872.36      $294.64
   54420  T                   Revision of penis......        537      28.65  $1,473.18      $872.36      $294.64
   54430  C                   Revision of penis......  .........  .........  .........  ...........  ...........

[[Page 35325]]

 
   54435  T                   Revision of penis......        537      28.65  $1,473.18      $872.36      $294.64
   54440  T                   Repair of penis........        537      28.65  $1,473.18      $872.36      $294.64
   54450  T                   Preputial stretching...        530       2.46    $126.49       $53.34       $25.30
   54500  T                   Biopsy of testis.......        122       4.59    $236.02      $113.00       $47.20
   54505  T                   Biopsy of testis.......        546      16.54    $850.49      $449.51      $170.10
   54510  T                   Removal of testis              546      16.54    $850.49      $449.51      $170.10
                               lesion.
   54520  T                   Removal of testis......        546      16.54    $850.49      $449.51      $170.10
   54530  T                   Removal of testis......        546      16.54    $850.49      $449.51      $170.10
   54535  C                   Extensive testis         .........  .........  .........  ...........  ...........
                               surgery.
   54550  T                   Exploration for testis.        546      16.54    $850.49      $449.51      $170.10
   54560  C                   Exploration for testis.  .........  .........  .........  ...........  ...........
   54600  T                   Reduce testis torsion..        546      16.54    $850.49      $449.51      $170.10
   54620  T                   Suspension of testis...        546      16.54    $850.49      $449.51      $170.10
   54640  T                   Suspension of testis...        546      16.54    $850.49      $449.51      $170.10
   54650  C                   Orchiopexy (Fowler-      .........  .........  .........  ...........  ...........
                               Stephens).
   54660  T                   Revision of testis.....        546      16.54    $850.49      $449.51      $170.10
   54670  T                   Repair testis injury...        546      16.54    $850.49      $449.51      $170.10
   54680  T                   Relocation of                  546      16.54    $850.49      $449.51      $170.10
                               testis(es).
   54700  T                   Drainage of scrotum....        546      16.54    $850.49      $449.51      $170.10
   54800  T                   Biopsy of epididymis...        122       4.59    $236.02      $113.00       $47.20
   54820  T                   Exploration of                 546      16.54    $850.49      $449.51      $170.10
                               epididymis.
   54830  T                   Remove epididymis              546      16.54    $850.49      $449.51      $170.10
                               lesion.
   54840  T                   Remove epididymis              546      16.54    $850.49      $449.51      $170.10
                               lesion.
   54860  T                   Removal of epididymis..        546      16.54    $850.49      $449.51      $170.10
   54861  T                   Removal of epididymis..        546      16.54    $850.49      $449.51      $170.10
   54900  T                   Fusion of spermatic            546      16.54    $850.49      $449.51      $170.10
                               ducts.
   54901  T                   Fusion of spermatic            546      16.54    $850.49      $449.51      $170.10
                               ducts.
   55000  T                   Drainage of hydrocele..        121       0.63     $32.39       $21.02        $6.48
   55040  T                   Removal of hydrocele...        466      20.67  $1,062.85      $556.64      $212.57
   55041  T                   Removal of hydroceles..        466      20.67  $1,062.85      $556.64      $212.57
   55060  T                   Repair of hydrocele....        546      16.54    $850.49      $449.51      $170.10
   55100  T                   Drainage of scrotum            132       5.63    $289.49      $132.89       $57.90
                               abscess.
   55110  T                   Explore scrotum........        546      16.54    $850.49      $449.51      $170.10
   55120  T                   Removal of scrotum             546      16.54    $850.49      $449.51      $170.10
                               lesion.
   55150  T                   Removal of scrotum.....        546      16.54    $850.49      $449.51      $170.10
   55175  T                   Revision of scrotum....        546      16.54    $850.49      $449.51      $170.10
   55180  T                   Revision of scrotum....        546      16.54    $850.49      $449.51      $170.10
   55200  T                   Incision of sperm duct.        546      16.54    $850.49      $449.51      $170.10
   55250  T                   Removal of sperm               546      16.54    $850.49      $449.51      $170.10
                               duct(s).
   55300  T                   Preparation,sperm duct         347       2.57    $132.15       $62.38       $26.43
                               x-ray.
   55400  T                   Repair of sperm duct...        546      16.54    $850.49      $449.51      $170.10
   55450  T                   Ligation of sperm duct.        546      16.54    $850.49      $449.51      $170.10
   55500  T                   Removal of hydrocele...        546      16.54    $850.49      $449.51      $170.10
   55520  T                   Removal of sperm cord          546      16.54    $850.49      $449.51      $170.10
                               lesion.
   55530  T                   Revise spermatic cord          546      16.54    $850.49      $449.51      $170.10
                               veins.
   55535  T                   Revise spermatic cord          546      16.54    $850.49      $449.51      $170.10
                               veins.
   55540  T                   Revise hernia & sperm          546      16.54    $850.49      $449.51      $170.10
                               veins.
   55600  C                   Incise sperm duct pouch  .........  .........  .........  ...........  ...........
   55605  C                   Incise sperm duct pouch  .........  .........  .........  ...........  ...........
   55650  C                   Remove sperm duct pouch  .........  .........  .........  ...........  ...........
   55680  T                   Remove sperm pouch             546      16.54    $850.49      $449.51      $170.10
                               lesion.
   55700  T                   Biopsy of prostate.....        547       4.39    $225.73      $125.20       $45.15
   55705  T                   Biopsy of prostate.....        547       4.39    $225.73      $125.20       $45.15
   55720  T                   Drainage of prostate           523      16.35    $840.72      $438.89      $168.14
                               abscess.
   55725  T                   Drainage of prostate           523      16.35    $840.72      $438.89      $168.14
                               abscess.
   55801  C                   Removal of prostate....  .........  .........  .........  ...........  ...........
   55810  C                   Extensive prostate       .........  .........  .........  ...........  ...........
                               surgery.
   55812  C                   Extensive prostate       .........  .........  .........  ...........  ...........
                               surgery.
   55815  C                   Extensive prostate       .........  .........  .........  ...........  ...........
                               surgery.
   55821  C                   Removal of prostate....  .........  .........  .........  ...........  ...........
   55831  C                   Removal of prostate....  .........  .........  .........  ...........  ...........
   55840  C                   Extensive prostate       .........  .........  .........  ...........  ...........
                               surgery.
   55842  C                   Extensive prostate       .........  .........  .........  ...........  ...........
                               surgery.
   55845  C                   Extensive prostate       .........  .........  .........  ...........  ...........
                               surgery.
   55859  T                   Percut/needle insert,          523      16.35    $840.72      $438.89      $168.14
                               pros.
   55860  C                   Surgical exposure,       .........  .........  .........  ...........  ...........
                               prostate.
   55862  C                   Extensive prostate       .........  .........  .........  ...........  ...........
                               surgery.
   55865  C                   Extensive prostate       .........  .........  .........  ...........  ...........
                               surgery.
   55870  T                   Electroejaculation.....        568       2.79    $143.46       $55.60       $28.69
   55899  T                   Genital surgery                530       2.46    $126.49       $53.34       $25.30
                               procedure.
   55970  E                   Sex transformation, M    .........  .........  .........  ...........  ...........
                               to F.
   55980  E                   Sex transformation, F    .........  .........  .........  ...........  ...........
                               to M.
   56300  T                   Laparoscopy; diagnostic        551      24.61  $1,265.45      $701.73      $253.09
   56301  T                   Laparoscopy; tubal             551      24.61  $1,265.45      $701.73      $253.09
                               cautery.
   56302  T                   Laparoscopy; tubal             551      24.61  $1,265.45      $701.73      $253.09
                               block.

[[Page 35326]]

 
   56303  T                   Laparoscopy; excise            551      24.61  $1,265.45      $701.73      $253.09
                               lesions.
   56304  T                   Laparoscopy; lysis.....        551      24.61  $1,265.45      $701.73      $253.09
   56305  T                   Laparoscopy; biopsy....        551      24.61  $1,265.45      $701.73      $253.09
   56306  T                   Laparoscopy; aspiration        551      24.61  $1,265.45      $701.73      $253.09
   56307  T                   Laparoscopy; remove            552      37.09  $1,907.17    $1,053.84      $381.43
                               adnexa.
   56308  C                   Laparoscopy;             .........  .........  .........  ...........  ...........
                               hysterectomy.
   56309  T                   Laparoscopy; remove            552      37.09  $1,907.17    $1,053.84      $381.43
                               myoma.
   56310  C                   Laparoscopic             .........  .........  .........  ...........  ...........
                               enterolysis.
   56311  T                   Laparoscopic lymph node        552      37.09  $1,907.17    $1,053.84      $381.43
                               biop.
   56312  T                   Laparoscopic                   552      37.09  $1,907.17    $1,053.84      $381.43
                               lymphadenectomy.
   56313  T                   Laparoscopic                   552      37.09  $1,907.17    $1,053.84      $381.43
                               lymphadenectomy.
   56314  C                   Lapar; drain lymphocele  .........  .........  .........  ...........  ...........
   56315  C                   Laparoscopic             .........  .........  .........  ...........  ...........
                               appendectomy.
   56316  T                   Laparoscopic hernia            552      37.09  $1,907.17    $1,053.84      $381.43
                               repair.
   56317  T                   Laparoscopic hernia            552      37.09  $1,907.17    $1,053.84      $381.43
                               repair.
   56318  T                   Laparoscopic                   552      37.09  $1,907.17    $1,053.84      $381.43
                               orchiectomy.
   56320  T                   Laparoscopy, spermatic         552      37.09  $1,907.17    $1,053.84      $381.43
                               veins.
   56322  C                   Laparoscopy, vagus       .........  .........  .........  ...........  ...........
                               nerves.
   56323  C                   Laparoscopy, vagus       .........  .........  .........  ...........  ...........
                               nerves.
   56324  C                   Laparoscopy,             .........  .........  .........  ...........  ...........
                               cholecystoenter.
   56340  C                   Laparoscopic             .........  .........  .........  ...........  ...........
                               cholecystectomy.
   56341  C                   Laparoscopic             .........  .........  .........  ...........  ...........
                               cholecystectomy.
   56342  C                   Laparoscopic             .........  .........  .........  ...........  ...........
                               cholecystectomy.
   56343  T                   Laparoscopic                   552      37.09  $1,907.17    $1,053.84      $381.43
                               salpingostomy.
   56344  T                   Laparoscopic                   552      37.09  $1,907.17    $1,053.84      $381.43
                               fimbrioplasty.
   56345  C                   Laparoscopic             .........  .........  .........  ...........  ...........
                               splenectomy.
   56346  T                   Laparoscopic                   551      24.61  $1,265.45      $701.73      $253.09
                               gastrostomy.
   56347  C                   Laparoscopic             .........  .........  .........  ...........  ...........
                               jejunostomy.
   56348  C                   Laparo; resect           .........  .........  .........  ...........  ...........
                               intestine.
   56349  C                   Laparoscopy;             .........  .........  .........  ...........  ...........
                               fundoplasty.
   56350  T                   Hysteroscopy;                  562      12.30    $632.47      $325.44      $126.49
                               diagnostic.
   56351  T                   Hysteroscopy; biopsy...        550      16.46    $846.37      $445.22      $169.27
   56352  T                   Hysteroscopy; lysis....        550      16.46    $846.37      $445.22      $169.27
   56353  T                   Hysteroscopy; resect           550      16.46    $846.37      $445.22      $169.27
                               septum.
   56354  T                   Hysteroscopy; remove           550      16.46    $846.37      $445.22      $169.27
                               myoma.
   56355  T                   Hysteroscopy; remove           550      16.46    $846.37      $445.22      $169.27
                               impact.
   56356  T                   Hysteroscopy; ablation.        550      16.46    $846.37      $445.22      $169.27
\2\ 5636  T                   Peritoneoscopy.........        551      24.61  $1,265.45      $701.73      $253.09
        0
\2\ 5636  T                   Peritoneoscopy w/biopsy        551      24.61  $1,265.45      $701.73      $253.09
        1
   56362  T                   Laparoscopy w/cholangio        552      37.09  $1,907.17    $1,053.84      $381.43
   56363  T                   Laparoscopy w/biopsy...        552      37.09  $1,907.17    $1,053.84      $381.43
   56399  T                   Laparoscopy procedure..        562      12.30    $632.47      $325.44      $126.49
   56405  T                   I & D of vulva/perineum        561       1.46     $75.07       $24.41       $15.01
   56420  T                   Drainage of gland              561       1.46     $75.07       $24.41       $15.01
                               abscess.
   56440  T                   Surgery for vulva              562      12.30    $632.47      $325.44      $126.49
                               lesion.
   56441  T                   Lysis of labial                561       1.46     $75.07       $24.41       $15.01
                               lesion(s).
   56501  T                   Destruction, vulva             152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   56515  T                   Destruction, vulva             152      10.07    $517.80      $251.54      $103.56
                               lesion(s).
   56605  T                   Biopsy of vulva/               161       3.43    $176.37       $75.71       $35.27
                               perineum.
   56606  T                   Biopsy of vulva/               161       3.43    $176.37       $75.71       $35.27
                               perineum.
   56620  T                   Partial removal of             563      16.50    $848.43      $461.72      $169.69
                               vulva.
   56625  T                   Complete removal of            563      16.50    $848.43      $461.72      $169.69
                               vulva.
   56630  C                   Extensive vulva surgery  .........  .........  .........  ...........  ...........
   56631  C                   Extensive vulva surgery  .........  .........  .........  ...........  ...........
   56632  C                   Extensive vulva surgery  .........  .........  .........  ...........  ...........
   56633  C                   Extensive vulva surgery  .........  .........  .........  ...........  ...........
   56634  C                   Extensive vulva surgery  .........  .........  .........  ...........  ...........
   56637  C                   Extensive vulva surgery  .........  .........  .........  ...........  ...........
   56640  C                   Extensive vulva surgery  .........  .........  .........  ...........  ...........
   56700  T                   Partial removal of             562      12.30    $632.47      $325.44      $126.49
                               hymen.
   56720  T                   Incision of hymen......        562      12.30    $632.47      $325.44      $126.49
   56740  T                   Remove vagina gland            562      12.30    $632.47      $325.44      $126.49
                               lesion.
   56800  T                   Repair of vagina.......        562      12.30    $632.47      $325.44      $126.49
   56805  C                   Repair clitoris........  .........  .........  .........  ...........  ...........
   56810  T                   Repair of perineum.....        562      12.30    $632.47      $325.44      $126.49
   57000  T                   Exploration of vagina..        562      12.30    $632.47      $325.44      $126.49
   57010  T                   Drainage of pelvic             562      12.30    $632.47      $325.44      $126.49
                               abscess.
   57020  T                   Drainage of pelvic             562      12.30    $632.47      $325.44      $126.49
                               fluid.
   57061  T                   Destruction vagina             561       1.46     $75.07       $24.41       $15.01
                               lesion(s).
   57065  T                   Destruction vagina             562      12.30    $632.47      $325.44      $126.49
                               lesion(s).
   57100  T                   Biopsy of vagina.......        561       1.46     $75.07       $24.41       $15.01
   57105  T                   Biopsy of vagina.......        562      12.30    $632.47      $325.44      $126.49
\2\ 5710  C                   Partial removal of       .........  .........  .........  ...........  ...........
        8                      vagina.
   57110  C                   Remove vagina wall,      .........  .........  .........  ...........  ...........
                               complete.
   57120  C                   Closure of vagina......  .........  .........  .........  ...........  ...........

[[Page 35327]]

 
   57130  T                   Remove vagina lesion...        562      12.30    $632.47      $325.44      $126.49
   57135  T                   Remove vagina lesion...        562      12.30    $632.47      $325.44      $126.49
   57150  T                   Treat vagina infection.        561       1.46     $75.07       $24.41       $15.01
   57160  T                   Insertion of pessary/          561       1.46     $75.07       $24.41       $15.01
                               device.
   57170  T                   Fitting of diaphragm/          561       1.46     $75.07       $24.41       $15.01
                               cap.
   57180  T                   Treat vaginal bleeding.        561       1.46     $75.07       $24.41       $15.01
   57200  T                   Repair of vagina.......        562      12.30    $632.47      $325.44      $126.49
   57210  T                   Repair vagina/perineum.        562      12.30    $632.47      $325.44      $126.49
   57220  T                   Revision of urethra....        563      16.50    $848.43      $461.72      $169.69
   57230  T                   Repair of urethral             562      12.30    $632.47      $325.44      $126.49
                               lesion.
   57240  T                   Repair bladder & vagina        563      16.50    $848.43      $461.72      $169.69
   57250  T                   Repair rectum & vagina.        563      16.50    $848.43      $461.72      $169.69
   57260  T                   Repair of vagina.......        563      16.50    $848.43      $461.72      $169.69
   57265  T                   Extensive repair of            563      16.50    $848.43      $461.72      $169.69
                               vagina.
   57268  T                   Repair of bowel bulge..        563      16.50    $848.43      $461.72      $169.69
   57270  C                   Repair of bowel pouch..  .........  .........  .........  ...........  ...........
   57280  C                   Suspension of vagina...  .........  .........  .........  ...........  ...........
   57282  C                   Repair of vaginal        .........  .........  .........  ...........  ...........
                               prolapse.
   57284  T                   Repair paravaginal             563      16.50    $848.43      $461.72      $169.69
                               defect.
   57288  T                   Repair bladder defect..        563      16.50    $848.43      $461.72      $169.69
   57289  T                   Repair bladder & vagina        563      16.50    $848.43      $461.72      $169.69
   57291  T                   Construction of vagina.        563      16.50    $848.43      $461.72      $169.69
   57292  C                   Construct vagina with    .........  .........  .........  ...........  ...........
                               graft.
   57300  T                   Repair rectum-vagina           563      16.50    $848.43      $461.72      $169.69
                               fistula.
   57305  C                   Repair rectum-vagina     .........  .........  .........  ...........  ...........
                               fistula.
   57307  C                   Fistula repair &         .........  .........  .........  ...........  ...........
                               colostomy.
   57308  C                   Fistula repair,          .........  .........  .........  ...........  ...........
                               transperine.
   57310  C                   Repair urethrovaginal    .........  .........  .........  ...........  ...........
                               lesion.
   57311  C                   Repair urethrovaginal    .........  .........  .........  ...........  ...........
                               lesion.
   57320  C                   Repair bladder-vagina    .........  .........  .........  ...........  ...........
                               lesion.
   57330  C                   Repair bladder-vagina    .........  .........  .........  ...........  ...........
                               lesion.
   57335  C                   Repair vagina..........  .........  .........  .........  ...........  ...........
   57400  T                   Dilation of vagina.....        562      12.30    $632.47      $325.44      $126.49
   57410  T                   Pelvic examination.....        562      12.30    $632.47      $325.44      $126.49
   57415  T                   Removal vaginal foreign        562      12.30    $632.47      $325.44      $126.49
                               body.
   57452  T                   Examination of vagina..        561       1.46     $75.07       $24.41       $15.01
   57454  T                   Vagina examination &           561       1.46     $75.07       $24.41       $15.01
                               biopsy.
   57460  T                   Cervix excision........        562      12.30    $632.47      $325.44      $126.49
   57500  T                   Biopsy of cervix.......        561       1.46     $75.07       $24.41       $15.01
   57505  T                   Endocervical curettage.        561       1.46     $75.07       $24.41       $15.01
   57510  T                   Cauterization of cervix        561       1.46     $75.07       $24.41       $15.01
   57511  T                   Cryocautery of cervix..        561       1.46     $75.07       $24.41       $15.01
   57513  T                   Laser surgery of cervix        561       1.46     $75.07       $24.41       $15.01
   57520  T                   Conization of cervix...        563      16.50    $848.43      $461.72      $169.69
   57522  T                   Conization of cervix...        563      16.50    $848.43      $461.72      $169.69
   57530  T                   Removal of cervix......        563      16.50    $848.43      $461.72      $169.69
   57531  C                   Removal of cervix,       .........  .........  .........  ...........  ...........
                               radical.
   57540  C                   Removal of residual      .........  .........  .........  ...........  ...........
                               cervix.
   57545  C                   Remove cervix, repair    .........  .........  .........  ...........  ...........
                               pelvis.
   57550  T                   Removal of residual            563      16.50    $848.43      $461.72      $169.69
                               cervix.
   57555  T                   Remove cervix, repair          563      16.50    $848.43      $461.72      $169.69
                               vagina.
   57556  T                   Remove cervix, repair          563      16.50    $848.43      $461.72      $169.69
                               bowel.
   57700  T                   Revision of cervix.....        562      12.30    $632.47      $325.44      $126.49
   57720  T                   Revision of cervix.....        562      12.30    $632.47      $325.44      $126.49
   57800  T                   Dilation of cervical           561       1.46     $75.07       $24.41       $15.01
                               canal.
   57820  T                   D&c of residual cervix.        567      13.18    $677.72      $360.70      $135.54
   58100  T                   Biopsy of uterus lining        561       1.46     $75.07       $24.41       $15.01
   58120  T                   Dilation and curettage         567      13.18    $677.72      $360.70      $135.54
                               (D&C).
   58140  C                   Removal of uterus        .........  .........  .........  ...........  ...........
                               lesion.
   58145  T                   Removal of uterus              563      16.50    $848.43      $461.72      $169.69
                               lesion.
   58150  C                   Total hysterectomy.....  .........  .........  .........  ...........  ...........
   58152  C                   Total hysterectomy.....  .........  .........  .........  ...........  ...........
   58180  C                   Partial hysterectomy...  .........  .........  .........  ...........  ...........
   58200  C                   Extensive hysterectomy.  .........  .........  .........  ...........  ...........
   58210  C                   Extensive hysterectomy.  .........  .........  .........  ...........  ...........
   58240  C                   Removal of pelvis        .........  .........  .........  ...........  ...........
                               contents.
   58260  C                   Vaginal hysterectomy...  .........  .........  .........  ...........  ...........
   58262  C                   Vaginal hysterectomy...  .........  .........  .........  ...........  ...........
   58263  C                   Vaginal hysterectomy...  .........  .........  .........  ...........  ...........
   58267  C                   Hysterectomy & vagina    .........  .........  .........  ...........  ...........
                               repair.
   58270  C                   Hysterectomy & vagina    .........  .........  .........  ...........  ...........
                               repair.
   58275  C                   Hysterectomy, revise     .........  .........  .........  ...........  ...........
                               vagina.
   58280  C                   Hysterectomy, revise     .........  .........  .........  ...........  ...........
                               vagina.
   58285  C                   Extensive hysterectomy.  .........  .........  .........  ...........  ...........
   58300  E                   Insert intrauterine      .........  .........  .........  ...........  ...........
                               device.

[[Page 35328]]

 
   58301  T                   Remove intrauterine            561       1.46     $75.07       $24.41       $15.01
                               device.
   58321  T                   Artificial insemination        568       2.79    $143.46       $55.60       $28.69
   58322  T                   Artificial insemination        568       2.79    $143.46       $55.60       $28.69
   58323  T                   Sperm washing..........        568       2.79    $143.46       $55.60       $28.69
   58340  T                   Catheter for                   347       2.57    $132.15       $62.38       $26.43
                               hysterography.
   58345  T                   Reopen fallopian tube..        562      12.30    $632.47      $325.44      $126.49
   58350  T                   Reopen fallopian tube..        562      12.30    $632.47      $325.44      $126.49
   58400  C                   Suspension of uterus...  .........  .........  .........  ...........  ...........
   58410  C                   Suspension of uterus...  .........  .........  .........  ...........  ...........
   58520  C                   Repair of ruptured       .........  .........  .........  ...........  ...........
                               uterus.
   58540  C                   Revision of uterus.....  .........  .........  .........  ...........  ...........
   58600  C                   Division of fallopian    .........  .........  .........  ...........  ...........
                               tube.
   58605  C                   Division of fallopian    .........  .........  .........  ...........  ...........
                               tube.
   58611  C                   Ligate oviduct(s) add-   .........  .........  .........  ...........  ...........
                               on.
   58615  C                   Occlude fallopian        .........  .........  .........  ...........  ...........
                               tube(s).
   58700  C                   Removal of fallopian     .........  .........  .........  ...........  ...........
                               tube.
   58720  C                   Removal of ovary/        .........  .........  .........  ...........  ...........
                               tube(s).
   58740  C                   Revise fallopian         .........  .........  .........  ...........  ...........
                               tube(s).
   58750  C                   Repair oviduct.........  .........  .........  .........  ...........  ...........
   58752  C                   Revise ovarian tube(s).  .........  .........  .........  ...........  ...........
   58760  C                   Remove tubal             .........  .........  .........  ...........  ...........
                               obstruction.
   58770  C                   Create new tubal         .........  .........  .........  ...........  ...........
                               opening.
   58800  T                   Drainage of ovarian            563      16.50    $848.43      $461.72      $169.69
                               cyst(s).
   58805  C                   Drainage of ovarian      .........  .........  .........  ...........  ...........
                               cyst(s).
   58820  T                   Open drain ovary               563      16.50    $848.43      $461.72      $169.69
                               abscess.
   58822  C                   Percut drain ovary       .........  .........  .........  ...........  ...........
                               abscess.
   58823  C                   Percut drain pelvic      .........  .........  .........  ...........  ...........
                               abscess.
   58825  C                   Transposition, ovary(s)  .........  .........  .........  ...........  ...........
   58900  C                   Biopsy of ovary(s).....  .........  .........  .........  ...........  ...........
   58920  C                   Partial removal of       .........  .........  .........  ...........  ...........
                               ovary(s).
   58925  C                   Removal of ovarian       .........  .........  .........  ...........  ...........
                               cyst(s).
   58940  C                   Removal of ovary(s)....  .........  .........  .........  ...........  ...........
   58943  C                   Removal of ovary(s)....  .........  .........  .........  ...........  ...........
   58950  C                   Resect ovarian           .........  .........  .........  ...........  ...........
                               malignancy.
   58951  C                   Resect ovarian           .........  .........  .........  ...........  ...........
                               malignancy.
   58952  C                   Resect ovarian           .........  .........  .........  ...........  ...........
                               malignancy.
   58960  C                   Exploration of abdomen.  .........  .........  .........  ...........  ...........
   58970  T                   Retrieval of oocyte....        562      12.30    $632.47      $325.44      $126.49
   58974  T                   Transfer of embryo.....        568       2.79    $143.46       $55.60       $28.69
   58976  T                   Transfer of embryo.....        568       2.79    $143.46       $55.60       $28.69
   58999  T                   Genital surgery                161       3.43    $176.37       $75.71       $35.27
                               procedure.
   59000  T                   Amniocentesis..........        578       1.17     $60.16       $32.77       $12.03
   59012  T                   Fetal cord                     578       1.17     $60.16       $32.77       $12.03
                               puncture,prenatal.
   59015  T                   Chorion biopsy.........        578       1.17     $60.16       $32.77       $12.03
   59020  T                   Fetal contract stress          578       1.17     $60.16       $32.77       $12.03
                               test.
   59025  T                   Fetal non-stress test..        578       1.17     $60.16       $32.77       $12.03
   59030  T                   Fetal scalp blood              578       1.17     $60.16       $32.77       $12.03
                               sample.
   59050  T                   Fetal monitor w/report.        578       1.17     $60.16       $32.77       $12.03
   59051  N                   Fetal monitor/interpret  .........  .........  .........  ...........  ...........
                               only.
   59100  C                   Remove uterus lesion...  .........  .........  .........  ...........  ...........
   59120  C                   Treat ectopic pregnancy  .........  .........  .........  ...........  ...........
   59121  C                   Treat ectopic pregnancy  .........  .........  .........  ...........  ...........
   59130  C                   Treat ectopic pregnancy  .........  .........  .........  ...........  ...........
   59135  C                   Treat ectopic pregnancy  .........  .........  .........  ...........  ...........
   59136  C                   Treat ectopic pregnancy  .........  .........  .........  ...........  ...........
   59140  C                   Treat ectopic pregnancy  .........  .........  .........  ...........  ...........
   59150  C                   Treat ectopic pregnancy  .........  .........  .........  ...........  ...........
   59151  C                   Treat ectopic pregnancy  .........  .........  .........  ...........  ...........
   59160  T                   D&C after delivery.....        567      13.18    $677.72      $360.70      $135.54
   59200  T                   Insert cervical dilator        561       1.46     $75.07       $24.41       $15.01
   59300  T                   Episiotomy or vaginal          562      12.30    $632.47      $325.44      $126.49
                               repair.
   59320  T                   Revision of cervix.....        562      12.30    $632.47      $325.44      $126.49
   59325  C                   Revision of cervix.....  .........  .........  .........  ...........  ...........
   59350  C                   Repair of uterus.......  .........  .........  .........  ...........  ...........
   59400  E                   Obstetrical care.......  .........  .........  .........  ...........  ...........
   59409  T                   Obstetrical care.......        580       4.31    $221.62       $44.32       $44.32
   59410  E                   Obstetrical care.......  .........  .........  .........  ...........  ...........
   59412  T                   Antepartum manipulation        580       4.31    $221.62       $44.32       $44.32
   59414  T                   Deliver placenta.......        580       4.31    $221.62       $44.32       $44.32
   59425  E                   Antepartum care only...  .........  .........  .........  ...........  ...........
   59426  E                   Antepartum care only...  .........  .........  .........  ...........  ...........
   59430  E                   Care after delivery....  .........  .........  .........  ...........  ...........
   59510  E                   Cesarean delivery......  .........  .........  .........  ...........  ...........
   59514  C                   Cesarean delivery only.  .........  .........  .........  ...........  ...........
   59515  E                   Cesarean delivery......  .........  .........  .........  ...........  ...........

[[Page 35329]]

 
   59525  C                   Remove uterus after      .........  .........  .........  ...........  ...........
                               cesarean.
   59610  E                   Vbac delivery..........  .........  .........  .........  ...........  ...........
   59612  T                   Vbac delivery only.....        580       4.31    $221.62       $44.32       $44.32
   59614  E                   Vbac care after          .........  .........  .........  ...........  ...........
                               delivery.
   59618  E                   Attempted vbac delivery  .........  .........  .........  ...........  ...........
   59620  C                   Attempted vbac delivery  .........  .........  .........  ...........  ...........
                               only.
   59622  E                   Attempted vbac after     .........  .........  .........  ...........  ...........
                               care.
   59812  T                   Treatment of                   587      12.96    $666.40      $347.14      $133.28
                               miscarriage.
   59820  T                   Care of miscarriage....        587      12.96    $666.40      $347.14      $133.28
   59821  T                   Treatment of                   587      12.96    $666.40      $347.14       $33.28
                               miscarriage.
   59830  C                   Treat uterus infection.  .........  .........  .........  ...........  ...........
   59840  T                   Abortion...............        586      11.98    $616.01      $409.29      $123.20
   59841  T                   Abortion...............        586      11.98    $616.01      $409.29      $123.20
   59850  C                   Abortion...............  .........  .........  .........  ...........  ...........
   59851  C                   Abortion...............  .........  .........  .........  ...........  ...........
   59852  C                   Abortion...............  .........  .........  .........  ...........  ...........
   59855  C                   Abortion...............  .........  .........  .........  ...........  ...........
   59856  C                   Abortion...............  .........  .........  .........  ...........  ...........
   59857  C                   Abortion...............  .........  .........  .........  ...........  ...........
   59866  C                   Abortion...............  .........  .........  .........  ...........  ...........
   59870  T                   Evacuate mole of uterus        587      12.96    $666.40      $347.14      $133.28
   59871  T                   Remove cerclage suture.        562      12.30    $632.47      $325.44      $126.49
   59899  T                   Maternity care                 578       1.17     $60.16       $32.77       $12.03
                               procedure.
   60000  T                   Drain thyroid/tongue           312       7.07    $363.54      $170.86       $72.71
                               cyst.
   60001  T                   Aspirate/inject thyriod        121       0.63     $32.39       $21.02        $6.48
                               cyst.
   60100  T                   Biopsy of thyroid......        122       4.59    $236.02      $113.00       $47.20
   60200  T                   Remove thyroid lesion..        397      19.12    $983.15      $542.17      $196.63
   60210  T                   Partial excision               397      19.12    $983.15      $542.17      $196.63
                               thyroid.
   60212  C                   Parital thyroid          .........  .........  .........  ...........  ...........
                               excision.
   60220  T                   Partial removal of             397      19.12    $983.15      $542.17      $196.63
                               thyroid.
   60225  T                   Partial removal of             397      19.12    $983.15      $542.17      $196.63
                               thyroid.
   60240  T                   Removal of thyroid.....        397      19.12    $983.15      $542.17      $196.63
   60252  C                   Removal of thyroid.....  .........  .........  .........  ...........  ...........
   60254  C                   Extensive thyroid        .........  .........  .........  ...........  ...........
                               surgery.
   60260  C                   Repeat thyroid surgery.  .........  .........  .........  ...........  ...........
   60270  C                   Removal of thyroid.....  .........  .........  .........  ...........  ...........
   60271  C                   Removal of thyroid.....  .........  .........  .........  ...........  ...........
   60280  T                   Remove thyroid duct            397      19.12    $983.15      $542.17      $196.63
                               lesion.
   60281  T                   Remove thyroid duct            397      19.12    $983.15      $542.17      $196.63
                               lesion.
   60500  C                   Explore parathyroid      .........  .........  .........  ...........  ...........
                               glands.
   60502  C                   Re-explore parathyroids  .........  .........  .........  ...........  ...........
   60505  C                   Explore parathyroid      .........  .........  .........  ...........  ...........
                               glands.
   60512  C                   Autotransplant,          .........  .........  .........  ...........  ...........
                               parathyroid.
   60520  C                   Removal of thymus gland  .........  .........  .........  ...........  ...........
   60521  C                   Removal thymus gland...  .........  .........  .........  ...........  ...........
   60522  C                   Removal of thymus gland  .........  .........  .........  ...........  ...........
   60540  C                   Explore adrenal gland..  .........  .........  .........  ...........  ...........
   60545  C                   Explore adrenal gland..  .........  .........  .........  ...........  ...........
   60600  C                   Remove carotid body      .........  .........  .........  ...........  ...........
                               lesion.
   60605  C                   Remove carotid body      .........  .........  .........  ...........  ...........
                               lesion.
   60699  T                   Endocrine surgery              121       0.63     $32.39       $21.02        $6.48
                               procedure.
   61000  T                   Remove cranial cavity          602       3.19    $164.03       $87.01       $32.81
                               fluid.
   61001  T                   Remove cranial cavity          602       3.19    $164.03       $87.01       $32.81
                               fluid.
   61020  T                   Remove brain cavity            602       3.19    $164.03       $87.01       $32.81
                               fluid.
   61026  T                   Injection into brain           602       3.19    $164.03       $87.01       $32.81
                               canal.
   61050  T                   Remove brain canal             602       3.19    $164.03       $87.01       $32.81
                               fluid.
   61055  T                   Injection into brain           602       3.19    $164.03       $87.01       $32.81
                               canal.
   61070  T                   Brain canal shunt              602       3.19    $164.03       $87.01       $32.81
                               procedure.
   61105  C                   Twist drill hole.......  .........  .........  .........  ...........  ...........
\2\ 6110  C                   Drill skull for exam/    .........  .........  .........  ...........  ...........
        6                      surgery.
   61107  C                   Drill skull for          .........  .........  .........  ...........  ...........
                               implantation.
   61108  C                   Drill skull for          .........  .........  .........  ...........  ...........
                               drainage.
   61120  C                   Burr hole for puncture.  .........  .........  .........  ...........  ...........
\2\ 6113  C                   Pierce skull, exam/      .........  .........  .........  ...........  ...........
        0                      surgery.
   61140  C                   Pierce skull for biopsy  .........  .........  .........  ...........  ...........
   61150  C                   Pierce skull for         .........  .........  .........  ...........  ...........
                               drainage.
   61151  C                   Pierce skull for         .........  .........  .........  ...........  ...........
                               drainage.
   61154  C                   Pierce skull, remove     .........  .........  .........  ...........  ...........
                               clot.
   61156  C                   Pierce skull for         .........  .........  .........  ...........  ...........
                               drainage.
   61210  C                   Pierce skull; implant    .........  .........  .........  ...........  ...........
                               device.
   61215  T                   Insert brain-fluid             618      24.78  $1,274.19      $808.18      $254.84
                               device.
   61250  C                   Pierce skull & explore.  .........  .........  .........  ...........  ...........
   61253  C                   Pierce skull & explore.  .........  .........  .........  ...........  ...........
   61304  C                   Open skull for           .........  .........  .........  ...........  ...........
                               exploration.
   61305  C                   Open skull for           .........  .........  .........  ...........  ...........
                               exploration.

[[Page 35330]]

 
   61312  C                   Open skull for drainage  .........  .........  .........  ...........  ...........
   61313  C                   Open skull for drainage  .........  .........  .........  ...........  ...........
   61314  C                   Open skull for drainage  .........  .........  .........  ...........  ...........
   61315  C                   Open skull for drainage  .........  .........  .........  ...........  ...........
   61320  C                   Open skull for drainage  .........  .........  .........  ...........  ...........
   61321  C                   Open skull for drainage  .........  .........  .........  ...........  ...........
   61330  C                   Decompress eye socket..  .........  .........  .........  ...........  ...........
   61332  C                   Explore/biopsy eye       .........  .........  .........  ...........  ...........
                               socket.
   61333  C                   Explore orbit; remove    .........  .........  .........  ...........  ...........
                               lesion.
   61334  C                   Explore orbit; remove    .........  .........  .........  ...........  ...........
                               object.
   61340  C                   Relieve cranial          .........  .........  .........  ...........  ...........
                               pressure.
   61343  C                   Incise skull,pressure    .........  .........  .........  ...........  ...........
                               relief.
   61345  C                   Relieve cranial          .........  .........  .........  ...........  ...........
                               pressure.
   61440  C                   Incise skull for         .........  .........  .........  ...........  ...........
                               surgery.
   61450  C                   Incise skull for         .........  .........  .........  ...........  ...........
                               surgery.
   61458  C                   Incise skull for brain   .........  .........  .........  ...........  ...........
                               wound.
   61460  C                   Incise skull for         .........  .........  .........  ...........  ...........
                               surgery.
   61470  C                   Incise skull for         .........  .........  .........  ...........  ...........
                               surgery.
   61480  C                   Incise skull for         .........  .........  .........  ...........  ...........
                               surgery.
   61490  C                   Incise skull for         .........  .........  .........  ...........  ...........
                               surgery.
   61500  C                   Removal of skull lesion  .........  .........  .........  ...........  ...........
   61501  C                   Remove infected skull    .........  .........  .........  ...........  ...........
                               bone.
   61510  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61512  C                   Remove brain lining      .........  .........  .........  ...........  ...........
                               lesion.
   61514  C                   Removal of brain         .........  .........  .........  ...........  ...........
                               abscess.
   61516  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61518  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61519  C                   Remove brain lining      .........  .........  .........  ...........  ...........
                               lesion.
   61520  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61521  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61522  C                   Removal of brain         .........  .........  .........  ...........  ...........
                               abscess.
   61524  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61526  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61530  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61531  C                   Implant brain            .........  .........  .........  ...........  ...........
                               electrodes.
   61533  C                   Implant brain            .........  .........  .........  ...........  ...........
                               electrodes.
   61534  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61535  C                   Remove brain electrodes  .........  .........  .........  ...........  ...........
   61536  C                   Removal of brain lesion  .........  .........  .........  ...........  ...........
   61538  C                   Removal of brain tissue  .........  .........  .........  ...........  ...........
   61539  C                   Removal of brain tissue  .........  .........  .........  ...........  ...........
   61541  C                   Incision of brain        .........  .........  .........  ...........  ...........
                               tissue.
   61542  C                   Removal of brain tissue  .........  .........  .........  ...........  ...........
   61543  C                   Removal of brain tissue  .........  .........  .........  ...........  ...........
   61544  C                   Remove & treat brain     .........  .........  .........  ...........  ...........
                               lesion.
   61545  C                   Excision of brain tumor  .........  .........  .........  ...........  ...........
   61546  C                   Removal of pituitary     .........  .........  .........  ...........  ...........
                               gland.
   61548  C                   Removal of pituitary     .........  .........  .........  ...........  ...........
                               gland.
   61550  C                   Release of skull seams.  .........  .........  .........  ...........  ...........
   61552  C                   Release of skull seams.  .........  .........  .........  ...........  ...........
   61556  C                   Incise skull/sutures...  .........  .........  .........  ...........  ...........
   61557  C                   Incise skull/sutures...  .........  .........  .........  ...........  ...........
   61558  C                   Excision of skull/       .........  .........  .........  ...........  ...........
                               sutures.
   61559  C                   Excision of skull/       .........  .........  .........  ...........  ...........
                               sutures.
   61563  C                   Excision of skull tumor  .........  .........  .........  ...........  ...........
   61564  C                   Excision of skull tumor  .........  .........  .........  ...........  ...........
   61570  C                   Remove brain foreign     .........  .........  .........  ...........  ...........
                               body.
   61571  C                   Incise skull for brain   .........  .........  .........  ...........  ...........
                               wound.
   61575  C                   Skull base/brainstem     .........  .........  .........  ...........  ...........
                               surgery.
   61576  C                   Skull base/brainstem     .........  .........  .........  ...........  ...........
                               surgery.
   61580  C                   Craniofacial approach,   .........  .........  .........  ...........  ...........
                               skull.
   61581  C                   Craniofacial approach,   .........  .........  .........  ...........  ...........
                               skull.
   61582  C                   Craniofacial approach,   .........  .........  .........  ...........  ...........
                               skull.
   61583  C                   Craniofacial approach,   .........  .........  .........  ...........  ...........
                               skull.
   61584  C                   Orbitocranial approach/  .........  .........  .........  ...........  ...........
                               skull.
   61585  C                   Orbitocranial approach/  .........  .........  .........  ...........  ...........
                               skull.
   61586  C                   Resect nasopharynx,      .........  .........  .........  ...........  ...........
                               skull.
   61590  C                   Infratemporal approach/  .........  .........  .........  ...........  ...........
                               skull.
   61591  C                   Infratemporal approach/  .........  .........  .........  ...........  ...........
                               skull.
   61592  C                   Orbitocranial approach/  .........  .........  .........  ...........  ...........
                               skull.
   61595  C                   Transtemporal approach/  .........  .........  .........  ...........  ...........
                               skull.
   61596  C                   Transcochlear approach/  .........  .........  .........  ...........  ...........
                               skull.
   61597  C                   Transcondylar approach/  .........  .........  .........  ...........  ...........
                               skull.
   61598  C                   Transpetrosal approach/  .........  .........  .........  ...........  ...........
                               skull.
   61600  C                   Resect/excise cranial    .........  .........  .........  ...........  ...........
                               lesion.

[[Page 35331]]

 
   61601  C                   Resect/excise cranial    .........  .........  .........  ...........  ...........
                               lesion.
   61605  C                   Resect/excise cranial    .........  .........  .........  ...........  ...........
                               lesion.
   61606  C                   Resect/excise cranial    .........  .........  .........  ...........  ...........
                               lesion.
   61607  C                   Resect/excise cranial    .........  .........  .........  ...........  ...........
                               lesion.
   61608  C                   Resect/excise cranial    .........  .........  .........  ...........  ...........
                               lesion.
   61609  C                   Transect, artery, sinus  .........  .........  .........  ...........  ...........
   61610  C                   Transect, artery, sinus  .........  .........  .........  ...........  ...........
   61611  C                   Transect, artery, sinus  .........  .........  .........  ...........  ...........
   61612  C                   Transect, artery, sinus  .........  .........  .........  ...........  ...........
   61613  C                   Remove aneurysm, sinus.  .........  .........  .........  ...........  ...........
   61615  C                   Resect/excise lesion,    .........  .........  .........  ...........  ...........
                               skull.
   61616  C                   Resect/excise lesion,    .........  .........  .........  ...........  ...........
                               skull.
   61618  C                   Repair dura............  .........  .........  .........  ...........  ...........
   61619  C                   Repair dura............  .........  .........  .........  ...........  ...........
   61624  C                   Occlusion/embolization   .........  .........  .........  ...........  ...........
                               cath.
   61626  C                   Occlusion/embolization   .........  .........  .........  ...........  ...........
                               cath.
   61680  C                   Intracranial vessel      .........  .........  .........  ...........  ...........
                               surgery.
   61682  C                   Intracranial vessel      .........  .........  .........  ...........  ...........
                               surgery.
   61684  C                   Intracranial vessel      .........  .........  .........  ...........  ...........
                               surgery.
   61686  C                   Intracranial vessel      .........  .........  .........  ...........  ...........
                               surgery.
   61690  C                   Intracranial vessel      .........  .........  .........  ...........  ...........
                               surgery.
   61692  C                   Intracranial vessel      .........  .........  .........  ...........  ...........
                               surgery.
   61700  C                   Inner skull vessel       .........  .........  .........  ...........  ...........
                               surgery.
   61702  C                   Inner skull vessel       .........  .........  .........  ...........  ...........
                               surgery.
   61703  C                   Clamp neck artery......  .........  .........  .........  ...........  ...........
   61705  C                   Revise circulation to    .........  .........  .........  ...........  ...........
                               head.
   61708  C                   Revise circulation to    .........  .........  .........  ...........  ...........
                               head.
   61710  C                   Revise circulation to    .........  .........  .........  ...........  ...........
                               head.
   61711  C                   Fusion of skull          .........  .........  .........  ...........  ...........
                               arteries.
\2\ 6171  C                   Skull or spine           .........  .........  .........  ...........  ...........
        2                      microsurgery.
   61720  C                   Incise skull/brain       .........  .........  .........  ...........  ...........
                               surgery.
   61735  C                   Incise skull/brain       .........  .........  .........  ...........  ...........
                               surgery.
   61750  C                   Incise skull; brain      .........  .........  .........  ...........  ...........
                               biopsy.
   61751  C                   Brain biopsy with cat    .........  .........  .........  ...........  ...........
                               scan.
   61760  C                   Implant brain            .........  .........  .........  ...........  ...........
                               electrodes.
   61770  C                   Incise skull for         .........  .........  .........  ...........  ...........
                               treatment.
   61790  T                   Treat trigeminal nerve.        631      12.70    $653.03      $329.06      $130.61
   61791  C                   Treat trigeminal tract.  .........  .........  .........  ...........  ...........
   61793  S                   Focus radiation beam...        757       2.26    $116.21       $52.43       $23.24
   61795  C                   Brain surgery using      .........  .........  .........  ...........  ...........
                               computer.
   61850  C                   Implant neuroelectrodes  .........  .........  .........  ...........  ...........
   61855  C                   Implant neuroelectrodes  .........  .........  .........  ...........  ...........
   61860  C                   Implant neuroelectrodes  .........  .........  .........  ...........  ...........
   61865  C                   Implant neuroelectrodes  .........  .........  .........  ...........  ...........
   61870  C                   Implant neuroelectrodes  .........  .........  .........  ...........  ...........
   61875  C                   Implant neuroelectrodes  .........  .........  .........  ...........  ...........
   61880  C                   Revise/remove            .........  .........  .........  ...........  ...........
                               neuroelectrode.
   61885  T                   Implant neuroreceiver..        618      24.78  $1,274.19      $808.18      $254.84
   61888  C                   Revise/remove            .........  .........  .........  ...........  ...........
                               neuroreceiver.
   62000  C                   Repair of skull          .........  .........  .........  ...........  ...........
                               fracture.
   62005  C                   Repair of skull          .........  .........  .........  ...........  ...........
                               fracture.
   62010  C                   Treatment of head        .........  .........  .........  ...........  ...........
                               injury.
   62100  C                   Repair brain fluid       .........  .........  .........  ...........  ...........
                               leakage.
   62115  C                   Reduction of skull       .........  .........  .........  ...........  ...........
                               defect.
   62116  C                   Reduction of skull       .........  .........  .........  ...........  ...........
                               defect.
   62117  C                   Reduction of skull       .........  .........  .........  ...........  ...........
                               defect.
   62120  C                   Repair skull cavity      .........  .........  .........  ...........  ...........
                               lesion.
   62121  C                   Incise skull repair....  .........  .........  .........  ...........  ...........
   62140  C                   Repair of skull defect.  .........  .........  .........  ...........  ...........
   62141  C                   Repair of skull defect.  .........  .........  .........  ...........  ...........
   62142  C                   Remove skull plate/flap  .........  .........  .........  ...........  ...........
   62143  C                   Replace skull plate/     .........  .........  .........  ...........  ...........
                               flap.
   62145  C                   Repair of skull & brain  .........  .........  .........  ...........  ...........
   62146  C                   Repair of skull with     .........  .........  .........  ...........  ...........
                               graft.
   62147  C                   Repair of skull with     .........  .........  .........  ...........  ...........
                               graft.
   62180  C                   Establish brain cavity   .........  .........  .........  ...........  ...........
                               shunt.
   62190  C                   Establish brain cavity   .........  .........  .........  ...........  ...........
                               shunt.
   62192  C                   Establish brain cavity   .........  .........  .........  ...........  ...........
                               shunt.
   62194  T                   Replace/irrigate               602       3.19    $164.03       $87.01       $32.81
                               catheter.
   62200  C                   Establish brain cavity   .........  .........  .........  ...........  ...........
                               shunt.
   62201  C                   Establish brain cavity   .........  .........  .........  ...........  ...........
                               shunt.
   62220  C                   Establish brain cavity   .........  .........  .........  ...........  ...........
                               shunt.
   62223  C                   Establish brain cavity   .........  .........  .........  ...........  ...........
                               shunt.
   62225  T                   Replace/irrigate               602       3.19    $164.03       $87.01       $32.81
                               catheter.
   62230  T                   Replace/revise brain           617      11.31    $581.56      $280.01      $116.31
                               shunt.

[[Page 35332]]

 
   62256  C                   Remove brain cavity      .........  .........  .........  ...........  ...........
                               shunt.
   62258  C                   Replace brain cavity     .........  .........  .........  ...........  ...........
                               shunt.
   62268  T                   Drain spinal cord cyst.        602       3.19    $164.03       $87.01       $32.81
   62269  T                   Needle biopsy spinal           122       4.59    $236.02      $113.00       $47.20
                               cord.
   62270  T                   Spinal fluid tap,              600       2.41    $123.92       $61.47       $24.78
                               diagnostic.
   62272  T                   Drain spinal fluid.....        600       2.41    $123.92       $61.47       $24.78
   62273  T                   Treat lumbar spine             602       3.19    $164.03       $87.01       $32.81
                               lesion.
   62274  T                   Inject spinal                  602       3.19    $164.03       $87.01       $32.81
                               anesthetic.
   62275  T                   Inject spinal                  602       3.19    $164.03       $87.01       $32.81
                               anesthetic.
   62276  T                   Inject spinal                  602       3.19    $164.03       $87.01       $32.81
                               anesthetic.
   62277  T                   Inject spinal                  602       3.19    $164.03       $87.01       $32.81
                               anesthetic.
   62278  T                   Inject spinal                  602       3.19    $164.03       $87.01       $32.81
                               anesthetic.
   62279  T                   Inject spinal                  602       3.19    $164.03       $87.01       $32.81
                               anesthetic.
   62280  T                   Treat spinal cord              602       3.19    $164.03       $87.01       $32.81
                               lesion.
   62281  T                   Treat spinal cord              602       3.19    $164.03       $87.01       $32.81
                               lesion.
   62282  T                   Treat spinal canal             602       3.19    $164.03       $87.01       $32.81
                               lesion.
   62284  T                   Injection for myelogram        347       2.57    $132.15       $62.38       $26.43
   62287  T                   Percutaneous diskectomy        631      12.70    $653.03      $329.06      $130.61
   62288  T                   Injection into spinal          602       3.19    $164.03       $87.01       $32.81
                               canal.
   62289  T                   Injection into spinal          602       3.19    $164.03       $87.01       $32.81
                               canal.
   62290  T                   Inject for spine disk x-       347       2.57    $132.15       $62.38       $26.43
                               ray.
   62291  T                   Inject for spine disk x-       347       2.57    $132.15       $62.38       $26.43
                               ray.
   62292  T                   Injection into disk            602       3.19    $164.03       $87.01       $32.81
                               lesion.
   62294  T                   Injection into spinal          602       3.19    $164.03       $87.01       $32.81
                               artery.
   62298  T                   Injection into spinal          602       3.19    $164.03       $87.01       $32.81
                               canal.
   62350  T                   Implant spinal catheter        617      11.31    $581.56      $280.01      $116.31
   62351  C                   Implant spinal catheter  .........  .........  .........  ...........  ...........
   62355  T                   Remove spinal canal            617      11.31    $581.56      $280.01      $116.31
                               catheter.
   62360  T                   Insert spine infusion          618      24.78  $1,274.19      $808.18      $254.84
                               device.
   62361  T                   Implant spine infusion         618      24.78  $1,274.19      $808.18      $254.84
                               pump.
   62362  T                   Implant spine infusion         618      24.78  $1,274.19      $808.18      $254.84
                               pump.
   62365  T                   Remove spine infusion          617      11.31    $581.56      $280.01      $116.31
                               device.
   62367  X                   Analyze spine infusion         966       0.39     $20.05       $12.43        $4.01
                               pump.
   62368  X                   Analyze spine infusion         966       0.39     $20.05       $12.43        $4.01
                               pump.
   63001  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63003  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63005  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63011  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63012  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63015  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63016  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63017  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63020  C                   Neck spine disk surgery  .........  .........  .........  ...........  ...........
   63030  C                   Low back disk surgery..  .........  .........  .........  ...........  ...........
   63035  C                   Spinal disk surgery add- .........  .........  .........  ...........  ...........
                               on.
   63040  C                   Neck spine disk surgery  .........  .........  .........  ...........  ...........
   63042  C                   Low back disk surgery..  .........  .........  .........  ...........  ...........
   63045  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63046  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63047  C                   Removal of spinal        .........  .........  .........  ...........  ...........
                               lamina.
   63048  C                   Remove spinal lamina     .........  .........  .........  ...........  ...........
                               add-on.
   63055  C                   Decompress spinal cord.  .........  .........  .........  ...........  ...........
   63056  C                   Decompress spinal cord.  .........  .........  .........  ...........  ...........
   63057  C                   Decompress spine cord    .........  .........  .........  ...........  ...........
                               add-on.
   63064  C                   Decompress spinal cord.  .........  .........  .........  ...........  ...........
   63066  C                   Decompress spine cord    .........  .........  .........  ...........  ...........
                               add-on.
   63075  C                   Neck spine disk surgery  .........  .........  .........  ...........  ...........
   63076  C                   Neck spine disk surgery  .........  .........  .........  ...........  ...........
   63077  C                   Spine disk surgery,      .........  .........  .........  ...........  ...........
                               thorax.
   63078  C                   Spine disk surgery,      .........  .........  .........  ...........  ...........
                               thorax.
   63081  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63082  C                   Remove vertebral body    .........  .........  .........  ...........  ...........
                               add-on.
   63085  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63086  C                   Remove vertebral body    .........  .........  .........  ...........  ...........
                               add-on.
   63087  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63088  C                   Remove vertebral body    .........  .........  .........  ...........  ...........
                               add-on.
   63090  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63091  C                   Remove vertebral body    .........  .........  .........  ...........  ...........
                               add-on.
   63170  C                   Incise spinal cord       .........  .........  .........  ...........  ...........
                               tract(s).
   63172  C                   Drainage of spinal cyst  .........  .........  .........  ...........  ...........
   63173  C                   Drainage of spinal cyst  .........  .........  .........  ...........  ...........
   63180  C                   Revise spinal cord       .........  .........  .........  ...........  ...........
                               ligaments.
   63182  C                   Revise spinal cord       .........  .........  .........  ...........  ...........
                               ligaments.
   63185  C                   Incise spinal column/    .........  .........  .........  ...........  ...........
                               nerves.
   63190  C                   Incise spinal column/    .........  .........  .........  ...........  ...........
                               nerves.

[[Page 35333]]

 
   63191  C                   Incise spinal column/    .........  .........  .........  ...........  ...........
                               nerves.
   63194  C                   Incise spinal column &   .........  .........  .........  ...........  ...........
                               cord.
   63195  C                   Incise spinal column &   .........  .........  .........  ...........  ...........
                               cord.
   63196  C                   Incise spinal column &   .........  .........  .........  ...........  ...........
                               cord.
   63197  C                   Incise spinal column &   .........  .........  .........  ...........  ...........
                               cord.
   63198  C                   Incise spinal column &   .........  .........  .........  ...........  ...........
                               cord.
   63199  C                   Incise spinal column &   .........  .........  .........  ...........  ...........
                               cord.
   63200  C                   Release of spinal cord.  .........  .........  .........  ...........  ...........
   63250  C                   Revise spinal cord       .........  .........  .........  ...........  ...........
                               vessels.
   63251  C                   Revise spinal cord       .........  .........  .........  ...........  ...........
                               vessels.
   63252  C                   Revise spinal cord       .........  .........  .........  ...........  ...........
                               vessels.
   63265  C                   Excise intraspinal       .........  .........  .........  ...........  ...........
                               lesion.
   63266  C                   Excise intraspinal       .........  .........  .........  ...........  ...........
                               lesion.
   63267  C                   Excise intraspinal       .........  .........  .........  ...........  ...........
                               lesion.
   63268  C                   Excise intraspinal       .........  .........  .........  ...........  ...........
                               lesion.
   63270  C                   Excise intraspinal       .........  .........  .........  ...........  ...........
                               lesion.
   63271  C                   Excise intraspinal       .........  .........  .........  ...........  ...........
                               lesion.
   63272  C                   Excise intraspinal       .........  .........  .........  ...........  ...........
                               lesion.
   63273  C                   Excise intraspinal       .........  .........  .........  ...........  ...........
                               lesion.
   63275  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63276  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63277  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63278  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63280  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63281  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63282  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63283  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63285  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63286  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63287  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63290  C                   Biopsy/excise spinal     .........  .........  .........  ...........  ...........
                               tumor.
   63300  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63301  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63302  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63303  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63304  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63305  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63306  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63307  C                   Removal of vertebral     .........  .........  .........  ...........  ...........
                               body.
   63308  C                   Remove vertebral body    .........  .........  .........  ...........  ...........
                               add-on.
   63600  T                   Remove spinal cord             631      12.70    $653.03      $329.06      $130.61
                               lesion.
   63610  T                   Stimulation of spinal          631      12.70    $653.03      $329.06      $130.61
                               cord.
   63615  T                   Remove lesion of spinal        631      12.70    $653.03      $329.06      $130.61
                               cord.
   63650  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   63655  C                   Implant neuroelectrodes  .........  .........  .........  ...........  ...........
   63660  T                   Revise/remove                  617      11.31    $581.56      $280.01      $116.31
                               neuroelectrode.
   63685  T                   Implant neuroreceiver..        618      24.78  $1,274.19      $808.18      $254.84
   63688  T                   Revise/remove                  617      11.31    $581.56      $280.01      $116.31
                               neuroreceiver.
\2\ 6369  X                   Analysis of                    966       0.39     $20.05       $12.43        $4.01
        0                      neuroreceiver.
\2\ 6369  X                   Analysis of                    966       0.39     $20.05       $12.43        $4.01
        1                      neuroreceiver.
   63700  C                   Repair of spinal         .........  .........  .........  ...........  ...........
                               herniation.
   63702  C                   Repair of spinal         .........  .........  .........  ...........  ...........
                               herniation.
   63704  C                   Repair of spinal         .........  .........  .........  ...........  ...........
                               herniation.
   63706  C                   Repair of spinal         .........  .........  .........  ...........  ...........
                               herniation.
   63707  C                   Repair spinal fluid      .........  .........  .........  ...........  ...........
                               leakage.
   63709  C                   Repair spinal fluid      .........  .........  .........  ...........  ...........
                               leakage.
   63710  C                   Graft repair of spine    .........  .........  .........  ...........  ...........
                               defect.
   63740  C                   Install spinal shunt...  .........  .........  .........  ...........  ...........
   63741  C                   Install spinal shunt...  .........  .........  .........  ...........  ...........
   63744  T                   Revision of spinal             617      11.31    $581.56      $280.01      $116.31
                               shunt.
   63746  T                   Removal of spinal shunt        617      11.31    $581.56      $280.01      $116.31
   64400  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64402  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64405  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64408  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64410  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64412  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64413  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64415  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64417  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64418  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64420  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64421  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64425  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64430  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.

[[Page 35334]]

 
   64435  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64440  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64441  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64442  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64443  T                   Inject, nerve block add-       601       3.00    $154.26       $74.13       $30.85
                               on.
   64445  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64450  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64505  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64508  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64510  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64520  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64530  T                   Injection for nerve            601       3.00    $154.26       $74.13       $30.85
                               block.
   64550  A                   Apply neurostimulator..  .........  .........  .........  ...........  ...........
   64553  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   64555  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   64560  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   64565  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   64573  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   64575  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   64577  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   64580  T                   Implant neuroelectrodes        616      11.85    $609.33      $329.06      $121.87
   64585  T                   Revise/remove                  617      11.31    $581.56      $280.01      $116.31
                               neuroelectrode.
   64590  T                   Implant neuroreceiver..        618      24.78  $1,274.19      $808.18      $254.84
   64595  T                   Revise/remove                  617      11.31    $581.56      $280.01      $116.31
                               neuroreceiver.
   64600  T                   Injection treatment of         601       3.00    $154.26       $74.13       $30.85
                               nerve.
   64605  T                   Injection treatment of         601       3.00    $154.26       $74.13       $30.85
                               nerve.
   64610  T                   Injection treatment of         601       3.00    $154.26       $74.13       $30.85
                               nerve.
   64612  T                   Destroy nerve, face            601       3.00    $154.26       $74.13       $30.85
                               muscle.
   64613  T                   Destroy nerve, spine           601       3.00    $154.26       $74.13       $30.85
                               muscle.
   64620  T                   Injection treatment of         601       3.00    $154.26       $74.13       $30.85
                               nerve.
   64622  T                   Injection treatment of         601       3.00    $154.26       $74.13       $30.85
                               nerve.
   64623  T                   Inject, tx of nerve add-       601       3.00    $154.26       $74.13       $30.85
                               on.
   64630  T                   Injection treatment of         601       3.00    $154.26       $74.13       $30.85
                               nerve.
   64640  T                   Injection treatment of         601       3.00    $154.26       $74.13       $30.85
                               nerve.
   64680  T                   Injection treatment of         601       3.00    $154.26       $74.13       $30.85
                               nerve.
   64702  T                   Revise finger/toe nerve        631      12.70    $653.03      $329.06      $130.61
   64704  T                   Revise hand/foot nerve.        631      12.70    $653.03      $329.06      $130.61
   64708  T                   Revise arm/leg nerve...        631      12.70    $653.03      $329.06      $130.61
   64712  T                   Revision of sciatic            631      12.70    $653.03      $329.06      $130.61
                               nerve.
   64713  T                   Revision of arm                631      12.70    $653.03      $329.06      $130.61
                               nerve(s).
   64714  T                   Revise low back                631      12.70    $653.03      $329.06      $130.61
                               nerve(s).
   64716  T                   Revision of cranial            631      12.70    $653.03      $329.06      $130.61
                               nerve.
   64718  T                   Revise ulnar nerve at          631      12.70    $653.03      $329.06      $130.61
                               elbow.
   64719  T                   Revise ulnar nerve at          631      12.70    $653.03      $329.06      $130.61
                               wrist.
   64721  T                   Carpal tunnel surgery..        631      12.70    $653.03      $329.06      $130.61
   64722  T                   Relieve pressure on            631      12.70    $653.03      $329.06      $130.61
                               nerve(s).
   64726  T                   Release foot/toe nerve.        631      12.70    $653.03      $329.06      $130.61
   64727  T                   Internal nerve revision        631      12.70    $653.03      $329.06      $130.61
   64732  T                   Incision of brow nerve.        631      12.70    $653.03      $329.06      $130.61
   64734  T                   Incision of cheek nerve        631      12.70    $653.03      $329.06      $130.61
   64736  T                   Incision of chin nerve.        631      12.70    $653.03      $329.06      $130.61
   64738  T                   Incision of jaw nerve..        631      12.70    $653.03      $329.06      $130.61
   64740  T                   Incision of tongue             631      12.70    $653.03      $329.06      $130.61
                               nerve.
   64742  T                   Incision of facial             631      12.70    $653.03      $329.06      $130.61
                               nerve.
   64744  T                   Incise nerve, back of          631      12.70    $653.03      $329.06      $130.61
                               head.
   64746  T                   Incise diaphragm nerve.        631      12.70    $653.03      $329.06      $130.61
   64752  C                   Incision of vagus nerve  .........  .........  .........  ...........  ...........
   64755  C                   Incision of stomach      .........  .........  .........  ...........  ...........
                               nerves.
   64760  C                   Incision of vagus nerve  .........  .........  .........  ...........  ...........
   64761  T                   Incision of pelvis             631      12.70    $653.03      $329.06      $130.61
                               nerve.
   64763  C                   Incise hip/thigh nerve.  .........  .........  .........  ...........  ...........
   64766  C                   Incise hip/thigh nerve.  .........  .........  .........  ...........  ...........
   64771  T                   Sever cranial nerve....        631      12.70    $653.03      $329.06      $130.61
   64772  T                   Incision of spinal             631      12.70    $653.03      $329.06      $130.61
                               nerve.
   64774  T                   Remove skin nerve              631      12.70    $653.03      $329.06      $130.61
                               lesion.
   64776  T                   Remove digit nerve             631      12.70    $653.03      $329.06      $130.61
                               lesion.
   64778  T                   Digit nerve surgery add-       631      12.70    $653.03      $329.06      $130.61
                               on.
   64782  T                   Remove limb nerve              631      12.70    $653.03      $329.06      $130.61
                               lesion.
   64783  T                   Limb nerve surgery add-        631      12.70    $653.03      $329.06      $130.61
                               on.
   64784  T                   Remove nerve lesion....        631      12.70    $653.03      $329.06      $130.61
   64786  T                   Remove sciatic nerve           632      16.48    $847.40      $453.58      $169.48
                               lesion.
   64787  T                   Implant nerve end......        631      12.70    $653.03      $329.06      $130.61
   64788  T                   Remove skin nerve              631      12.70    $653.03      $329.06      $130.61
                               lesion.
   64790  T                   Removal of nerve lesion        631      12.70    $653.03      $329.06      $130.61
   64792  T                   Removal of nerve lesion        632      16.48    $847.40      $453.58      $169.48

[[Page 35335]]

 
   64795  T                   Biopsy of nerve........        631      12.70    $653.03      $329.06      $130.61
   64802  C                   Remove sympathetic       .........  .........  .........  ...........  ...........
                               nerves.
   64804  C                   Remove sympathetic       .........  .........  .........  ...........  ...........
                               nerves.
   64809  C                   Remove sympathetic       .........  .........  .........  ...........  ...........
                               nerves.
   64818  C                   Remove sympathetic       .........  .........  .........  ...........  ...........
                               nerves.
   64820  C                   Remove sympathetic       .........  .........  .........  ...........  ...........
                               nerves.
\2\ 6483  T                   Microrepair of nerve...        631      12.70    $653.03      $329.06      $130.61
        0
   64831  T                   Repair of digit nerve..        632      16.48    $847.40      $453.58      $169.48
   64832  T                   Repair nerve add-on....        632      16.48    $847.40      $453.58      $169.48
   64834  T                   Repair of hand or foot         632      16.48    $847.40      $453.58      $169.48
                               nerve.
   64835  T                   Repair of hand or foot         632      16.48    $847.40      $453.58      $169.48
                               nerve.
   64836  T                   Repair of hand or foot         632      16.48    $847.40      $453.58      $169.48
                               nerve.
   64837  T                   Repair nerve add-on....        632      16.48    $847.40      $453.58      $169.48
   64840  T                   Repair of leg nerve....        632      16.48    $847.40      $453.58      $169.48
   64856  T                   Repair/transpose nerve.        632      16.48    $847.40      $453.58      $169.48
   64857  T                   Repair arm/leg nerve...        632      16.48    $847.40      $453.58      $169.48
   64858  T                   Repair sciatic nerve...        632      16.48    $847.40      $453.58      $169.48
   64859  T                   Nerve surgery..........        632      16.48    $847.40      $453.58      $169.48
   64861  T                   Repair of arm nerves...        632      16.48    $847.40      $453.58      $169.48
   64862  T                   Repair of low back             632      16.48    $847.40      $453.58      $169.48
                               nerves.
   64864  T                   Repair of facial nerve.        632      16.48    $847.40      $453.58      $169.48
   64865  T                   Repair of facial nerve.        632      16.48    $847.40      $453.58      $169.48
   64866  C                   Fusion of facial/other   .........  .........  .........  ...........  ...........
                               nerve.
   64868  C                   Fusion of facial/other   .........  .........  .........  ...........  ...........
                               nerve.
   64870  T                   Fusion of facial/other         632      16.48    $847.40      $453.58      $169.48
                               nerve.
   64872  T                   Subsequent repair of           632      16.48    $847.40      $453.58      $169.48
                               nerve.
   64874  T                   Repair & revise nerve          632      16.48    $847.40      $453.58      $169.48
                               add-on.
   64876  T                   Repair nerve; shorten          632      16.48    $847.40      $453.58      $169.48
                               bone.
   64885  T                   Nerve graft, head or           632      16.48    $847.40      $453.58      $169.48
                               neck.
   64886  T                   Nerve graft, head or           632      16.48    $847.40      $453.58      $169.48
                               neck.
   64890  T                   Nerve graft, hand or           632      16.48    $847.40      $453.58      $169.48
                               foot.
   64891  T                   Nerve graft, hand or           632      16.48    $847.40      $453.58      $169.48
                               foot.
   64892  T                   Nerve graft, arm or leg        632      16.48    $847.40      $453.58      $169.48
   64893  T                   Nerve graft, arm or leg        632      16.48    $847.40      $453.58      $169.48
   64895  T                   Nerve graft, hand or           632      16.48    $847.40      $453.58      $169.48
                               foot.
   64896  T                   Nerve graft, hand or           632      16.48    $847.40      $453.58      $169.48
                               foot.
   64897  T                   Nerve graft, arm or leg        632      16.48    $847.40      $453.58      $169.48
   64898  T                   Nerve graft, arm or leg        632      16.48    $847.40      $453.58      $169.48
   64901  T                   Nerve graft add-on.....        632      16.48    $847.40      $453.58      $169.48
   64902  T                   Nerve graft add-on.....        632      16.48    $847.40      $453.58      $169.48
   64905  T                   Nerve pedicle transfer.        632      16.48    $847.40      $453.58      $169.48
   64907  T                   Nerve pedicle transfer.        632      16.48    $847.40      $453.58      $169.48
   64999  T                   Nervous system surgery.        601       3.00    $154.26       $74.13       $30.85
   65091  T                   Revise eye.............        684      13.26    $681.83      $341.94      $136.37
   65093  T                   Revise eye with implant        684      13.26    $681.83      $341.94      $136.37
   65101  T                   Removal of eye.........        684      13.26    $681.83      $341.94      $136.37
   65103  T                   Remove eye/insert              684      13.26    $681.83      $341.94      $136.37
                               implant.
   65105  T                   Remove eye/attach              684      13.26    $681.83      $341.94      $136.37
                               implant.
   65110  C                   Removal of eye.........  .........  .........  .........  ...........  ...........
   65112  C                   Remove eye, revise       .........  .........  .........  ...........  ...........
                               socket.
   65114  C                   Remove eye, revise       .........  .........  .........  ...........  ...........
                               socket.
   65125  T                   Revise ocular implant..        681       1.65     $84.84       $30.51       $16.97
   65130  T                   Insert ocular implant..        684      13.26    $681.83      $341.94      $136.37
   65135  T                   Insert ocular implant..        684      13.26    $681.83      $341.94      $136.37
   65140  T                   Attach ocular implant..        684      13.26    $681.83      $341.94      $136.37
   65150  T                   Revise ocular implant..        684      13.26    $681.83      $341.94      $136.37
   65155  T                   Reinsert ocular implant        684      13.26    $681.83      $341.94      $136.37
   65175  T                   Removal of ocular              683       9.56    $491.58      $252.44       $98.32
                               implant.
   65205  T                   Remove foreign body            681       1.65     $84.84       $30.51       $16.97
                               from eye.
   65210  T                   Remove foreign body            681       1.65     $84.84       $30.51       $16.97
                               from eye.
   65220  T                   Remove foreign body            681       1.65     $84.84       $30.51       $16.97
                               from eye.
   65222  T                   Remove foreign body            681       1.65     $84.84       $30.51       $16.97
                               from eye.
   65235  T                   Remove foreign body            652      16.35    $840.72      $433.92      $168.14
                               from eye.
   65260  T                   Remove foreign body            676       5.87    $301.84      $138.54       $60.37
                               from eye.
   65265  T                   Remove foreign body            676       5.87    $301.84      $138.54       $60.37
                               from eye.
   65270  T                   Repair of eye wound....        183      11.04    $567.68      $283.18      $113.54
   65272  T                   Repair of eye wound....        651       6.85    $352.23      $171.99       $70.45
   65273  C                   Repair of eye wound....  .........  .........  .........  ...........  ...........
   65275  T                   Repair of eye wound....        651       6.85    $352.23      $171.99       $70.45
   65280  T                   Repair of eye wound....        652      16.35    $840.72      $433.92      $168.14
   65285  T                   Repair of eye wound....        652      16.35    $840.72      $433.92      $168.14
   65286  T                   Repair of eye wound....        651       6.85    $352.23      $171.99       $70.45
   65290  T                   Repair of eye socket           677      16.11    $828.38      $428.95      $165.68
                               wound.
   65400  T                   Removal of eye lesion..        652      16.35    $840.72      $433.92      $168.14
   65410  T                   Biopsy of cornea.......        683       9.56    $491.58      $252.44       $98.32

[[Page 35336]]

 
   65420  T                   Removal of eye lesion..        651       6.85    $352.23      $171.99       $70.45
   65426  T                   Removal of eye lesion..        652      16.35    $840.72      $433.92      $168.14
   65430  T                   Corneal smear..........        681       1.65     $84.84       $30.51       $16.97
   65435  T                   Curette/treat cornea...        681       1.65     $84.84       $30.51       $16.97
   65436  T                   Curette/treat cornea...        651       6.85    $352.23      $171.99       $70.45
   65450  T                   Treatment of corneal           651       6.85    $352.23      $171.99       $70.45
                               lesion.
   65600  T                   Revision of cornea.....        681       1.65     $84.84       $30.51       $16.97
   65710  T                   Corneal transplant.....        670      30.78  $1,582.71      $885.92      $316.54
   65730  T                   Corneal transplant.....        670      30.78  $1,582.71      $885.92      $316.54
   65750  T                   Corneal transplant.....        670      30.78  $1,582.71      $885.92      $316.54
   65755  T                   Corneal transplant.....        670      30.78  $1,582.71      $885.92      $316.54
   65760  E                   Revision of cornea.....  .........  .........  .........  ...........  ...........
   65765  E                   Revision of cornea.....  .........  .........  .........  ...........  ...........
   65767  E                   Corneal tissue           .........  .........  .........  ...........  ...........
                               transplant.
   65770  T                   Revise cornea with             652      16.35    $840.72      $433.92      $168.14
                               implant.
   65771  E                   Radial keratotomy......  .........  .........  .........  ...........  ...........
   65772  T                   Correction of                  651       6.85    $352.23      $171.99       $70.45
                               astigmatism.
   65775  T                   Correction of                  652      16.35    $840.72      $433.92      $168.14
                               astigmatism.
   65800  T                   Drainage of eye........        683       9.56    $491.58      $252.44       $98.32
   65805  T                   Drainage of eye........        683       9.56    $491.58      $252.44       $98.32
   65810  T                   Drainage of eye........        651       6.85    $352.23      $171.99       $70.45
   65815  T                   Drainage of eye........        651       6.85    $352.23      $171.99       $70.45
   65820  T                   Relieve inner eye              651       6.85    $352.23      $171.99       $70.45
                               pressure.
   65850  T                   Incision of eye........        652      16.35    $840.72      $433.92      $168.14
   65855  T                   Laser surgery of eye...        649       4.37    $224.71      $111.64       $44.94
   65860  T                   Incise inner eye               649       4.37    $224.71      $111.64       $44.94
                               adhesions.
   65865  T                   Incise inner eye               652      16.35    $840.72      $433.92      $168.14
                               adhesions.
   65870  T                   Incise inner eye               652      16.35    $840.72      $433.92      $168.14
                               adhesions.
   65875  T                   Incise inner eye               652      16.35    $840.72      $433.92      $168.14
                               adhesions.
   65880  T                   Incise inner eye               652      16.35    $840.72      $433.92      $168.14
                               adhesions.
   65900  T                   Remove eye lesion......        652      16.35    $840.72      $433.92      $168.14
   65920  T                   Remove implant from eye        652      16.35    $840.72      $433.92      $168.14
   65930  T                   Remove blood clot from         652      16.35    $840.72      $433.92      $168.14
                               eye.
   66020  T                   Injection treatment of         683       9.56    $491.58      $252.44       $98.32
                               eye.
   66030  T                   Injection treatment of         683       9.56    $491.58      $252.44       $98.32
                               eye.
   66130  T                   Remove eye lesion......        651       6.85    $352.23      $171.99       $70.45
   66150  T                   Glaucoma surgery.......        652      16.35    $840.72      $433.92      $168.14
   66155  T                   Glaucoma surgery.......        652      16.35    $840.72      $433.92      $168.14
   66160  T                   Glaucoma surgery.......        652      16.35    $840.72      $433.92      $168.14
   66165  T                   Glaucoma surgery.......        652      16.35    $840.72      $433.92      $168.14
   66170  T                   Glaucoma surgery.......        652      16.35    $840.72      $433.92      $168.14
   66172  T                   Incision of eye........        652      16.35    $840.72      $433.92      $168.14
   66180  T                   Implant eye shunt......        652      16.35    $840.72      $433.92      $168.14
   66185  T                   Revise eye shunt.......        652      16.35    $840.72      $433.92      $168.14
   66220  T                   Repair eye lesion......        676       5.87    $301.84      $138.54       $60.37
   66225  T                   Repair/graft eye lesion        652      16.35    $840.72      $433.92      $168.14
   66250  T                   Follow-up surgery of           652      16.35    $840.72      $433.92      $168.14
                               eye.
   66500  T                   Incision of iris.......        651       6.85    $352.23      $171.99       $70.45
   66505  T                   Incision of iris.......        651       6.85    $352.23      $171.99       $70.45
   66600  T                   Remove iris and lesion.        651       6.85    $352.23      $171.99       $70.45
   66605  T                   Removal of iris........        652      16.35    $840.72      $433.92      $168.14
   66625  T                   Removal of iris........        651       6.85    $352.23      $171.99       $70.45
   66630  T                   Removal of iris........        651       6.85    $352.23      $171.99       $70.45
   66635  T                   Removal of iris........        652      16.35    $840.72      $433.92      $168.14
   66680  T                   Repair iris & ciliary          652      16.35    $840.72      $433.92      $168.14
                               body.
   66682  T                   Repair iris and ciliary        652      16.35    $840.72      $433.92      $168.14
                               body.
   66700  T                   Destruction, ciliary           651       6.85    $352.23      $171.99       $70.45
                               body.
   66710  T                   Destruction, ciliary           651       6.85    $352.23      $171.99       $70.45
                               body.
   66720  T                   Destruction, ciliary           651       6.85    $352.23      $171.99       $70.45
                               body.
   66740  T                   Destruction, ciliary           652      16.35    $840.72      $433.92      $168.14
                               body.
   66761  T                   Revision of iris.......        649       4.37    $224.71      $111.64       $44.94
   66762  T                   Revision of iris.......        649       4.37    $224.71      $111.64       $44.94
   66770  T                   Removal of inner eye           649       4.37    $224.71      $111.64       $44.94
                               lesion.
   66820  T                   Incision, secondary            651       6.85    $352.23      $171.99       $70.45
                               cataract.
   66821  T                   After cataract laser           649       4.37    $224.71      $111.64       $44.94
                               surgery.
   66825  T                   Reposition intraocular         651       6.85    $352.23      $171.99       $70.45
                               lens.
   66830  T                   Removal of lens lesion.        652      16.35    $840.72      $433.92      $168.14
   66840  T                   Removal of lens                667      20.35  $1,046.40      $538.11      $209.28
                               material.
   66850  T                   Removal of lens                667      20.35  $1,046.40      $538.11      $209.28
                               material.
   66852  T                   Removal of lens                667      20.35  $1,046.40      $538.11      $209.28
                               material.
   66920  T                   Extraction of lens.....        667      20.35  $1,046.40      $538.11      $209.28
   66930  T                   Extraction of lens.....        667      20.35  $1,046.40      $538.11      $209.28
   66940  T                   Extraction of lens.....        667      20.35  $1,046.40      $538.11      $209.28
   66983  T                   Remove cataract, insert        668      22.02  $1,132.27      $617.21      $226.45
                               lens.
   66984  T                   Remove cataract, insert        668      22.02  $1,132.27      $617.21      $226.45
                               lens.

[[Page 35337]]

 
   66985  T                   Insert lens prosthesis.        668      22.02  $1,132.27      $617.21      $226.45
   66986  T                   Exchange lens                  668      22.02  $1,132.27      $617.21      $226.45
                               prosthesis.
   66999  T                   Eye surgery procedure..        649       4.37    $224.71      $111.64       $44.94
   67005  T                   Partial removal of eye         676       5.87    $301.84      $138.54       $60.37
                               fluid.
   67010  T                   Partial removal of eye         676       5.87    $301.84      $138.54       $60.37
                               fluid.
   67015  T                   Release of eye fluid...        676       5.87    $301.84      $138.54       $60.37
   67025  T                   Replace eye fluid......        683       9.56    $491.58      $252.44       $98.32
   67027  T                   Implant eye drug system        690      30.39  $1,562.65      $845.69      $312.53
   67028  T                   Injection eye drug.....        682       3.41    $175.34       $80.68       $35.07
   67030  T                   Incise inner eye               676       5.87    $301.84      $138.54       $60.37
                               strands.
   67031  T                   Laser surgery, eye             649       4.37    $224.71      $111.64       $44.94
                               strands.
   67036  T                   Removal of inner eye           690      30.39  $1,562.65      $845.69      $312.53
                               fluid.
   67038  T                   Strip retinal membrane.        690      30.39  $1,562.65      $845.69      $312.53
   67039  T                   Laser treatment of             690      30.39  $1,562.65      $845.69      $312.53
                               retina.
   67040  T                   Laser treatment of             690      30.39  $1,562.65      $845.69      $312.53
                               retina.
   67101  T                   Repair, detached retina        676       5.87    $301.84      $138.54       $60.37
   67105  T                   Repair, detached retina        648       3.76    $193.34       $93.56       $38.67
   67107  T                   Repair detached retina.        690      30.39  $1,562.65      $845.69      $312.53
   67108  T                   Repair detached retina.        690      30.39  $1,562.65      $845.69      $312.53
   67110  T                   Repair detached retina.        676       5.87    $301.84      $138.54       $60.37
   67112  T                   Re-repair detached             690      30.39  $1,562.65      $845.69      $312.53
                               retina.
   67115  T                   Release, encircling            676       5.87    $301.84      $138.54       $60.37
                               material.
   67120  T                   Remove eye implant             676       5.87    $301.84      $138.54       $60.37
                               material.
   67121  T                   Remove eye implant             676       5.87    $301.84      $138.54       $60.37
                               material.
   67141  T                   Treatment of retina....        676       5.87    $301.84      $138.54       $60.37
   67145  T                   Treatment of retina....        648       3.76    $193.34       $93.56       $38.67
   67208  T                   Treatment of retinal           676       5.87    $301.84      $138.54       $60.37
                               lesion.
   67210  T                   Treatment of retinal           648       3.76    $193.34       $93.56       $38.67
                               lesion.
   67218  T                   Treatment of retinal           676       5.87    $301.84      $138.54       $60.37
                               lesion.
   67227  T                   Treatment of retinal           676       5.87    $301.84      $138.54       $60.37
                               lesion.
   67228  T                   Treatment of retinal           648       3.76    $193.34       $93.56       $38.67
                               lesion.
   67250  T                   Reinforce eye wall.....        684      13.26    $681.83      $341.94      $136.37
   67255  T                   Reinforce/graft eye            684      13.26    $681.83      $341.94      $136.37
                               wall.
   67299  T                   Eye surgery procedure..        649       4.37    $224.71      $111.64       $44.94
   67311  T                   Revise eye muscle......        677      16.11    $828.38      $428.95      $165.68
   67312  T                   Revise two eye muscles.        677      16.11    $828.38      $428.95      $165.68
   67314  T                   Revise eye muscle......        677      16.11    $828.38      $428.95      $165.68
   67316  T                   Revise two eye muscles.        677      16.11    $828.38      $428.95      $165.68
   67318  T                   Revise eye muscle(s)...        677      16.11    $828.38      $428.95      $165.68
   67320  T                   Revise eye muscle(s)           677      16.11    $828.38      $428.95      $165.68
                               add-on.
   67331  T                   Eye surgery follow-up          677      16.11    $828.38      $428.95      $165.68
                               add-on.
   67332  T                   Rerevise eye muscles           677      16.11    $828.38      $428.95      $165.68
                               add-on.
   67334  T                   Revise eye muscle w/           677      16.11    $828.38      $428.95      $165.68
                               suture.
   67335  T                   Eye suture during              677      16.11    $828.38      $428.95      $165.68
                               surgery.
   67340  T                   Revise eye muscle add-         677      16.11    $828.38      $428.95      $165.68
                               on.
   67343  T                   Release eye tissue.....        677      16.11    $828.38      $428.95      $165.68
   67345  T                   Destroy nerve of eye           681       1.65     $84.84       $30.51       $16.97
                               muscle.
   67350  T                   Biopsy eye muscle......        162       5.59    $287.44      $125.66       $57.49
   67399  T                   Eye muscle surgery             162       5.59    $287.44      $125.66       $57.49
                               procedure.
   67400  T                   Explore/biopsy eye             684      13.26    $681.83      $341.94      $136.37
                               socket.
   67405  T                   Explore/drain eye              684      13.26    $681.83      $341.94      $136.37
                               socket.
   67412  T                   Explore/treat eye              684      13.26    $681.83      $341.94      $136.37
                               socket.
   67413  T                   Explore/treat eye              684      13.26    $681.83      $341.94      $136.37
                               socket.
   67414  C                   Explore/decompress eye   .........  .........  .........  ...........  ...........
                               socke.
   67415  T                   Aspiration orbital             122       4.59    $236.02      $113.00       $47.20
                               contents.
   67420  T                   Explore/treat eye              232      23.82  $1,224.82      $636.87      $244.96
                               socket.
   67430  T                   Explore/treat eye              232      23.82  $1,224.82      $636.87      $244.96
                               socket.
   67440  T                   Explore/drain eye              232      23.82  $1,224.82      $636.87      $244.96
                               socket.
   67445  C                   Explore/decompress eye   .........  .........  .........  ...........  ...........
                               socke.
   67450  T                   Explore/biopsy eye             232      23.82  $1,224.82      $636.87      $244.96
                               socket.
   67500  T                   Inject/treat eye socket        681       1.65     $84.84       $30.51       $16.97
   67505  T                   Inject/treat eye socket        681       1.65     $84.84       $30.51       $16.97
   67515  T                   Inject/treat eye socket        681       1.65     $84.84       $30.51       $16.97
   67550  T                   Insert eye socket              684      13.26    $681.83      $341.94      $136.37
                               implant.
   67560  T                   Revise eye socket              684      13.26    $681.83      $341.94      $136.37
                               implant.
   67570  C                   Decompress optic nerve.  .........  .........  .........  ...........  ...........
   67599  T                   Orbit surgery procedure        681       1.65     $84.84       $30.51       $16.97
   67700  T                   Drainage of eyelid             682       3.41    $175.34       $80.68       $35.07
                               abscess.
   67710  T                   Incision of eyelid.....        682       3.41    $175.34       $80.68       $35.07
   67715  T                   Incision of eyelid fold        683       9.56    $491.58      $252.44       $98.32
   67800  T                   Remove eyelid lesion...        682       3.41    $175.34       $80.68       $35.07
   67801  T                   Remove eyelid lesions..        682       3.41    $175.34       $80.68       $35.07
   67805  T                   Remove eyelid lesions..        682       3.41    $175.34       $80.68       $35.07
   67808  T                   Remove eyelid lesion(s)        684      13.26    $681.83      $341.94      $136.37
   67810  T                   Biopsy of eyelid.......        682       3.41    $175.34       $80.68       $35.07

[[Page 35338]]

 
   67820  T                   Revise eyelashes.......        682       3.41    $175.34       $80.68       $35.07
   67825  T                   Revise eyelashes.......        682       3.41    $175.34       $80.68       $35.07
   67830  T                   Revise eyelashes.......        683       9.56    $491.58      $252.44       $98.32
   67835  T                   Revise eyelashes.......        684      13.26    $681.83      $341.94      $136.37
   67840  T                   Remove eyelid lesion...        682       3.41    $175.34       $80.68       $35.07
   67850  T                   Treat eyelid lesion....        682       3.41    $175.34       $80.68       $35.07
   67875  T                   Closure of eyelid by           682       3.41    $175.34       $80.68       $35.07
                               suture.
   67880  T                   Revision of eyelid.....        683       9.56    $491.58      $252.44       $98.32
   67882  T                   Revision of eyelid.....        684      13.26    $681.83      $341.94      $136.37
   67900  T                   Repair brow defect.....        684      13.26    $681.83      $341.94      $136.37
   67901  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67902  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67903  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67904  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67906  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67908  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67909  T                   Revise eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67911  T                   Revise eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67914  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67915  T                   Repair eyelid defect...        682       3.41    $175.34       $80.68       $35.07
   67916  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67917  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67921  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67922  T                   Repair eyelid defect...        682       3.41    $175.34       $80.68       $35.07
   67923  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67924  T                   Repair eyelid defect...        684      13.26    $681.83      $341.94      $136.37
   67930  T                   Repair eyelid wound....        682       3.41    $175.34       $80.68       $35.07
   67935  T                   Repair eyelid wound....        683       9.56    $491.58      $252.44       $98.32
   67938  T                   Remove eyelid foreign          682       3.41    $175.34       $80.68       $35.07
                               body.
   67950  T                   Revision of eyelid.....        684      13.26    $681.83      $341.94      $136.37
   67961  T                   Revision of eyelid.....        684      13.26    $681.83      $341.94      $136.37
   67966  T                   Revision of eyelid.....        684      13.26    $681.83      $341.94      $136.37
   67971  T                   Reconstruction of              684      13.26    $681.83      $341.94      $136.37
                               eyelid.
   67973  T                   Reconstruction of              684      13.26    $681.83      $341.94      $136.37
                               eyelid.
   67974  T                   Reconstruction of              684      13.26    $681.83      $341.94      $136.37
                               eyelid.
   67975  T                   Reconstruction of              684      13.26    $681.83      $341.94      $136.37
                               eyelid.
   67999  T                   Revision of eyelid.....        682       3.41    $175.34       $80.68       $35.07
   68020  T                   Incise/drain eyelid            682       3.41    $175.34       $80.68       $35.07
                               lining.
   68040  T                   Treatment of eyelid            682       3.41    $175.34       $80.68       $35.07
                               lesions.
   68100  T                   Biopsy of eyelid lining        162       5.59    $287.44      $125.66       $57.49
   68110  T                   Remove eyelid lining           162       5.59    $287.44      $125.66       $57.49
                               lesion.
   68115  T                   Remove eyelid lining           162       5.59    $287.44      $125.66       $57.49
                               lesion.
   68130  T                   Remove eyelid lining           652      16.35    $840.72      $433.92      $168.14
                               lesion.
   68135  T                   Remove eyelid lining           162       5.59    $287.44      $125.66       $57.49
                               lesion.
   68200  T                   Treat eyelid by                681       1.65     $84.84       $30.51       $16.97
                               injection.
   68320  T                   Revise/graft eyelid            684      13.26    $681.83      $341.94      $136.37
                               lining.
   68325  T                   Revise/graft eyelid            684      13.26    $681.83      $341.94      $136.37
                               lining.
   68326  T                   Revise/graft eyelid            684      13.26    $681.83      $341.94      $136.37
                               lining.
   68328  T                   Revise/graft eyelid            684      13.26    $681.83      $341.94      $136.37
                               lining.
   68330  T                   Revise eyelid lining...        652      16.35    $840.72      $433.92      $168.14
   68335  T                   Revise/graft eyelid            684      13.26    $681.83      $341.94      $136.37
                               lining.
   68340  T                   Separate eyelid                684      13.26    $681.83      $341.94      $136.37
                               adhesions.
   68360  T                   Revise eyelid lining...        652      16.35    $840.72      $433.92      $168.14
   68362  T                   Revise eyelid lining...        652      16.35    $840.72      $433.92      $168.14
   68399  T                   Eyelid lining surgery..        162       5.59    $287.44      $125.66       $57.49
   68400  T                   Incise/drain tear gland        682       3.41    $175.34       $80.68       $35.07
   68420  T                   Incise/drain tear sac..        682       3.41    $175.34       $80.68       $35.07
   68440  T                   Incise tear duct               682       3.41    $175.34       $80.68       $35.07
                               opening.
   68500  T                   Removal of tear gland..        684      13.26    $681.83      $341.94      $136.37
   68505  T                   Partial removal tear           684      13.26    $681.83      $341.94      $136.37
                               gland.
   68510  T                   Biopsy of tear gland...        683       9.56    $491.58      $252.44       $98.32
   68520  T                   Removal of tear sac....        684      13.26    $681.83      $341.94      $136.37
   68525  T                   Biopsy of tear sac.....        683       9.56    $491.58      $252.44       $98.32
   68530  T                   Clearance of tear duct.        682       3.41    $175.34       $80.68       $35.07
   68540  T                   Remove tear gland              684      13.26    $681.83      $341.94      $136.37
                               lesion.
   68550  T                   Remove tear gland              684      13.26    $681.83      $341.94      $136.37
                               lesion.
   68700  T                   Repair tear ducts......        684      13.26    $681.83      $341.94      $136.37
   68705  T                   Revise tear duct               682       3.41    $175.34       $80.68       $35.07
                               opening.
   68720  T                   Create tear sac drain..        684      13.26    $681.83      $341.94      $136.37
   68745  T                   Create tear duct drain.        684      13.26    $681.83      $341.94      $136.37
   68750  T                   Create tear duct drain.        684      13.26    $681.83      $341.94      $136.37
   68760  T                   Close tear duct opening        682       3.41    $175.34       $80.68       $35.07
   68761  T                   Close tear duct opening        681       1.65     $84.84       $30.51       $16.97
   68770  T                   Close tear system              684      13.26    $681.83      $341.94      $136.37
                               fistula.
\2\ 6880  T                   Dilate tear duct               682       3.41    $175.34       $80.68       $35.07
        0                      opening(s).

[[Page 35339]]

 
   68801  T                   Dilate tear duct               682       3.41    $175.34       $80.68       $35.07
                               opening.
   68810  T                   Probe nasolacrimal duct        683       9.56    $491.58      $252.44       $98.32
   68811  T                   Probe nasolacrimal duct        684      13.26    $681.83      $341.94      $136.37
   68815  T                   Probe nasolacrimal duct        684      13.26    $681.83      $341.94      $136.37
\2\ 6882  T                   Explore tear duct              683       9.56    $491.58      $252.44       $98.32
        0                      system.
\2\ 6882  T                   Explore tear duct              683       9.56    $491.58      $252.44       $98.32
        5                      system.
\2\ 6883  T                   Reopen tear duct               683       9.56    $491.58      $252.44       $98.32
        0                      channel.
   68840  T                   Explore/irrigate tear          682       3.41    $175.34       $80.68       $35.07
                               ducts.
   68850  T                   Injection for tear sac         347       2.57    $132.15       $62.38       $26.43
                               x-ray.
   68899  T                   Tear duct system               681       1.65     $84.84       $30.51       $16.97
                               surgery.
   69000  T                   Drain external ear             131       1.93     $99.24       $36.61       $19.85
                               lesion.
   69005  T                   Drain external ear             131       1.93     $99.24       $36.61       $19.85
                               lesion.
   69020  T                   Drain outer ear canal          131       1.93     $99.24       $36.61       $19.85
                               lesion.
   69090  E                   Pierce earlobes........  .........  .........  .........  ...........  ...........
   69100  T                   Biopsy of external ear.        161       3.43    $176.37       $75.71       $35.27
   69105  T                   Biopsy of external ear         161       3.43    $176.37       $75.71       $35.27
                               canal.
   69110  T                   Partial removal                163      10.48    $538.88      $260.80      $107.78
                               external ear.
   69120  T                   Removal of external ear        313      15.46    $794.95      $407.70      $158.99
   69140  T                   Remove ear canal               313      15.46    $794.95      $407.70      $158.99
                               lesion(s).
   69145  T                   Remove ear canal               163      10.48    $538.88      $260.80      $107.78
                               lesion(s).
   69150  T                   Extensive ear canal            314      25.15  $1,293.21      $687.72      $258.64
                               surgery.
   69155  C                   Extensive ear/neck       .........  .........  .........  ...........  ...........
                               surgery.
   69200  T                   Clear outer ear canal..        311       1.41     $72.50       $20.57       $14.50
   69205  T                   Clear outer ear canal..        163      10.48    $538.88      $260.80      $107.78
   69210  T                   Remove impacted ear wax        311       1.41     $72.50       $20.57       $14.50
   69220  T                   Clean out mastoid              151       1.63     $83.81       $33.22       $16.76
                               cavity.
   69222  T                   Clean out mastoid              311       1.41     $72.50       $20.57       $14.50
                               cavity.
   69300  T                   Revise external ear....        313      15.46    $794.95      $407.70      $158.99
   69310  T                   Rebuild outer ear canal        314      25.15  $1,293.21      $687.72      $258.64
   69320  T                   Rebuild outer ear canal        314      25.15  $1,293.21      $687.72      $258.64
   69399  T                   Outer ear surgery              311       1.41     $72.50       $20.57       $14.50
                               procedure.
   69400  T                   Inflate middle ear             311       1.41     $72.50       $20.57       $14.50
                               canal.
   69401  N                   Inflate middle ear       .........  .........  .........  ...........  ...........
                               canal.
   69405  T                   Catheterize middle ear         311       1.41     $72.50       $20.57       $14.50
                               canal.
   69410  T                   Inset middle ear baffle        311       1.41     $72.50       $20.57       $14.50
   69420  T                   Incision of eardrum....        311       1.41     $72.50       $20.57       $14.50
   69421  T                   Incision of eardrum....        312       7.07    $363.54      $170.86       $72.71
   69424  T                   Remove ventilating tube        311       1.41     $72.50       $20.57       $14.50
   69433  T                   Create eardrum opening.        312       7.07    $363.54      $170.86       $72.71
   69436  T                   Create eardrum opening.        312       7.07    $363.54      $170.86       $72.71
   69440  T                   Exploration of middle          313      15.46    $794.95      $407.70      $158.99
                               ear.
   69450  T                   Eardrum revision.......        313      15.46    $794.95      $407.70      $158.99
   69501  T                   Mastoidectomy..........        314      25.15  $1,293.21      $687.72      $258.64
   69502  T                   Mastoidectomy..........        314      25.15  $1,293.21      $687.72      $258.64
   69505  T                   Remove mastoid                 314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69511  T                   Extensive mastoid              314      25.15  $1,293.21      $687.72      $258.64
                               surgery.
   69530  T                   Extensive mastoid              314      25.15  $1,293.21      $687.72      $258.64
                               surgery.
   69535  C                   Remove part of temporal  .........  .........  .........  ...........  ...........
                               bone.
   69540  T                   Remove ear lesion......        311       1.41     $72.50       $20.57       $14.50
   69550  T                   Remove ear lesion......        314      25.15  $1,293.21      $687.72      $258.64
   69552  T                   Remove ear lesion......        314      25.15  $1,293.21      $687.72      $258.64
   69554  C                   Remove ear lesion......  .........  .........  .........  ...........  ...........
   69601  T                   Mastoid surgery                314      25.15  $1,293.21      $687.72      $258.64
                               revision.
   69602  T                   Mastoid surgery                314      25.15  $1,293.21      $687.72      $258.64
                               revision.
   69603  T                   Mastoid surgery                314      25.15  $1,293.21      $687.72      $258.64
                               revision.
   69604  T                   Mastoid surgery                314      25.15  $1,293.21      $687.72      $258.64
                               revision.
   69605  T                   Mastoid surgery                314      25.15  $1,293.21      $687.72      $258.64
                               revision.
   69610  T                   Repair of eardrum......        311       1.41     $72.50       $20.57       $14.50
   69620  T                   Repair of eardrum......        313      15.46    $794.95      $407.70      $158.99
   69631  T                   Repair eardrum                 314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69632  T                   Rebuild eardrum                314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69633  T                   Rebuild eardrum                314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69635  T                   Repair eardrum                 314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69636  T                   Rebuild eardrum                314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69637  T                   Rebuild eardrum                314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69641  T                   Revise middle ear &            314      25.15  $1,293.21      $687.72      $258.64
                               mastoid.
   69642  T                   Revise middle ear &            314      25.15  $1,293.21      $687.72      $258.64
                               mastoid.
   69643  T                   Revise middle ear &            314      25.15  $1,293.21      $687.72      $258.64
                               mastoid.
   69644  T                   Revise middle ear &            314      25.15  $1,293.21      $687.72      $258.64
                               mastoid.
   69645  T                   Revise middle ear &            314      25.15  $1,293.21      $687.72      $258.64
                               mastoid.
   69646  T                   Revise middle ear &            314      25.15  $1,293.21      $687.72      $258.64
                               mastoid.
   69650  T                   Release middle ear bone        314      25.15  $1,293.21      $687.72      $258.64
   69660  T                   Revise middle ear bone.        314      25.15  $1,293.21      $687.72      $258.64
   69661  T                   Revise middle ear bone.        314      25.15  $1,293.21      $687.72      $258.64
   69662  T                   Revise middle ear bone.        314      25.15  $1,293.21      $687.72      $258.64

[[Page 35340]]

 
   69666  T                   Repair middle ear              314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69667  T                   Repair middle ear              314      25.15  $1,293.21      $687.72      $258.64
                               structures.
   69670  T                   Remove mastoid air             314      25.15  $1,293.21      $687.72      $258.64
                               cells.
   69676  T                   Remove middle ear nerve        314      25.15  $1,293.21      $687.72      $258.64
   69700  T                   Close mastoid fistula..        314      25.15  $1,293.21      $687.72      $258.64
   69710  E                   Implant/replace hearing  .........  .........  .........  ...........  ...........
                               aid.
   69711  T                   Remove/repair hearing          314      25.15  $1,293.21      $687.72      $258.64
                               aid.
   69720  T                   Release facial nerve...        314      25.15  $1,293.21      $687.72      $258.64
   69725  T                   Release facial nerve...        314      25.15  $1,293.21      $687.72      $258.64
   69740  T                   Repair facial nerve....        314      25.15  $1,293.21      $687.72      $258.64
   69745  T                   Repair facial nerve....        314      25.15  $1,293.21      $687.72      $258.64
   69799  T                   Middle ear surgery             311       1.41     $72.50       $20.57       $14.50
                               procedure.
   69801  T                   Incise inner ear.......        314      25.15  $1,293.21      $687.72      $258.64
   69802  T                   Incise inner ear.......        314      25.15  $1,293.21      $687.72      $258.64
   69805  T                   Explore inner ear......        314      25.15  $1,293.21      $687.72      $258.64
   69806  T                   Explore inner ear......        314      25.15  $1,293.21      $687.72      $258.64
   69820  T                   Establish inner ear            314      25.15  $1,293.21      $687.72      $258.64
                               window.
   69840  T                   Revise inner ear window        314      25.15  $1,293.21      $687.72      $258.64
   69905  T                   Remove inner ear.......        314      25.15  $1,293.21      $687.72      $258.64
   69910  T                   Remove inner ear &             314      25.15  $1,293.21      $687.72      $258.64
                               mastoid.
   69915  T                   Incise inner ear nerve.        314      25.15  $1,293.21      $687.72      $258.64
   69930  T                   Implant cochlear device        317  .........  .........  ...........  ...........
   69949  T                   Inner ear surgery              314      25.15  $1,293.21      $687.72      $258.64
                               procedure.
   69950  C                   Incise inner ear nerve.  .........  .........  .........  ...........  ...........
   69955  C                   Release facial nerve...  .........  .........  .........  ...........  ...........
   69960  C                   Release inner ear canal  .........  .........  .........  ...........  ...........
   69970  C                   Remove inner ear lesion  .........  .........  .........  ...........  ...........
   69979  C                   Temporal bone surgery..  .........  .........  .........  ...........  ...........
   70010  S                   Contrast x-ray of brain        728       3.50    $179.97       $91.98       $35.99
   70015  S                   Contrast x-ray of brain        728       3.50    $179.97       $91.98       $35.99
   70030  X                   X-ray eye for foreign          700       0.80     $41.14       $22.37        $8.23
                               body.
   70100  X                   X-ray exam of jaw......        700       0.80     $41.14       $22.37        $8.23
   70110  X                   X-ray exam of jaw......        700       0.80     $41.14       $22.37        $8.23
   70120  X                   X-ray exam of mastoids.        700       0.80     $41.14       $22.37        $8.23
   70130  X                   X-ray exam of mastoids.        700       0.80     $41.14       $22.37        $8.23
   70134  X                   X-ray exam of middle           700       0.80     $41.14       $22.37        $8.23
                               ear.
   70140  X                   X-ray exam of facial           700       0.80     $41.14       $22.37        $8.23
                               bones.
   70150  X                   X-ray exam of facial           700       0.80     $41.14       $22.37        $8.23
                               bones.
   70160  X                   X-ray exam of nasal            700       0.80     $41.14       $22.37        $8.23
                               bones.
   70170  X                   X-ray exam of tear duct        706       1.43     $73.53       $39.10       $14.71
   70190  X                   X-ray exam of eye              700       0.80     $41.14       $22.37        $8.23
                               sockets.
   70200  X                   X-ray exam of eye              700       0.80     $41.14       $22.37        $8.23
                               sockets.
   70210  X                   X-ray exam of sinuses..        700       0.80     $41.14       $22.37        $8.23
   70220  X                   X-ray exam of sinuses..        700       0.80     $41.14       $22.37        $8.23
   70240  X                   X-ray exam pituitary           700       0.80     $41.14       $22.37        $8.23
                               saddle.
   70250  X                   X-ray exam of skull....        700       0.80     $41.14       $22.37        $8.23
   70260  X                   X-ray exam of skull....        700       0.80     $41.14       $22.37        $8.23
   70300  X                   X-ray exam of teeth....        700       0.80     $41.14       $22.37        $8.23
   70310  X                   X-ray exam of teeth....        700       0.80     $41.14       $22.37        $8.23
   70320  X                   Full mouth x-ray of            700       0.80     $41.14       $22.37        $8.23
                               teeth.
   70328  X                   X-ray exam of jaw joint        700       0.80     $41.14       $22.37        $8.23
   70330  X                   X-ray exam of jaw              700       0.80     $41.14       $22.37        $8.23
                               joints.
   70332  S                   X-ray exam of jaw joint        730       2.30    $118.27       $65.77       $23.65
   70336  S                   Magnetic image jaw             726       7.91    $406.73      $256.06       $81.35
                               joint.
   70350  X                   X-ray head for                 700       0.80     $41.14       $22.37        $8.23
                               orthodontia.
   70355  X                   Panoramic x-ray of jaws        700       0.80     $41.14       $22.37        $8.23
   70360  X                   X-ray exam of neck.....        700       0.80     $41.14       $22.37        $8.23
   70370  X                   Throat x-ray &                 716       1.39     $71.47       $40.00       $14.29
                               fluoroscopy.
   70371  X                   Speech evaluation,             716       1.39     $71.47       $40.00       $14.29
                               complex.
   70373  X                   Contrast x-ray of              706       1.43     $73.53       $39.10       $14.71
                               larynx.
   70380  X                   X-ray exam of salivary         700       0.80     $41.14       $22.37        $8.23
                               gland.
   70390  X                   X-ray exam of salivary         706       1.43     $73.53       $39.10       $14.71
                               duct.
   70450  S                   CAT scan of head or            710       4.98    $256.07      $173.12       $51.21
                               brain.
   70460  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               head.
   70470  S                   Contrast CAT scans of          710       4.98    $256.07      $173.12       $51.21
                               head.
   70480  S                   CAT scan of skull......        710       4.98    $256.07      $173.12       $51.21
   70481  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               skull.
   70482  S                   Contrast CAT scans of          710       4.98    $256.07      $173.12       $51.21
                               skull.
   70486  S                   CAT scan of face, jaw..        710       4.98    $256.07      $173.12       $51.21
   70487  S                   Contrast CAT scan, face/       710       4.98    $256.07      $173.12       $51.21
                               jaw.
   70488  S                   Contrast CAT scans face/       710       4.98    $256.07      $173.12       $51.21
                               jaw.
   70490  S                   CAT scan of neck tissue        710       4.98    $256.07      $173.12       $51.21
   70491  S                   Contrast CAT of neck           710       4.98    $256.07      $173.12       $51.21
                               tissue.
   70492  S                   Contrast CAT of neck           710       4.98    $256.07      $173.12       $51.21
                               tissue.
   70540  S                   Magnetic image, face,          726       7.91    $406.73      $256.06       $81.35
                               neck.

[[Page 35341]]

 
   70541  S                   Magnetic image, head           720       6.37    $327.55      $204.98       $65.51
                               (MRA).
   70551  S                   Magnetic image, brain          726       7.91    $406.73      $256.06       $81.35
                               (MRI).
   70552  S                   Magnetic image, brain          726       7.91    $406.73      $256.06       $81.35
                               (MRI).
   70553  S                   Magnetic image, brain..        726       7.91    $406.73      $256.06       $81.35
   71010  X                   Chest x-ray............        700       0.80     $41.14       $22.37        $8.23
   71015  X                   X-ray exam of chest....        700       0.80     $41.14       $22.37        $8.23
   71020  X                   Chest x-ray............        700       0.80     $41.14       $22.37        $8.23
   71021  X                   Chest x-ray............        700       0.80     $41.14       $22.37        $8.23
   71022  X                   Chest x-ray............        700       0.80     $41.14       $22.37        $8.23
   71023  X                   Chest x-ray and                716       1.39     $71.47       $40.00       $14.29
                               fluoroscopy.
   71030  X                   Chest x-ray............        700       0.80     $41.14       $22.37        $8.23
   71034  X                   Chest x-ray &                  716       1.39     $71.47       $40.00       $14.29
                               fluoroscopy.
   71035  X                   Chest x-ray............        700       0.80     $41.14       $22.37        $8.23
   71036  X                   X-ray guidance for             716       1.39     $71.47       $40.00       $14.29
                               biopsy.
\2\ 7103  X                   X-ray guidance for             716       1.39     $71.47       $40.00       $14.29
        8                      biopsy.
   71040  X                   Contrast x-ray of              706       1.43     $73.53       $39.10       $14.71
                               bronchi.
   71060  X                   Contrast x-ray of              706       1.43     $73.53       $39.10       $14.71
                               bronchi.
   71090  X                   X-ray & pacemaker              716       1.39     $71.47       $40.00       $14.29
                               insertion.
   71100  X                   X-ray exam of ribs.....        700       0.80     $41.14       $22.37        $8.23
   71101  X                   X-ray exam of ribs,            700       0.80     $41.14       $22.37        $8.23
                               chest.
   71110  X                   X-ray exam of ribs.....        700       0.80     $41.14       $22.37        $8.23
   71111  X                   X-ray exam of ribs,            700       0.80     $41.14       $22.37        $8.23
                               chest.
   71120  X                   X-ray exam of                  700       0.80     $41.14       $22.37        $8.23
                               breastbone.
   71130  X                   X-ray exam of                  700       0.80     $41.14       $22.37        $8.23
                               breastbone.
   71250  S                   Cat scan of chest......        710       4.98    $256.07      $173.12       $51.21
   71260  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               chest.
   71270  S                   Contrast CAT scans of          710       4.98    $256.07      $173.12       $51.21
                               chest.
   71550  S                   Magnetic image, chest..        726       7.91    $406.73      $256.06       $81.35
   71555  E                   Magnetic imaging/chest   .........  .........  .........  ...........  ...........
                               (MRA).
   72010  X                   X-ray exam of spine....        700       0.80     $41.14       $22.37        $8.23
   72020  X                   X-ray exam of spine....        700       0.80     $41.14       $22.37        $8.23
   72040  X                   X-ray exam of neck             700       0.80     $41.14       $22.37        $8.23
                               spine.
   72050  X                   X-ray exam of neck             700       0.80     $41.14       $22.37        $8.23
                               spine.
   72052  X                   X-ray exam of neck             700       0.80     $41.14       $22.37        $8.23
                               spine.
   72069  X                   X-ray exam of trunk            700       0.80     $41.14       $22.37        $8.23
                               spine.
   72070  X                   X-ray exam of thorax           700       0.80     $41.14       $22.37        $8.23
                               spine.
   72072  X                   X-ray exam of thoracic         700       0.80     $41.14       $22.37        $8.23
                               spine.
   72074  X                   X-ray exam of thoracic         700       0.80     $41.14       $22.37        $8.23
                               spine.
   72080  X                   X-ray exam of trunk            700       0.80     $41.14       $22.37        $8.23
                               spine.
   72090  X                   X-ray exam of trunk            700       0.80     $41.14       $22.37        $8.23
                               spine.
   72100  X                   X-ray exam of lower            700       0.80     $41.14       $22.37        $8.23
                               spine.
   72110  X                   X-ray exam of lower            700       0.80     $41.14       $22.37        $8.23
                               spine.
   72114  X                   X-ray exam of lower            700       0.80     $41.14       $22.37        $8.23
                               spine.
   72120  X                   X-ray exam of lower            700       0.80     $41.14       $22.37        $8.23
                               spine.
   72125  S                   CAT scan of neck spine.        710       4.98    $256.07      $173.12       $51.21
   72126  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               neck.
   72127  S                   Contrast CAT scans of          710       4.98    $256.07      $173.12       $51.21
                               neck.
   72128  S                   CAT scan of thorax             710       4.98    $256.07      $173.12       $51.21
                               spine.
   72129  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               thorax.
   72130  S                   Contrast CAT scans of          710       4.98    $256.07      $173.12       $51.21
                               thorax.
   72131  S                   CAT scan of lower spine        710       4.98    $256.07      $173.12       $51.21
   72132  S                   Contrast CAT of lower          710       4.98    $256.07      $173.12       $51.21
                               spine.
   72133  S                   Contrast CAT scans,low         710       4.98    $256.07      $173.12       $51.21
                               spine.
   72141  S                   Magnetic image, neck           726       7.91    $406.73      $256.06       $81.35
                               spine.
   72142  S                   Magnetic image, neck           726       7.91    $406.73      $256.06       $81.35
                               spine.
   72146  S                   Magnetic image, chest          726       7.91    $406.73      $256.06       $81.35
                               spine.
   72147  S                   Magnetic image, chest          726       7.91    $406.73      $256.06       $81.35
                               spine.
   72148  S                   Magnetic image, lumbar         726       7.91    $406.73      $256.06       $81.35
                               spine.
   72149  S                   Magnetic image, lumbar         726       7.91    $406.73      $256.06       $81.35
                               spine.
   72156  S                   Magnetic image, neck           726       7.91    $406.73      $256.06       $81.35
                               spine.
   72157  S                   Magnetic image, chest          726       7.91    $406.73      $256.06       $81.35
                               spine.
   72158  S                   Magnetic image, lumbar         726       7.91    $406.73      $256.06       $81.35
                               spine.
   72159  E                   Magnetic imaging/spine   .........  .........  .........  ...........  ...........
                               (MRA).
   72170  X                   X-ray exam of pelvis...        700       0.80     $41.14       $22.37        $8.23
   72190  X                   X-ray exam of pelvis...        700       0.80     $41.14       $22.37        $8.23
   72192  S                   CAT scan of pelvis.....        710       4.98    $256.07      $173.12       $51.21
   72193  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               pelvis.
   72194  S                   Contrast CAT scans of          710       4.98    $256.07      $173.12       $51.21
                               pelvis.
   72196  S                   Magnetic image, pelvis.        726       7.91    $406.73      $256.06       $81.35
   72198  E                   Magnetic imaging/        .........  .........  .........  ...........  ...........
                               pelvis(MRA).
   72200  X                   X-ray exam sacroiliac          700       0.80     $41.14       $22.37        $8.23
                               joints.
   72202  X                   X-ray exam sacroiliac          700       0.80     $41.14       $22.37        $8.23
                               joints.
   72220  X                   X-ray exam of tailbone.        700       0.80     $41.14       $22.37        $8.23
   72240  S                   Contrast x-ray of neck         728       3.50    $179.97       $91.98       $35.99
                               spine.
   72255  S                   Contrast x-ray thorax          728       3.50    $179.97       $91.98       $35.99
                               spine.

[[Page 35342]]

 
   72265  S                   Contrast x-ray lower           728       3.50    $179.97       $91.98       $35.99
                               spine.
   72270  S                   Contrast x-ray of spine        728       3.50    $179.97       $91.98       $35.99
   72285  S                   X-ray of neck spine            728       3.50    $179.97       $91.98       $35.99
                               disk.
   72295  S                   X-ray of lower spine           728       3.50    $179.97       $91.98       $35.99
                               disk.
   73000  X                   X-ray exam of                  700       0.80     $41.14       $22.37        $8.23
                               collarbone.
   73010  X                   X-ray exam of shoulder         700       0.80     $41.14       $22.37        $8.23
                               blade.
   73020  X                   X-ray exam of shoulder.        700       0.80     $41.14       $22.37        $8.23
   73030  X                   X-ray exam of shoulder.        700       0.80     $41.14       $22.37        $8.23
   73040  S                   Contrast x-ray of              730       2.30    $118.27       $65.77       $23.65
                               shoulder.
   73050  X                   X-ray exam of shoulders        700       0.80     $41.14       $22.37        $8.23
   73060  X                   X-ray exam of humerus..        700       0.80     $41.14       $22.37        $8.23
   73070  X                   X-ray exam of elbow....        700       0.80     $41.14       $22.37        $8.23
   73080  X                   X-ray exam of elbow....        700       0.80     $41.14       $22.37        $8.23
   73085  S                   Contrast x-ray of elbow        730       2.30    $118.27       $65.77       $23.65
   73090  X                   X-ray exam of forearm..        700       0.80     $41.14       $22.37        $8.23
   73092  X                   X-ray exam of arm,             700       0.80     $41.14       $22.37        $8.23
                               infant.
   73100  X                   X-ray exam of wrist....        700       0.80     $41.14       $22.37        $8.23
   73110  X                   X-ray exam of wrist....        700       0.80     $41.14       $22.37        $8.23
   73115  S                   Contrast x-ray of wrist        730       2.30    $118.27       $65.77       $23.65
   73120  X                   X-ray exam of hand.....        700       0.80     $41.14       $22.37        $8.23
   73130  X                   X-ray exam of hand.....        700       0.80     $41.14       $22.37        $8.23
   73140  X                   X-ray exam of finger(s)        700       0.80     $41.14       $22.37        $8.23
   73200  S                   CAT scan of arm........        710       4.98    $256.07      $173.12       $51.21
   73201  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               arm.
   73202  S                   Contrast CAT scans of          710       4.98    $256.07      $173.12       $51.21
                               arm.
   73220  S                   Magnetic image, arm,           726       7.91    $406.73      $256.06       $81.35
                               hand.
   73221  S                   Magnetic image, joint          726       7.91    $406.73      $256.06       $81.35
                               of arm.
   73225  E                   Magnetic imaging/upper   .........  .........  .........  ...........  ...........
                               (MRA).
   73500  X                   X-ray exam of hip......        700       0.80     $41.14       $22.37        $8.23
   73510  X                   X-ray exam of hip......        700       0.80     $41.14       $22.37        $8.23
   73520  X                   X-ray exam of hips.....        700       0.80     $41.14       $22.37        $8.23
   73525  S                   Contrast x-ray of hip..        730       2.30    $118.27       $65.77       $23.65
   73530  X                   X-ray exam of hip......        700       0.80     $41.14       $22.37        $8.23
   73540  X                   X-ray exam of pelvis &         700       0.80     $41.14       $22.37        $8.23
                               hips.
   73550  X                   X-ray exam of thigh....        700       0.80     $41.14       $22.37        $8.23
   73560  X                   X-ray exam of knee, 1          700       0.80     $41.14       $22.37        $8.23
                               or 2.
   73562  X                   X-ray exam of knee, 3..        700       0.80     $41.14       $22.37        $8.23
   73564  X                   X-ray exam of knee, 4+.        700       0.80     $41.14       $22.37        $8.23
   73565  X                   X-ray exam of knee.....        700       0.80     $41.14       $22.37        $8.23
   73580  S                   Contrast x-ray of knee         730       2.30    $118.27       $65.77       $23.65
                               joint.
   73590  X                   X-ray exam of lower leg        700       0.80     $41.14       $22.37        $8.23
   73592  X                   X-ray exam of leg,             700       0.80     $41.14       $22.37        $8.23
                               infant.
   73600  X                   X-ray exam of ankle....        700       0.80     $41.14       $22.37        $8.23
   73610  X                   X-ray exam of ankle....        700       0.80     $41.14       $22.37        $8.23
   73615  S                   Contrast x-ray of ankle        730       2.30    $118.27       $65.77       $23.65
   73620  X                   X-ray exam of foot.....        700       0.80     $41.14       $22.37        $8.23
   73630  X                   X-ray exam of foot.....        700       0.80     $41.14       $22.37        $8.23
   73650  X                   X-ray exam of heel.....        700       0.80     $41.14       $22.37        $8.23
   73660  X                   X-ray exam of toe(s)...        700       0.80     $41.14       $22.37        $8.23
   73700  S                   CAT scan of leg........        710       4.98    $256.07      $173.12       $51.21
   73701  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               leg.
   73702  S                   Contrast CAT scans of          710       4.98    $256.07      $173.12       $51.21
                               leg.
   73720  S                   Magnetic image, leg,           726       7.91    $406.73      $256.06       $81.35
                               foot.
   73721  S                   Magnetic image, joint          726       7.91    $406.73      $256.06       $81.35
                               of leg.
   73725  E                   Magnetic imaging/lower   .........  .........  .........  ...........  ...........
                               (MRA).
   74000  X                   X-ray exam of abdomen..        700       0.80     $41.14       $22.37        $8.23
   74010  X                   X-ray exam of abdomen..        700       0.80     $41.14       $22.37        $8.23
   74020  X                   X-ray exam of abdomen..        700       0.80     $41.14       $22.37        $8.23
   74022  X                   X-ray exam series,             700       0.80     $41.14       $22.37        $8.23
                               abdomen.
   74150  S                   CAT scan of abdomen....        710       4.98    $256.07      $173.12       $51.21
   74160  S                   Contrast CAT scan of           710       4.98    $256.07      $173.12       $51.21
                               abdomen.
   74170  S                   Contrast CAT scans,            710       4.98    $256.07      $173.12       $51.21
                               abdomen.
   74181  S                   Magnetic image,abdomen         726       7.91    $406.73      $256.06       $81.35
                               (MRI).
   74185  E                   Magnetic image/abdomen   .........  .........  .........  ...........  ...........
                               (MRA).
   74190  X                   X-ray exam of                  706       1.43     $73.53       $39.10       $14.71
                               peritoneum.
   74210  S                   Contrast xray exam of          736       1.85     $95.13       $53.79       $19.03
                               throat.
   74220  S                   Contrast xray                  736       1.85     $95.13       $53.79       $19.03
                               exam,esophagus.
   74230  S                   Cinema xray throat/            736       1.85     $95.13       $53.79       $19.03
                               esophagus.
   74235  S                   Remove esophagus               738       3.74    $192.31      $104.86       $38.46
                               obstruction.
   74240  S                   X-ray exam upper GI            736       1.85     $95.13       $53.79       $19.03
                               tract.
   74241  S                   X-ray exam upper GI            736       1.85     $95.13       $53.79       $19.03
                               tract.
   74245  S                   X-ray exam upper GI            736       1.85     $95.13       $53.79       $19.03
                               tract.
   74246  S                   Contrast xray upper GI         736       1.85     $95.13       $53.79       $19.03
                               tract.
   74247  S                   Contrast xray upper GI         736       1.85     $95.13       $53.79       $19.03
                               tract.
   74249  S                   Contrast xray upper GI         736       1.85     $95.13       $53.79       $19.03
                               tract.

[[Page 35343]]

 
   74250  S                   X-ray exam of small            736       1.85     $95.13       $53.79       $19.03
                               bowel.
   74251  S                   X-ray exam of small            736       1.85     $95.13       $53.79       $19.03
                               bowel.
   74260  S                   X-ray exam of small            736       1.85     $95.13       $53.79       $19.03
                               bowel.
   74270  S                   Contrast x-ray exam of         736       1.85     $95.13       $53.79       $19.03
                               colon.
   74280  S                   Contrast x-ray exam of         736       1.85     $95.13       $53.79       $19.03
                               colon.
   74283  S                   Contrast x-ray exam of         736       1.85     $95.13       $53.79       $19.03
                               colon.
   74290  S                   Contrast x-ray,                736       1.85     $95.13       $53.79       $19.03
                               gallbladder.
   74291  S                   Contrast x-rays,               736       1.85     $95.13       $53.79       $19.03
                               gallbladder.
   74300  C                   X-ray bile ducts,        .........  .........  .........  ...........  ...........
                               pancreas.
   74301  C                   X-rays at surgery add-   .........  .........  .........  ...........  ...........
                               on.
   74305  X                   X-ray bile ducts,              706       1.43     $73.53       $39.10       $14.71
                               pancreas.
   74320  X                   Contrast x-ray of bile         706       1.43     $73.53       $39.10       $14.71
                               ducts.
   74327  S                   X-ray for bile stone           738       3.74    $192.31      $104.86       $38.46
                               removal.
   74328  X                   X-ray for bile duct            706       1.43     $73.53       $39.10       $14.71
                               endoscopy.
   74329  X                   X-ray for pancreas             706       1.43     $73.53       $39.10       $14.71
                               endoscopy.
   74330  X                   X-ray, bile/pancreas           706       1.43     $73.53       $39.10       $14.71
                               endoscopy.
   74340  X                   X-ray guide for GI tube        716       1.39     $71.47       $40.00       $14.29
   74350  X                   X-ray guide, stomach           706       1.43     $73.53       $39.10       $14.71
                               tube.
   74355  X                   X-ray guide, intestinal        706       1.43     $73.53       $39.10       $14.71
                               tube.
   74360  S                   X-ray guide, GI                738       3.74    $192.31      $104.86       $38.46
                               dilation.
   74363  S                   X-ray, bile duct               738       3.74    $192.31      $104.86       $38.46
                               dilation.
   74400  S                   Contrast x-ray urinary         737       2.69    $138.32       $81.81       $27.66
                               tract.
\2\ 7440  S                   Contrast x-ray urinary         737       2.69    $138.32       $81.81       $27.66
        5                      tract.
   74410  S                   Contrast x-ray urinary         737       2.69    $138.32       $81.81       $27.66
                               tract.
   74415  S                   Contrast x-ray urinary         737       2.69    $138.32       $81.81       $27.66
                               tract.
   74420  S                   Contrast x-ray urinary         737       2.69    $138.32       $81.81       $27.66
                               tract.
   74425  S                   Contrast x-ray urinary         737       2.69    $138.32       $81.81       $27.66
                               tract.
   74430  S                   Contrast x-ray of              737       2.69    $138.32       $81.81       $27.66
                               bladder.
   74440  S                   X-ray exam male genital        737       2.69    $138.32       $81.81       $27.66
                               tract.
   74445  S                   X-ray exam of penis....        737       2.69    $138.32       $81.81       $27.66
   74450  S                   X-ray exam urethra/            737       2.69    $138.32       $81.81       $27.66
                               bladder.
   74455  S                   X-ray exam urethra/            737       2.69    $138.32       $81.81       $27.66
                               bladder.
   74470  X                   X-ray exam of kidney           706       1.43     $73.53       $39.10       $14.71
                               lesion.
   74475  S                   X-ray control catheter         738       3.74    $192.31      $104.86       $38.46
                               insert.
   74480  S                   X-ray control catheter         738       3.74    $192.31      $104.86       $38.46
                               insert.
   74485  S                   X-ray guide, GU                738       3.74    $192.31      $104.86       $38.46
                               dilation.
   74710  X                   X-ray measurement of           700       0.80     $41.14       $22.37        $8.23
                               pelvis.
   74740  X                   X-ray female genital           706       1.43     $73.53       $39.10       $14.71
                               tract.
   74742  X                   X-ray fallopian tube...        706       1.43     $73.53       $39.10       $14.71
   74775  S                   X-ray exam of perineum.        737       2.69    $138.32       $81.81       $27.66
   75552  S                   Magnetic image,                726       7.91    $406.73      $256.06       $81.35
                               myocardium.
   75553  S                   Magnetic image,                726       7.91    $406.73      $256.06       $81.35
                               myocardium.
   75554  S                   Cardiac MRI/function...        726       7.91    $406.73      $256.06       $81.35
   75555  S                   Cardiac MRI/limited            726       7.91    $406.73      $256.06       $81.35
                               study.
   75556  E                   Cardiac MRI/flow         .........  .........  .........  ...........  ...........
                               mapping.
   75600  S                   Contrast x-ray exam of         739       5.33    $274.07      $150.74       $54.81
                               aorta.
   75605  S                   Contrast x-ray exam of         739       5.33    $274.07      $150.74       $54.81
                               aorta.
   75625  S                   Contrast x-ray exam of         739       5.33    $274.07      $150.74       $54.81
                               aorta.
   75630  S                   X-ray aorta, leg               739       5.33    $274.07      $150.74       $54.81
                               arteries.
   75650  S                   Artery x-rays, head &          739       5.33    $274.07      $150.74       $54.81
                               neck.
   75658  S                   X-ray exam of arm              739       5.33    $274.07      $150.74       $54.81
                               arteries.
   75660  S                   Artery x-rays, head &          739       5.33    $274.07      $150.74       $54.81
                               neck.
   75662  S                   Artery x-rays, head &          739       5.33    $274.07      $150.74       $54.81
                               neck.
   75665  S                   Artery x-rays, head &          739       5.33    $274.07      $150.74       $54.81
                               neck.
   75671  S                   Artery x-rays, head &          739       5.33    $274.07      $150.74       $54.81
                               neck.
   75676  S                   Artery x-rays, neck....        739       5.33    $274.07      $150.74       $54.81
   75680  S                   Artery x-rays, neck....        739       5.33    $274.07      $150.74       $54.81
   75685  S                   Artery x-rays, spine...        739       5.33    $274.07      $150.74       $54.81
   75705  S                   Artery x-rays, spine...        739       5.33    $274.07      $150.74       $54.81
   75710  S                   Artery x-rays, arm/leg.        739       5.33    $274.07      $150.74       $54.81
   75716  S                   Artery x-rays, arms/           739       5.33    $274.07      $150.74       $54.81
                               legs.
   75722  S                   Artery x-rays, kidney..        739       5.33    $274.07      $150.74       $54.81
   75724  S                   Artery x-rays, kidneys.        739       5.33    $274.07      $150.74       $54.81
   75726  S                   Artery x-rays, abdomen.        739       5.33    $274.07      $150.74       $54.81
   75731  S                   Artery x-rays, adrenal         739       5.33    $274.07      $150.74       $54.81
                               gland.
   75733  S                   Artery x-rays,adrenal          739       5.33    $274.07      $150.74       $54.81
                               glands.
   75736  S                   Artery x-rays, pelvis..        739       5.33    $274.07      $150.74       $54.81
   75741  S                   Artery x-rays, lung....        739       5.33    $274.07      $150.74       $54.81
   75743  S                   Artery x-rays, lungs...        739       5.33    $274.07      $150.74       $54.81
   75746  S                   Artery x-rays, lung....        739       5.33    $274.07      $150.74       $54.81
   75756  S                   Artery x-rays, chest...        739       5.33    $274.07      $150.74       $54.81
   75774  S                   Artery x-ray, each             739       5.33    $274.07      $150.74       $54.81
                               vessel.
   75790  S                   Visualize A-V shunt....        739       5.33    $274.07      $150.74       $54.81
   75801  X                   Lymph vessel x-ray, arm/       706       1.43     $73.53       $39.10       $14.71
                               leg.
   75803  X                   Lymph vessel x-ray,            706       1.43     $73.53       $39.10       $14.71
                               arms/legs.

[[Page 35344]]

 
   75805  X                   Lymph vessel x-ray,            706       1.43     $73.53       $39.10       $14.71
                               trunk.
   75807  X                   Lymph vessel x-ray,            706       1.43     $73.53       $39.10       $14.71
                               trunk.
   75809  X                   Nonvascular shunt, x-          706       1.43     $73.53       $39.10       $14.71
                               ray.
   75810  S                   Vein x-ray, spleen/            739       5.33    $274.07      $150.74       $54.81
                               liver.
   75820  S                   Vein x-ray, arm/leg....        739       5.33    $274.07      $150.74       $54.81
   75822  S                   Vein x-ray, arms/legs..        739       5.33    $274.07      $150.74       $54.81
   75825  S                   Vein x-ray, trunk......        739       5.33    $274.07      $150.74       $54.81
   75827  S                   Vein x-ray, chest......        739       5.33    $274.07      $150.74       $54.81
   75831  S                   Vein x-ray, kidney.....        739       5.33    $274.07      $150.74       $54.81
   75833  S                   Vein x-ray, kidneys....        739       5.33    $274.07      $150.74       $54.81
   75840  S                   Vein x-ray, adrenal            739       5.33    $274.07      $150.74       $54.81
                               gland.
   75842  S                   Vein x-ray, adrenal            739       5.33    $274.07      $150.74       $54.81
                               glands.
   75860  S                   Vein x-ray, neck.......        739       5.33    $274.07      $150.74       $54.81
   75870  S                   Vein x-ray, skull......        739       5.33    $274.07      $150.74       $54.81
   75872  S                   Vein x-ray, skull......        739       5.33    $274.07      $150.74       $54.81
   75880  S                   Vein x-ray, eye socket.        739       5.33    $274.07      $150.74       $54.81
   75885  S                   Vein x-ray, liver......        739       5.33    $274.07      $150.74       $54.81
   75887  S                   Vein x-ray, liver......        739       5.33    $274.07      $150.74       $54.81
   75889  S                   Vein x-ray, liver......        739       5.33    $274.07      $150.74       $54.81
   75891  S                   Vein x-ray, liver......        739       5.33    $274.07      $150.74       $54.81
   75893  N                   Venous sampling by       .........  .........  .........  ...........  ...........
                               catheter.
   75894  C                   X-rays, transcatheter    .........  .........  .........  ...........  ...........
                               therapy.
   75896  C                   X-rays, transcatheter    .........  .........  .........  ...........  ...........
                               therapy.
   75898  X                   Follow-up angiogram....        706       1.43     $73.53       $39.10       $14.71
   75900  C                   Arterial catheter        .........  .........  .........  ...........  ...........
                               exchange.
   75940  C                   X-ray placement, vein    .........  .........  .........  ...........  ...........
                               filter.
   75945  C                   Intravascular us.......  .........  .........  .........  ...........  ...........
   75946  C                   Intravascular us add-on  .........  .........  .........  ...........  ...........
   75960  C                   Transcatheter intro,     .........  .........  .........  ...........  ...........
                               stent.
   75961  C                   Retrieval, broken        .........  .........  .........  ...........  ...........
                               catheter.
   75962  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   75964  C                   Repair artery blockage,  .........  .........  .........  ...........  ...........
                               each.
   75966  C                   Repair arterial          .........  .........  .........  ...........  ...........
                               blockage.
   75968  C                   Repair artery blockage,  .........  .........  .........  ...........  ...........
                               each.
   75970  C                   Vascular biopsy........  .........  .........  .........  ...........  ...........
   75978  C                   Repair venous blockage.  .........  .........  .........  ...........  ...........
   75980  S                   Contrast xray exam bile        738       3.74    $192.31      $104.86       $38.46
                               duct.
   75982  S                   Contrast xray exam bile        738       3.74    $192.31      $104.86       $38.46
                               duct.
   75984  S                   X-ray control catheter         738       3.74    $192.31      $104.86       $38.46
                               change.
   75989  X                   Abscess drainage under         716       1.39     $71.47       $40.00       $14.29
                               x-ray.
   75992  C                   Atherectomy, x-ray exam  .........  .........  .........  ...........  ...........
   75993  C                   Atherectomy, x-ray exam  .........  .........  .........  ...........  ...........
   75994  C                   Atherectomy, x-ray exam  .........  .........  .........  ...........  ...........
   75995  C                   Atherectomy, x-ray exam  .........  .........  .........  ...........  ...........
   75996  C                   Atherectomy, x-ray exam  .........  .........  .........  ...........  ...........
   76000  X                   Fluoroscope examination        716       1.39     $71.47       $40.00       $14.29
   76001  X                   Fluoroscope exam,              716       1.39     $71.47       $40.00       $14.29
                               extensive.
   76003  X                   Needle localization by         716       1.39     $71.47       $40.00       $14.29
                               x-ray.
   76010  X                   X-ray, nose to rectum..        700       0.80     $41.14       $22.37        $8.23
   76020  X                   X-rays for bone age....        700       0.80     $41.14       $22.37        $8.23
   76040  X                   X-rays, bone evaluation        700       0.80     $41.14       $22.37        $8.23
   76061  X                   X-rays, bone survey....        700       0.80     $41.14       $22.37        $8.23
   76062  X                   X-rays, bone survey....        700       0.80     $41.14       $22.37        $8.23
   76065  X                   X-rays, bone evaluation        700       0.80     $41.14       $22.37        $8.23
   76066  X                   Joint(s) survey, single        700       0.80     $41.14       $22.37        $8.23
                               film.
   76070  E                   CT scan, bone density    .........  .........  .........  ...........  ...........
                               study.
   76075  X                   Dual energy x-ray study        706       1.43     $73.53       $39.10       $14.71
   76076  X                   Dual energy x-ray study        700       0.80     $41.14       $22.37        $8.23
   76078  X                   Photodensitometry......        700       0.80     $41.14       $22.37        $8.23
   76080  X                   X-ray exam of fistula..        706       1.43     $73.53       $39.10       $14.71
   76086  X                   X-ray of mammary duct..        706       1.43     $73.53       $39.10       $14.71
   76088  X                   X-ray of mammary ducts.        706       1.43     $73.53       $39.10       $14.71
   76090  S                   Mammogram, one breast..        746       0.69     $35.48       $19.44        $7.10
   76091  S                   Mammogram, both breasts        746       0.69     $35.48       $19.44        $7.10
   76092  A                   Mammogram, screening...  .........  .........  .........  ...........  ...........
   76093  S                   Magnetic image, breast.        726       7.91    $406.73      $256.06       $81.35
   76094  S                   Magnetic image, both           726       7.91    $406.73      $256.06       $81.35
                               breasts.
   76095  X                   Stereotactic breast            706       1.43     $73.53       $39.10       $14.71
                               biopsy.
   76096  X                   X-ray of needle wire,          706       1.43     $73.53       $39.10       $14.71
                               breast.
   76098  X                   X-ray exam, breast             700       0.80     $41.14       $22.37        $8.23
                               specimen.
   76100  X                   X-ray exam of body             700       0.80     $41.14       $22.37        $8.23
                               section.
   76101  X                   Complex body section x-        706       1.43     $73.53       $39.10       $14.71
                               ray.
   76102  X                   Complex body section x-        706       1.43     $73.53       $39.10       $14.71
                               rays.
   76120  X                   Cinematic x-rays.......        700       0.80     $41.14       $22.37        $8.23
   76125  X                   Cinematic x-rays add-on        700       0.80     $41.14       $22.37        $8.23

[[Page 35345]]

 
   76140  E                   X-ray consultation.....  .........  .........  .........  ...........  ...........
   76150  X                   X-ray exam, dry process        700       0.80     $41.14       $22.37        $8.23
   76350  N                   Special x-ray contrast   .........  .........  .........  ...........  ...........
                               study.
   76355  S                   CAT scan for                   710       4.98    $256.07      $173.12       $51.21
                               localization.
   76360  S                   CAT scan for needle            710       4.98    $256.07      $173.12       $51.21
                               biopsy.
   76365  S                   CAT scan for cyst              710       4.98    $256.07      $173.12       $51.21
                               aspiration.
   76370  S                   CAT scan for therapy           710       4.98    $256.07      $173.12       $51.21
                               guide.
   76375  S                   3d/holograph reconstr          710       4.98    $256.07      $173.12       $51.21
                               add-on.
   76380  S                   CAT scan follow-up             710       4.98    $256.07      $173.12       $51.21
                               study.
   76390  S                   Mr spectroscopy........        726       7.91    $406.73      $256.06       $81.35
   76400  S                   Magnetic image, bone           726       7.91    $406.73      $256.06       $81.35
                               marrow.
   76499  X                   Radiographic procedure.        700       0.80     $41.14       $22.37        $8.23
   76506  S                   Echo exam of head......        747       1.65     $84.84       $54.47       $16.97
   76511  S                   Echo exam of eye.......        747       1.65     $84.84       $54.47       $16.97
   76512  S                   Echo exam of eye.......        747       1.65     $84.84       $54.47       $16.97
   76513  S                   Echo exam of eye, water        747       1.65     $84.84       $54.47       $16.97
                               bath.
   76516  S                   Echo exam of eye.......        747       1.65     $84.84       $54.47       $16.97
   76519  S                   Echo exam of eye.......        747       1.65     $84.84       $54.47       $16.97
   76529  S                   Echo exam of eye.......        747       1.65     $84.84       $54.47       $16.97
   76536  S                   Echo exam of head and          747       1.65     $84.84       $54.47       $16.97
                               neck.
   76604  S                   Echo exam of chest.....        747       1.65     $84.84       $54.47       $16.97
   76645  S                   Echo exam of breast....        747       1.65     $84.84       $54.47       $16.97
   76700  S                   Echo exam of abdomen...        747       1.65     $84.84       $54.47       $16.97
   76705  S                   Echo exam of abdomen...        747       1.65     $84.84       $54.47       $16.97
   76770  S                   Echo exam abdomen back         747       1.65     $84.84       $54.47       $16.97
                               wall.
   76775  S                   Echo exam abdomen back         747       1.65     $84.84       $54.47       $16.97
                               wall.
   76778  S                   Echo exam kidney               747       1.65     $84.84       $54.47       $16.97
                               transplant.
   76800  S                   Echo exam spinal canal.        747       1.65     $84.84       $54.47       $16.97
   76805  S                   Echo exam of pregnant          747       1.65     $84.84       $54.47       $16.97
                               uterus.
   76810  S                   Echo exam of pregnant          747       1.65     $84.84       $54.47       $16.97
                               uterus.
   76815  S                   Echo exam of pregnant          747       1.65     $84.84       $54.47       $16.97
                               uterus.
   76816  S                   Echo exam followup or          747       1.65     $84.84       $54.47       $16.97
                               repeat.
   76818  S                   Fetal biophysical              747       1.65     $84.84       $54.47       $16.97
                               profile.
   76825  S                   Echo exam of fetal             957       4.04    $207.74      $114.13       $41.55
                               heart.
   76826  S                   Echo exam of fetal             957       4.04    $207.74      $114.13       $41.55
                               heart.
   76827  S                   Echo exam of fetal             957       4.04    $207.74      $114.13       $41.55
                               heart.
   76828  S                   Echo exam of fetal             957       4.04    $207.74      $114.13       $41.55
                               heart.
   76830  S                   Echo exam, transvaginal        747       1.65     $84.84       $54.47       $16.97
   76831  S                   Echo exam, uterus......        747       1.65     $84.84       $54.47       $16.97
   76856  S                   Echo exam of pelvis....        747       1.65     $84.84       $54.47       $16.97
   76857  S                   Echo exam of pelvis....        747       1.65     $84.84       $54.47       $16.97
   76870  S                   Echo exam of scrotum...        747       1.65     $84.84       $54.47       $16.97
   76872  S                   Echo exam, transrectal.        747       1.65     $84.84       $54.47       $16.97
   76880  S                   Echo exam of extremity.        747       1.65     $84.84       $54.47       $16.97
   76885  S                   Echo exam, infant hips.        747       1.65     $84.84       $54.47       $16.97
   76886  S                   Echo exam, infant hips.        747       1.65     $84.84       $54.47       $16.97
   76930  X                   Echo guide for heart           749       2.22    $114.15       $70.06       $22.83
                               sac tap.
   76932  X                   Echo guide for heart           749       2.22    $114.15       $70.06       $22.83
                               biopsy.
   76934  X                   Echo guide for chest           749       2.22    $114.15       $70.06       $22.83
                               tap.
   76936  X                   Echo guide for artery          749       2.22    $114.15       $70.06       $22.83
                               repair.
   76938  X                   Echo exam for drainage.        749       2.22    $114.15       $70.06       $22.83
   76941  X                   Echo guide for                 749       2.22    $114.15       $70.06       $22.83
                               transfusion.
   76942  X                   Echo guide for biopsy..        749       2.22    $114.15       $70.06       $22.83
   76945  X                   Echo guide, villus             749       2.22    $114.15       $70.06       $22.83
                               sampling.
   76946  X                   Echo guide for                 749       2.22    $114.15       $70.06       $22.83
                               amniocentesis.
   76948  X                   Echo guide, ova                749       2.22    $114.15       $70.06       $22.83
                               aspiration.
   76950  X                   Echo guidance                  749       2.22    $114.15       $70.06       $22.83
                               radiotherapy.
   76960  X                   Echo guidance                  749       2.22    $114.15       $70.06       $22.83
                               radiotherapy.
   76965  X                   Echo guidance                  749       2.22    $114.15       $70.06       $22.83
                               radiotherapy.
   76970  S                   Ultrasound exam follow-        747       1.65     $84.84       $54.47       $16.97
                               up.
   76975  S                   GI endoscopic                  747       1.65     $84.84       $54.47       $16.97
                               ultrasound.
   76986  S                   Echo exam at surgery...        747       1.65     $84.84       $54.47       $16.97
   76999  S                   Echo examination               747       1.65     $84.84       $54.47       $16.97
                               procedure.
   77261  X                   Radiation therapy              750       0.96     $49.36       $25.99        $9.87
                               planning.
   77262  X                   Radiation therapy              750       0.96     $49.36       $25.99        $9.87
                               planning.
   77263  X                   Radiation therapy              750       0.96     $49.36       $25.99        $9.87
                               planning.
   77280  X                   Set radiation therapy          752       3.48    $178.94       $86.56       $35.79
                               field.
   77285  X                   Set radiation therapy          752       3.48    $178.94       $86.56       $35.79
                               field.
   77290  X                   Set radiation therapy          752       3.48    $178.94       $86.56       $35.79
                               field.
   77295  X                   Set radiation therapy          752       3.48    $178.94       $86.56       $35.79
                               field.
   77299  X                   Radiation therapy              751       1.15     $59.13       $33.22       $11.83
                               planning.
   77300  X                   Radiation therapy dose         751       1.15     $59.13       $33.22       $11.83
                               plan.
   77305  X                   Radiation therapy dose         751       1.15     $59.13       $33.22       $11.83
                               plan.
   77310  X                   Radiation therapy dose         751       1.15     $59.13       $33.22       $11.83
                               plan.
   77315  X                   Radiation therapy dose         751       1.15     $59.13       $33.22       $11.83
                               plan.

[[Page 35346]]

 
   77321  X                   Radiation therapy port         751       1.15     $59.13       $33.22       $11.83
                               plan.
   77326  X                   Radiation therapy dose         751       1.15     $59.13       $33.22       $11.83
                               plan.
   77327  X                   Radiation therapy dose         751       1.15     $59.13       $33.22       $11.83
                               plan.
   77328  X                   Radiation therapy dose         751       1.15     $59.13       $33.22       $11.83
                               plan.
   77331  X                   Special radiation              751       1.15     $59.13       $33.22       $11.83
                               dosimetry.
   77332  X                   Radiation treatment            751       1.15     $59.13       $33.22       $11.83
                               aid(s).
   77333  X                   Radiation treatment            751       1.15     $59.13       $33.22       $11.83
                               aid(s).
   77334  X                   Radiation treatment            751       1.15     $59.13       $33.22       $11.83
                               aid(s).
   77336  X                   Radiation physics              750       0.96     $49.36       $25.99        $9.87
                               consult.
   77370  X                   Radiation physics              750       0.96     $49.36       $25.99        $9.87
                               consult.
   77399  X                   External radiation             750       0.96     $49.36       $25.99        $9.87
                               dosimetry.
   77401  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77402  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77403  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77404  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77406  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77407  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77408  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77409  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77411  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77412  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77413  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77414  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77416  S                   Radiation treatment            757       2.26    $116.21       $52.43       $23.24
                               delivery.
   77417  X                   Radiology port film(s).        700       0.80     $41.14       $22.37        $8.23
   77419  E                   Weekly radiation         .........  .........  .........  ...........  ...........
                               therapy.
   77420  E                   Weekly radiation         .........  .........  .........  ...........  ...........
                               therapy.
   77425  E                   Weekly radiation         .........  .........  .........  ...........  ...........
                               therapy.
   77430  E                   Weekly radiation         .........  .........  .........  ...........  ...........
                               therapy.
   77431  X                   Radiation therapy              750       0.96     $49.36       $25.99        $9.87
                               management.
   77432  X                   Stereotactic radiation         750       0.96     $49.36       $25.99        $9.87
                               trmt.
   77470  S                   Special radiation              757       2.26    $116.21       $52.43       $23.24
                               treatment.
   77499  N                   Radiation therapy        .........  .........  .........  ...........  ...........
                               management.
   77600  S                   Hyperthermia treatment.        758       5.08    $261.21      $137.18       $52.24
   77605  S                   Hyperthermia treatment.        758       5.08    $261.21      $137.18       $52.24
   77610  S                   Hyperthermia treatment.        758       5.08    $261.21      $137.18       $52.24
   77615  S                   Hyperthermia treatment.        758       5.08    $261.21      $137.18       $52.24
   77620  S                   Hyperthermia treatment.        758       5.08    $261.21      $137.18       $52.24
   77750  S                   Infuse radioactive             759       7.98    $410.33      $157.97       $82.07
                               materials.
   77761  S                   Radioelement                   759       7.98    $410.33      $157.97       $82.07
                               application.
   77762  S                   Radioelement                   759       7.98    $410.33      $157.97       $82.07
                               application.
   77763  S                   Radioelement                   759       7.98    $410.33      $157.97       $82.07
                               application.
   77776  S                   Radioelement                   759       7.98    $410.33      $157.97       $82.07
                               application.
   77777  S                   Radioelement                   759       7.98    $410.33      $157.97       $82.07
                               application.
   77778  S                   Radioelement                   759       7.98    $410.33      $157.97       $82.07
                               application.
   77781  S                   High intensity                 759       7.98    $410.33      $157.97       $82.07
                               brachytherapy.
   77782  S                   High intensity                 759       7.98    $410.33      $157.97       $82.07
                               brachytherapy.
   77783  S                   High intensity                 759       7.98    $410.33      $157.97       $82.07
                               brachytherapy.
   77784  S                   High intensity                 759       7.98    $410.33      $157.97       $82.07
                               brachytherapy.
   77789  S                   Radioelement                   759       7.98    $410.33      $157.97       $82.07
                               application.
   77790  N                   Radioelement handling..  .........  .........  .........  ...........  ...........
   77799  S                   Radium/radioisotope            759       7.98    $410.33      $157.97       $82.07
                               therapy.
   78000  S                   Thyroid, single uptake.        761       1.80     $92.56       $54.01       $18.51
   78001  S                   Thyroid, multiple              762       2.02    $103.87       $55.82       $20.77
                               uptakes.
   78003  S                   Thyroid suppress/stimul        762       2.02    $103.87       $55.82       $20.77
   78006  S                   Thyroid,imaging with           771       3.81    $195.91      $117.29       $39.18
                               uptake.
   78007  S                   Thyroid, image, mult           772       4.26    $219.05      $128.37       $43.81
                               uptakes.
   78010  S                   Thyroid imaging........        771       3.81    $195.91      $117.29       $39.18
   78011  S                   Thyroid imaging with           771       3.81    $195.91      $117.29       $39.18
                               flow.
   78015  S                   Thyroid met imaging....        771       3.81    $195.91      $117.29       $39.18
   78016  S                   Thyroid met imaging/           772       4.26    $219.05      $128.37       $43.81
                               studies.
\2\ 7801  S                   Thyroid met imaging,           772       4.26    $219.05      $128.37       $43.81
        7                      mult.
   78018  S                   Thyroid, met imaging,          772       4.26    $219.05      $128.37       $43.81
                               body.
   78070  S                   Parathyroid nuclear            772       4.26    $219.05      $128.37       $43.81
                               imaging.
   78075  S                   Adrenal nuclear imaging        772       4.26    $219.05      $128.37       $43.81
   78099  S                   Endocrine nuclear              761       1.80     $92.56       $54.01       $18.51
                               procedure.
   78102  S                   Bone marrow imaging,           771       3.81    $195.91      $117.29       $39.18
                               ltd.
   78103  S                   Bone marrow imaging,           771       3.81    $195.91      $117.29       $39.18
                               mult.
   78104  S                   Bone marrow imaging,           771       3.81    $195.91      $117.29       $39.18
                               body.
   78110  S                   Plasma volume, single..        761       1.80     $92.56       $54.01       $18.51
   78111  S                   Plasma volume, multiple        761       1.80     $92.56       $54.01       $18.51
   78120  S                   Red cell mass, single..        761       1.80     $92.56       $54.01       $18.51
   78121  S                   Red cell mass, multiple        762       2.02    $103.87       $55.82       $20.77
   78122  S                   Blood volume...........        762       2.02    $103.87       $55.82       $20.77
   78130  S                   Red cell survival study        762       2.02    $103.87       $55.82       $20.77

[[Page 35347]]

 
   78135  S                   Red cell survival              762       2.02    $103.87       $55.82       $20.77
                               kinetics.
   78140  S                   Red cell sequestration.        762       2.02    $103.87       $55.82       $20.77
   78160  S                   Plasma iron turnover...        762       2.02    $103.87       $55.82       $20.77
   78162  S                   Iron absorption exam...        762       2.02    $103.87       $55.82       $20.77
   78170  S                   Red cell iron                  762       2.02    $103.87       $55.82       $20.77
                               utilization.
   78172  S                   Total body iron                762       2.02    $103.87       $55.82       $20.77
                               estimation.
   78185  S                   Spleen imaging.........        771       3.81    $195.91      $117.29       $39.18
   78190  S                   Platelet survival,             762       2.02    $103.87       $55.82       $20.77
                               kinetics.
   78191  S                   Platelet survival......        762       2.02    $103.87       $55.82       $20.77
   78195  S                   Lymph system imaging...        772       4.26    $219.05      $128.37       $43.81
   78199  S                   Blood/lymph nuclear            761       1.80     $92.56       $54.01       $18.51
                               exam.
   78201  S                   Liver imaging..........        771       3.81    $195.91      $117.29       $39.18
   78202  S                   Liver imaging with flow        771       3.81    $195.91      $117.29       $39.18
   78205  S                   Liver imaging (3D).....        781       5.43    $279.21      $155.04       $55.84
   78215  S                   Liver and spleen               771       3.81    $195.91      $117.29       $39.18
                               imaging.
   78216  S                   Liver & spleen image,          771       3.81    $195.91      $117.29       $39.18
                               flow.
   78220  S                   Liver function study...        772       4.26    $219.05      $128.37       $43.81
   78223  S                   Hepatobiliary imaging..        772       4.26    $219.05      $128.37       $43.81
   78230  S                   Salivary gland imaging.        771       3.81    $195.91      $117.29       $39.18
   78231  S                   Serial salivary imaging        771       3.81    $195.91      $117.29       $39.18
   78232  S                   Salivary gland function        772       4.26    $219.05      $128.37       $43.81
                               exam.
   78258  S                   Esophageal motility            772       4.26    $219.05      $128.37       $43.81
                               study.
   78261  S                   Gastric mucosa imaging.        771       3.81    $195.91      $117.29       $39.18
   78262  S                   Gastroesophageal reflux        772       4.26    $219.05      $128.37       $43.81
                               exam.
   78264  S                   Gastric emptying study.        772       4.26    $219.05      $128.37       $43.81
   78270  S                   Vit B-12 absorption            761       1.80     $92.56       $54.01       $18.51
                               exam.
   78271  S                   Vit B-12 absorp exam,          761       1.80     $92.56       $54.01       $18.51
                               IF.
   78272  S                   Vit B-12 absorp,               761       1.80     $92.56       $54.01       $18.51
                               combined.
   78278  S                   Acute GI blood loss            772       4.26    $219.05      $128.37       $43.81
                               imaging.
   78282  S                   GI protein loss exam...        761       1.80     $92.56       $54.01       $18.51
   78290  S                   Meckel's divert exam...        771       3.81    $195.91      $117.29       $39.18
   78291  S                   Leveen/shunt patency           772       4.26    $219.05      $128.37       $43.81
                               exam.
   78299  S                   GI nuclear procedure...        761       1.80     $92.56       $54.01       $18.51
   78300  S                   Bone imaging, limited          771       3.81    $195.91      $117.29       $39.18
                               area.
   78305  S                   Bone imaging, multiple         771       3.81    $195.91      $117.29       $39.18
                               areas.
   78306  S                   Bone imaging, whole            771       3.81    $195.91      $117.29       $39.18
                               body.
   78315  S                   Bone imaging, 3 phase..        772       4.26    $219.05      $128.37       $43.81
   78320  S                   Bone imaging (3D)......        781       5.43    $279.21      $155.04       $55.84
   78350  X                   Bone mineral, single           700       0.80     $41.14       $22.37        $8.23
                               photon.
   78351  E                   Bone mineral, dual       .........  .........  .........  ...........  ...........
                               photon.
   78399  S                   Musculoskeletal nuclear        771       3.81    $195.91      $117.29       $39.18
                               exam.
   78414  S                   Non-imaging heart              762       2.02    $103.87       $55.82       $20.77
                               function.
   78428  S                   Cardiac shunt imaging..        771       3.81    $195.91      $117.29       $39.18
   78445  S                   Vascular flow imaging..        771       3.81    $195.91      $117.29       $39.18
   78455  S                   Venous thrombosis study        762       2.02    $103.87       $55.82       $20.77
   78457  S                   Venous thrombosis              771       3.81    $195.91      $117.29       $39.18
                               imaging.
   78458  S                   Ven thrombosis images,         771       3.81    $195.91      $117.29       $39.18
                               bilat.
   78459  S                   Heart muscle imaging           760      14.89    $765.64      $419.46      $153.13
                               (PET).
   78460  S                   Heart muscle blood             771       3.81    $195.91      $117.29       $39.18
                               single.
   78461  S                   Heart muscle blood             772       4.26    $219.05      $128.37       $43.81
                               multiple.
   78464  S                   Heart image (3D) single        781       5.43    $279.21      $155.04       $55.84
   78465  S                   Heart image (3D)               782       9.00    $462.78      $267.13       $92.56
                               multiple.
   78466  S                   Heart infarct image....        771       3.81    $195.91      $117.29       $39.18
   78468  S                   Heart infarct image, EF        772       4.26    $219.05      $128.37       $43.81
   78469  S                   Heart infarct image            781       5.43    $279.21      $155.04       $55.84
                               (3D).
   78472  S                   Gated heart, planar            772       4.26    $219.05      $128.37       $43.81
                               single.
   78473  S                   Gated heart, multiple..        772       4.26    $219.05      $128.37       $43.81
   78478  S                   Heart wall motion add-         771       3.81    $195.91      $117.29       $39.18
                               on.
   78480  S                   Heart function add-on..        771       3.81    $195.91      $117.29       $39.18
   78481  S                   Heart first pass single        771       3.81    $195.91      $117.29       $39.18
   78483  S                   Heart first pass               772       4.26    $219.05      $128.37       $43.81
                               multiple.
   78491  E                   Heart image (pet)        .........  .........  .........  ...........  ...........
                               single.
   78492  E                   Heart image (pet)        .........  .........  .........  ...........  ...........
                               multiple.
   78499  S                   Cardiovascular nuclear         762       2.02    $103.87       $55.82       $20.77
                               exam.
   78580  S                   Lung perfusion imaging.        771       3.81    $195.91      $117.29       $39.18
   78584  S                   Lung V/Q image single          772       4.26    $219.05      $128.37       $43.81
                               breath.
   78585  S                   Lung V/Q imaging.......        772       4.26    $219.05      $128.37       $43.81
   78586  S                   Aerosol lung image,            771       3.81    $195.91      $117.29       $39.18
                               single.
   78587  S                   Aerosol lung image,            771       3.81    $195.91      $117.29       $39.18
                               multiple.
   78591  S                   Vent image, 1 breath, 1        771       3.81    $195.91      $117.29       $39.18
                               proj.
   78593  S                   Vent image, 1 proj, gas        771       3.81    $195.91      $117.29       $39.18
   78594  S                   Vent image, mult proj,         772       4.26    $219.05      $128.37       $43.81
                               gas.
   78596  S                   Lung differential              772       4.26    $219.05      $128.37       $43.81
                               function.
   78599  S                   Respiratory nuclear            771       3.81    $195.91      $117.29       $39.18
                               exam.
   78600  S                   Brain imaging, ltd             771       3.81    $195.91      $117.29       $39.18
                               static.

[[Page 35348]]

 
   78601  S                   Brain ltd imaging &            771       3.81    $195.91      $117.29       $39.18
                               flow.
   78605  S                   Brain imaging, complete        771       3.81    $195.91      $117.29       $39.18
   78606  S                   Brain imaging comp &           772       4.26    $219.05      $128.37       $43.81
                               flow.
   78607  S                   Brain imaging (3D).....        781       5.43    $279.21      $155.04       $55.84
   78608  S                   Brain imaging (PET)....        760      14.89    $765.64      $419.46      $153.13
   78609  S                   Brain imaging (PET)....        760      14.89    $765.64      $419.46      $153.13
   78610  S                   Brain flow imaging only        771       3.81    $195.91      $117.29       $39.18
   78615  S                   Cerebral blood flow            772       4.26    $219.05      $128.37       $43.81
                               imaging.
   78630  S                   Cerebrospinal fluid            772       4.26    $219.05      $128.37       $43.81
                               scan.
   78635  S                   CSF ventriculography...        772       4.26    $219.05      $128.37       $43.81
   78645  S                   CSF shunt evaluation...        772       4.26    $219.05      $128.37       $43.81
   78647  S                   Cerebrospinal fluid            781       5.43    $279.21      $155.04       $55.84
                               scan.
   78650  S                   CSF leakage imaging....        772       4.26    $219.05      $128.37       $43.81
   78660  S                   Nuclear exam of tear           771       3.81    $195.91      $117.29       $39.18
                               flow.
   78699  S                   Nervous system nuclear         771       3.81    $195.91      $117.29       $39.18
                               exam.
   78700  S                   Kidney imaging, static.        771       3.81    $195.91      $117.29       $39.18
   78701  S                   Kidney imaging with            771       3.81    $195.91      $117.29       $39.18
                               flow.
   78704  S                   Imaging renogram.......        771       3.81    $195.91      $117.29       $39.18
   78707  S                   Kidney flow & function         771       3.81    $195.91      $117.29       $39.18
                               image.
   78708  S                   Kidney flow & function         772       4.26    $219.05      $128.37       $43.81
                               image.
   78709  S                   Kidney flow & function         772       4.26    $219.05      $128.37       $43.81
                               image.
   78710  S                   Kidney imaging (3D)....        781       5.43    $279.21      $155.04       $55.84
   78715  S                   Renal vascular flow            771       3.81    $195.91      $117.29       $39.18
                               exam.
   78725  S                   Kidney function study..        761       1.80     $92.56       $54.01       $18.51
   78730  S                   Urinary bladder                771       3.81    $195.91      $117.29       $39.18
                               retention.
   78740  S                   Ureteral reflux study..        772       4.26    $219.05      $128.37       $43.81
   78760  S                   Testicular imaging.....        771       3.81    $195.91      $117.29       $39.18
   78761  S                   Testicular imaging &           771       3.81    $195.91      $117.29       $39.18
                               flow.
   78799  S                   Genitourinary nuclear          771       3.81    $195.91      $117.29       $39.18
                               exam.
   78800  S                   Tumor imaging, limited         772       4.26    $219.05      $128.37       $43.81
                               area.
   78801  S                   Tumor imaging, mult            772       4.26    $219.05      $128.37       $43.81
                               areas.
   78802  S                   Tumor imaging, whole           772       4.26    $219.05      $128.37       $43.81
                               body.
   78803  S                   Tumor imaging (3D).....        782       9.00    $462.78      $267.13       $92.56
   78805  S                   Abscess imaging, ltd           772       4.26    $219.05      $128.37       $43.81
                               area.
   78806  S                   Abscess imaging, whole         772       4.26    $219.05      $128.37       $43.81
                               body.
   78807  S                   Nuclear localization/          782       9.00    $462.78      $267.13       $92.56
                               abscess.
   78810  S                   Tumor imaging (PET)....        760      14.89    $765.64      $419.46      $153.13
   78890  N                   Nuclear medicine data    .........  .........  .........  ...........  ...........
                               proc.
   78891  N                   Nuclear med data proc..  .........  .........  .........  ...........  ...........
   78990  N                   Provide diag             .........  .........  .........  ...........  ...........
                               radionuclide(s).
   78999  S                   Nuclear diagnostic exam        761       1.80     $92.56       $54.01       $18.51
   79000  S                   Intial hyperthyroid            792       4.81    $247.33      $143.06       $49.47
                               therapy.
   79001  S                   Repeat hyperthyroid            791      14.74    $757.93      $539.91      $151.59
                               therapy.
   79020  S                   Thyroid ablation.......        792       4.81    $247.33      $143.06       $49.47
   79030  S                   Thyroid ablation,              792       4.81    $247.33      $143.06       $49.47
                               carcinoma.
   79035  S                   Thyroid metastatic             792       4.81    $247.33      $143.06       $49.47
                               therapy.
   79100  S                   Hematopoetic nuclear           791      14.74    $757.93      $539.91      $151.59
                               therapy.
   79200  S                   Intracavitary nuc              792       4.81    $247.33      $143.06       $49.47
                               treatment.
   79300  S                   Interstitial nuclear           791      14.74    $757.93      $539.91      $151.59
                               therapy.
   79400  S                   Nonhemato nuclear              791      14.74    $757.93      $539.91      $151.59
                               therapy.
   79420  S                   Intravascular nuc              791      14.74    $757.93      $539.91      $151.59
                               therapy.
   79440  S                   Nuclear joint therapy..        791      14.74    $757.93      $539.91      $151.59
   79900  N                   Provide ther             .........  .........  .........  ...........  ...........
                               radiopharm(s).
   79999  S                   Nuclear medicine               791      14.74    $757.93      $539.91      $151.59
                               therapy.
   80049  A                   Metabolic panel, basic.  .........  .........  .........  ...........  ...........
   80050  A                   General health panel...  .........  .........  .........  ...........  ...........
   80051  A                   Electrolyte panel......  .........  .........  .........  ...........  ...........
   80054  A                   Comprehen metabolic      .........  .........  .........  ...........  ...........
                               panel.
   80055  A                   Obstetric panel........  .........  .........  .........  ...........  ...........
   80058  A                   Hepatic function panel.  .........  .........  .........  ...........  ...........
   80059  A                   Hepatitis panel........  .........  .........  .........  ...........  ...........
   80061  A                   Lipid panel............  .........  .........  .........  ...........  ...........
   80072  A                   Arthritis panel........  .........  .........  .........  ...........  ...........
   80090  A                   Torch antibody panel...  .........  .........  .........  ...........  ...........
   80091  A                   Thyroid panel..........  .........  .........  .........  ...........  ...........
   80092  A                   Thyroid panel w/TSH....  .........  .........  .........  ...........  ...........
   80100  A                   Drug screen............  .........  .........  .........  ...........  ...........
   80101  A                   Drug screen............  .........  .........  .........  ...........  ...........
   80102  A                   Drug confirmation......  .........  .........  .........  ...........  ...........
   80103  N                   Drug analysis, tissue    .........  .........  .........  ...........  ...........
                               prep.
   80150  A                   Assay of amikacin......  .........  .........  .........  ...........  ...........
   80152  A                   Assay of amitriptyline.  .........  .........  .........  ...........  ...........
   80154  A                   Assay of                 .........  .........  .........  ...........  ...........
                               benzodiazepines.
   80156  A                   Assay carbamazepine....  .........  .........  .........  ...........  ...........
   80158  A                   Assay of cyclosporine..  .........  .........  .........  ...........  ...........

[[Page 35349]]

 
   80160  A                   Assay of desipramine...  .........  .........  .........  ...........  ...........
   80162  A                   Assay for digoxin......  .........  .........  .........  ...........  ...........
   80164  A                   Assay, dipropylacetic    .........  .........  .........  ...........  ...........
                               acid.
   80166  A                   Assay of doxepin.......  .........  .........  .........  ...........  ...........
   80168  A                   Assay of ethosuximide..  .........  .........  .........  ...........  ...........
   80170  A                   Gentamicin.............  .........  .........  .........  ...........  ...........
   80172  A                   Assay for gold.........  .........  .........  .........  ...........  ...........
   80174  A                   Assay of imipramine....  .........  .........  .........  ...........  ...........
   80176  A                   Assay for lidocaine....  .........  .........  .........  ...........  ...........
   80178  A                   Assay for lithium......  .........  .........  .........  ...........  ...........
   80182  A                   Assay for nortriptyline  .........  .........  .........  ...........  ...........
   80184  A                   Assay for phenobarbital  .........  .........  .........  ...........  ...........
   80185  A                   Assay for phenytoin....  .........  .........  .........  ...........  ...........
   80186  A                   Assay for phenytoin,     .........  .........  .........  ...........  ...........
                               free.
   80188  A                   Assay for primidone....  .........  .........  .........  ...........  ...........
   80190  A                   Assay for procainamide.  .........  .........  .........  ...........  ...........
   80192  A                   Assay for procainamide.  .........  .........  .........  ...........  ...........
   80194  A                   Assay for quinidine....  .........  .........  .........  ...........  ...........
   80196  A                   Assay for salicylate...  .........  .........  .........  ...........  ...........
   80197  A                   Assay for tacrolimus...  .........  .........  .........  ...........  ...........
   80198  A                   Assay for theophylline.  .........  .........  .........  ...........  ...........
   80200  A                   Assay for tobramycin...  .........  .........  .........  ...........  ...........
   80201  A                   Assay for topiramate...  .........  .........  .........  ...........  ...........
   80202  A                   Assay for vancomycin...  .........  .........  .........  ...........  ...........
   80299  A                   Quantitative assay,      .........  .........  .........  ...........  ...........
                               drug.
   80400  A                   Acth stimulation panel.  .........  .........  .........  ...........  ...........
   80402  A                   Acth stimulation panel.  .........  .........  .........  ...........  ...........
   80406  A                   Acth stimulation panel.  .........  .........  .........  ...........  ...........
   80408  A                   Aldosterone suppression  .........  .........  .........  ...........  ...........
                               eval.
   80410  A                   Calcitonin stimul panel  .........  .........  .........  ...........  ...........
   80412  A                   CRH stimulation panel..  .........  .........  .........  ...........  ...........
   80414  A                   Testosterone response..  .........  .........  .........  ...........  ...........
   80415  A                   Estradiol response       .........  .........  .........  ...........  ...........
                               panel.
   80416  A                   Renin stimulation panel  .........  .........  .........  ...........  ...........
   80417  A                   Renin stimulation panel  .........  .........  .........  ...........  ...........
   80418  A                   Pituitary evaluation     .........  .........  .........  ...........  ...........
                               panel.
   80420  A                   Dexamethasone panel....  .........  .........  .........  ...........  ...........
   80422  A                   Glucagon tolerance       .........  .........  .........  ...........  ...........
                               panel.
   80424  A                   Glucagon tolerance       .........  .........  .........  ...........  ...........
                               panel.
   80426  A                   Gonadotropin hormone     .........  .........  .........  ...........  ...........
                               panel.
   80428  A                   Growth hormone panel...  .........  .........  .........  ...........  ...........
   80430  A                   Growth hormone panel...  .........  .........  .........  ...........  ...........
   80432  A                   Insulin suppression      .........  .........  .........  ...........  ...........
                               panel.
   80434  A                   Insulin tolerance panel  .........  .........  .........  ...........  ...........
   80435  A                   Insulin tolerance panel  .........  .........  .........  ...........  ...........
   80436  A                   Metyrapone panel.......  .........  .........  .........  ...........  ...........
   80438  A                   TRH stimulation panel..  .........  .........  .........  ...........  ...........
   80439  A                   TRH stimulation panel..  .........  .........  .........  ...........  ...........
   80440  A                   TRH stimulation panel..  .........  .........  .........  ...........  ...........
   80500  X                   Lab pathology                  882       0.39     $20.05       $11.75        $4.01
                               consultation.
   80502  X                   Lab pathology                  882       0.39     $20.05       $11.75        $4.01
                               consultation.
   81000  A                   Urinalysis, nonauto, w/  .........  .........  .........  ...........  ...........
                               scope.
   81001  A                   Urinalysis, auto, w/     .........  .........  .........  ...........  ...........
                               scope.
   81002  A                   Urinalysis nonauto w/o   .........  .........  .........  ...........  ...........
                               scope.
   81003  A                   Urinalysis, auto, w/o    .........  .........  .........  ...........  ...........
                               scope.
   81005  A                   Urinalysis.............  .........  .........  .........  ...........  ...........
   81007  A                   Urine screen for         .........  .........  .........  ...........  ...........
                               bacteria.
   81015  A                   Microscopic exam of      .........  .........  .........  ...........  ...........
                               urine.
   81020  A                   Urinalysis, glass test.  .........  .........  .........  ...........  ...........
   81025  A                   Urine pregnancy test...  .........  .........  .........  ...........  ...........
   81050  A                   Urinalysis, volume       .........  .........  .........  ...........  ...........
                               measure.
   81099  A                   Urinalysis test          .........  .........  .........  ...........  ...........
                               procedure.
   82000  A                   Assay blood              .........  .........  .........  ...........  ...........
                               acetaldehyde.
   82003  A                   Assay acetaminophen....  .........  .........  .........  ...........  ...........
   82009  A                   Test for acetone/        .........  .........  .........  ...........  ...........
                               ketones.
   82010  A                   Acetone assay..........  .........  .........  .........  ...........  ...........
   82013  A                   Acetylcholinesterase     .........  .........  .........  ...........  ...........
                               assay.
   82024  A                   ACTH...................  .........  .........  .........  ...........  ...........
   82030  A                   ADP & AMP..............  .........  .........  .........  ...........  ...........
   82040  A                   Assay serum albumin....  .........  .........  .........  ...........  ...........
   82042  A                   Assay urine albumin....  .........  .........  .........  ...........  ...........
   82043  A                   Microalbumin,            .........  .........  .........  ...........  ...........
                               quantitative.
   82044  A                   Microalbumin, semiquant  .........  .........  .........  ...........  ...........
   82055  A                   Assay ethanol..........  .........  .........  .........  ...........  ...........
   82075  A                   Assay breath ethanol...  .........  .........  .........  ...........  ...........

[[Page 35350]]

 
   82085  A                   Assay of aldolase......  .........  .........  .........  ...........  ...........
   82088  A                   Aldosterone............  .........  .........  .........  ...........  ...........
   82101  A                   Assay of urine           .........  .........  .........  ...........  ...........
                               alkaloids.
   82103  A                   Alpha-1-antitrypsin,     .........  .........  .........  ...........  ...........
                               total.
   82104  A                   Alpha-1-antitrypsin,     .........  .........  .........  ...........  ...........
                               pheno.
   82105  A                   Alpha-fetoprotein,       .........  .........  .........  ...........  ...........
                               serum.
   82106  A                   Alpha-fetoprotein;       .........  .........  .........  ...........  ...........
                               amniotic.
   82108  A                   Assay, aluminum........  .........  .........  .........  ...........  ...........
   82128  A                   Amino acids, mult qual.  .........  .........  .........  ...........  ...........
\2\ 8213  A                   Amino acids analysis...  .........  .........  .........  ...........  ...........
        0
   82131  A                   Amino acids, single      .........  .........  .........  ...........  ...........
                               quant.
   82135  A                   Assay, aminolevulinic    .........  .........  .........  ...........  ...........
                               acid.
   82140  A                   Assay of ammonia.......  .........  .........  .........  ...........  ...........
   82143  A                   Amniotic fluid scan....  .........  .........  .........  ...........  ...........
   82145  A                   Assay of amphetamines..  .........  .........  .........  ...........  ...........
   82150  A                   Assay of amylase.......  .........  .........  .........  ...........  ...........
   82154  A                   Androstanediol           .........  .........  .........  ...........  ...........
                               glucuronide.
   82157  A                   Assay of                 .........  .........  .........  ...........  ...........
                               androstenedione.
   82160  A                   Androsterone assay.....  .........  .........  .........  ...........  ...........
   82163  A                   Assay of angiotensin II  .........  .........  .........  ...........  ...........
   82164  A                   Angiotensin I enzyme     .........  .........  .........  ...........  ...........
                               test.
   82172  A                   Apolipoprotein.........  .........  .........  .........  ...........  ...........
   82175  A                   Assay of arsenic.......  .........  .........  .........  ...........  ...........
   82180  A                   Assay of ascorbic acid.  .........  .........  .........  ...........  ...........
   82190  A                   Atomic absorption......  .........  .........  .........  ...........  ...........
   82205  A                   Assay of barbiturates..  .........  .........  .........  ...........  ...........
   82232  A                   Beta-2 protein.........  .........  .........  .........  ...........  ...........
   82239  A                   Bile acids, total......  .........  .........  .........  ...........  ...........
   82240  A                   Bile acids,              .........  .........  .........  ...........  ...........
                               cholylglycine.
\2\ 8225  A                   Assay bilirubin........  .........  .........  .........  ...........  ...........
        0
   82251  A                   Assay bilirubin........  .........  .........  .........  ...........  ...........
   82252  A                   Fecal bilirubin test...  .........  .........  .........  ...........  ...........
   82270  A                   Test feces for blood...  .........  .........  .........  ...........  ...........
   82273  A                   Test for blood, other    .........  .........  .........  ...........  ...........
                               source.
   82286  A                   Assay of bradykinin....  .........  .........  .........  ...........  ...........
   82300  A                   Assay cadmium..........  .........  .........  .........  ...........  ...........
   82306  A                   Assay of vitamin D.....  .........  .........  .........  ...........  ...........
   82307  A                   Assay of vitamin D.....  .........  .........  .........  ...........  ...........
   82308  A                   Assay of calcitonin....  .........  .........  .........  ...........  ...........
   82310  A                   Assay calcium..........  .........  .........  .........  ...........  ...........
   82330  A                   Assay calcium..........  .........  .........  .........  ...........  ...........
   82331  A                   Calcium infusion test..  .........  .........  .........  ...........  ...........
   82340  A                   Assay calcium in urine.  .........  .........  .........  ...........  ...........
   82355  A                   Calculus (stone)         .........  .........  .........  ...........  ...........
                               analysis.
   82360  A                   Calculus (stone) assay.  .........  .........  .........  ...........  ...........
   82365  A                   Calculus (stone) assay.  .........  .........  .........  ...........  ...........
   82370  A                   X-ray assay,calculus     .........  .........  .........  ...........  ...........
                               (stone).
   82374  A                   Assay blood carbon       .........  .........  .........  ...........  ...........
                               dioxide.
   82375  A                   Assay blood carbon       .........  .........  .........  ...........  ...........
                               monoxide.
   82376  A                   Test for carbon          .........  .........  .........  ...........  ...........
                               monoxide.
   82378  A                   Carcinoembryonic         .........  .........  .........  ...........  ...........
                               antigen.
   82380  A                   Assay carotene.........  .........  .........  .........  ...........  ...........
   82382  A                   Assay urine              .........  .........  .........  ...........  ...........
                               catecholamines.
   82383  A                   Assay blood              .........  .........  .........  ...........  ...........
                               catecholamines.
   82384  A                   Assay three              .........  .........  .........  ...........  ...........
                               catecholamines.
   82387  A                   Cathepsin-D............  .........  .........  .........  ...........  ...........
   82390  A                   Assay ceruloplasmin....  .........  .........  .........  ...........  ...........
   82397  A                   Chemiluminescent assay.  .........  .........  .........  ...........  ...........
   82415  A                   Assay chloramphenicol..  .........  .........  .........  ...........  ...........
   82435  A                   Assay blood chloride...  .........  .........  .........  ...........  ...........
   82436  A                   Assay urine chloride...  .........  .........  .........  ...........  ...........
   82438  A                   Assay other fluid        .........  .........  .........  ...........  ...........
                               chlorides.
   82441  A                   Test for                 .........  .........  .........  ...........  ...........
                               chlorohydrocarbons.
   82465  A                   Assay serum cholesterol  .........  .........  .........  ...........  ...........
   82480  A                   Assay serum              .........  .........  .........  ...........  ...........
                               cholinesterase.
   82482  A                   Assay rbc                .........  .........  .........  ...........  ...........
                               cholinesterase.
   82485  A                   Assay chondroitin        .........  .........  .........  ...........  ...........
                               sulfate.
   82486  A                   Gas/liquid               .........  .........  .........  ...........  ...........
                               chromatography.
   82487  A                   Paper chromatography...  .........  .........  .........  ...........  ...........
   82488  A                   Paper chromatography...  .........  .........  .........  ...........  ...........
   82489  A                   Thin layer               .........  .........  .........  ...........  ...........
                               chromatography.
   82491  A                   Chromotography,          .........  .........  .........  ...........  ...........
                               quantitative.
   82495  A                   Assay chromium.........  .........  .........  .........  ...........  ...........
   82507  A                   Assay citrate..........  .........  .........  .........  ...........  ...........
   82520  A                   Assay for cocaine......  .........  .........  .........  ...........  ...........

[[Page 35351]]

 
   82523  A                   Collagen crosslinks....  .........  .........  .........  ...........  ...........
   82525  A                   Assay copper...........  .........  .........  .........  ...........  ...........
   82528  A                   Assay corticosterone...  .........  .........  .........  ...........  ...........
   82530  A                   Cortisol, free.........  .........  .........  .........  ...........  ...........
   82533  A                   Total cortisol.........  .........  .........  .........  ...........  ...........
   82540  A                   Assay creatine.........  .........  .........  .........  ...........  ...........
   82550  A                   Assay CK (CPK).........  .........  .........  .........  ...........  ...........
   82552  A                   Assay CPK in blood.....  .........  .........  .........  ...........  ...........
   82553  A                   Creatine, MB fraction..  .........  .........  .........  ...........  ...........
   82554  A                   Creatine, isoforms.....  .........  .........  .........  ...........  ...........
   82565  A                   Assay creatinine.......  .........  .........  .........  ...........  ...........
   82570  A                   Assay urine creatinine.  .........  .........  .........  ...........  ...........
   82575  A                   Creatinine clearance     .........  .........  .........  ...........  ...........
                               test.
   82585  A                   Assay cryofibrinogen...  .........  .........  .........  ...........  ...........
   82595  A                   Assay cryoglobulin.....  .........  .........  .........  ...........  ...........
   82600  A                   Assay cyanide..........  .........  .........  .........  ...........  ...........
   82607  A                   Vitamin B-12...........  .........  .........  .........  ...........  ...........
   82608  A                   B-12 binding capacity..  .........  .........  .........  ...........  ...........
   82615  A                   Test for urine cystines  .........  .........  .........  ...........  ...........
   82626  A                   Dehydroepiandrosterone.  .........  .........  .........  ...........  ...........
   82627  A                   Dehydroepiandrosterone.  .........  .........  .........  ...........  ...........
   82633  A                   Desoxycorticosterone...  .........  .........  .........  ...........  ...........
   82634  A                   Deoxycortisol..........  .........  .........  .........  ...........  ...........
   82638  A                   Assay dibucaine number.  .........  .........  .........  ...........  ...........
   82646  A                   Assay of                 .........  .........  .........  ...........  ...........
                               dihydrocodeinone.
   82649  A                   Assay of                 .........  .........  .........  ...........  ...........
                               dihydromorphinone.
   82651  A                   Dihydrotestosterone      .........  .........  .........  ...........  ...........
                               assay.
   82652  A                   Assay, dihydroxyvitamin  .........  .........  .........  ...........  ...........
                               D.
   82654  A                   Assay of dimethadione..  .........  .........  .........  ...........  ...........
   82664  A                   Electrophoretic test...  .........  .........  .........  ...........  ...........
   82666  A                   Epiandrosterone assay..  .........  .........  .........  ...........  ...........
   82668  A                   Erythropoietin.........  .........  .........  .........  ...........  ...........
   82670  A                   Estradiol..............  .........  .........  .........  ...........  ...........
   82671  A                   Estrogens assay........  .........  .........  .........  ...........  ...........
   82672  A                   Estrogen assay.........  .........  .........  .........  ...........  ...........
   82677  A                   Estriol................  .........  .........  .........  ...........  ...........
   82679  A                   Estrone................  .........  .........  .........  ...........  ...........
   82690  A                   Ethchlorvynol..........  .........  .........  .........  ...........  ...........
   82693  A                   Ethylene glycol........  .........  .........  .........  ...........  ...........
   82696  A                   Etiocholanolone........  .........  .........  .........  ...........  ...........
   82705  A                   Fats/                    .........  .........  .........  ...........  ...........
                               lipids,feces,qualitati
                               v.
   82710  A                   Fats/                    .........  .........  .........  ...........  ...........
                               lipids,feces,quantitat
                               i.
   82715  A                   Fecal fat assay........  .........  .........  .........  ...........  ...........
   82725  A                   Assay blood fatty acids  .........  .........  .........  ...........  ...........
   82728  A                   Assay ferritin.........  .........  .........  .........  ...........  ...........
   82735  A                   Assay fluoride.........  .........  .........  .........  ...........  ...........
   82742  A                   Assay of flurazepam....  .........  .........  .........  ...........  ...........
   82746  A                   Blood folic acid serum.  .........  .........  .........  ...........  ...........
   82747  A                   Folic acid, RBC........  .........  .........  .........  ...........  ...........
   82757  A                   Assay semen fructose...  .........  .........  .........  ...........  ...........
   82759  A                   RBC galactokinase assay  .........  .........  .........  ...........  ...........
   82760  A                   Assay galactose........  .........  .........  .........  ...........  ...........
   82775  A                   Assay galactose          .........  .........  .........  ...........  ...........
                               transferase.
   82776  A                   Galactose transferase    .........  .........  .........  ...........  ...........
                               test.
   82784  A                   Assay gammaglobulin IgM  .........  .........  .........  ...........  ...........
   82785  A                   Assay, gammaglobulin     .........  .........  .........  ...........  ...........
                               IgE.
   82787  A                   IgG1, 2, 3 and 4.......  .........  .........  .........  ...........  ...........
   82800  A                   Blood pH...............  .........  .........  .........  ...........  ...........
   82803  A                   Blood gases: pH, pO2 &   .........  .........  .........  ...........  ...........
                               pCO2.
   82805  A                   Blood gases W/02         .........  .........  .........  ...........  ...........
                               saturation.
   82810  A                   Blood gases, O2 sat      .........  .........  .........  ...........  ...........
                               only.
   82820  A                   Hemoglobin-oxygen        .........  .........  .........  ...........  ...........
                               affinity.
   82926  A                   Assay gastric acid.....  .........  .........  .........  ...........  ...........
   82928  A                   Assay gastric acid.....  .........  .........  .........  ...........  ...........
   82938  A                   Gastrin test...........  .........  .........  .........  ...........  ...........
   82941  A                   Assay of gastrin.......  .........  .........  .........  ...........  ...........
   82943  A                   Assay of glucagon......  .........  .........  .........  ...........  ...........
   82946  A                   Glucagon tolerance test  .........  .........  .........  ...........  ...........
   82947  A                   Assay quantitative,      .........  .........  .........  ...........  ...........
                               glucose.
   82948  A                   Reagent strip/blood      .........  .........  .........  ...........  ...........
                               glucose.
   82950  A                   Glucose test...........  .........  .........  .........  ...........  ...........
   82951  A                   Glucose tolerance test   .........  .........  .........  ...........  ...........
                               (GTT).
   82952  A                   GTT-added samples......  .........  .........  .........  ...........  ...........
   82953  A                   Glucose-tolbutamide      .........  .........  .........  ...........  ...........
                               test.
   82955  A                   Assay G6PD enzyme......  .........  .........  .........  ...........  ...........

[[Page 35352]]

 
   82960  A                   Test for G6PD enzyme...  .........  .........  .........  ...........  ...........
   82962  A                   Glucose blood test.....  .........  .........  .........  ...........  ...........
   82963  A                   Glucosidase assay......  .........  .........  .........  ...........  ...........
   82965  A                   Assay GDH enzyme.......  .........  .........  .........  ...........  ...........
   82975  A                   Assay glutamine........  .........  .........  .........  ...........  ...........
   82977  A                   Assay of GGT...........  .........  .........  .........  ...........  ...........
   82978  A                   Glutathione assay......  .........  .........  .........  ...........  ...........
   82979  A                   Assay RBC glutathione    .........  .........  .........  ...........  ...........
                               enzyme.
   82980  A                   Assay of glutethimide..  .........  .........  .........  ...........  ...........
   82985  A                   Glycated protein.......  .........  .........  .........  ...........  ...........
   83001  A                   Gonadotropin (FSH).....  .........  .........  .........  ...........  ...........
   83002  A                   Gonadotropin (LH)......  .........  .........  .........  ...........  ...........
   83003  A                   Assay growth hormone     .........  .........  .........  ...........  ...........
                               (HGH).
   83008  A                   Assay guanosine........  .........  .........  .........  ...........  ...........
   83010  A                   Quant assay haptoglobin  .........  .........  .........  ...........  ...........
   83012  A                   Assay haptoglobins.....  .........  .........  .........  ...........  ...........
   83015  A                   Heavy metal screen.....  .........  .........  .........  ...........  ...........
   83018  A                   Quantitative screen,     .........  .........  .........  ...........  ...........
                               metals.
\2\ 8301  A                   Breath isotope test....  .........  .........  .........  ...........  ...........
        9
   83020  A                   Hemoglobin               .........  .........  .........  ...........  ...........
                               electrophoresis.
   83026  A                   Hemoglobin, copper       .........  .........  .........  ...........  ...........
                               sulfate.
   83030  A                   Fetal hemoglobin assay.  .........  .........  .........  ...........  ...........
   83033  A                   Fetal fecal hemoglobin   .........  .........  .........  ...........  ...........
                               assay.
   83036  A                   Glycated hemoglobin      .........  .........  .........  ...........  ...........
                               test.
   83045  A                   Blood methemoglobin      .........  .........  .........  ...........  ...........
                               test.
   83050  A                   Blood methemoglobin      .........  .........  .........  ...........  ...........
                               assay.
   83051  A                   Assay plasma hemoglobin  .........  .........  .........  ...........  ...........
   83055  A                   Blood sulfhemoglobin     .........  .........  .........  ...........  ...........
                               test.
   83060  A                   Blood sulfhemoglobin     .........  .........  .........  ...........  ...........
                               assay.
   83065  A                   Hemoglobin heat assay..  .........  .........  .........  ...........  ...........
   83068  A                   Hemoglobin stability     .........  .........  .........  ...........  ...........
                               screen.
   83069  A                   Assay urine hemoglobin.  .........  .........  .........  ...........  ...........
   83070  A                   Qualt assay hemosiderin  .........  .........  .........  ...........  ...........
   83071  A                   Quant assay of           .........  .........  .........  ...........  ...........
                               hemosiderin.
   83088  A                   Assay histamine........  .........  .........  .........  ...........  ...........
   83150  A                   Assay for HVA..........  .........  .........  .........  ...........  ...........
   83491  A                   Assay of                 .........  .........  .........  ...........  ...........
                               corticosteroids.
   83497  A                   Assay 5-HIAA...........  .........  .........  .........  ...........  ...........
   83498  A                   Assay of progesterone..  .........  .........  .........  ...........  ...........
   83499  A                   Assay of progesterone..  .........  .........  .........  ...........  ...........
   83500  A                   Assay free               .........  .........  .........  ...........  ...........
                               hydroxyproline.
   83505  A                   Assay total              .........  .........  .........  ...........  ...........
                               hydroxyproline.
   83516  A                   Immunoassay, non         .........  .........  .........  ...........  ...........
                               antibody.
   83518  A                   Immunoassay, dipstick..  .........  .........  .........  ...........  ...........
   83519  A                   Immunoassay nonantibody  .........  .........  .........  ...........  ...........
   83520  A                   Immunoassay, RIA.......  .........  .........  .........  ...........  ...........
   83525  A                   Assay of insulin.......  .........  .........  .........  ...........  ...........
   83527  A                   Assay of insulin.......  .........  .........  .........  ...........  ...........
   83528  A                   Assay intrinsic factor.  .........  .........  .........  ...........  ...........
   83540  A                   Assay iron.............  .........  .........  .........  ...........  ...........
   83550  A                   Iron binding test......  .........  .........  .........  ...........  ...........
   83570  A                   Assay IDH enzyme.......  .........  .........  .........  ...........  ...........
   83582  A                   Assay ketogenic          .........  .........  .........  ...........  ...........
                               steroids.
   83586  A                   Assay 17-(17-            .........  .........  .........  ...........  ...........
                               KS)ketosteroids.
   83593  A                   Fractionation            .........  .........  .........  ...........  ...........
                               ketosteroids.
   83605  A                   Lactic acid assay......  .........  .........  .........  ...........  ...........
   83615  A                   Lactate (LD) (LDH)       .........  .........  .........  ...........  ...........
                               enzyme.
   83625  A                   Assay LDH enzymes......  .........  .........  .........  ...........  ...........
   83632  A                   Placental lactogen.....  .........  .........  .........  ...........  ...........
   83633  A                   Test urine for lactose.  .........  .........  .........  ...........  ...........
   83634  A                   Assay urine for lactose  .........  .........  .........  ...........  ...........
   83655  A                   Assay for lead.........  .........  .........  .........  ...........  ...........
   83661  A                   Assay L/S ratio........  .........  .........  .........  ...........  ...........
   83662  A                   L/S ratio, foam          .........  .........  .........  ...........  ...........
                               stability.
   83670  A                   Assay LAP enzyme.......  .........  .........  .........  ...........  ...........
   83690  A                   Assay lipase...........  .........  .........  .........  ...........  ...........
   83715  A                   Assay blood              .........  .........  .........  ...........  ...........
                               lipoproteins.
\2\ 8371  A                   Assay blood              .........  .........  .........  ...........  ...........
        7                      lipoproteins.
   83718  A                   Blood lipoprotein assay  .........  .........  .........  ...........  ...........
   83719  A                   Blood lipoprotein assay  .........  .........  .........  ...........  ...........
   83721  A                   Blood lipoprotein assay  .........  .........  .........  ...........  ...........
   83727  A                   LRH hormone assay......  .........  .........  .........  ...........  ...........
   83735  A                   Assay magnesium........  .........  .........  .........  ...........  ...........
   83775  A                   Assay of md enzyme.....  .........  .........  .........  ...........  ...........
   83785  A                   Assay of manganese.....  .........  .........  .........  ...........  ...........

[[Page 35353]]

 
   83805  A                   Assay of meprobamate...  .........  .........  .........  ...........  ...........
   83825  A                   Assay mercury..........  .........  .........  .........  ...........  ...........
   83835  A                   Assay metanephrines....  .........  .........  .........  ...........  ...........
   83840  A                   Assay methadone........  .........  .........  .........  ...........  ...........
   83857  A                   Assay methemalbumin....  .........  .........  .........  ...........  ...........
   83858  A                   Assay methsuximide.....  .........  .........  .........  ...........  ...........
   83864  A                   Mucopolysaccharides....  .........  .........  .........  ...........  ...........
   83866  A                   Mucopolysaccharides      .........  .........  .........  ...........  ...........
                               screen.
   83872  A                   Assay synovial fluid     .........  .........  .........  ...........  ...........
                               mucin.
   83873  A                   Assay, CSF protein.....  .........  .........  .........  ...........  ...........
   83874  A                   Myoglobin..............  .........  .........  .........  ...........  ...........
   83883  A                   Nephelometry, not        .........  .........  .........  ...........  ...........
                               specified.
   83885  A                   Assay for nickel.......  .........  .........  .........  ...........  ...........
   83887  A                   Assay nicotine.........  .........  .........  .........  ...........  ...........
   83890  A                   Molecule isolate.......  .........  .........  .........  ...........  ...........
   83892  A                   Molecular diagnostics..  .........  .........  .........  ...........  ...........
   83894  A                   Molecule gel             .........  .........  .........  ...........  ...........
                               electrophor.
   83896  A                   Molecular diagnostics..  .........  .........  .........  ...........  ...........
   83898  A                   Molecule nucleic amp...  .........  .........  .........  ...........  ...........
   83902  A                   Molecular diagnostics..  .........  .........  .........  ...........  ...........
   83912  A                   Genetic examination....  .........  .........  .........  ...........  ...........
   83915  A                   Assay nucleotidase.....  .........  .........  .........  ...........  ...........
   83916  A                   Oligoclonal bands......  .........  .........  .........  ...........  ...........
   83918  A                   Assay organic acids      .........  .........  .........  ...........  ...........
                               quant.
   83925  A                   Opiates................  .........  .........  .........  ...........  ...........
   83930  A                   Assay blood osmolality.  .........  .........  .........  ...........  ...........
   83935  A                   Assay urine osmolality.  .........  .........  .........  ...........  ...........
   83937  A                   Assay for osteocalcin..  .........  .........  .........  ...........  ...........
   83945  A                   Assay oxalate..........  .........  .........  .........  ...........  ...........
   83970  A                   Assay of parathormone..  .........  .........  .........  ...........  ...........
   83986  A                   Assay body fluid         .........  .........  .........  ...........  ...........
                               acidity.
   83992  A                   Assay for phencyclidine  .........  .........  .........  ...........  ...........
   84022  A                   Assay of phenothiazine.  .........  .........  .........  ...........  ...........
   84030  A                   Assay blood PKU........  .........  .........  .........  ...........  ...........
   84035  A                   Assay phenylketones....  .........  .........  .........  ...........  ...........
   84060  A                   Assay acid phosphatase.  .........  .........  .........  ...........  ...........
   84061  A                   Phosphatase, forensic    .........  .........  .........  ...........  ...........
                               exam.
   84066  A                   Assay prostate           .........  .........  .........  ...........  ...........
                               phosphatase.
   84075  A                   Assay alkaline           .........  .........  .........  ...........  ...........
                               phosphatase.
   84078  A                   Assay alkaline           .........  .........  .........  ...........  ...........
                               phosphatase.
   84080  A                   Assay alkaline           .........  .........  .........  ...........  ...........
                               phosphatases.
   84081  A                   Amniotic fluid enzyme    .........  .........  .........  ...........  ...........
                               test.
   84085  A                   Assay RBC PG6D enzyme..  .........  .........  .........  ...........  ...........
   84087  A                   Assay phosphohexose      .........  .........  .........  ...........  ...........
                               enzymes.
   84100  A                   Assay phosphorus.......  .........  .........  .........  ...........  ...........
   84105  A                   Assay urine phosphorus.  .........  .........  .........  ...........  ...........
   84106  A                   Test for                 .........  .........  .........  ...........  ...........
                               porphobilinogen.
   84110  A                   Assay porphobilinogen..  .........  .........  .........  ...........  ...........
   84119  A                   Test urine for           .........  .........  .........  ...........  ...........
                               porphyrins.
   84120  A                   Assay urine porphyrins.  .........  .........  .........  ...........  ...........
   84126  A                   Assay feces porphyrins.  .........  .........  .........  ...........  ...........
   84127  A                   Porphyrins, feces......  .........  .........  .........  ...........  ...........
   84132  A                   Assay serum potassium..  .........  .........  .........  ...........  ...........
   84133  A                   Assay urine potassium..  .........  .........  .........  ...........  ...........
   84134  A                   Prealbumin.............  .........  .........  .........  ...........  ...........
   84135  A                   Assay pregnanediol.....  .........  .........  .........  ...........  ...........
   84138  A                   Assay pregnanetriol....  .........  .........  .........  ...........  ...........
   84140  A                   Assay for pregnenolone.  .........  .........  .........  ...........  ...........
   84143  A                   Assay/17-                .........  .........  .........  ...........  ...........
                               hydroxypregnenolone.
   84144  A                   Assay progesterone.....  .........  .........  .........  ...........  ...........
   84146  A                   Assay for prolactin....  .........  .........  .........  ...........  ...........
   84150  A                   Assay of prostaglandin.  .........  .........  .........  ...........  ...........
   84153  A                   Psa total..............  .........  .........  .........  ...........  ...........
   84155  A                   Assay protein..........  .........  .........  .........  ...........  ...........
   84160  A                   Assay serum protein....  .........  .........  .........  ...........  ...........
   84165  A                   Assay serum proteins...  .........  .........  .........  ...........  ...........
   84181  A                   Western blot test......  .........  .........  .........  ...........  ...........
   84182  A                   Protein, western blot    .........  .........  .........  ...........  ...........
                               test.
   84202  A                   Assay RBC                .........  .........  .........  ...........  ...........
                               protoporphyrin.
   84203  A                   Test RBC protoporphyrin  .........  .........  .........  ...........  ...........
   84206  A                   Assay of proinsulin....  .........  .........  .........  ...........  ...........
   84207  A                   Assay vitamin B-6......  .........  .........  .........  ...........  ...........
   84210  A                   Assay pyruvate.........  .........  .........  .........  ...........  ...........
   84220  A                   Assay pyruvate kinase..  .........  .........  .........  ...........  ...........
   84228  A                   Assay quinine..........  .........  .........  .........  ...........  ...........

[[Page 35354]]

 
   84233  A                   Assay estrogen.........  .........  .........  .........  ...........  ...........
   84234  A                   Assay progesterone.....  .........  .........  .........  ...........  ...........
   84235  A                   Assay endocrine hormone  .........  .........  .........  ...........  ...........
   84238  A                   Assay non-endocrine      .........  .........  .........  ...........  ...........
                               receptor.
   84244  A                   Assay of renin.........  .........  .........  .........  ...........  ...........
   84252  A                   Assay vitamin B-2......  .........  .........  .........  ...........  ...........
   84255  A                   Assay selenium.........  .........  .........  .........  ...........  ...........
   84260  A                   Assay serotonin........  .........  .........  .........  ...........  ...........
   84270  A                   Sex hormone globulin     .........  .........  .........  ...........  ...........
                               (SHBG).
   84275  A                   Assay sialic acid......  .........  .........  .........  ...........  ...........
   84285  A                   Assay silica...........  .........  .........  .........  ...........  ...........
   84295  A                   Assay serum sodium.....  .........  .........  .........  ...........  ...........
   84300  A                   Assay urine sodium.....  .........  .........  .........  ...........  ...........
   84305  A                   Somatomedin............  .........  .........  .........  ...........  ...........
   84307  A                   Somatostatin...........  .........  .........  .........  ...........  ...........
   84311  A                   Spectrophotometry......  .........  .........  .........  ...........  ...........
   84315  A                   Body fluid specific      .........  .........  .........  ...........  ...........
                               gravity.
   84375  A                   Chromatogram assay,      .........  .........  .........  ...........  ...........
                               sugars.
   84392  A                   Assay urine sulfate....  .........  .........  .........  ...........  ...........
   84402  A                   Testosterone...........  .........  .........  .........  ...........  ...........
   84403  A                   Assay total              .........  .........  .........  ...........  ...........
                               testosterone.
   84425  A                   Assay vitamin B-1......  .........  .........  .........  ...........  ...........
   84430  A                   Assay thiocyanate......  .........  .........  .........  ...........  ...........
   84432  A                   Thyroglobulin..........  .........  .........  .........  ...........  ...........
   84436  A                   Assay, total thyroxine.  .........  .........  .........  ...........  ...........
   84437  A                   Assay neonatal           .........  .........  .........  ...........  ...........
                               thyroxine.
   84439  A                   Assay, free thyroxine..  .........  .........  .........  ...........  ...........
   84442  A                   Thyroid activity (TBG)   .........  .........  .........  ...........  ...........
                               assay.
   84443  A                   Assay thyroid stim       .........  .........  .........  ...........  ...........
                               hormone.
   84445  A                   Thyroid immunoglobulins  .........  .........  .........  ...........  ...........
                               TSI.
   84446  A                   Assay vitamin E........  .........  .........  .........  ...........  ...........
   84449  A                   Assay for transcortin..  .........  .........  .........  ...........  ...........
   84450  A                   Transferase (AST)        .........  .........  .........  ...........  ...........
                               (SGOT).
   84460  A                   Alanine amino (ALT)      .........  .........  .........  ...........  ...........
                               (SGPT).
   84466  A                   Transferrin............  .........  .........  .........  ...........  ...........
   84478  A                   Assay triglycerides....  .........  .........  .........  ...........  ...........
   84479  A                   Assay thyroid (t-3 or t- .........  .........  .........  ...........  ...........
                               4).
   84480  A                   Assay triiodothyronine   .........  .........  .........  ...........  ...........
                               (t-3).
   84481  A                   Free assay (FT-3)......  .........  .........  .........  ...........  ...........
   84482  A                   T3 reverse.............  .........  .........  .........  ...........  ...........
   84484  A                   Troponin, quant........  .........  .........  .........  ...........  ...........
   84485  A                   Assay duodenal fluid     .........  .........  .........  ...........  ...........
                               trypsin.
   84488  A                   Test feces for trypsin.  .........  .........  .........  ...........  ...........
   84490  A                   Assay feces for trypsin  .........  .........  .........  ...........  ...........
   84510  A                   Assay tyrosine.........  .........  .........  .........  ...........  ...........
   84512  A                   Troponin, qual.........  .........  .........  .........  ...........  ...........
   84520  A                   Assay urea nitrogen....  .........  .........  .........  ...........  ...........
   84525  A                   Urea nitrogen semi-      .........  .........  .........  ...........  ...........
                               quant.
   84540  A                   Assay urine urea-N.....  .........  .........  .........  ...........  ...........
   84545  A                   Urea-N clearance test..  .........  .........  .........  ...........  ...........
   84550  A                   Assay blood uric acid..  .........  .........  .........  ...........  ...........
   84560  A                   Assay urine uric acid..  .........  .........  .........  ...........  ...........
   84577  A                   Assay feces              .........  .........  .........  ...........  ...........
                               urobilinogen.
   84578  A                   Test urine urobilinogen  .........  .........  .........  ...........  ...........
   84580  A                   Assay urine              .........  .........  .........  ...........  ...........
                               urobilinogen.
   84583  A                   Assay urine              .........  .........  .........  ...........  ...........
                               urobilinogen.
   84585  A                   Assay urine VMA........  .........  .........  .........  ...........  ...........
   84586  A                   VIP assay..............  .........  .........  .........  ...........  ...........
   84588  A                   Assay vasopressin......  .........  .........  .........  ...........  ...........
   84590  A                   Assay vitamin-A........  .........  .........  .........  ...........  ...........
   84597  A                   Assay vitamin-K........  .........  .........  .........  ...........  ...........
   84600  A                   Assay for volatiles....  .........  .........  .........  ...........  ...........
   84620  A                   Xylose tolerance test..  .........  .........  .........  ...........  ...........
   84630  A                   Assay zinc.............  .........  .........  .........  ...........  ...........
   84681  A                   Assay C-peptide........  .........  .........  .........  ...........  ...........
   84702  A                   Chorionic gonadotropin   .........  .........  .........  ...........  ...........
                               test.
   84703  A                   Chorionic gonadotropin   .........  .........  .........  ...........  ...........
                               assay.
   84830  A                   Ovulation tests........  .........  .........  .........  ...........  ...........
   84999  A                   Clinical chemistry test  .........  .........  .........  ...........  ...........
   85002  A                   Bleeding time test.....  .........  .........  .........  ...........  ...........
   85007  A                   Differential WBC count.  .........  .........  .........  ...........  ...........
   85008  A                   Nondifferential WBC      .........  .........  .........  ...........  ...........
                               count.
   85009  A                   Differential WBC count.  .........  .........  .........  ...........  ...........
   85013  A                   Hematocrit.............  .........  .........  .........  ...........  ...........
   85014  A                   Hematocrit.............  .........  .........  .........  ...........  ...........

[[Page 35355]]

 
   85018  A                   Hemoglobin.............  .........  .........  .........  ...........  ...........
   85021  A                   Automated hemogram.....  .........  .........  .........  ...........  ...........
   85022  A                   Automated hemogram.....  .........  .........  .........  ...........  ...........
   85023  A                   Automated hemogram.....  .........  .........  .........  ...........  ...........
   85024  A                   Automated hemogram.....  .........  .........  .........  ...........  ...........
   85025  A                   Automated hemogram.....  .........  .........  .........  ...........  ...........
   85027  A                   Automated hemogram.....  .........  .........  .........  ...........  ...........
\2\ 8502  A                   Automated hemogram.....  .........  .........  .........  ...........  ...........
        9
\2\ 8503  A                   Automated hemogram.....  .........  .........  .........  ...........  ...........
        0
   85031  A                   Manual                   .........  .........  .........  ...........  ...........
                               hemogram,complete cbc.
   85041  A                   Red blood cell (RBC)     .........  .........  .........  ...........  ...........
                               count.
   85044  A                   Reticulocyte count.....  .........  .........  .........  ...........  ...........
   85045  A                   Reticulocyte count.....  .........  .........  .........  ...........  ...........
   85048  A                   White blood cell (WBC)   .........  .........  .........  ...........  ...........
                               count.
   85060  X                   Blood smear                    882       0.39     $20.05       $11.75        $4.01
                               interpretation.
   85095  S                   Bone marrow aspiration.        121       0.63     $32.39       $21.02        $6.48
   85097  X                   Bone marrow                    882       0.39     $20.05       $11.75        $4.01
                               interpretation.
   85102  S                   Bone marrow biopsy.....        121       0.63     $32.39       $21.02        $6.48
   85130  A                   Chromogenic substrate    .........  .........  .........  ...........  ...........
                               assay.
   85170  A                   Blood clot retraction..  .........  .........  .........  ...........  ...........
   85175  A                   Blood clot lysis time..  .........  .........  .........  ...........  ...........
   85210  A                   Blood clot factor II     .........  .........  .........  ...........  ...........
                               test.
   85220  A                   Blood clot factor V      .........  .........  .........  ...........  ...........
                               test.
   85230  A                   Blood clot factor VII    .........  .........  .........  ...........  ...........
                               test.
   85240  A                   Blood clot factor VIII   .........  .........  .........  ...........  ...........
                               test.
   85244  A                   Blood clot factor VIII   .........  .........  .........  ...........  ...........
                               test.
   85245  A                   Blood clot factor VIII   .........  .........  .........  ...........  ...........
                               test.
   85246  A                   Blood clot factor VIII   .........  .........  .........  ...........  ...........
                               test.
   85247  A                   Blood clot factor VIII   .........  .........  .........  ...........  ...........
                               test.
   85250  A                   Blood clot factor IX     .........  .........  .........  ...........  ...........
                               test.
   85260  A                   Blood clot factor X      .........  .........  .........  ...........  ...........
                               test.
   85270  A                   Blood clot factor XI     .........  .........  .........  ...........  ...........
                               test.
   85280  A                   Blood clot factor XII    .........  .........  .........  ...........  ...........
                               test.
   85290  A                   Blood clot factor XIII   .........  .........  .........  ...........  ...........
                               test.
   85291  A                   Blood clot factor XIII   .........  .........  .........  ...........  ...........
                               test.
   85292  A                   Blood clot factor assay  .........  .........  .........  ...........  ...........
   85293  A                   Blood clot factor assay  .........  .........  .........  ...........  ...........
   85300  A                   Antithrombin III test..  .........  .........  .........  ...........  ...........
   85301  A                   Antithrombin III test..  .........  .........  .........  ...........  ...........
   85302  A                   Blood clot inhibitor     .........  .........  .........  ...........  ...........
                               antigen.
   85303  A                   Blood clot inhibitor     .........  .........  .........  ...........  ...........
                               test.
   85305  A                   Blood clot inhibitor     .........  .........  .........  ...........  ...........
                               assay.
   85306  A                   Blood clot inhibitor     .........  .........  .........  ...........  ...........
                               test.
   85335  A                   Factor inhibitor test..  .........  .........  .........  ...........  ...........
   85337  A                   Thrombomodulin.........  .........  .........  .........  ...........  ...........
   85345  A                   Coagulation time.......  .........  .........  .........  ...........  ...........
   85347  A                   Coagulation time.......  .........  .........  .........  ...........  ...........
   85348  A                   Coagulation time.......  .........  .........  .........  ...........  ...........
   85360  A                   Euglobulin lysis.......  .........  .........  .........  ...........  ...........
   85362  A                   Fibrin degradation       .........  .........  .........  ...........  ...........
                               products.
   85366  A                   Fibrinogen test........  .........  .........  .........  ...........  ...........
   85370  A                   Fibrinogen test........  .........  .........  .........  ...........  ...........
   85378  A                   Fibrin degradation.....  .........  .........  .........  ...........  ...........
   85379  A                   Fibrin degradation.....  .........  .........  .........  ...........  ...........
   85384  A                   Fibrinogen.............  .........  .........  .........  ...........  ...........
   85385  A                   Fibrinogen.............  .........  .........  .........  ...........  ...........
   85390  A                   Fibrinolysins screen...  .........  .........  .........  ...........  ...........
   85400  A                   Fibrinolytic plasmin...  .........  .........  .........  ...........  ...........
   85410  A                   Fibrinolytic             .........  .........  .........  ...........  ...........
                               antiplasmin.
   85415  A                   Fibrinolytic             .........  .........  .........  ...........  ...........
                               plasminogen.
   85420  A                   Fibrinolytic             .........  .........  .........  ...........  ...........
                               plasminogen.
   85421  A                   Fibrinolytic             .........  .........  .........  ...........  ...........
                               plasminogen.
   85441  A                   Heinz bodies; direct...  .........  .........  .........  ...........  ...........
   85445  A                   Heinz bodies; induced..  .........  .........  .........  ...........  ...........
   85460  A                   Hemoglobin, fetal......  .........  .........  .........  ...........  ...........
   85461  A                   Hemoglobin, fetal......  .........  .........  .........  ...........  ...........
   85475  A                   Hemolysin..............  .........  .........  .........  ...........  ...........
   85520  A                   Heparin assay..........  .........  .........  .........  ...........  ...........
   85525  A                   Heparin................  .........  .........  .........  ...........  ...........
   85530  A                   Heparin-protamine        .........  .........  .........  ...........  ...........
                               tolerance.
   85535  A                   Iron stain, blood cells  .........  .........  .........  ...........  ...........
   85540  A                   Wbc alkaline             .........  .........  .........  ...........  ...........
                               phosphatase.
   85547  A                   RBC mechanical           .........  .........  .........  ...........  ...........
                               fragility.
   85549  A                   Muramidase.............  .........  .........  .........  ...........  ...........
   85555  A                   RBC osmotic fragility..  .........  .........  .........  ...........  ...........

[[Page 35356]]

 
   85557  A                   RBC osmotic fragility..  .........  .........  .........  ...........  ...........
   85576  A                   Blood platelet           .........  .........  .........  ...........  ...........
                               aggregation.
   85585  A                   Blood platelet           .........  .........  .........  ...........  ...........
                               estimation.
   85590  A                   Platelet manual count..  .........  .........  .........  ...........  ...........
   85595  A                   Platelet count,          .........  .........  .........  ...........  ...........
                               automated.
   85597  A                   Platelet neutralization  .........  .........  .........  ...........  ...........
   85610  A                   Prothrombin time.......  .........  .........  .........  ...........  ...........
   85611  A                   Prothrombin test.......  .........  .........  .........  ...........  ...........
   85612  A                   Viper venom prothrombin  .........  .........  .........  ...........  ...........
                               time.
   85613  A                   Russell viper venom,     .........  .........  .........  ...........  ...........
                               diluted.
   85635  A                   Reptilase test.........  .........  .........  .........  ...........  ...........
   85651  A                   Rbc sed rate, nonauto..  .........  .........  .........  ...........  ...........
   85652  A                   Rbc sed rate, auto.....  .........  .........  .........  ...........  ...........
   85660  A                   RBC sickle cell test...  .........  .........  .........  ...........  ...........
   85670  A                   Thrombin time, plasma..  .........  .........  .........  ...........  ...........
   85675  A                   Thrombin time, titer...  .........  .........  .........  ...........  ...........
   85705  A                   Thromboplastin           .........  .........  .........  ...........  ...........
                               inhibition.
   85730  A                   Thromboplastin time,     .........  .........  .........  ...........  ...........
                               partial.
   85732  A                   Thromboplastin time,     .........  .........  .........  ...........  ...........
                               partial.
   85810  A                   Blood viscosity          .........  .........  .........  ...........  ...........
                               examination.
   85999  A                   Hematology procedure...  .........  .........  .........  ...........  ...........
   86000  A                   Agglutinins; febrile...  .........  .........  .........  ...........  ...........
   86003  A                   Allergen specific IgE..  .........  .........  .........  ...........  ...........
   86005  A                   Allergen specific IgE..  .........  .........  .........  ...........  ...........
   86021  A                   WBC antibody             .........  .........  .........  ...........  ...........
                               identification.
   86022  A                   Platelet antibodies....  .........  .........  .........  ...........  ...........
   86023  A                   Immunoglobulin assay...  .........  .........  .........  ...........  ...........
   86038  A                   Antinuclear antibodies.  .........  .........  .........  ...........  ...........
   86039  A                   Antinuclear antibodies   .........  .........  .........  ...........  ...........
                               (ANA).
   86060  A                   Antistreptolysin O       .........  .........  .........  ...........  ...........
                               titer.
   86063  A                   Antistreptolysin O       .........  .........  .........  ...........  ...........
                               screen.
   86077  X                   Physician blood bank           882       0.39     $20.05       $11.75        $4.01
                               service.
   86078  X                   Physician blood bank           882       0.39     $20.05       $11.75        $4.01
                               service.
   86079  X                   Physician blood bank           882       0.39     $20.05       $11.75        $4.01
                               service.
   86140  A                   C-reactive protein.....  .........  .........  .........  ...........  ...........
   86147  A                   Cardiolipin antibody...  .........  .........  .........  ...........  ...........
   86148  A                   Phospholipid antibody..  .........  .........  .........  ...........  ...........
   86155  A                   Chemotaxis assay.......  .........  .........  .........  ...........  ...........
   86156  A                   Cold agglutinin screen.  .........  .........  .........  ...........  ...........
   86157  A                   Cold agglutinin, titer.  .........  .........  .........  ...........  ...........
   86160  A                   Complement, antigen....  .........  .........  .........  ...........  ...........
   86161  A                   Complement/function      .........  .........  .........  ...........  ...........
                               activity.
   86162  A                   Complement, total        .........  .........  .........  ...........  ...........
                               (CH50).
   86171  A                   Complement fixation,     .........  .........  .........  ...........  ...........
                               each.
   86185  A                   Counterimmunoelectropho  .........  .........  .........  ...........  ...........
                               resis.
   86215  A                   Deoxyribonuclease,       .........  .........  .........  ...........  ...........
                               antibody.
   86225  A                   DNA antibody...........  .........  .........  .........  ...........  ...........
   86226  A                   DNA antibody, single     .........  .........  .........  ...........  ...........
                               strand.
   86235  A                   Nuclear antigen          .........  .........  .........  ...........  ...........
                               antibody.
   86243  A                   Fc receptor............  .........  .........  .........  ...........  ...........
   86255  A                   Fluorescent antibody;    .........  .........  .........  ...........  ...........
                               screen.
   86256  A                   Fluorescent antibody;    .........  .........  .........  ...........  ...........
                               titer.
   86277  A                   Growth hormone antibody  .........  .........  .........  ...........  ...........
   86280  A                   Hemagglutination         .........  .........  .........  ...........  ...........
                               inhibition.
   86308  A                   Heterophile antibodies.  .........  .........  .........  ...........  ...........
   86309  A                   Heterophile antibodies.  .........  .........  .........  ...........  ...........
   86310  A                   Heterophile antibodies.  .........  .........  .........  ...........  ...........
   86316  A                   Immunoassay, tumor       .........  .........  .........  ...........  ...........
                               antigen.
   86317  A                   Immunoassay, infectious  .........  .........  .........  ...........  ...........
                               agent.
   86318  A                   Immunoassay, infectious  .........  .........  .........  ...........  ...........
                               agent.
   86320  A                   Serum                    .........  .........  .........  ...........  ...........
                               immunoelectrophoresis.
   86325  A                   Other                    .........  .........  .........  ...........  ...........
                               immunoelectrophoresis.
   86327  A                   Immunoelectrophoresis    .........  .........  .........  ...........  ...........
                               assay.
   86329  A                   Immunodiffusion........  .........  .........  .........  ...........  ...........
   86331  A                   Immunodiffusion          .........  .........  .........  ...........  ...........
                               ouchterlony.
   86332  A                   Immune complex assay...  .........  .........  .........  ...........  ...........
   86334  A                   Immunofixation           .........  .........  .........  ...........  ...........
                               procedure.
   86337  A                   Insulin antibodies.....  .........  .........  .........  ...........  ...........
   86340  A                   Intrinsic factor         .........  .........  .........  ...........  ...........
                               antibody.
   86341  A                   Islet cell antibody....  .........  .........  .........  ...........  ...........
   86343  A                   Leukocyte histamine      .........  .........  .........  ...........  ...........
                               release.
   86344  A                   Leukocyte phagocytosis.  .........  .........  .........  ...........  ...........
   86353  A                   Lymphocyte               .........  .........  .........  ...........  ...........
                               transformation.
   86359  A                   T cells, total count...  .........  .........  .........  ...........  ...........
   86360  A                   T cell absolute count/   .........  .........  .........  ...........  ...........
                               ratio.

[[Page 35357]]

 
   86361  A                   T cell absolute count..  .........  .........  .........  ...........  ...........
   86376  A                   Microsomal antibody....  .........  .........  .........  ...........  ...........
   86378  A                   Migration inhibitory     .........  .........  .........  ...........  ...........
                               factor.
   86382  A                   Neutralization test,     .........  .........  .........  ...........  ...........
                               viral.
   86384  A                   Nitroblue tetrazolium    .........  .........  .........  ...........  ...........
                               dye.
   86403  A                   Particle agglutination   .........  .........  .........  ...........  ...........
                               test.
   86406  A                   Particle agglutination   .........  .........  .........  ...........  ...........
                               test.
   86430  A                   Rheumatoid factor test.  .........  .........  .........  ...........  ...........
   86431  A                   Rheumatoid factor,       .........  .........  .........  ...........  ...........
                               quant.
   86485  X                   Skin test, candida.....        861       0.13      $6.68        $3.62        $1.34
   86490  X                   Coccidioidomycosis skin        861       0.13      $6.68        $3.62        $1.34
                               test.
   86510  X                   Histoplasmosis skin            861       0.13      $6.68        $3.62        $1.34
                               test.
   86580  X                   TB intradermal test....        861       0.13      $6.68        $3.62        $1.34
   86585  X                   TB tine test...........        861       0.13      $6.68        $3.62        $1.34
   86586  X                   Skin test, unlisted....        861       0.13      $6.68        $3.62        $1.34
   86588  A                   Streptocollus, direct    .........  .........  .........  ...........  ...........
                               screen.
   86590  A                   Streptokinase, antibody  .........  .........  .........  ...........  ...........
   86592  A                   Blood serology,          .........  .........  .........  ...........  ...........
                               qualitative.
   86593  A                   Blood serology,          .........  .........  .........  ...........  ...........
                               quantitative.
   86602  A                   Antinomyces antibody...  .........  .........  .........  ...........  ...........
   86603  A                   Adenovirus, antibody...  .........  .........  .........  ...........  ...........
   86606  A                   Aspergillus antibody...  .........  .........  .........  ...........  ...........
   86609  A                   Bacterium, antibody....  .........  .........  .........  ...........  ...........
   86612  A                   Blastomyces, antibody..  .........  .........  .........  ...........  ...........
   86615  A                   Bordetella antibody....  .........  .........  .........  ...........  ...........
   86617  A                   Lyme disease antibody..  .........  .........  .........  ...........  ...........
   86618  A                   Lyme disease antibody..  .........  .........  .........  ...........  ...........
   86619  A                   Borrelia antibody......  .........  .........  .........  ...........  ...........
   86622  A                   Brucella, antibody.....  .........  .........  .........  ...........  ...........
   86625  A                   Campylobacter, antibody  .........  .........  .........  ...........  ...........
   86628  A                   Candida, antibody......  .........  .........  .........  ...........  ...........
   86631  A                   Chlamydia, antibody....  .........  .........  .........  ...........  ...........
   86632  A                   Chlamydia, IgM,          .........  .........  .........  ...........  ...........
                               antibody.
   86635  A                   Coccidioides, antibody.  .........  .........  .........  ...........  ...........
   86638  A                   Q fever antibody.......  .........  .........  .........  ...........  ...........
   86641  A                   Cryptococcus antibody..  .........  .........  .........  ...........  ...........
   86644  A                   CMV antibody...........  .........  .........  .........  ...........  ...........
   86645  A                   CMV antibody, IgM......  .........  .........  .........  ...........  ...........
   86648  A                   Diphtheria antibody....  .........  .........  .........  ...........  ...........
   86651  A                   Encephalitis antibody..  .........  .........  .........  ...........  ...........
   86652  A                   Encephalitis antibody..  .........  .........  .........  ...........  ...........
   86653  A                   Encephalitis, antibody.  .........  .........  .........  ...........  ...........
   86654  A                   Encephalitis, antibody.  .........  .........  .........  ...........  ...........
   86658  A                   Enterovirus, antibody..  .........  .........  .........  ...........  ...........
   86663  A                   Epstein-barr antibody..  .........  .........  .........  ...........  ...........
   86664  A                   Epstein-barr antibody..  .........  .........  .........  ...........  ...........
   86665  A                   Epstein-barr, antibody.  .........  .........  .........  ...........  ...........
   86668  A                   Francisella tularensis.  .........  .........  .........  ...........  ...........
   86671  A                   Fungus, antibody.......  .........  .........  .........  ...........  ...........
   86674  A                   Giardia lamblia........  .........  .........  .........  ...........  ...........
   86677  A                   Helicobacter pylori....  .........  .........  .........  ...........  ...........
   86682  A                   Helminth, antibody.....  .........  .........  .........  ...........  ...........
   86684  A                   Hemophilus influenza...  .........  .........  .........  ...........  ...........
   86687  A                   HTLV I.................  .........  .........  .........  ...........  ...........
   86688  A                   HTLV-II................  .........  .........  .........  ...........  ...........
   86689  A                   HTLV/HIV confirmatory    .........  .........  .........  ...........  ...........
                               test.
   86692  A                   Hepatitis, delta agent.  .........  .........  .........  ...........  ...........
   86694  A                   Herpes simplex test....  .........  .........  .........  ...........  ...........
   86695  A                   Herpes simplex test....  .........  .........  .........  ...........  ...........
   86698  A                   Histoplasma............  .........  .........  .........  ...........  ...........
   86701  A                   HIV-1..................  .........  .........  .........  ...........  ...........
   86702  A                   HIV-2..................  .........  .........  .........  ...........  ...........
   86703  A                   HIV-1/HIV-2, single      .........  .........  .........  ...........  ...........
                               assay.
   86704  A                   Hep b core ab test, igg  .........  .........  .........  ...........  ...........
                               & m.
   86705  A                   Hep b core ab test, igm  .........  .........  .........  ...........  ...........
   86706  A                   Hepatitis b surface ab   .........  .........  .........  ...........  ...........
                               test.
   86707  A                   Hepatitis be ab test...  .........  .........  .........  ...........  ...........
   86708  A                   Hep a ab test, igg & m.  .........  .........  .........  ...........  ...........
   86709  A                   Hep a ab test, igm.....  .........  .........  .........  ...........  ...........
   86710  A                   Influenza virus........  .........  .........  .........  ...........  ...........
   86713  A                   Legionella.............  .........  .........  .........  ...........  ...........
   86717  A                   Leishmania.............  .........  .........  .........  ...........  ...........
   86720  A                   Leptospira.............  .........  .........  .........  ...........  ...........
   86723  A                   Listeria monocytogenes.  .........  .........  .........  ...........  ...........
   86727  A                   Lymph choriomeningitis.  .........  .........  .........  ...........  ...........

[[Page 35358]]

 
   86729  A                   Lympho venereum........  .........  .........  .........  ...........  ...........
   86732  A                   Mucormycosis...........  .........  .........  .........  ...........  ...........
   86735  A                   Mumps..................  .........  .........  .........  ...........  ...........
   86738  A                   Mycoplasma.............  .........  .........  .........  ...........  ...........
   86741  A                   Neisseria meningitidis.  .........  .........  .........  ...........  ...........
   86744  A                   Nocardia...............  .........  .........  .........  ...........  ...........
   86747  A                   Parvovirus.............  .........  .........  .........  ...........  ...........
   86750  A                   Malaria................  .........  .........  .........  ...........  ...........
   86753  A                   Protozoa, not elsewhere  .........  .........  .........  ...........  ...........
   86756  A                   Respiratory virus......  .........  .........  .........  ...........  ...........
   86759  A                   Rotavirus..............  .........  .........  .........  ...........  ...........
   86762  A                   Rubella................  .........  .........  .........  ...........  ...........
   86765  A                   Rubeola................  .........  .........  .........  ...........  ...........
   86768  A                   Salmonella.............  .........  .........  .........  ...........  ...........
   86771  A                   Shigella...............  .........  .........  .........  ...........  ...........
   86774  A                   Tetanus................  .........  .........  .........  ...........  ...........
   86777  A                   Toxoplasma.............  .........  .........  .........  ...........  ...........
   86778  A                   Toxoplasma, IgM........  .........  .........  .........  ...........  ...........
   86781  A                   Treponema pallidum       .........  .........  .........  ...........  ...........
                               confirm.
   86784  A                   Trichinella............  .........  .........  .........  ...........  ...........
   86787  A                   Varicella-zoster.......  .........  .........  .........  ...........  ...........
   86790  A                   Virus, not specified...  .........  .........  .........  ...........  ...........
   86793  A                   Yersinia...............  .........  .........  .........  ...........  ...........
   86800  A                   Thyroglobulin antibody.  .........  .........  .........  ...........  ...........
   86803  A                   Hepatitis c ab test....  .........  .........  .........  ...........  ...........
   86804  A                   Hep c ab test, confirm.  .........  .........  .........  ...........  ...........
   86805  A                   Lymphocytotoxicity       .........  .........  .........  ...........  ...........
                               assay.
   86806  A                   Lymphocytotoxicity       .........  .........  .........  ...........  ...........
                               assay.
   86807  A                   Cytotoxic antibody       .........  .........  .........  ...........  ...........
                               screening.
   86808  A                   Cytotoxic antibody       .........  .........  .........  ...........  ...........
                               screening.
   86812  A                   HLA typing, A, B, or C.  .........  .........  .........  ...........  ...........
   86813  A                   HLA typing, A, B, or C.  .........  .........  .........  ...........  ...........
   86816  A                   HLA typing, DR/DQ......  .........  .........  .........  ...........  ...........
   86817  A                   HLA typing, DR/DQ......  .........  .........  .........  ...........  ...........
   86821  A                   Lymphocyte culture,      .........  .........  .........  ...........  ...........
                               mixed.
   86822  A                   Lymphocyte culture,      .........  .........  .........  ...........  ...........
                               primed.
   86849  A                   Immunology procedure...  .........  .........  .........  ...........  ...........
   86850  A                   RBC antibody screen....  .........  .........  .........  ...........  ...........
   86860  A                   RBC antibody elution...  .........  .........  .........  ...........  ...........
   86870  A                   RBC antibody             .........  .........  .........  ...........  ...........
                               identification.
   86880  A                   Coombs test............  .........  .........  .........  ...........  ...........
   86885  A                   Coombs test............  .........  .........  .........  ...........  ...........
   86886  A                   Coombs test............  .........  .........  .........  ...........  ...........
   86890  A                   Autologous blood         .........  .........  .........  ...........  ...........
                               process.
   86891  A                   Autologous blood, op     .........  .........  .........  ...........  ...........
                               salvage.
   86900  A                   Blood typing, ABO......  .........  .........  .........  ...........  ...........
   86901  A                   Blood typing, Rh (D)...  .........  .........  .........  ...........  ...........
   86903  A                   Blood typing, antigen    .........  .........  .........  ...........  ...........
                               screen.
   86904  A                   Blood typing, patient    .........  .........  .........  ...........  ...........
                               serum.
   86905  A                   Blood typing, RBC        .........  .........  .........  ...........  ...........
                               antigens.
   86906  A                   Blood typing, Rh         .........  .........  .........  ...........  ...........
                               phenotype.
   86910  E                   Blood typing, paternity  .........  .........  .........  ...........  ...........
                               test.
   86911  E                   Blood typing, antigen    .........  .........  .........  ...........  ...........
                               system.
   86915  A                   Bone marrow............  .........  .........  .........  ...........  ...........
   86920  A                   Compatibility test.....  .........  .........  .........  ...........  ...........
   86921  A                   Compatibility test.....  .........  .........  .........  ...........  ...........
   86922  A                   Compatibility test.....  .........  .........  .........  ...........  ...........
   86927  A                   Plasma, fresh frozen...  .........  .........  .........  ...........  ...........
   86930  A                   Frozen blood prep......  .........  .........  .........  ...........  ...........
   86931  A                   Frozen blood thaw......  .........  .........  .........  ...........  ...........
   86932  A                   Frozen blood, freeze/    .........  .........  .........  ...........  ...........
                               thaw.
   86940  A                   Hemolysins/agglutinins   .........  .........  .........  ...........  ...........
                               auto.
   86941  A                   Hemolysins/agglutinins.  .........  .........  .........  ...........  ...........
   86945  A                   Blood product/           .........  .........  .........  ...........  ...........
                               irradiation.
   86950  A                   Leukacyte transfusion..  .........  .........  .........  ...........  ...........
   86965  A                   Pooling blood platelets  .........  .........  .........  ...........  ...........
   86970  A                   RBC pretreatment.......  .........  .........  .........  ...........  ...........
   86971  A                   RBC pretreatment.......  .........  .........  .........  ...........  ...........
   86972  A                   RBC pretreatment.......  .........  .........  .........  ...........  ...........
   86975  A                   RBC pretreatment, serum  .........  .........  .........  ...........  ...........
   86976  A                   RBC pretreatment, serum  .........  .........  .........  ...........  ...........
   86977  A                   RBC pretreatment, serum  .........  .........  .........  ...........  ...........
   86978  A                   RBC pretreatment, serum  .........  .........  .........  ...........  ...........
   86985  A                   Split blood or products  .........  .........  .........  ...........  ...........
   86999  A                   Transfusion procedure..  .........  .........  .........  ...........  ...........

[[Page 35359]]

 
   87001  A                   Small animal             .........  .........  .........  ...........  ...........
                               inoculation.
   87003  A                   Small animal             .........  .........  .........  ...........  ...........
                               inoculation.
   87015  A                   Specimen concentration.  .........  .........  .........  ...........  ...........
   87040  A                   Blood culture for        .........  .........  .........  ...........  ...........
                               bacteria.
   87045  A                   Stool culture for        .........  .........  .........  ...........  ...........
                               bacteria.
   87060  A                   Nose/throat              .........  .........  .........  ...........  ...........
                               culture,bacteria.
   87070  A                   Culture specimen,        .........  .........  .........  ...........  ...........
                               bacteria.
   87072  A                   Culture of specimen by   .........  .........  .........  ...........  ...........
                               kit.
   87075  A                   Culture specimen,        .........  .........  .........  ...........  ...........
                               bacteria.
   87076  A                   Bacteria identification  .........  .........  .........  ...........  ...........
   87081  A                   Bacteria culture screen  .........  .........  .........  ...........  ...........
   87082  A                   Culture of specimen by   .........  .........  .........  ...........  ...........
                               kit.
   87083  A                   Culture of specimen by   .........  .........  .........  ...........  ...........
                               kit.
   87084  A                   Culture of specimen by   .........  .........  .........  ...........  ...........
                               kit.
   87085  A                   Culture of specimen by   .........  .........  .........  ...........  ...........
                               kit.
   87086  A                   Urine culture, colony    .........  .........  .........  ...........  ...........
                               count.
   87087  A                   Urine bacteria culture.  .........  .........  .........  ...........  ...........
   87088  A                   Urine bacteria culture.  .........  .........  .........  ...........  ...........
   87101  A                   Skin fungus culture....  .........  .........  .........  ...........  ...........
   87102  A                   Fungus isolation         .........  .........  .........  ...........  ...........
                               culture.
   87103  A                   Blood fungus culture...  .........  .........  .........  ...........  ...........
   87106  A                   Fungus identification..  .........  .........  .........  ...........  ...........
   87109  A                   Mycoplasma culture.....  .........  .........  .........  ...........  ...........
   87110  A                   Culture, chlamydia.....  .........  .........  .........  ...........  ...........
   87116  A                   Mycobacteria culture...  .........  .........  .........  ...........  ...........
   87117  A                   Mycobacteria culture...  .........  .........  .........  ...........  ...........
   87118  A                   Mycobacteria             .........  .........  .........  ...........  ...........
                               identification.
   87140  A                   Culture typing,          .........  .........  .........  ...........  ...........
                               fluorescent.
   87143  A                   Culture typing, GLC      .........  .........  .........  ...........  ...........
                               method.
   87145  A                   Culture typing, phage    .........  .........  .........  ...........  ...........
                               method.
   87147  A                   Culture typing,          .........  .........  .........  ...........  ...........
                               serologic.
   87151  A                   Culture typing,          .........  .........  .........  ...........  ...........
                               serologic.
   87155  A                   Culture typing,          .........  .........  .........  ...........  ...........
                               precipitin.
   87158  A                   Culture typing, added    .........  .........  .........  ...........  ...........
                               method.
   87163  A                   Special microbiology     .........  .........  .........  ...........  ...........
                               culture.
   87164  A                   Dark field examination.  .........  .........  .........  ...........  ...........
   87166  A                   Dark field examination.  .........  .........  .........  ...........  ...........
   87174  A                   Endotoxin, bacterial...  .........  .........  .........  ...........  ...........
   87175  A                   Assay, endotoxin,        .........  .........  .........  ...........  ...........
                               bacterial.
   87176  A                   Endotoxin, bacterial...  .........  .........  .........  ...........  ...........
   87177  A                   Ova and parasites        .........  .........  .........  ...........  ...........
                               smears.
   87181  A                   Antibiotic sensitivity,  .........  .........  .........  ...........  ...........
                               each.
   87184  A                   Antibiotic sensitivity,  .........  .........  .........  ...........  ...........
                               each.
   87186  A                   Antibiotic sensitivity,  .........  .........  .........  ...........  ...........
                               MIC.
   87187  A                   Antibiotic sensitivity,  .........  .........  .........  ...........  ...........
                               MBC.
   87188  A                   Antibiotic sensitivity,  .........  .........  .........  ...........  ...........
                               each.
   87190  A                   TB antibiotic            .........  .........  .........  ...........  ...........
                               sensitivity.
   87192  A                   Antibiotic sensitivity,  .........  .........  .........  ...........  ...........
                               each.
   87197  A                   Bactericidal level,      .........  .........  .........  ...........  ...........
                               serum.
   87205  A                   Smear, stain &           .........  .........  .........  ...........  ...........
                               interpret.
   87206  A                   Smear, stain &           .........  .........  .........  ...........  ...........
                               interpret.
   87207  A                   Smear, stain &           .........  .........  .........  ...........  ...........
                               interpret.
   87208  A                   Smear, stain &           .........  .........  .........  ...........  ...........
                               interpret.
   87210  A                   Smear, stain &           .........  .........  .........  ...........  ...........
                               interpret.
   87211  A                   Smear, stain &           .........  .........  .........  ...........  ...........
                               interpret.
   87220  A                   Tissue exam for fungi..  .........  .........  .........  ...........  ...........
   87230  A                   Assay, toxin or          .........  .........  .........  ...........  ...........
                               antitoxin.
   87250  A                   Virus inoculation for    .........  .........  .........  ...........  ...........
                               test.
   87252  A                   Virus inoculation for    .........  .........  .........  ...........  ...........
                               test.
   87253  A                   Virus inoculation for    .........  .........  .........  ...........  ...........
                               test.
   87260  A                   Adenovirus ag, dfa.....  .........  .........  .........  ...........  ...........
   87265  A                   Pertussis ag, dfa......  .........  .........  .........  ...........  ...........
   87270  A                   Chylmd trach ag, dfa...  .........  .........  .........  ...........  ...........
   87272  A                   Cryptosporidum ag, dfa.  .........  .........  .........  ...........  ...........
   87274  A                   Herpes simplex ag, dfa.  .........  .........  .........  ...........  ...........
   87276  A                   Influenza ag, dfa......  .........  .........  .........  ...........  ...........
   87278  A                   Legion pneumo ag, dfa..  .........  .........  .........  ...........  ...........
   87280  A                   Resp syncytial ag, dfa.  .........  .........  .........  ...........  ...........
   87285  A                   Trepon pallidum ag, dfa  .........  .........  .........  ...........  ...........
   87290  A                   Varicella ag, dfa......  .........  .........  .........  ...........  ...........
   87299  A                   Ag detection nos, dfa..  .........  .........  .........  ...........  ...........
   87301  A                   Adenovirus ag, eia.....  .........  .........  .........  ...........  ...........
   87320  A                   Chylmd trach ag, eia...  .........  .........  .........  ...........  ...........
   87324  A                   Clostridium ag, eia....  .........  .........  .........  ...........  ...........
   87328  A                   Cryptospor ag, eia.....  .........  .........  .........  ...........  ...........

[[Page 35360]]

 
   87332  A                   Cytomegalovirus ag, eia  .........  .........  .........  ...........  ...........
   87335  A                   E coli 0157 ag, eia....  .........  .........  .........  ...........  ...........
   87340  A                   Hepatitis b surface ag,  .........  .........  .........  ...........  ...........
                               eia.
   87350  A                   Hepatitis b ag, eia....  .........  .........  .........  ...........  ...........
   87380  A                   Hepatitis delta ag, eia  .........  .........  .........  ...........  ...........
   87385  A                   Histoplasma capsul ag,   .........  .........  .........  ...........  ...........
                               eia.
   87390  A                   Hiv-1 ag, eia..........  .........  .........  .........  ...........  ...........
   87391  A                   Hiv-2 ag, eia..........  .........  .........  .........  ...........  ...........
   87420  A                   Resp syncytial ag, eia.  .........  .........  .........  ...........  ...........
   87425  A                   Rotavirus ag, eia......  .........  .........  .........  ...........  ...........
   87430  A                   Strep a ag, eia........  .........  .........  .........  ...........  ...........
   87449  A                   Ag detect nos, eia,      .........  .........  .........  ...........  ...........
                               mult.
   87450  A                   Ag detect nos, eia,      .........  .........  .........  ...........  ...........
                               single.
   87470  A                   Bartonella, dna, dir     .........  .........  .........  ...........  ...........
                               probe.
   87471  A                   Bartonella, dna, amp     .........  .........  .........  ...........  ...........
                               probe.
   87472  A                   Bartonella, dna, quant.  .........  .........  .........  ...........  ...........
   87475  A                   Lyme dis, dna, dir       .........  .........  .........  ...........  ...........
                               probe.
   87476  A                   Lyme dis, dna, amp       .........  .........  .........  ...........  ...........
                               probe.
   87477  A                   Lyme dis, dna, quant...  .........  .........  .........  ...........  ...........
   87480  A                   Candida, dna, dir probe  .........  .........  .........  ...........  ...........
   87481  A                   Candida, dna, amp probe  .........  .........  .........  ...........  ...........
   87482  A                   Candida, dna, quant....  .........  .........  .........  ...........  ...........
   87485  A                   Chylmd pneum, dna, dir   .........  .........  .........  ...........  ...........
                               probe.
   87486  A                   Chylmd pneum, dna, amp   .........  .........  .........  ...........  ...........
                               probe.
   87487  A                   Chylmd pneum, dna,       .........  .........  .........  ...........  ...........
                               quant.
   87490  A                   Chylmd trach, dna, dir   .........  .........  .........  ...........  ...........
                               probe.
   87491  A                   Chylmd trach, dna, amp   .........  .........  .........  ...........  ...........
                               probe.
   87492  A                   Chylmd trach, dna,       .........  .........  .........  ...........  ...........
                               quant.
   87495  A                   Cytomeg, dna, dir probe  .........  .........  .........  ...........  ...........
   87496  A                   Cytomeg, dna, amp probe  .........  .........  .........  ...........  ...........
   87497  A                   Cytomeg, dna, quant....  .........  .........  .........  ...........  ...........
   87510  A                   Gardner vag, dna, dir    .........  .........  .........  ...........  ...........
                               probe.
   87511  A                   Gardner vag, dna, amp    .........  .........  .........  ...........  ...........
                               probe.
   87512  A                   Gardner vag, dna, quant  .........  .........  .........  ...........  ...........
   87515  A                   Hepatitis b, dna, dir    .........  .........  .........  ...........  ...........
                               probe.
   87516  A                   Hepatitis b, dna, amp    .........  .........  .........  ...........  ...........
                               probe.
   87517  A                   Hepatitis b, dna, quant  .........  .........  .........  ...........  ...........
   87520  A                   Hepatitis c, rna, dir    .........  .........  .........  ...........  ...........
                               probe.
   87521  A                   Hepatitis c, rna, amp    .........  .........  .........  ...........  ...........
                               probe.
   87522  A                   Hepatitis c, rna, quant  .........  .........  .........  ...........  ...........
   87525  A                   Hepatitis g, dna, dir    .........  .........  .........  ...........  ...........
                               probe.
   87526  A                   Hepatitis g, dna, amp    .........  .........  .........  ...........  ...........
                               probe.
   87527  A                   Hepatitis g, dna, quant  .........  .........  .........  ...........  ...........
   87528  A                   Hsv, dna, dir probe....  .........  .........  .........  ...........  ...........
   87529  A                   Hsv, dna, amp probe....  .........  .........  .........  ...........  ...........
   87530  A                   Hsv, dna, quant........  .........  .........  .........  ...........  ...........
   87531  A                   Hhv-6, dna, dir probe..  .........  .........  .........  ...........  ...........
   87532  A                   Hhv-6, dna, amp probe..  .........  .........  .........  ...........  ...........
   87533  A                   Hhv-6, dna, quant......  .........  .........  .........  ...........  ...........
   87534  A                   Hiv-1, dna, dir probe..  .........  .........  .........  ...........  ...........
   87535  A                   Hiv-1, dna, amp probe..  .........  .........  .........  ...........  ...........
   87536  A                   Hiv-1, dna, quant......  .........  .........  .........  ...........  ...........
   87537  A                   Hiv-2, dna, dir probe..  .........  .........  .........  ...........  ...........
   87538  A                   Hiv-2, dna, amp probe..  .........  .........  .........  ...........  ...........
   87539  A                   Hiv-2, dna, quant......  .........  .........  .........  ...........  ...........
   87540  A                   Legion pneumo, dna, dir  .........  .........  .........  ...........  ...........
                               prob.
   87541  A                   Legion pneumo, dna, amp  .........  .........  .........  ...........  ...........
                               prob.
   87542  A                   Legion pneumo, dna,      .........  .........  .........  ...........  ...........
                               quant.
   87550  A                   Mycobacteria, dna, dir   .........  .........  .........  ...........  ...........
                               probe.
   87551  A                   Mycobacteria, dna, amp   .........  .........  .........  ...........  ...........
                               probe.
   87552  A                   Mycobacteria, dna,       .........  .........  .........  ...........  ...........
                               quant.
   87555  A                   M.tuberculo, dna, dir    .........  .........  .........  ...........  ...........
                               probe.
   87556  A                   M.tuberculo, dna, amp    .........  .........  .........  ...........  ...........
                               probe.
   87557  A                   M.tuberculo, dna, quant  .........  .........  .........  ...........  ...........
   87560  A                   M.avium-intra, dna, dir  .........  .........  .........  ...........  ...........
                               prob.
   87561  A                   M.avium-intra, dna, amp  .........  .........  .........  ...........  ...........
                               prob.
   87562  A                   M.avium-intra, dna,      .........  .........  .........  ...........  ...........
                               quant.
   87580  A                   M.pneumon, dna, dir      .........  .........  .........  ...........  ...........
                               probe.
   87581  A                   M.pneumon, dna, amp      .........  .........  .........  ...........  ...........
                               probe.
   87582  A                   M.pneumon, dna, quant..  .........  .........  .........  ...........  ...........
   87590  A                   N.gonorrhoeae, dna, dir  .........  .........  .........  ...........  ...........
                               prob.
   87591  A                   N.gonorrhoeae, dna, amp  .........  .........  .........  ...........  ...........
                               prob.
   87592  A                   N.gonorrhoeae, dna,      .........  .........  .........  ...........  ...........
                               quant.
   87620  A                   Hpv, dna, dir probe....  .........  .........  .........  ...........  ...........
   87621  A                   Hpv, dna, amp probe....  .........  .........  .........  ...........  ...........

[[Page 35361]]

 
   87622  A                   Hpv, dna, quant........  .........  .........  .........  ...........  ...........
   87650  A                   Strep a, dna, dir probe  .........  .........  .........  ...........  ...........
   87651  A                   Strep a, dna, amp probe  .........  .........  .........  ...........  ...........
   87652  A                   Strep a, dna, quant....  .........  .........  .........  ...........  ...........
   87797  A                   Detect agent nos, dna,   .........  .........  .........  ...........  ...........
                               dir.
   87798  A                   Detect agent nos, dna,   .........  .........  .........  ...........  ...........
                               amp.
   87799  A                   Detect agent nos, dna,   .........  .........  .........  ...........  ...........
                               quant.
   87810  A                   Chylmd trach assay w/    .........  .........  .........  ...........  ...........
                               optic.
   87850  A                   N. gonorrhoeae assay w/  .........  .........  .........  ...........  ...........
                               optic.
   87880  A                   Strep a assay w/optic..  .........  .........  .........  ...........  ...........
   87899  A                   Agent nos assay w/optic  .........  .........  .........  ...........  ...........
   87999  A                   Microbiology procedure.  .........  .........  .........  ...........  ...........
   88000  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               gross.
   88005  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               gross.
   88007  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               gross.
   88012  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               gross.
   88014  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               gross.
   88016  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               gross.
   88020  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               complete.
   88025  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               complete.
   88027  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               complete.
   88028  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               complete.
   88029  E                   Autopsy (necropsy),      .........  .........  .........  ...........  ...........
                               complete.
   88036  E                   Limited autopsy........  .........  .........  .........  ...........  ...........
   88037  E                   Limited autopsy........  .........  .........  .........  ...........  ...........
   88040  E                   Forensic autopsy         .........  .........  .........  ...........  ...........
                               (necropsy).
   88045  E                   Coroner's autopsy        .........  .........  .........  ...........  ...........
                               (necropsy).
   88099  E                   Necropsy (autopsy)       .........  .........  .........  ...........  ...........
                               procedure.
   88104  X                   Cytopathology, fluids..        882       0.39     $20.05       $11.75        $4.01
   88106  X                   Cytopathology, fluids..        882       0.39     $20.05       $11.75        $4.01
   88107  X                   Cytopathology, fluids..        882       0.39     $20.05       $11.75        $4.01
   88108  X                   Cytopath, concentrate          882       0.39     $20.05       $11.75        $4.01
                               tech.
   88125  X                   Forensic cytopathology.        881       0.22     $11.31        $6.78        $2.26
   88130  A                   Sex chromatin            .........  .........  .........  ...........  ...........
                               identification.
   88140  A                   Sex chromatin            .........  .........  .........  ...........  ...........
                               identification.
   88141  N                   Cytpath c/vag interpret  .........  .........  .........  ...........  ...........
   88142  A                   Cytpath c/vag t/layer..  .........  .........  .........  ...........  ...........
   88150  A                   Cytpath c/vag manual...  .........  .........  .........  ...........  ...........
   88152  A                   Cytpath c/vag auto redo  .........  .........  .........  ...........  ...........
   88155  A                   Cytpath c/vag index add- .........  .........  .........  ...........  ...........
                               on.
\2\ 8815  A                   Cytopath cerv/vag tbs..  .........  .........  .........  ...........  ...........
        6
\2\ 8815  A                   Cytopath cerv/vag tbs    .........  .........  .........  ...........  ...........
        8                      auto.
   88160  X                   Cytopath smear, other          882       0.39     $20.05       $11.75        $4.01
                               source.
   88161  X                   Cytopath smear, other          882       0.39     $20.05       $11.75        $4.01
                               source.
   88162  X                   Cytopath smear, other          882       0.39     $20.05       $11.75        $4.01
                               source.
   88170  S                   Fine needle aspiration.        121       0.63     $32.39       $21.02        $6.48
   88171  S                   Fine needle aspiration.        121       0.63     $32.39       $21.02        $6.48
   88172  X                   Evaluation of smear....        882       0.39     $20.05       $11.75        $4.01
   88173  X                   Interpretation of smear        882       0.39     $20.05       $11.75        $4.01
   88180  X                   Cell marker study......        882       0.39     $20.05       $11.75        $4.01
   88182  X                   Cell marker study......        882       0.39     $20.05       $11.75        $4.01
   88199  X                   Cytopathology procedure        881       0.22     $11.31        $6.78        $2.26
   88230  A                   Tissue culture,          .........  .........  .........  ...........  ...........
                               lymphocyte.
   88233  A                   Tissue culture, skin/    .........  .........  .........  ...........  ...........
                               biopsy.
   88235  A                   Tissue culture,          .........  .........  .........  ...........  ...........
                               placenta.
   88237  A                   Tissue culture, bone     .........  .........  .........  ...........  ...........
                               marrow.
   88239  A                   Tissue culture, tumor..  .........  .........  .........  ...........  ...........
   88245  A                   Chromosome analysis, 20- .........  .........  .........  ...........  ...........
                               25.
   88248  A                   Chromosome analysis, 50- .........  .........  .........  ...........  ...........
                               100.
\2\ 8825  A                   Chromosome analysis....  .........  .........  .........  ...........  ...........
        0
\2\ 8826  A                   Chromosome analysis: 5   .........  .........  .........  ...........  ...........
        0                      cells.
   88261  A                   Chromosome analysis, 5.  .........  .........  .........  ...........  ...........
   88262  A                   Chromosome analysis, 15- .........  .........  .........  ...........  ...........
                               20.
   88263  A                   Chromosome analysis, 45  .........  .........  .........  ...........  ...........
   88267  A                   Chromosome analysis:     .........  .........  .........  ...........  ...........
                               placenta.
   88269  A                   Chromosome analysis:     .........  .........  .........  ...........  ...........
                               amniotic.
   88280  A                   Chromosome karyotype     .........  .........  .........  ...........  ...........
                               study.
   88283  A                   Chromosome banding       .........  .........  .........  ...........  ...........
                               study.
   88285  A                   Chromosome count:        .........  .........  .........  ...........  ...........
                               additional.
   88289  A                   Chromosome study:        .........  .........  .........  ...........  ...........
                               additional.
   88299  A                   Cytogenetic study......  .........  .........  .........  ...........  ...........
   88300  X                   Surg path, gross.......        881       0.22     $11.31        $6.78        $2.26
   88302  X                   Tissue exam by                 882       0.39     $20.05       $11.75        $4.01
                               pathologist.
   88304  X                   Tissue exam by                 882       0.39     $20.05       $11.75        $4.01
                               pathologist.
   88305  X                   Tissue exam by                 882       0.39     $20.05       $11.75        $4.01
                               pathologist.

[[Page 35362]]

 
   88307  X                   Tissue exam by                 883       0.69     $35.48       $20.34        $7.10
                               pathologist.
   88309  X                   Tissue exam by                 883       0.69     $35.48       $20.34        $7.10
                               pathologist.
   88311  X                   Decalcify tissue.......        881       0.22     $11.31        $6.78        $2.26
   88312  X                   Special stains.........        882       0.39     $20.05       $11.75        $4.01
   88313  X                   Special stains.........        881       0.22     $11.31        $6.78        $2.26
   88314  X                   Histochemical stain....        882       0.39     $20.05       $11.75        $4.01
   88318  X                   Chemical histochemistry        882       0.39     $20.05       $11.75        $4.01
   88319  X                   Enzyme histochemistry..        882       0.39     $20.05       $11.75        $4.01
   88321  X                   Microslide consultation        882       0.39     $20.05       $11.75        $4.01
   88323  X                   Microslide consultation        882       0.39     $20.05       $11.75        $4.01
   88325  X                   Comprehensive review of        882       0.39     $20.05       $11.75        $4.01
                               data.
   88329  X                   Pathology consult in           882       0.39     $20.05       $11.75        $4.01
                               surgery.
   88331  X                   Pathology consult in           882       0.39     $20.05       $11.75        $4.01
                               surgery.
   88332  X                   Pathology consult in           882       0.39     $20.05       $11.75        $4.01
                               surgery.
   88342  X                   Immunocytochemistry....        882       0.39     $20.05       $11.75        $4.01
   88346  X                   Immunofluorescent study        882       0.39     $20.05       $11.75        $4.01
   88347  X                   Immunofluorescent study        882       0.39     $20.05       $11.75        $4.01
   88348  X                   Electron microscopy....        883       0.69     $35.48       $20.34        $7.10
   88349  X                   Scanning electron              883       0.69     $35.48       $20.34        $7.10
                               microscopy.
   88355  X                   Analysis, skeletal             883       0.69     $35.48       $20.34        $7.10
                               muscle.
   88356  X                   Analysis, nerve........        883       0.69     $35.48       $20.34        $7.10
   88358  X                   Analysis, tumor........        883       0.69     $35.48       $20.34        $7.10
   88362  X                   Nerve teasing                  883       0.69     $35.48       $20.34        $7.10
                               preparations.
   88365  X                   Tissue hybridization...        883       0.69     $35.48       $20.34        $7.10
   88371  A                   Protein, western blot    .........  .........  .........  ...........  ...........
                               tissue.
   88372  A                   Protein analysis w/      .........  .........  .........  ...........  ...........
                               probe.
   88399  X                   Surgical pathology             881       0.22     $11.31        $6.78        $2.26
                               procedure.
   89050  A                   Body fluid cell count..  .........  .........  .........  ...........  ...........
   89051  A                   Body fluid cell count..  .........  .........  .........  ...........  ...........
   89060  A                   Exam,synovial fluid      .........  .........  .........  ...........  ...........
                               crystals.
   89100  X                   Sample intestinal              928       2.91    $149.63       $79.78       $29.93
                               contents.
   89105  X                   Sample intestinal              928       2.91    $149.63       $79.78       $29.93
                               contents.
   89125  A                   Specimen fat stain.....  .........  .........  .........  ...........  ...........
   89130  X                   Sample stomach contents        928       2.91    $149.63       $79.78       $29.93
   89132  X                   Sample stomach contents        928       2.91    $149.63       $79.78       $29.93
   89135  X                   Sample stomach contents        928       2.91    $149.63       $79.78       $29.93
   89136  X                   Sample stomach contents        928       2.91    $149.63       $79.78       $29.93
   89140  X                   Sample stomach contents        928       2.91    $149.63       $79.78       $29.93
   89141  X                   Sample stomach contents        928       2.91    $149.63       $79.78       $29.93
   89160  A                   Exam feces for meat      .........  .........  .........  ...........  ...........
                               fibers.
   89190  A                   Nasal smear for          .........  .........  .........  ...........  ...........
                               eosinophils.
   89250  A                   Fertilization of oocyte  .........  .........  .........  ...........  ...........
   89251  A                   Culture oocyte w/        .........  .........  .........  ...........  ...........
                               embryos.
   89252  A                   Assist oocyte            .........  .........  .........  ...........  ...........
                               fertilization.
   89253  A                   Embryo hatching........  .........  .........  .........  ...........  ...........
   89254  A                   Oocyte identification..  .........  .........  .........  ...........  ...........
   89255  A                   Prepare embryo for       .........  .........  .........  ...........  ...........
                               transfer.
   89256  A                   Prepare cryopreserved    .........  .........  .........  ...........  ...........
                               embryo.
   89257  A                   Sperm identification...  .........  .........  .........  ...........  ...........
   89258  A                   Cryopreservation,        .........  .........  .........  ...........  ...........
                               embryo.
   89259  A                   Cryopreservation, sperm  .........  .........  .........  ...........  ...........
   89260  A                   Sperm isolation, simple  .........  .........  .........  ...........  ...........
   89261  A                   Sperm isolation,         .........  .........  .........  ...........  ...........
                               complex.
   89300  A                   Semen analysis.........  .........  .........  .........  ...........  ...........
   89310  A                   Semen analysis.........  .........  .........  .........  ...........  ...........
   89320  A                   Semen analysis.........  .........  .........  .........  ...........  ...........
   89325  A                   Sperm antibody test....  .........  .........  .........  ...........  ...........
   89329  A                   Sperm evaluation test..  .........  .........  .........  ...........  ...........
   89330  A                   Evaluation, cervical     .........  .........  .........  ...........  ...........
                               mucus.
   89350  X                   Sputum specimen                881       0.22     $11.31        $6.78        $2.26
                               collection.
   89355  A                   Exam feces for starch..  .........  .........  .........  ...........  ...........
   89360  X                   Collect sweat for test.        881       0.22     $11.31        $6.78        $2.26
   89365  A                   Water load test........  .........  .........  .........  ...........  ...........
   89399  X                   Pathology lab procedure        881       0.22     $11.31        $6.78        $2.26
   90700  X                   Dtap vaccine, im.......        901       0.07      $3.60        $2.49        $0.72
   90701  X                   Dtp vaccine, im........        901       0.07      $3.60        $2.49        $0.72
   90702  X                   Dt vaccine, im.........        901       0.07      $3.60        $2.49        $0.72
   90703  X                   Tetanus vaccine, im....        901       0.07      $3.60        $2.49        $0.72
   90704  X                   Mumps vaccine, sc......        901       0.07      $3.60        $2.49        $0.72
   90705  X                   Measles vaccine, sc....        901       0.07      $3.60        $2.49        $0.72
   90706  X                   Rubella vaccine, sc....        901       0.07      $3.60        $2.49        $0.72
   90707  X                   Mmr vaccine, sc........        902       1.31     $67.36       $38.19       $13.47
   90708  X                   Measles-rubella vaccine        901       0.07      $3.60        $2.49        $0.72
                               sc.
   90709  X                   Rubella & mumps vaccine        901       0.07      $3.60        $2.49        $0.72
                               sc.
   90710  X                   Mmrv vaccine, sc.......        901       0.07      $3.60        $2.49        $0.72

[[Page 35363]]

 
\2\ 9071  X                   Combined vaccine.......        901       0.07      $3.60        $2.49        $0.72
        1
   90712  X                   Oral poliovirus vaccine        902       1.31     $67.36       $38.19       $13.47
   90713  X                   Poliovirus, ipv, sc....        902       1.31     $67.36       $38.19       $13.47
\2\ 9071  X                   Typhoid immunization...        901       0.07      $3.60        $2.49        $0.72
        4
   90716  X                   Chicken pox vaccine, sc        902       1.31     $67.36       $38.19       $13.47
   90717  X                   Yellow fever vaccine,          902       1.31     $67.36       $38.19       $13.47
                               sc.
   90718  X                   Td vaccine, im.........        901       0.07      $3.60        $2.49        $0.72
   90719  X                   Diphtheria vaccine, im.        901       0.07      $3.60        $2.49        $0.72
   90720  X                   Dtp/hib vaccine, im....        902       1.31     $67.36       $38.19       $13.47
   90721  X                   Dtap/hib vaccine, im...        903       1.00     $51.42       $24.86       $10.28
\2\ 9072  X                   Influenza immunization.        901       0.07      $3.60        $2.49        $0.72
        4
   90725  X                   Cholera vaccine,               901       0.07      $3.60        $2.49        $0.72
                               injectable.
\2\ 9072  X                   Rabies immunization....        903       1.00     $51.42       $24.86       $10.28
        6
   90727  X                   Plague vaccine, im.....        903       1.00     $51.42       $24.86       $10.28
\2\ 9072  X                   BCG immunization.......        903       1.00     $51.42       $24.86       $10.28
        8
\2\ 9073  X                   Hepatitis A vaccine....        901       0.07      $3.60        $2.49        $0.72
        0
   90732  X                   Pneumococcal vaccine,          901       0.07      $3.60        $2.49        $0.72
                               adult.
   90733  X                   Meningococcal vaccine,         902       1.31     $67.36       $38.19       $13.47
                               sc.
   90735  X                   Encephalitis vaccine,          903       1.00     $51.42       $24.86       $10.28
                               sc.
\2\ 9073  X                   Influenza B                    902       1.31     $67.36       $38.19       $13.47
        7                      immunization.
\2\ 9074  X                   Passive immunization,          902       1.31     $67.36       $38.19       $13.47
        1                      ISG.
\2\ 9074  X                   Special passive                903       1.00     $51.42       $24.86       $10.28
        2                      immunization.
   90744  X                   Hepb vaccine, ped/adol,        902       1.31     $67.36       $38.19       $13.47
                               im.
   90745  X                   Hepb vaccine, adol/            902       1.31     $67.36       $38.19       $13.47
                               risk, im.
   90746  X                   Hepb vaccine, adult, im        902       1.31     $67.36       $38.19       $13.47
   90747  X                   Hepb vaccine, ill pat,         902       1.31     $67.36       $38.19       $13.47
                               im.
   90748  X                   Hepb/hib vaccine, im...        901       0.07      $3.60        $2.49        $0.72
   90749  X                   Vaccine toxoid.........        901       0.07      $3.60        $2.49        $0.72
   90780  X                   IV infusion therapy, 1         906       1.93     $99.24       $57.18       $19.85
                               hour.
   90781  X                   IV infusion, additional        906       1.93     $99.24       $57.18       $19.85
                               hour.
   90782  X                   Injection (SC)/(IM)....        907       0.74     $38.05       $11.53        $7.61
   90783  X                   Injection (IA).........        907       0.74     $38.05       $11.53        $7.61
   90784  X                   Injection (IV).........        907       0.74     $38.05       $11.53        $7.61
   90788  X                   Injection of antibiotic        907       0.74     $38.05       $11.53        $7.61
   90799  X                   Therapeutic/diag               907       0.74     $38.05       $11.53        $7.61
                               injection.
\1\ 9080  S                   Psy dx interview.......        092       1.63     $83.81       $21.47       $16.76
        1
   90802  S                   Intac psy dx interview.        092       1.63     $83.81       $21.47       $16.76
   90804  S                   Psytx, office (20-30)..        091       1.09     $56.05       $14.01       $11.21
   90805  S                   Psytx, office (20-30) w/       091       1.09     $56.05       $14.01       $11.21
                               e&m.
   90806  S                   Psytx, office (45-50)..        092       1.63     $83.81       $21.47       $16.76
   90807  S                   Psytx, office (45-50) w/       092       1.63     $83.81       $21.47       $16.76
                               e&m.
   90808  S                   Psytx, office (75-80)..        092       1.63     $83.81       $21.47       $16.76
   90809  S                   Psytx, office (75-80) w/       092       1.63     $83.81       $21.47       $16.76
                               e&m.
   90810  S                   Intac psytx, office (20-       091       1.09     $56.05       $14.01       $11.21
                               30).
   90811  S                   Intac psytx, off 20-30         091       1.09     $56.05       $14.01       $11.21
                               w/e&m.
   90812  S                   Intac psytx, office (45-       092       1.63     $83.81       $21.47       $16.76
                               50).
   90813  S                   Intac psytx, off 45-50         092       1.63     $83.81       $21.47       $16.76
                               w/e&m.
   90814  S                   Intac psytx, office (75-       092       1.63     $83.81       $21.47       $16.76
                               80).
   90815  S                   Intac psytx, off 75-80         092       1.63     $83.81       $21.47       $16.76
                               w/e&m.
   90816  S                   Psytx, hosp (20-30)....        091       1.09     $56.05       $14.01       $11.21
   90817  S                   Psytx, hosp (20-30) w/         091       1.09     $56.05       $14.01       $11.21
                               e&m.
   90818  S                   Psytx, hosp (45-50)....        092       1.63     $83.81       $21.47       $16.76
   90819  S                   Psytx, hosp (45-50) w/         092       1.63     $83.81       $21.47       $16.76
                               e&m.
\1\ \2\   S                   Diagnostic interview...        092       1.63     $83.81       $21.47       $16.76
    90820
   90821  S                   Psytx, hosp (75-80)....        092       1.63     $83.81       $21.47       $16.76
   90822  S                   Psytx, hosp (75-80) w/         092       1.63     $83.81       $21.47       $16.76
                               e&m.
   90823  S                   Intac psytx, hosp (20-         091       1.09     $56.05       $14.01       $11.21
                               30).
   90824  S                   Intac psytx, hsp 20-30         091       1.09     $56.05       $14.01       $11.21
                               w/e&m.
   90826  S                   Intac psytx, hosp (45-         092       1.63     $83.81       $21.47       $16.76
                               50).
   90827  S                   Intac psytx, hsp 45-50         092       1.63     $83.81       $21.47       $16.76
                               w/e&m.
   90828  S                   Intac psytx, hosp (75-         092       1.63     $83.81       $21.47       $16.76
                               80).
   90829  S                   Intac psytx, hsp 75-80         092       1.63     $83.81       $21.47       $16.76
                               w/e&m.
\1\ \2\   S                   Special interview......        092       1.63     $83.81       $21.47       $16.76
    90835
\1\ \2\   S                   Psychotherapy, 75-80           092       1.63     $83.81       $21.47       $16.76
    90842                      min..
\1\ \2\   S                   Psychotherapy, 20-30           091       1.09     $56.05       $14.01       $11.21
    90843                      min..
\1\ \2\   S                   Psychotherapy, 45-50           092       1.63     $83.81       $21.47       $16.76
    90844                      min..
\1\ 9084  S                   Psychoanalysis.........        092       1.63     $83.81       $21.47       $16.76
        5
\1\ 9084  S                   Family psytx w/o               093       1.56     $80.22       $20.11       $16.04
        6                      patient.
\1\ 9084  S                   Family psytx w/patient.        093       1.56     $80.22       $20.11       $16.04
        7
\1\ 9084  S                   Multiple family group          094       1.31     $67.36       $19.89       $13.47
        9                      psytx.
\1\ 9085  S                   Group psychotherapy....        094       1.31     $67.36       $19.89       $13.47
        3
\1\ \2\   S                   Individual                     092       1.63     $83.81       $21.47       $16.76
    90855                      psychotherapy.
\1\ 9085  S                   Intac group psytx......        094       1.31     $67.36       $19.89       $13.47
        7
\1\ 9086  X                   Medication management..        090       0.85     $43.71       $12.20        $8.74
        2
   90865  S                   Narcosynthesis.........        092       1.63     $83.81       $21.47       $16.76

[[Page 35364]]

 
   90870  S                   Electroconvulsive              919       3.09    $158.89       $80.00       $31.78
                               therapy.
   90871  S                   Electroconvulsive              919       3.09    $158.89       $80.00       $31.78
                               therapy.
   90875  E                   Psychophysiological      .........  .........  .........  ...........  ...........
                               therapy.
   90876  E                   Psychophysiological      .........  .........  .........  ...........  ...........
                               therapy.
\1\ 9088  S                   Hypnotherapy...........        092       1.63     $83.81       $21.47       $16.76
        0
   90882  E                   Environmental            .........  .........  .........  ...........  ...........
                               manipulation.
   90885  N                   Psy evaluation of        .........  .........  .........  ...........  ...........
                               records.
   90887  N                   Consultation with        .........  .........  .........  ...........  ...........
                               family.
   90889  N                   Preparation of report..  .........  .........  .........  ...........  ...........
\1\ 9089  S                   Psychiatric service/           091       1.09     $56.05       $14.01       $11.21
        9                      therapy.
\2\ 9090  S                   Biofeedback,                   920       1.17     $60.16       $29.61       $12.03
        0                      electromyogram.
   90901  S                   Biofeedback, any method        920       1.17     $60.16       $29.61       $12.03
\2\ 9090  S                   Biofeedback, nerve             920       1.17     $60.16       $29.61       $12.03
        2                      impulse.
\2\ 9090  S                   Biofeedback, blood             920       1.17     $60.16       $29.61       $12.03
        4                      pressure.
\2\ 9090  S                   Biofeedback, blood flow        920       1.17     $60.16       $29.61       $12.03
        6
\2\ 9090  S                   Biofeedback, brain             920       1.17     $60.16       $29.61       $12.03
        8                      waves.
\2\ 9091  S                   Biofeedback, oculogram.        920       1.17     $60.16       $29.61       $12.03
        0
   90911  S                   Biofeedback peri/uro/          920       1.17     $60.16       $29.61       $12.03
                               rectal.
\2\ 9091  S                   Biofeedback,                   920       1.17     $60.16       $29.61       $12.03
        5                      unspecified.
   90918  A                   ESRD related services,   .........  .........  .........  ...........  ...........
                               month.
   90919  A                   ESRD related services,   .........  .........  .........  ...........  ...........
                               month.
   90920  A                   ESRD related services,   .........  .........  .........  ...........  ...........
                               month.
   90921  A                   ESRD related services,   .........  .........  .........  ...........  ...........
                               month.
   90922  A                   ESRD related services,   .........  .........  .........  ...........  ...........
                               day.
   90923  A                   Esrd related services,   .........  .........  .........  ...........  ...........
                               day.
   90924  A                   Esrd related services,   .........  .........  .........  ...........  ...........
                               day.
   90925  A                   Esrd related services,   .........  .........  .........  ...........  ...........
                               day.
   90935  S                   Hemodialysis, one              926       4.22    $216.99       $69.83       $43.40
                               evaluation.
   90937  S                   Hemodialysis, repeated         926       4.22    $216.99       $69.83       $43.40
                               eval..
   90945  S                   Dialysis, one                  926       4.22    $216.99       $69.83       $43.40
                               evaluation.
   90947  S                   Dialysis, repeated             926       4.22    $216.99       $69.83       $43.40
                               eval..
   90989  E                   Dialysis training/       .........  .........  .........  ...........  ...........
                               complete.
   90993  N                   Dialysis training/       .........  .........  .........  ...........  ...........
                               incomplete.
   90997  S                   Hemoperfusion..........        926       4.22    $216.99       $69.83       $43.40
   90999  S                   Dialysis procedure.....        926       4.22    $216.99       $69.83       $43.40
   91000  X                   Esophageal intubation..        928       2.91    $149.63       $79.78       $29.93
   91010  X                   Esophagus motility             928       2.91    $149.63       $79.78       $29.93
                               study.
   91011  X                   Esophagus motility             928       2.91    $149.63       $79.78       $29.93
                               study.
   91012  X                   Esophagus motility             928       2.91    $149.63       $79.78       $29.93
                               study.
   91020  X                   Gastric motility.......        928       2.91    $149.63       $79.78       $29.93
   91030  X                   Acid perfusion of              928       2.91    $149.63       $79.78       $29.93
                               esophagus.
   91032  X                   Esophagus, acid reflux         928       2.91    $149.63       $79.78       $29.93
                               test.
   91033  X                   Prolonged acid reflux          928       2.91    $149.63       $79.78       $29.93
                               test.
   91052  X                   Gastric analysis test..        928       2.91    $149.63       $79.78       $29.93
   91055  X                   Gastric intubation for         928       2.91    $149.63       $79.78       $29.93
                               smear.
   91060  X                   Gastric saline load            928       2.91    $149.63       $79.78       $29.93
                               test.
   91065  X                   Breath hydrogen test...        928       2.91    $149.63       $79.78       $29.93
   91100  X                   Pass intestine bleeding        928       2.91    $149.63       $79.78       $29.93
                               tube.
   91105  X                   Gastric intubation             928       2.91    $149.63       $79.78       $29.93
                               treatment.
   91122  N                   Anal pressure record...  .........  .........  .........  ...........  ...........
   91299  X                   Gastroenterology               928       2.91    $149.63       $79.78       $29.93
                               procedure.
   92002  V                   Eye exam, new patient..        913  .........  .........  ...........  ...........
   92004  V                   Eye exam, new patient..        915  .........  .........  ...........  ...........
   92012  V                   Eye exam established pt        913  .........  .........  ...........  ...........
   92014  V                   Eye exam & treatment...        915  .........  .........  ...........  ...........
   92015  E                   Refraction.............  .........  .........  .........  ...........  ...........
   92018  S                   New eye exam &                 676       5.87    $301.84      $138.54       $60.37
                               treatment.
   92019  S                   Eye exam & treatment...        676       5.87    $301.84      $138.54       $60.37
   92020  N                   Special eye evaluation.  .........  .........  .........  ...........  ...........
   92060  X                   Special eye evaluation.        930       1.04     $53.48       $22.83       $10.70
   92065  X                   Orthoptic/pleoptic             930       1.04     $53.48       $22.83       $10.70
                               training.
   92070  N                   Fitting of contact lens  .........  .........  .........  ...........  ...........
   92081  X                   Visual field                   930       1.04     $53.48       $22.83       $10.70
                               examination(s).
   92082  X                   Visual field                   930       1.04     $53.48       $22.83       $10.70
                               examination(s).
   92083  X                   Visual field                   930       1.04     $53.48       $22.83       $10.70
                               examination(s).
   92100  N                   Serial tonometry         .........  .........  .........  ...........  ...........
                               exam(s).
   92120  X                   Tonography & eye               931       0.74     $38.05       $21.47        $7.61
                               evaluation.
   92130  X                   Water provocation              931       0.74     $38.05       $21.47        $7.61
                               tonography.
   92140  X                   Glaucoma provocative           930       1.04     $53.48       $22.83       $10.70
                               tests.
   92225  N                   Special eye exam,        .........  .........  .........  ...........  ...........
                               initial.
   92226  N                   Special eye exam,        .........  .........  .........  ...........  ...........
                               subsequent.
   92230  X                   Eye exam with photos...        931       0.74     $38.05       $21.47        $7.61
   92235  X                   Eye exam with photos...        932       2.41    $123.92       $63.73       $24.78
   92240  X                   Icg angiography........        931       0.74     $38.05       $21.47        $7.61
   92250  X                   Eye exam with photos...        931       0.74     $38.05       $21.47        $7.61

[[Page 35365]]

 
   92260  N                   Ophthalmoscopy/          .........  .........  .........  ...........  ...........
                               dynamometry.
   92265  X                   Eye muscle evaluation..        932       2.41    $123.92       $63.73       $24.78
   92270  X                   Electro-oculography....        932       2.41    $123.92       $63.73       $24.78
   92275  X                   Electroretinography....        981       1.22     $62.73       $34.35       $12.55
   92283  X                   Color vision                   930       1.04     $53.48       $22.83       $10.70
                               examination.
   92284  X                   Dark adaptation eye            930       1.04     $53.48       $22.83       $10.70
                               exam.
   92285  X                   Eye photography........        930       1.04     $53.48       $22.83       $10.70
   92286  X                   Internal eye                   932       2.41    $123.92       $63.73       $24.78
                               photography.
   92287  X                   Internal eye                   932       2.41    $123.92       $63.73       $24.78
                               photography.
   92310  E                   Contact lens fitting...  .........  .........  .........  ...........  ...........
   92311  X                   Contact lens fitting...        936       0.48     $24.68        $9.49        $4.94
   92312  X                   Contact lens fitting...        936       0.48     $24.68        $9.49        $4.94
   92313  X                   Contact lens fitting...        936       0.48     $24.68        $9.49        $4.94
   92314  E                   Prescription of contact  .........  .........  .........  ...........  ...........
                               lens.
   92315  X                   Prescription of contact        936       0.48     $24.68        $9.49        $4.94
                               lens.
   92316  X                   Prescription of contact        936       0.48     $24.68        $9.49        $4.94
                               lens.
   92317  X                   Prescription of contact        936       0.48     $24.68        $9.49        $4.94
                               lens.
   92325  X                   Modification of contact        936       0.48     $24.68        $9.49        $4.94
                               lens.
   92326  X                   Replacement of contact         936       0.48     $24.68        $9.49        $4.94
                               lens.
   92330  X                   Fitting of artificial          936       0.48     $24.68        $9.49        $4.94
                               eye.
   92335  N                   Fitting of artificial    .........  .........  .........  ...........  ...........
                               eye.
   92340  E                   Fitting of spectacles..  .........  .........  .........  ...........  ...........
   92341  E                   Fitting of spectacles..  .........  .........  .........  ...........  ...........
   92342  E                   Fitting of spectacles..  .........  .........  .........  ...........  ...........
   92352  X                   Special spectacles             936       0.48     $24.68        $9.49        $4.94
                               fitting.
   92353  X                   Special spectacles             936       0.48     $24.68        $9.49        $4.94
                               fitting.
   92354  X                   Special spectacles             936       0.48     $24.68        $9.49        $4.94
                               fitting.
   92355  X                   Special spectacles             936       0.48     $24.68        $9.49        $4.94
                               fitting.
   92358  X                   Eye prosthesis service.        936       0.48     $24.68        $9.49        $4.94
   92370  E                   Repair & adjust          .........  .........  .........  ...........  ...........
                               spectacles.
   92371  X                   Repair & adjust                936       0.48     $24.68        $9.49        $4.94
                               spectacles.
   92390  E                   Supply of spectacles...  .........  .........  .........  ...........  ...........
   92391  E                   Supply of contact        .........  .........  .........  ...........  ...........
                               lenses.
   92392  E                   Supply of low vision     .........  .........  .........  ...........  ...........
                               aids.
   92393  E                   Supply of artificial     .........  .........  .........  ...........  ...........
                               eye.
   92395  E                   Supply of spectacles...  .........  .........  .........  ...........  ...........
   92396  E                   Supply of contact        .........  .........  .........  ...........  ...........
                               lenses.
   92499  X                   Eye service or                 931       0.74     $38.05       $21.47        $7.61
                               procedure.
   92502  S                   Ear and throat                 311       1.41     $72.50       $20.57       $14.50
                               examination.
   92504  N                   Ear microscopy           .........  .........  .........  ...........  ...........
                               examination.
   92506  A                   Speech & hearing         .........  .........  .........  ...........  ...........
                               evaluation.
   92507  A                   Speech/hearing therapy.  .........  .........  .........  ...........  ...........
   92508  A                   Speech/hearing therapy.  .........  .........  .........  ...........  ...........
   92510  A                   Rehab for ear implant..  .........  .........  .........  ...........  ...........
   92511  S                   Nasopharyngoscopy......        331       0.57     $29.31       $14.01        $5.86
   92512  X                   Nasal function studies.        940       3.13    $160.94       $52.21       $32.19
   92516  X                   Facial nerve function          940       3.13    $160.94       $52.21       $32.19
                               test.
   92520  X                   Laryngeal function             940       3.13    $160.94       $52.21       $32.19
                               studies.
   92525  A                   Oral function            .........  .........  .........  ...........  ...........
                               evaluation.
   92526  A                   Oral function therapy..  .........  .........  .........  ...........  ...........
   92531  N                   Spontaneous nystagmus    .........  .........  .........  ...........  ...........
                               study.
   92532  N                   Positional nystagmus     .........  .........  .........  ...........  ...........
                               study.
   92533  N                   Caloric vestibular test  .........  .........  .........  ...........  ...........
   92534  N                   Optokinetic nystagmus..  .........  .........  .........  ...........  ...........
   92541  X                   Spontaneous nystagmus          940       3.13    $160.94       $52.21       $32.19
                               test.
   92542  X                   Positional nystagmus           940       3.13    $160.94       $52.21       $32.19
                               test.
   92543  X                   Caloric vestibular test        940       3.13    $160.94       $52.21       $32.19
   92544  X                   Optokinetic nystagmus          940       3.13    $160.94       $52.21       $32.19
                               test.
   92545  X                   Oscillating tracking           940       3.13    $160.94       $52.21       $32.19
                               test.
   92546  X                   Sinusoidal rotational          940       3.13    $160.94       $52.21       $32.19
                               test.
   92547  X                   Supplemental electrical        940       3.13    $160.94       $52.21       $32.19
                               test.
   92548  X                   Posturography..........        940       3.13    $160.94       $52.21       $32.19
   92551  E                   Pure tone hearing test,  .........  .........  .........  ...........  ...........
                               air.
   92552  X                   Pure tone audiometry,          941       0.74     $38.05       $13.33        $7.61
                               air.
   92553  X                   Audiometry, air & bone.        941       0.74     $38.05       $13.33        $7.61
   92555  X                   Speech threshold               941       0.74     $38.05       $13.33        $7.61
                               audiometry.
   92556  X                   Speech audiometry,             941       0.74     $38.05       $13.33        $7.61
                               complete.
   92557  X                   Comprehensive hearing          942       1.46     $75.07       $22.15       $15.01
                               test.
   92559  E                   Group audiometric        .........  .........  .........  ...........  ...........
                               testing.
   92560  E                   Bekesy audiometry,       .........  .........  .........  ...........  ...........
                               screen.
   92561  X                   Bekesy audiometry,             942       1.46     $75.07       $22.15       $15.01
                               diagnosis.
   92562  X                   Loudness balance test..        942       1.46     $75.07       $22.15       $15.01
   92563  X                   Tone decay hearing test        942       1.46     $75.07       $22.15       $15.01
   92564  X                   Sisi hearing test......        942       1.46     $75.07       $22.15       $15.01
   92565  X                   Stenger test, pure tone        942       1.46     $75.07       $22.15       $15.01

[[Page 35366]]

 
   92567  X                   Tympanometry...........        941       0.74     $38.05       $13.33        $7.61
   92568  X                   Acoustic reflex testing        942       1.46     $75.07       $22.15       $15.01
   92569  X                   Acoustic reflex decay          942       1.46     $75.07       $22.15       $15.01
                               test.
   92571  X                   Filtered speech hearing        942       1.46     $75.07       $22.15       $15.01
                               test.
   92572  X                   Staggered spondaic word        942       1.46     $75.07       $22.15       $15.01
                               test.
   92573  X                   Lombard test...........        942       1.46     $75.07       $22.15       $15.01
   92575  X                   Sensorineural acuity           942       1.46     $75.07       $22.15       $15.01
                               test.
   92576  X                   Synthetic sentence test        942       1.46     $75.07       $22.15       $15.01
   92577  X                   Stenger test, speech...        942       1.46     $75.07       $22.15       $15.01
   92579  X                   Visual audiometry (vra)        942       1.46     $75.07       $22.15       $15.01
   92582  X                   Conditioning play              942       1.46     $75.07       $22.15       $15.01
                               audiometry.
   92583  X                   Select picture                 942       1.46     $75.07       $22.15       $15.01
                               audiometry.
   92584  X                   Electrocochleography...        940       3.13    $160.94       $52.21       $32.19
   92585  X                   Auditory evoked                982       1.37     $70.45       $38.42       $14.09
                               potential.
   92587  X                   Evoked auditory test...        940       3.13    $160.94       $52.21       $32.19
   92588  X                   Evoked auditory test...        940       3.13    $160.94       $52.21       $32.19
   92589  X                   Auditory function              942       1.46     $75.07       $22.15       $15.01
                               test(s).
   92590  E                   Hearing aid exam, one    .........  .........  .........  ...........  ...........
                               ear.
   92591  E                   Hearing aid exam, both   .........  .........  .........  ...........  ...........
                               ears.
   92592  E                   Hearing aid check, one   .........  .........  .........  ...........  ...........
                               ear.
   92593  E                   Hearing aid check, both  .........  .........  .........  ...........  ...........
                               ears.
   92594  E                   Electro hearing aid      .........  .........  .........  ...........  ...........
                               test,one.
   92595  E                   Electro hearingaid       .........  .........  .........  ...........  ...........
                               test,both.
   92596  X                   Ear protector                  942       1.46     $75.07       $22.15       $15.01
                               evaluation.
   92597  A                   Oral speech device eval  .........  .........  .........  ...........  ...........
   92598  A                   Modify oral speech       .........  .........  .........  ...........  ...........
                               device.
   92599  X                   ENT procedure/service..        941       0.74     $38.05       $13.33        $7.61
   92950  S                   Heart/lung                     947       4.11    $211.34      $106.22       $42.27
                               resuscitation(CPR.
   92953  S                   Temporary external             947       4.11    $211.34      $106.22       $42.27
                               pacing.
   92960  S                   Heart electroconversion        947       4.11    $211.34      $106.22       $42.27
   92970  C                   Cardioassist, internal.  .........  .........  .........  ...........  ...........
   92971  C                   Cardioassist, external.  .........  .........  .........  ...........  ...........
   92975  C                   Dissolve clot, heart     .........  .........  .........  ...........  ...........
                               vessel.
   92977  C                   Dissolve clot, heart     .........  .........  .........  ...........  ...........
                               vessel.
   92978  C                   Intravas us, heart add-  .........  .........  .........  ...........  ...........
                               on.
   92979  C                   Intravas us, heart (add- .........  .........  .........  ...........  ...........
                               on).
   92980  C                   Insert intracoronary     .........  .........  .........  ...........  ...........
                               stent.
   92981  C                   Insert intracoronary     .........  .........  .........  ...........  ...........
                               stent.
   92982  C                   Coronary artery          .........  .........  .........  ...........  ...........
                               dilation.
   92984  C                   Coronary artery          .........  .........  .........  ...........  ...........
                               dilation.
   92986  C                   Revision of aortic       .........  .........  .........  ...........  ...........
                               valve.
   92987  C                   Revision of mitral       .........  .........  .........  ...........  ...........
                               valve.
   92990  C                   Revision of pulmonary    .........  .........  .........  ...........  ...........
                               valve.
   92992  C                   Revision of heart        .........  .........  .........  ...........  ...........
                               chamber.
   92993  C                   Revision of heart        .........  .........  .........  ...........  ...........
                               chamber.
   92995  C                   Coronary atherectomy...  .........  .........  .........  ...........  ...........
   92996  C                   Coronary atherectomy     .........  .........  .........  ...........  ...........
                               add-on.
   92997  C                   Pul art balloon repair,  .........  .........  .........  ...........  ...........
                               perc.
   92998  C                   Pul art balloon repair,  .........  .........  .........  ...........  ...........
                               perc.
   93000  N                   Electrocardiogram,       .........  .........  .........  ...........  ...........
                               complete.
   93005  X                   Electrocardiogram,             950       0.35     $18.00       $15.82        $3.60
                               tracing.
   93010  N                   Electrocardiogram        .........  .........  .........  ...........  ...........
                               report.
   93012  X                   Transmission of ecg....        956       1.09     $56.05       $54.47       $11.21
   93014  N                   Report on transmitted    .........  .........  .........  ...........  ...........
                               ecg.
   93015  N                   Cardiovascular stress    .........  .........  .........  ...........  ...........
                               test.
   93016  N                   Cardiovascular stress    .........  .........  .........  ...........  ...........
                               test.
   93017  X                   Cardiovascular stress          949       1.43     $73.53       $61.92       $14.71
                               test.
   93018  N                   Cardiovascular stress    .........  .........  .........  ...........  ...........
                               test.
   93024  X                   Cardiac drug stress            949       1.43     $73.53       $61.92       $14.71
                               test.
   93040  N                   Rhythm ECG with report.  .........  .........  .........  ...........  ...........
   93041  X                   Rhythm ECG, tracing....        950       0.35     $18.00       $15.82        $3.60
   93042  N                   Rhythm ECG, report.....  .........  .........  .........  ...........  ...........
   93224  X                   ECG monitor/report, 24         956       1.09     $56.05       $54.47       $11.21
                               hrs.
   93225  X                   ECG monitor/record, 24         956       1.09     $56.05       $54.47       $11.21
                               hrs.
   93226  X                   ECG monitor/report, 24         956       1.09     $56.05       $54.47       $11.21
                               hrs.
   93227  N                   ECG monitor/review, 24   .........  .........  .........  ...........  ...........
                               hrs.
   93230  X                   ECG monitor/report, 24         956       1.09     $56.05       $54.47       $11.21
                               hrs.
   93231  X                   Ecg monitor/record, 24         956       1.09     $56.05       $54.47       $11.21
                               hrs.
   93232  X                   ECG monitor/report, 24         956       1.09     $56.05       $54.47       $11.21
                               hrs.
   93233  N                   ECG monitor/review, 24   .........  .........  .........  ...........  ...........
                               hrs.
   93235  X                   ECG monitor/report, 24         956       1.09     $56.05       $54.47       $11.21
                               hrs.
   93236  X                   ECG monitor/report, 24         956       1.09     $56.05       $54.47       $11.21
                               hrs.
   93237  N                   ECG monitor/review, 24   .........  .........  .........  ...........  ...........
                               hrs.
   93268  X                   ECG record/review......        956       1.09     $56.05       $54.47       $11.21
   93270  X                   ECG recording..........        956       1.09     $56.05       $54.47       $11.21

[[Page 35367]]

 
   93271  X                   Ecg/monitoring and             956       1.09     $56.05       $54.47       $11.21
                               anaylysis.
   93272  N                   Ecg/review, interpret    .........  .........  .........  ...........  ...........
                               only.
   93278  X                   ECG/signal-averaged....        956       1.09     $56.05       $54.47       $11.21
   93303  S                   Echo transthoracic.....        957       4.04    $207.74      $114.13       $41.55
   93304  S                   Echo transthoracic.....        957       4.04    $207.74      $114.13       $41.55
   93307  S                   Echo exam of heart.....        957       4.04    $207.74      $114.13       $41.55
   93308  S                   Echo exam of heart.....        957       4.04    $207.74      $114.13       $41.55
   93312  S                   Echo transesophageal...        957       4.04    $207.74      $114.13       $41.55
   93313  S                   Echo transesophageal...        957       4.04    $207.74      $114.13       $41.55
   93314  N                   Echo transesophageal...  .........  .........  .........  ...........  ...........
   93315  S                   Echo transesophageal...        957       4.04    $207.74      $114.13       $41.55
   93316  S                   Echo transesophageal...        957       4.04    $207.74      $114.13       $41.55
   93317  N                   Echo transesophageal...  .........  .........  .........  ...........  ...........
   93320  S                   Doppler echo exam,             957       4.04    $207.74      $114.13       $41.55
                               heart.
   93321  S                   Doppler echo exam,             957       4.04    $207.74      $114.13       $41.55
                               heart.
   93325  S                   Doppler color flow add-        957       4.04    $207.74      $114.13       $41.55
                               on.
   93350  S                   Echo transthoracic.....        957       4.04    $207.74      $114.13       $41.55
   93501  S                   Right heart                    958      23.74  $1,220.71      $705.57      $244.14
                               catheterization.
   93503  S                   Insert/place heart             958      23.74  $1,220.71      $705.57      $244.14
                               catheter.
   93505  S                   Biopsy of heart lining.        958      23.74  $1,220.71      $705.57      $244.14
   93508  S                   Cath placement,                343       8.76    $450.44      $240.24       $90.09
                               angiography.
   93510  S                   Left heart                     958      23.74  $1,220.71      $705.57      $244.14
                               catheterization.
   93511  S                   Left heart                     958      23.74  $1,220.71      $705.57      $244.14
                               catheterization.
   93514  S                   Left heart                     958      23.74  $1,220.71      $705.57      $244.14
                               catheterization.
   93524  S                   Left heart                     958      23.74  $1,220.71      $705.57      $244.14
                               catheterization.
   93526  S                   Rt & Lt heart catheters        958      23.74  $1,220.71      $705.57      $244.14
   93527  S                   Rt & Lt heart catheters        958      23.74  $1,220.71      $705.57      $244.14
   93528  S                   Rt & Lt heart catheters        958      23.74  $1,220.71      $705.57      $244.14
   93529  S                   Rt, Lt heart                   958      23.74  $1,220.71      $705.57      $244.14
                               catheterization.
   93530  S                   Rt heart cath,                 958      23.74  $1,220.71      $705.57      $244.14
                               congenital.
   93531  S                   R & l heart cath,              958      23.74  $1,220.71      $705.57      $244.14
                               congenital.
   93532  S                   R & l heart cath,              958      23.74  $1,220.71      $705.57      $244.14
                               congenital.
   93533  S                   R & l heart cath,              958      23.74  $1,220.71      $705.57      $244.14
                               congenital.
   93536  S                   Insert circulation assi        958      23.74  $1,220.71      $705.57      $244.14
   93539  N                   Injection, cardiac cath  .........  .........  .........  ...........  ...........
   93540  N                   Injection, cardiac cath  .........  .........  .........  ...........  ...........
   93541  N                   Injection for lung       .........  .........  .........  ...........  ...........
                               angiogram.
   93542  N                   Injection for heart x-   .........  .........  .........  ...........  ...........
                               rays.
   93543  N                   Injection for heart x-   .........  .........  .........  ...........  ...........
                               rays.
   93544  N                   Injection for            .........  .........  .........  ...........  ...........
                               aortography.
   93545  N                   Injection for coronary   .........  .........  .........  ...........  ...........
                               x-rays.
   93555  N                   Imaging, cardiac cath..  .........  .........  .........  ...........  ...........
   93556  N                   Imaging, cardiac cath..  .........  .........  .........  ...........  ...........
   93561  N                   Cardiac output           .........  .........  .........  ...........  ...........
                               measurement.
   93562  N                   Cardiac output           .........  .........  .........  ...........  ...........
                               measurement.
   93600  S                   Bundle of His recording        960       4.80    $246.82      $143.74       $49.36
   93602  S                   Intra-atrial recording.        960       4.80    $246.82      $143.74       $49.36
   93603  S                   Right ventricular              960       4.80    $246.82      $143.74       $49.36
                               recording.
   93607  S                   Right ventricular              960       4.80    $246.82      $143.74       $49.36
                               recording.
   93609  S                   Mapping of tachycardia.        960       4.80    $246.82      $143.74       $49.36
   93610  S                   Intra-atrial pacing....        960       4.80    $246.82      $143.74       $49.36
   93612  S                   Intraventricular pacing        960       4.80    $246.82      $143.74       $49.36
   93615  S                   Esophageal recording...        960       4.80    $246.82      $143.74       $49.36
   93616  S                   Esophageal recording...        960       4.80    $246.82      $143.74       $49.36
   93618  S                   Heart rhythm pacing....        960       4.80    $246.82      $143.74       $49.36
   93619  S                   Electrophysiology              960       4.80    $246.82      $143.74       $49.36
                               evaluation.
   93620  S                   Electrophysiology              960       4.80    $246.82      $143.74       $49.36
                               evaluation.
   93621  S                   Electrophysiology              960       4.80    $246.82      $143.74       $49.36
                               evaluation.
   93622  S                   Electrophysiology              960       4.80    $246.82      $143.74       $49.36
                               evaluation.
   93623  S                   Stimulation, pacing            960       4.80    $246.82      $143.74       $49.36
                               heart.
   93624  S                   Electrophysiologic             960       4.80    $246.82      $143.74       $49.36
                               study.
   93631  S                   Heart pacing, mapping..        960       4.80    $246.82      $143.74       $49.36
   93640  S                   Evaluation heart device        960       4.80    $246.82      $143.74       $49.36
   93641  S                   Electrophysiology              960       4.80    $246.82      $143.74       $49.36
                               evaluation.
   93642  S                   Electrophysiology              960       4.80    $246.82      $143.74       $49.36
                               evaluation.
   93650  S                   Ablate heart dysrhythm         960       4.80    $246.82      $143.74       $49.36
                               focus.
   93651  S                   Ablate heart dysrhythm         960       4.80    $246.82      $143.74       $49.36
                               focus.
   93652  S                   Ablate heart dysrhythm         960       4.80    $246.82      $143.74       $49.36
                               focus.
   93660  S                   Tilt table evaluation..        960       4.80    $246.82      $143.74       $49.36
   93720  X                   Total body                     967       1.70     $87.41       $57.40       $17.48
                               plethysmography.
   93721  X                   Plethysmography tracing        967       1.70     $87.41       $57.40       $17.48
   93722  N                   Plethysmography report.  .........  .........  .........  ...........  ...........
   93724  S                   Analyze pacemaker              960       4.80    $246.82      $143.74       $49.36
                               system.
   93731  X                   Analyze pacemaker              966       0.39     $20.05       $12.43        $4.01
                               system.
   93732  X                   Analyze pacemaker              966       0.39     $20.05       $12.43        $4.01
                               system.

[[Page 35368]]

 
   93733  X                   Telephone analysis,            966       0.39     $20.05       $12.43        $4.01
                               pacemaker.
   93734  X                   Analyze pacemaker              966       0.39     $20.05       $12.43        $4.01
                               system.
   93735  X                   Analyze pacemaker              966       0.39     $20.05       $12.43        $4.01
                               system.
   93736  X                   Telephone analysis,            966       0.39     $20.05       $12.43        $4.01
                               pacemaker.
   93737  X                   Analyze cardio/                966       0.39     $20.05       $12.43        $4.01
                               defibrillator.
   93738  X                   Analyze cardio/                966       0.39     $20.05       $12.43        $4.01
                               defibrillator.
   93740  X                   Temperature gradient           967       1.70     $87.41       $57.40       $17.48
                               studies.
   93760  E                   Cephalic thermogram....  .........  .........  .........  ...........  ...........
   93762  E                   Peripheral thermogram..  .........  .........  .........  ...........  ...........
   93770  N                   Measure venous pressure  .........  .........  .........  ...........  ...........
   93784  E                   Ambulatory BP            .........  .........  .........  ...........  ...........
                               monitoring.
   93786  E                   Ambulatory BP recording  .........  .........  .........  ...........  ...........
   93788  E                   Ambulatory BP analysis.  .........  .........  .........  ...........  ...........
   93790  E                   Review/report BP         .........  .........  .........  ...........  ...........
                               recording.
   93797  X                   Cardiac rehab..........        948       0.81     $41.65       $16.95        $8.33
   93798  X                   Cardiac rehab/monitor..        948       0.81     $41.65       $16.95        $8.33
   93799  X                   Cardiovascular                 967       1.70     $87.41       $57.40       $17.48
                               procedure.
   93875  X                   Extracranial study.....        968       2.39    $122.89       $79.55       $24.58
   93880  X                   Extracranial study.....        968       2.39    $122.89       $79.55       $24.58
   93882  X                   Extracranial study.....        968       2.39    $122.89       $79.55       $24.58
   93886  X                   Intracranial study.....        968       2.39    $122.89       $79.55       $24.58
   93888  X                   Intracranial study.....        968       2.39    $122.89       $79.55       $24.58
   93922  X                   Extremity study........        967       1.70     $87.41       $57.40       $17.48
   93923  X                   Extremity study........        967       1.70     $87.41       $57.40       $17.48
   93924  X                   Extremity study........        967       1.70     $87.41       $57.40       $17.48
   93925  X                   Lower extremity study..        968       2.39    $122.89       $79.55       $24.58
   93926  X                   Lower extremity study..        968       2.39    $122.89       $79.55       $24.58
   93930  X                   Upper extremity study..        968       2.39    $122.89       $79.55       $24.58
   93931  X                   Upper extremity study..        968       2.39    $122.89       $79.55       $24.58
   93965  X                   Extremity study........        967       1.70     $87.41       $57.40       $17.48
   93970  X                   Extremity study........        968       2.39    $122.89       $79.55       $24.58
   93971  X                   Extremity study........        968       2.39    $122.89       $79.55       $24.58
   93975  X                   Vascular study.........        968       2.39    $122.89       $79.55       $24.58
   93976  X                   Vascular study.........        968       2.39    $122.89       $79.55       $24.58
   93978  X                   Vascular study.........        968       2.39    $122.89       $79.55       $24.58
   93979  X                   Vascular study.........        968       2.39    $122.89       $79.55       $24.58
   93980  X                   Penile vascular study..        968       2.39    $122.89       $79.55       $24.58
   93981  X                   Penile vascular study..        968       2.39    $122.89       $79.55       $24.58
   93990  X                   Doppler flow testing...        968       2.39    $122.89       $79.55       $24.58
   94010  X                   Breathing capacity test        971       0.98     $50.39       $26.44       $10.08
   94060  X                   Evaluation of wheezing.        971       0.98     $50.39       $26.44       $10.08
   94070  S                   Evaluation of wheezing.        973       1.81     $93.07       $55.82       $18.61
   94150  N                   Vital capacity test....  .........  .........  .........  ...........  ...........
\2\ 9416  X                   Vital capacity                 971       0.98     $50.39       $26.44       $10.08
        0                      screening.
   94200  X                   Lung function test (MBC/       971       0.98     $50.39       $26.44       $10.08
                               MVV).
   94240  X                   Residual lung capacity.        972       1.00     $51.42       $29.38       $10.28
   94250  X                   Expired gas collection.        971       0.98     $50.39       $26.44       $10.08
   94260  X                   Thoracic gas volume....        971       0.98     $50.39       $26.44       $10.08
   94350  X                   Lung nitrogen washout          972       1.00     $51.42       $29.38       $10.28
                               curve.
   94360  X                   Measure airflow                971       0.98     $50.39       $26.44       $10.08
                               resistance.
   94370  X                   Breath airway closing          972       1.00     $51.42       $29.38       $10.28
                               volume.
   94375  X                   Respiratory flow volume        971       0.98     $50.39       $26.44       $10.08
                               loop.
   94400  X                   CO2 breathing response         971       0.98     $50.39       $26.44       $10.08
                               curve.
   94450  X                   Hypoxia response curve.        971       0.98     $50.39       $26.44       $10.08
   94620  S                   Pulmonary stress test/         973       1.81     $93.07       $55.82       $18.61
                               simple.
   94640  S                   Airway inhalation              976       0.44     $22.62       $14.69        $4.53
                               treatment.
   94642  S                   Aerosol inhalation             976       0.44     $22.62       $14.69        $4.53
                               treatment.
   94650  S                   Pressure breathing             976       0.44     $22.62       $14.69        $4.53
                               (IPPB).
   94651  S                   Pressure breathing             976       0.44     $22.62       $14.69        $4.53
                               (IPPB).
   94652  C                   Pressure breathing       .........  .........  .........  ...........  ...........
                               (IPPB).
   94656  C                   Initial ventilator mgmt  .........  .........  .........  ...........  ...........
   94657  S                   Cont. ventilator.......        976       0.44     $22.62       $14.69        $4.53
   94660  S                   Pos airway pressure,           976       0.44     $22.62       $14.69        $4.53
                               CPAP.
   94662  S                   Neg pressure                   976       0.44     $22.62       $14.69        $4.53
                               ventilation, cnp.
   94664  S                   Aerosol or vapor               976       0.44     $22.62       $14.69        $4.53
                               inhalations.
   94665  S                   Aerosol or vapor               976       0.44     $22.62       $14.69        $4.53
                               inhalations.
   94667  S                   Chest wall manipulation        976       0.44     $22.62       $14.69        $4.53
   94668  S                   Chest wall manipulation        976       0.44     $22.62       $14.69        $4.53
   94680  X                   Exhaled air analysis:          972       1.00     $51.42       $29.38       $10.28
                               O2.
   94681  X                   Exhaled air analysis:          972       1.00     $51.42       $29.38       $10.28
                               O2, CO2.
   94690  X                   Exhaled air analysis...        972       1.00     $51.42       $29.38       $10.28
   94720  X                   Monoxide diffusing             972       1.00     $51.42       $29.38       $10.28
                               capacity.
   94725  X                   Membrane diffusion             972       1.00     $51.42       $29.38       $10.28
                               capacity.
   94750  S                   Pulmonary compliance           973       1.81     $93.07       $55.82       $18.61
                               study.
   94760  N                   Measure blood oxygen     .........  .........  .........  ...........  ...........
                               level.

[[Page 35369]]

 
   94761  N                   Measure blood oxygen     .........  .........  .........  ...........  ...........
                               level.
   94762  X                   Measure blood oxygen           971       0.98     $50.39       $26.44       $10.08
                               level.
   94770  X                   Exhaled carbon dioxide         971       0.98     $50.39       $26.44       $10.08
                               test.
   94772  S                   Breath recording,              973       1.81     $93.07       $55.82       $18.61
                               infant.
   94799  X                   Pulmonary service/             971       0.98     $50.39       $26.44       $10.08
                               procedure.
   95004  X                   Allergy skin tests.....        977       0.56     $28.80       $11.30        $5.76
   95010  X                   Sensitivity skin tests.        977       0.56     $28.80       $11.30        $5.76
   95015  X                   Sensitivity skin tests.        977       0.56     $28.80       $11.30        $5.76
   95024  X                   Allergy skin tests.....        977       0.56     $28.80       $11.30        $5.76
   95027  X                   Skin end point                 977       0.56     $28.80       $11.30        $5.76
                               titration.
   95028  X                   Allergy skin tests.....        977       0.56     $28.80       $11.30        $5.76
   95044  X                   Allergy patch tests....        977       0.56     $28.80       $11.30        $5.76
   95052  X                   Photo patch test.......        977       0.56     $28.80       $11.30        $5.76
   95056  X                   Photosensitivity tests.        977       0.56     $28.80       $11.30        $5.76
   95060  X                   Eye allergy tests......        977       0.56     $28.80       $11.30        $5.76
   95065  X                   Nose allergy test......        977       0.56     $28.80       $11.30        $5.76
   95070  S                   Bronchial allergy tests        973       1.81     $93.07       $55.82       $18.61
   95071  S                   Bronchial allergy tests        973       1.81     $93.07       $55.82       $18.61
   95075  X                   Ingestion challenge            928       2.91    $149.63       $79.78       $29.93
                               test.
   95078  X                   Provocative testing....        977       0.56     $28.80       $11.30        $5.76
   95115  X                   Immunotherapy, one             978       0.30     $15.43        $3.39        $3.09
                               injection.
   95117  X                   Immunotherapy                  978       0.30     $15.43        $3.39        $3.09
                               injections.
   95120  E                   Immunotherapy, one       .........  .........  .........  ...........  ...........
                               injection.
   95125  E                   Immunotherapy, many      .........  .........  .........  ...........  ...........
                               antigens.
   95130  E                   Immunotherapy, insect    .........  .........  .........  ...........  ...........
                               venom.
   95131  E                   Immunotherapy, insect    .........  .........  .........  ...........  ...........
                               venoms.
   95132  E                   Immunotherapy, insect    .........  .........  .........  ...........  ...........
                               venoms.
   95133  E                   Immunotherapy, insect    .........  .........  .........  ...........  ...........
                               venoms.
   95134  E                   Immunotherapy, insect    .........  .........  .........  ...........  ...........
                               venoms.
   95144  X                   Antigen therapy                978       0.30     $15.43        $3.39        $3.09
                               services.
   95145  X                   Antigen therapy                978       0.30     $15.43        $3.39        $3.09
                               services.
   95146  X                   Antigen therapy                978       0.30     $15.43        $3.39        $3.09
                               services.
   95147  X                   Antigen therapy                978       0.30     $15.43        $3.39        $3.09
                               services.
   95148  X                   Antigen therapy                978       0.30     $15.43        $3.39        $3.09
                               services.
   95149  X                   Antigen therapy                901       0.07      $3.60        $2.49        $0.72
                               services.
   95165  X                   Antigen therapy                978       0.30     $15.43        $3.39        $3.09
                               services.
   95170  X                   Antigen therapy                901       0.07      $3.60        $2.49        $0.72
                               services.
   95180  X                   Rapid desensitization..        977       0.56     $28.80       $11.30        $5.76
   95199  X                   Allergy immunology             977       0.56     $28.80       $11.30        $5.76
                               services.
   95805  S                   Multiple sleep latency         979      10.15    $521.91      $287.25      $104.38
                               test.
   95806  S                   Sleep study, unattended        979      10.15    $521.91      $287.25      $104.38
   95807  S                   Sleep study, attended..        979      10.15    $521.91      $287.25      $104.38
   95808  S                   Polysomnography, 1-3...        979      10.15    $521.91      $287.25      $104.38
   95810  S                   Polysomnography, 4 or          979      10.15    $521.91      $287.25      $104.38
                               more.
   95811  S                   Polysomnography w/cpap.        979      10.15    $521.91      $287.25      $104.38
   95812  S                   Electroencephalogram           979      10.15    $521.91      $287.25      $104.38
                               (EEG).
   95813  S                   Electroencephalogram           979      10.15    $521.91      $287.25      $104.38
                               (EEG).
   95816  S                   Electroencephalogram           980       2.15    $110.55       $57.86       $22.11
                               (EEG).
   95819  S                   Electroencephalogram           980       2.15    $110.55       $57.86       $22.11
                               (EEG).
   95822  S                   Sleep                          980       2.15    $110.55       $57.86       $22.11
                               electroencephalogram.
   95824  S                   Electroencephalography.        980       2.15    $110.55       $57.86       $22.11
   95827  S                   Night                          979      10.15    $521.91      $287.25      $104.38
                               electroencephalogram.
   95829  S                   Surgery                        980       2.15    $110.55       $57.86       $22.11
                               electrocorticogram.
   95830  N                   Insert electrodes for    .........  .........  .........  ...........  ...........
                               EEG.
   95831  N                   Limb muscle testing,     .........  .........  .........  ...........  ...........
                               manual.
   95832  N                   Hand muscle testing,     .........  .........  .........  ...........  ...........
                               manual.
   95833  N                   Body muscle testing,     .........  .........  .........  ...........  ...........
                               manual.
   95834  N                   Body muscle testing,     .........  .........  .........  ...........  ...........
                               manual.
   95851  N                   Range of motion          .........  .........  .........  ...........  ...........
                               measurements.
   95852  N                   Range of motion          .........  .........  .........  ...........  ...........
                               measurements.
   95857  X                   Tensilon test..........        981       1.22     $62.73       $34.35       $12.55
   95858  X                   Tensilon test & myogram        982       1.37     $70.45       $38.42       $14.09
   95860  X                   Muscle test, one limb..        982       1.37     $70.45       $38.42       $14.09
   95861  X                   Muscle test, two limbs.        982       1.37     $70.45       $38.42       $14.09
   95863  X                   Muscle test, 3 limbs...        982       1.37     $70.45       $38.42       $14.09
   95864  X                   Muscle test, 4 limbs...        982       1.37     $70.45       $38.42       $14.09
   95867  X                   Muscle test, head or           981       1.22     $62.73       $34.35       $12.55
                               neck.
   95868  X                   Muscle test, head or           982       1.37     $70.45       $38.42       $14.09
                               neck.
   95869  X                   Muscle test, thor              981       1.22     $62.73       $34.35       $12.55
                               paraspinal.
   95870  X                   Muscle test, non-              981       1.22     $62.73       $34.35       $12.55
                               paraspinal.
   95872  X                   Muscle test, one fiber.        982       1.37     $70.45       $38.42       $14.09
   95875  X                   Limb exercise test.....        982       1.37     $70.45       $38.42       $14.09
   95900  X                   Motor nerve conduction         981       1.22     $62.73       $34.35       $12.55
                               test.
   95903  X                   Motor nerve conduction         982       1.37     $70.45       $38.42       $14.09
                               test.
   95904  X                   Sense nerve conduction         982       1.37     $70.45       $38.42       $14.09
                               test.

[[Page 35370]]

 
   95920  C                   Intraop nerve test add-  .........  .........  .........  ...........  ...........
                               on.
   95921  X                   Autonomic nervous func         981       1.22     $62.73       $34.35       $12.55
                               test.
   95922  X                   Autonomic nervous func         981       1.22     $62.73       $34.35       $12.55
                               test.
   95923  X                   Autonomic nervous func         981       1.22     $62.73       $34.35       $12.55
                               test.
   95925  X                   Somatosensory testing..        982       1.37     $70.45       $38.42       $14.09
   95926  X                   Somatosensory testing..        981       1.22     $62.73       $34.35       $12.55
   95927  X                   Somatosensory testing..        981       1.22     $62.73       $34.35       $12.55
   95930  X                   Visual evoked potential        981       1.22     $62.73       $34.35       $12.55
                               test.
   95933  X                   Blink reflex test......        981       1.22     $62.73       $34.35       $12.55
   95934  X                   'h' reflex test........        981       1.22     $62.73       $34.35       $12.55
   95936  X                   'h' reflex test........        981       1.22     $62.73       $34.35       $12.55
   95937  X                   Neuromuscular junction         981       1.22     $62.73       $34.35       $12.55
                               test.
   95950  X                   Ambulatory eeg                 981       1.22     $62.73       $34.35       $12.55
                               monitoring.
   95951  S                   EEG monitoring/                979      10.15    $521.91      $287.25      $104.38
                               videorecord.
   95953  S                   EEG monitoring/computer        979      10.15    $521.91      $287.25      $104.38
   95954  S                   EEG monitoring/giving          979      10.15    $521.91      $287.25      $104.38
                               drugs.
   95955  S                   EEG during surgery.....        980       2.15    $110.55       $57.86       $22.11
   95956  N                   EEG monitoring/cable/    .........  .........  .........  ...........  ...........
                               radio.
   95957  N                   EEG digital analysis...  .........  .........  .........  ...........  ...........
   95958  S                   EEG monitoring/function        979      10.15    $521.91      $287.25      $104.38
                               test.
   95961  C                   Electrode stimulation,   .........  .........  .........  ...........  ...........
                               brain.
   95962  C                   Electrode stimulation,   .........  .........  .........  ...........  ...........
                               brain.
   95999  N                   Neurological procedure.  .........  .........  .........  ...........  ...........
\1\ 9610  X                   Psychological testing..        089       4.06    $208.77       $46.10       $41.75
        0
   96105  X                   Assessment of aphasia..        089       4.06    $208.77       $46.10       $41.75
   96110  X                   Developmental test, lim        089       4.06    $208.77       $46.10       $41.75
   96111  X                   Developmental test,            089       4.06    $208.77       $46.10       $41.75
                               extend.
\1\ 9611  X                   Neurobehavior status           089       4.06    $208.77       $46.10       $41.75
        5                      exam.
\1\ 9611  X                   Neuropsych test battery        089       4.06    $208.77       $46.10       $41.75
        7
   96400  S                   Chemotherapy, (SC)/(IM)        987       2.09    $107.47       $65.09       $21.49
   96405  S                   Intralesional chemo            987       2.09    $107.47       $65.09       $21.49
                               admin.
   96406  S                   Intralesional chemo            987       2.09    $107.47       $65.09       $21.49
                               admin.
   96408  S                   Chemotherapy, push             988       4.02    $206.71      $110.29       $41.34
                               technique.
   96410  S                   Chemotherapy,infusion          988       4.02    $206.71      $110.29       $41.34
                               method.
   96412  S                   Chemotx infuse method          988       4.02    $206.71      $110.29       $41.34
                               add-on.
   96414  S                   Chemotx infuse method          989       1.91     $98.21       $44.52       $19.64
                               add-on.
   96420  S                   Chemotherapy, push             988       4.02    $206.71      $110.29       $41.34
                               technique.
   96422  S                   Chemotherapy,infusion          988       4.02    $206.71      $110.29       $41.34
                               method.
   96423  S                   Chemotx infuse method          988       4.02    $206.71      $110.29       $41.34
                               add-on.
   96425  S                   Chemotherapy,infusion          989       1.91     $98.21       $44.52       $19.64
                               method.
   96440  S                   Chemotherapy,                  989       1.91     $98.21       $44.52       $19.64
                               intracavitary.
   96445  S                   Chemotherapy,                  989       1.91     $98.21       $44.52       $19.64
                               intracavitary.
   96450  S                   Chemotherapy, into CNS.        989       1.91     $98.21       $44.52       $19.64
   96520  E                   Pump refilling,          .........  .........  .........  ...........  ...........
                               maintenance.
   96530  E                   Pump refilling,          .........  .........  .........  ...........  ...........
                               maintenance.
   96542  S                   Chemotherapy injection.        989       1.91     $98.21       $44.52       $19.64
   96545  E                   Provide chemotherapy     .........  .........  .........  ...........  ...........
                               agent.
   96549  S                   Chemotherapy,                  987       2.09    $107.47       $65.09       $21.49
                               unspecified.
   96900  S                   Ultraviolet light              990       0.43     $22.11        $8.14        $4.42
                               therapy.
   96902  N                   Trichogram.............  .........  .........  .........  ...........  ...........
   96910  S                   Photochemotherapy with         990       0.43     $22.11        $8.14        $4.42
                               UV-B.
   96912  S                   Photochemotherapy with         990       0.43     $22.11        $8.14        $4.42
                               UV-A.
   96913  S                   Photochemotherapy, UV-A        990       0.43     $22.11        $8.14        $4.42
                               or B.
   96999  S                   Dermatological                 990       0.43     $22.11        $8.14        $4.42
                               procedure.
   97001  A                   Pt evaluation..........  .........  .........  .........  ...........  ...........
   97002  A                   Pt re-evaluation.......  .........  .........  .........  ...........  ...........
   97003  A                   Ot evaluation..........  .........  .........  .........  ...........  ...........
   97004  A                   Ot re-evaluation.......  .........  .........  .........  ...........  ...........
   97010  A                   Hot or cold packs        .........  .........  .........  ...........  ...........
                               therapy.
   97012  A                   Mechanical traction      .........  .........  .........  ...........  ...........
                               therapy.
   97014  A                   Electric stimulation     .........  .........  .........  ...........  ...........
                               therapy.
   97016  A                   Vasopneumatic device     .........  .........  .........  ...........  ...........
                               therapy.
   97018  A                   Paraffin bath therapy..  .........  .........  .........  ...........  ...........
   97020  A                   Microwave therapy......  .........  .........  .........  ...........  ...........
   97022  A                   Whirlpool therapy......  .........  .........  .........  ...........  ...........
   97024  A                   Diathermy treatment....  .........  .........  .........  ...........  ...........
   97026  A                   Infrared therapy.......  .........  .........  .........  ...........  ...........
   97028  A                   Ultraviolet therapy....  .........  .........  .........  ...........  ...........
   97032  A                   Electrical stimulation.  .........  .........  .........  ...........  ...........
   97033  A                   Electric current         .........  .........  .........  ...........  ...........
                               therapy.
   97034  A                   Contrast bath therapy..  .........  .........  .........  ...........  ...........
   97035  A                   Ultrasound therapy.....  .........  .........  .........  ...........  ...........
   97036  A                   Hydrotherapy...........  .........  .........  .........  ...........  ...........
   97039  A                   Physical therapy         .........  .........  .........  ...........  ...........
                               treatment.
   97110  A                   Therapeutic exercises..  .........  .........  .........  ...........  ...........

[[Page 35371]]

 
   97112  A                   Neuromuscular            .........  .........  .........  ...........  ...........
                               reeducation.
   97113  A                   Aquatic therapy/         .........  .........  .........  ...........  ...........
                               exercises.
   97116  A                   Gait training therapy..  .........  .........  .........  ...........  ...........
\2\ 9712  A                   Manual traction therapy  .........  .........  .........  ...........  ...........
        2
   97124  A                   Massage therapy........  .........  .........  .........  ...........  ...........
   97139  A                   Physical medicine        .........  .........  .........  ...........  ...........
                               procedure.
   97150  A                   Group therapeutic        .........  .........  .........  ...........  ...........
                               procedures.
\2\ 9725  S                   Myofascial release.....        997       0.69     $35.48        $7.46        $7.10
        0
\2\ 9726  S                   Regional manipulation..        997       0.69     $35.48        $7.46        $7.10
        0
\2\ 9726  S                   Supplemental                   997       0.69     $35.48        $7.46        $7.10
        1                      manipulations.
\2\ 9726  A                   Joint mobilization.....  .........  .........  .........  ...........  ...........
        5
   97504  A                   Orthotic training......  .........  .........  .........  ...........  ...........
   97520  A                   Prosthetic training....  .........  .........  .........  ...........  ...........
\1\ 9753  A                   Therapeutic activities.  .........  .........  .........  ...........  ...........
        0
   97535  A                   Self care mngment        .........  .........  .........  ...........  ...........
                               training.
\1\ 9753  A                   Community/work           .........  .........  .........  ...........  ...........
        7                      reintegration.
   97542  A                   Wheelchair mngement      .........  .........  .........  ...........  ...........
                               training.
   97545  A                   Work hardening.........  .........  .........  .........  ...........  ...........
   97546  A                   Work hardening add-on..  .........  .........  .........  ...........  ...........
   97703  A                   Prosthetic checkout....  .........  .........  .........  ...........  ...........
   97750  A                   Physical performance     .........  .........  .........  ...........  ...........
                               test.
\1\ 9777  A                   Cognitive skills         .........  .........  .........  ...........  ...........
        0                      development.
   97780  E                   Acupuncture w/o stim...  .........  .........  .........  ...........  ...........
   97781  E                   Acupuncture w/stim.....  .........  .........  .........  ...........  ...........
   97799  A                   Physical medicine        .........  .........  .........  ...........  ...........
                               procedure.
   98925  S                   Osteopathic                    997       0.69     $35.48        $7.46        $7.10
                               manipulation.
   98926  S                   Osteopathic                    997       0.69     $35.48        $7.46        $7.10
                               manipulation.
   98927  S                   Osteopathic                    997       0.69     $35.48        $7.46        $7.10
                               manipulation.
   98928  S                   Osteopathic                    997       0.69     $35.48        $7.46        $7.10
                               manipulation.
   98929  S                   Osteopathic                    997       0.69     $35.48        $7.46        $7.10
                               manipulation.
   98940  S                   Chiropractic                   997       0.69     $35.48        $7.46        $7.10
                               manipulation.
   98941  S                   Chiropractic                   997       0.69     $35.48        $7.46        $7.10
                               manipulation.
   98942  S                   Chiropractic                   997       0.69     $35.48        $7.46        $7.10
                               manipulation.
   98943  E                   Chiropractic             .........  .........  .........  ...........  ...........
                               manipulation.
   99000  E                   Specimen handling......  .........  .........  .........  ...........  ...........
   99001  N                   Specimen handling......  .........  .........  .........  ...........  ...........
   99002  E                   Device handling........  .........  .........  .........  ...........  ...........
   99024  N                   Post-op follow-up visit  .........  .........  .........  ...........  ...........
   99025  N                   Initial surgical         .........  .........  .........  ...........  ...........
                               evaluation.
   99050  E                   Medical services after   .........  .........  .........  ...........  ...........
                               hrs.
   99052  E                   Medical services at      .........  .........  .........  ...........  ...........
                               night.
   99054  E                   Medical services,        .........  .........  .........  ...........  ...........
                               unusual hrs.
   99056  E                   Non-office medical       .........  .........  .........  ...........  ...........
                               services.
   99058  E                   Office emergency care..  .........  .........  .........  ...........  ...........
   99070  E                   Special supplies.......  .........  .........  .........  ...........  ...........
   99071  E                   Patient education        .........  .........  .........  ...........  ...........
                               materials.
   99075  E                   Medical testimony......  .........  .........  .........  ...........  ...........
   99078  S                   Group health education.        921  .........  .........  ...........  ...........
   99080  E                   Special reports or       .........  .........  .........  ...........  ...........
                               forms.
   99082  E                   Unusual physician        .........  .........  .........  ...........  ...........
                               travel.
   99090  E                   Computer data analysis.  .........  .........  .........  ...........  ...........
   99100  N                   Special anesthesia       .........  .........  .........  ...........  ...........
                               service.
   99116  N                   Anesthesia with          .........  .........  .........  ...........  ...........
                               hypothermia.
   99135  N                   Special anesthesia       .........  .........  .........  ...........  ...........
                               procedure.
   99140  N                   Emergency anesthesia...  .........  .........  .........  ...........  ...........
   99141  N                   Sedation, iv/im or       .........  .........  .........  ...........  ...........
                               inhalant.
   99142  N                   Sedation, oral/rectal/   .........  .........  .........  ...........  ...........
                               nasal.
   99175  N                   Induction of vomiting..  .........  .........  .........  ...........  ...........
   99183  S                   Hyperbaric oxygen              969       2.65    $136.26      $141.70       $27.25
                               therapy.
   99185  N                   Regional hypothermia...  .........  .........  .........  ...........  ...........
   99186  N                   Total body hypothermia.  .........  .........  .........  ...........  ...........
   99190  C                   Special pump services..  .........  .........  .........  ...........  ...........
   99191  C                   Special pump services..  .........  .........  .........  ...........  ...........
   99192  C                   Special pump services..  .........  .........  .........  ...........  ...........
   99195  X                   Phlebotomy.............        999       0.43     $22.11       $11.07        $4.42
   99199  N                   Special service or       .........  .........  .........  ...........  ...........
                               report.
   99201  V                   Office/outpatient              911  .........  .........  ...........  ...........
                               visit, new.
   99202  V                   Office/outpatient              911  .........  .........  ...........  ...........
                               visit, new.
   99203  V                   Office/outpatient              913  .........  .........  ...........  ...........
                               visit, new.
   99204  V                   Office/outpatient              915  .........  .........  ...........  ...........
                               visit, new.
   99205  V                   Office/outpatient              915  .........  .........  ...........  ...........
                               visit, new.
   99211  V                   Office/outpatient              911  .........  .........  ...........  ...........
                               visit, est.
   99212  V                   Office/outpatient              911  .........  .........  ...........  ...........
                               visit, est.
   99213  V                   Office/outpatient              913  .........  .........  ...........  ...........
                               visit, est.
   99214  V                   Office/outpatient              915  .........  .........  ...........  ...........
                               visit, est.

[[Page 35372]]

 
   99215  V                   Office/outpatient              915  .........  .........  ...........  ...........
                               visit, est.
   99217  N                   Observation care         .........  .........  .........  ...........  ...........
                               discharge.
   99218  N                   Observation care.......  .........  .........  .........  ...........  ...........
   99219  N                   Observation care.......  .........  .........  .........  ...........  ...........
   99220  N                   Observation care.......  .........  .........  .........  ...........  ...........
   99221  E                   Initial hospital care..  .........  .........  .........  ...........  ...........
   99222  E                   Initial hospital care..  .........  .........  .........  ...........  ...........
   99223  E                   Initial hospital care..  .........  .........  .........  ...........  ...........
   99231  E                   Subsequent hospital      .........  .........  .........  ...........  ...........
                               care.
   99232  E                   Subsequent hospital      .........  .........  .........  ...........  ...........
                               care.
   99233  E                   Subsequent hospital      .........  .........  .........  ...........  ...........
                               care.
   99234  C                   Observ/hosp same date..  .........  .........  .........  ...........  ...........
   99235  C                   Observ/hosp same date..  .........  .........  .........  ...........  ...........
   99236  C                   Observ/hosp same date..  .........  .........  .........  ...........  ...........
   99238  E                   Hospital discharge day.  .........  .........  .........  ...........  ...........
   99239  E                   Hospital discharge day.  .........  .........  .........  ...........  ...........
   99241  V                   Office consultation....        911  .........  .........  ...........  ...........
   99242  V                   Office consultation....        911  .........  .........  ...........  ...........
   99243  V                   Office consultation....        913  .........  .........  ...........  ...........
   99244  V                   Office consultation....        915  .........  .........  ...........  ...........
   99245  V                   Office consultation....        915  .........  .........  ...........  ...........
   99251  C                   Initial inpatient        .........  .........  .........  ...........  ...........
                               consult.
   99252  C                   Initial inpatient        .........  .........  .........  ...........  ...........
                               consult.
   99253  C                   Initial inpatient        .........  .........  .........  ...........  ...........
                               consult.
   99254  C                   Initial inpatient        .........  .........  .........  ...........  ...........
                               consult.
   99255  C                   Initial inpatient        .........  .........  .........  ...........  ...........
                               consult.
   99261  C                   Follow-up inpatient      .........  .........  .........  ...........  ...........
                               consult.
   99262  C                   Follow-up inpatient      .........  .........  .........  ...........  ...........
                               consult.
   99263  C                   Follow-up inpatient      .........  .........  .........  ...........  ...........
                               consult.
   99271  V                   Confirmatory                   911  .........  .........  ...........  ...........
                               consultation.
   99272  V                   Confirmatory                   911  .........  .........  ...........  ...........
                               consultation.
   99273  V                   Confirmatory                   913  .........  .........  ...........  ...........
                               consultation.
   99274  V                   Confirmatory                   915  .........  .........  ...........  ...........
                               consultation.
   99275  V                   Confirmatory                   915  .........  .........  ...........  ...........
                               consultation.
   99281  V                   Emergency dept visit...        951  .........  .........  ...........  ...........
   99282  V                   Emergency dept visit...        951  .........  .........  ...........  ...........
   99283  V                   Emergency dept visit...        953  .........  .........  ...........  ...........
   99284  V                   Emergency dept visit...        955  .........  .........  ...........  ...........
   99285  V                   Emergency dept visit...        955  .........  .........  ...........  ...........
   99288  E                   Direct advanced life     .........  .........  .........  ...........  ...........
                               support.
   99291  S                   Critical care, first           900       7.54    $387.71      $145.09       $77.54
                               hour.
   99292  N                   Critical care, addt'l    .........  .........  .........  ...........  ...........
                               30 min.
   99295  C                   Neonatal critical care.  .........  .........  .........  ...........  ...........
   99296  C                   Neonatal critical care.  .........  .........  .........  ...........  ...........
   99297  C                   Neonatal critical care.  .........  .........  .........  ...........  ...........
   99301  E                   Nursing facility care..  .........  .........  .........  ...........  ...........
   99302  E                   Nursing facility care..  .........  .........  .........  ...........  ...........
   99303  E                   Nursing facility care..  .........  .........  .........  ...........  ...........
   99311  E                   Nursing facility care,   .........  .........  .........  ...........  ...........
                               subseq.
   99312  E                   Nursing facility care,   .........  .........  .........  ...........  ...........
                               subseq.
   99313  E                   Nursing facility care,   .........  .........  .........  ...........  ...........
                               subseq.
   99315  E                   Nursing fac discharge    .........  .........  .........  ...........  ...........
                               day.
   99316  E                   Nursing fac discharge    .........  .........  .........  ...........  ...........
                               day.
   99321  E                   Rest home visit, new     .........  .........  .........  ...........  ...........
                               patient.
   99322  E                   Rest home visit, new     .........  .........  .........  ...........  ...........
                               patient.
   99323  E                   Rest home visit, new     .........  .........  .........  ...........  ...........
                               patient.
   99331  E                   Rest home visit, estab   .........  .........  .........  ...........  ...........
                               pat.
   99332  E                   Rest home visit, estab   .........  .........  .........  ...........  ...........
                               pat.
   99333  E                   Rest home visit, estab   .........  .........  .........  ...........  ...........
                               pat.
   99341  E                   Home visit, new patient  .........  .........  .........  ...........  ...........
   99342  E                   Home visit, new patient  .........  .........  .........  ...........  ...........
   99343  E                   Home visit, new patient  .........  .........  .........  ...........  ...........
   99344  E                   Home visit, new patient  .........  .........  .........  ...........  ...........
   99345  E                   Home visit, new patient  .........  .........  .........  ...........  ...........
   99347  E                   Home visit, estab        .........  .........  .........  ...........  ...........
                               patient.
   99348  E                   Home visit, estab        .........  .........  .........  ...........  ...........
                               patient.
   99349  E                   Home visit, estab        .........  .........  .........  ...........  ...........
                               patient.
   99350  E                   Home visit, estab        .........  .........  .........  ...........  ...........
                               patient.
   99354  N                   Prolonged service,       .........  .........  .........  ...........  ...........
                               office.
   99355  N                   Prolonged service,       .........  .........  .........  ...........  ...........
                               office.
   99356  C                   Prolonged service,       .........  .........  .........  ...........  ...........
                               inpatient.
   99357  C                   Prolonged service,       .........  .........  .........  ...........  ...........
                               inpatient.
   99358  N                   Prolonged serv, w/o      .........  .........  .........  ...........  ...........
                               contact.
   99359  N                   Prolonged serv, w/o      .........  .........  .........  ...........  ...........
                               contact.
   99360  E                   Physician standby        .........  .........  .........  ...........  ...........
                               services.

[[Page 35373]]

 
   99361  E                   Physician/team           .........  .........  .........  ...........  ...........
                               conference.
   99362  E                   Physician/team           .........  .........  .........  ...........  ...........
                               conference.
   99371  E                   Physician phone          .........  .........  .........  ...........  ...........
                               consultation.
   99372  E                   Physician phone          .........  .........  .........  ...........  ...........
                               consultation.
   99373  E                   Physician phone          .........  .........  .........  ...........  ...........
                               consultation.
   99374  E                   Home health care         .........  .........  .........  ...........  ...........
                               supervision.
   99375  E                   Home health care         .........  .........  .........  ...........  ...........
                               supervision.
   99377  E                   Hospice care             .........  .........  .........  ...........  ...........
                               supervision.
   99378  E                   Hospice care             .........  .........  .........  ...........  ...........
                               supervision.
   99379  E                   Nursing fac care         .........  .........  .........  ...........  ...........
                               supervision.
   99380  E                   Nursing fac care         .........  .........  .........  ...........  ...........
                               supervision.
   99381  E                   Preventive visit, new,   .........  .........  .........  ...........  ...........
                               infant.
   99382  E                   Preventive visit, new,   .........  .........  .........  ...........  ...........
                               age 1-4.
   99383  E                   Preventive visit, new,   .........  .........  .........  ...........  ...........
                               age 5-11.
   99384  E                   Preventive visit, new,   .........  .........  .........  ...........  ...........
                               12-17.
   99385  E                   Preventive visit, new,   .........  .........  .........  ...........  ...........
                               18-39.
   99386  E                   Preventive visit, new,   .........  .........  .........  ...........  ...........
                               40-64.
   99387  E                   Preventive visit, new,   .........  .........  .........  ...........  ...........
                               65 & over.
   99391  E                   Preventive visit, est,   .........  .........  .........  ...........  ...........
                               infant.
   99392  E                   Preventive visit, est,   .........  .........  .........  ...........  ...........
                               age 1-4.
   99393  E                   Preventive visit, est,   .........  .........  .........  ...........  ...........
                               age 5-11.
   99394  E                   Preventive visit, est,   .........  .........  .........  ...........  ...........
                               12-17.
   99395  E                   Preventive visit, est,   .........  .........  .........  ...........  ...........
                               18-39.
   99396  E                   Preventive visit, est,   .........  .........  .........  ...........  ...........
                               40-64.
   99397  E                   Preventive visit, est,   .........  .........  .........  ...........  ...........
                               65 & over.
   99401  E                   Preventive counseling,   .........  .........  .........  ...........  ...........
                               indiv.
   99402  E                   Preventive counseling,   .........  .........  .........  ...........  ...........
                               indiv.
   99403  E                   Preventive counseling,   .........  .........  .........  ...........  ...........
                               indiv.
   99404  E                   Preventive counseling,   .........  .........  .........  ...........  ...........
                               indiv.
   99411  E                   Preventive counseling,   .........  .........  .........  ...........  ...........
                               group.
   99412  E                   Preventive counseling,   .........  .........  .........  ...........  ...........
                               group.
   99420  E                   Health risk assessment   .........  .........  .........  ...........  ...........
                               test.
   99429  E                   Unlisted preventive      .........  .........  .........  ...........  ...........
                               service.
   99431  N                   Initial care, normal     .........  .........  .........  ...........  ...........
                               newborn.
   99432  N                   Newborn care not in      .........  .........  .........  ...........  ...........
                               hospital.
   99433  C                   Normal newborn           .........  .........  .........  ...........  ...........
                               care,hospital.
   99435  E                   Hospital NB discharge    .........  .........  .........  ...........  ...........
                               day.
   99436  N                   Attendance, birth......  .........  .........  .........  ...........  ...........
   99440  S                   Newborn resuscitation..        947       4.11    $211.34      $106.22       $42.27
   99450  E                   Life/disability          .........  .........  .........  ...........  ...........
                               evaluation.
   99455  E                   Disability examination.  .........  .........  .........  ...........  ...........
   99456  E                   Disability examination.  .........  .........  .........  ...........  ...........
   99499  E                   Unlisted E/M service...  .........  .........  .........  ...........  ...........
   A0021  E                   Outside state ambulance  .........  .........  .........  ...........  ...........
                               serv.
   A0030  A                   Air ambulance service..  .........  .........  .........  ...........  ...........
   A0040  A                   Helicopter ambulance     .........  .........  .........  ...........  ...........
                               service.
   A0050  A                   Water amb service        .........  .........  .........  ...........  ...........
                               emergency.
   A0080  E                   Noninterest escort in    .........  .........  .........  ...........  ...........
                               non er.
   A0090  E                   Interest escort in non   .........  .........  .........  ...........  ...........
                               er.
   A0100  E                   Nonemergency transport   .........  .........  .........  ...........  ...........
                               taxi.
   A0110  E                   Nonemergency transport   .........  .........  .........  ...........  ...........
                               bus.
   A0120  E                   Noner transport mini-    .........  .........  .........  ...........  ...........
                               bus.
   A0130  E                   Noner transport wheelch  .........  .........  .........  ...........  ...........
                               van.
   A0140  E                   Nonemergency transport   .........  .........  .........  ...........  ...........
                               air.
   A0160  E                   Noner transport case     .........  .........  .........  ...........  ...........
                               worker.
   A0170  E                   Noner transport parking  .........  .........  .........  ...........  ...........
                               fees.
   A0180  E                   Noner transport lodgng   .........  .........  .........  ...........  ...........
                               recip.
   A0190  E                   Noner transport meals    .........  .........  .........  ...........  ...........
                               recip.
   A0200  E                   Noner transport lodgng   .........  .........  .........  ...........  ...........
                               escrt.
   A0210  E                   Noner transport meals    .........  .........  .........  ...........  ...........
                               escort.
   A0225  A                   Neonatal emergency       .........  .........  .........  ...........  ...........
                               transport.
   A0300  A                   Ambulance basic non-     .........  .........  .........  ...........  ...........
                               emer all.
   A0302  A                   Ambulance basic          .........  .........  .........  ...........  ...........
                               emergeny all.
   A0304  A                   Amb adv non-er no serv   .........  .........  .........  ...........  ...........
                               all.
   A0306  A                   Amb adv non-er spec      .........  .........  .........  ...........  ...........
                               serv all.
   A0308  A                   Amb adv er no spec serv  .........  .........  .........  ...........  ...........
                               all.
   A0310  A                   Amb adv er spec serv     .........  .........  .........  ...........  ...........
                               all.
   A0320  A                   Amb basic non-er +       .........  .........  .........  ...........  ...........
                               supplies.
   A0322  A                   Amb basic emerg +        .........  .........  .........  ...........  ...........
                               supplies.
   A0324  A                   Adv non-er serv sep      .........  .........  .........  ...........  ...........
                               mileage.
   A0326  A                   Adv non-er no serv sep   .........  .........  .........  ...........  ...........
                               mile.
   A0328  A                   Adv er no serv sep       .........  .........  .........  ...........  ...........
                               mileage.
   A0330  A                   Adv er spec serv sep     .........  .........  .........  ...........  ...........
                               mile.
   A0340  A                   Amb basic non-er +       .........  .........  .........  ...........  ...........
                               mileage.
   A0342  A                   Ambul basic emer +       .........  .........  .........  ...........  ...........
                               mileage.

[[Page 35374]]

 
   A0344  A                   Amb adv non-er no serv   .........  .........  .........  ...........  ...........
                               +mile.
   A0346  A                   Amb adv non-er serv +    .........  .........  .........  ...........  ...........
                               mile.
   A0348  A                   Adv emer no spec serv +  .........  .........  .........  ...........  ...........
                               mile.
   A0350  A                   Adv emer spec serv +     .........  .........  .........  ...........  ...........
                               mileage.
   A0360  A                   Basic non-er sep mile &  .........  .........  .........  ...........  ...........
                               supp.
   A0362  A                   Basic emer sep mile &    .........  .........  .........  ...........  ...........
                               supply.
   A0364  A                   Adv non-er no serv sep   .........  .........  .........  ...........  ...........
                               mi&su.
   A0366  A                   Adv non-er serv sep      .........  .........  .........  ...........  ...........
                               mil&supp.
   A0368  A                   Adv er no serv sep       .........  .........  .........  ...........  ...........
                               mile&supp.
   A0370  A                   Adv er spec serv sep     .........  .........  .........  ...........  ...........
                               mi&supp.
   A0380  A                   Basic life support       .........  .........  .........  ...........  ...........
                               mileage.
   A0382  A                   Basic support routine    .........  .........  .........  ...........  ...........
                               suppls.
   A0384  A                   Bls defibrillation       .........  .........  .........  ...........  ...........
                               supplies.
   A0390  A                   Advanced life support    .........  .........  .........  ...........  ...........
                               mileag.
   A0392  A                   Als defibrillation       .........  .........  .........  ...........  ...........
                               supplies.
   A0394  A                   Als IV drug therapy      .........  .........  .........  ...........  ...........
                               supplies.
   A0396  A                   Als esophageal intub     .........  .........  .........  ...........  ...........
                               suppls.
   A0398  A                   Als routine disposble    .........  .........  .........  ...........  ...........
                               suppls.
   A0420  A                   Ambulance waiting 1/2    .........  .........  .........  ...........  ...........
                               hr.
   A0422  A                   Ambulance 02 life        .........  .........  .........  ...........  ...........
                               sustaining.
   A0424  A                   Extra ambulance          .........  .........  .........  ...........  ...........
                               attendant.
   A0888  E                   Noncovered ambulance     .........  .........  .........  ...........  ...........
                               mileage.
   A0999  A                   Unlisted ambulance       .........  .........  .........  ...........  ...........
                               service.
   A4206  A                   1 CC sterile syringe &   .........  .........  .........  ...........  ...........
                               needle.
   A4207  A                   2 CC sterile syringe &   .........  .........  .........  ...........  ...........
                               needle.
   A4208  A                   3 CC sterile syringe &   .........  .........  .........  ...........  ...........
                               needle.
   A4209  A                   5+ CC sterile syringe &  .........  .........  .........  ...........  ...........
                               needle.
   A4210  E                   Nonneedle injection      .........  .........  .........  ...........  ...........
                               device.
   A4211  A                   Supp for self-adm        .........  .........  .........  ...........  ...........
                               injections.
   A4212  A                   Non coring needle or     .........  .........  .........  ...........  ...........
                               stylet.
   A4213  A                   20+ CC syringe only....  .........  .........  .........  ...........  ...........
   A4214  A                   30 CC sterile water/     .........  .........  .........  ...........  ...........
                               saline.
   A4215  A                   Sterile needle.........  .........  .........  .........  ...........  ...........
   A4220  A                   Infusion pump refill     .........  .........  .........  ...........  ...........
                               kit.
   A4221  A                   Maint drug infus cath    .........  .........  .........  ...........  ...........
                               per wk.
   A4222  A                   Drug infusion pump       .........  .........  .........  ...........  ...........
                               supplies.
   A4230  E                   Infus insulin pump non   .........  .........  .........  ...........  ...........
                               needl.
   A4231  E                   Infusion insulin pump    .........  .........  .........  ...........  ...........
                               needle.
   A4232  E                   Syringe w/needle         .........  .........  .........  ...........  ...........
                               insulin 3cc.
   A4244  A                   Alcohol or peroxide per  .........  .........  .........  ...........  ...........
                               pint.
   A4245  A                   Alcohol wipes per box..  .........  .........  .........  ...........  ...........
   A4246  A                   Betadine/phisohex        .........  .........  .........  ...........  ...........
                               solution.
   A4247  A                   Betadine/iodine swabs/   .........  .........  .........  ...........  ...........
                               wipes.
   A4250  E                   Urine reagent strips/    .........  .........  .........  ...........  ...........
                               tablets.
   A4253  A                   Blood glucose/reagent    .........  .........  .........  ...........  ...........
                               strips.
   A4254  A                   Battery for glucose      .........  .........  .........  ...........  ...........
                               monitor.
   A4255  A                   Glucose monitor          .........  .........  .........  ...........  ...........
                               platforms.
   A4256  A                   Calibrator solution/     .........  .........  .........  ...........  ...........
                               chips.
   A4258  A                   Lancet device each.....  .........  .........  .........  ...........  ...........
   A4259  A                   Lancets per box........  .........  .........  .........  ...........  ...........
   A4260  E                   Levonorgestrel implant.  .........  .........  .........  ...........  ...........
   A4262  N                   Temporary tear duct      .........  .........  .........  ...........  ...........
                               plug.
   A4263  A                   Permanent tear duct      .........  .........  .........  ...........  ...........
                               plug.
   A4265  A                   Paraffin...............  .........  .........  .........  ...........  ...........
   A4270  A                   Disposable endoscope     .........  .........  .........  ...........  ...........
                               sheath.
   A4300  A                   Cath impl vasc access    .........  .........  .........  ...........  ...........
                               portal.
   A4301  A                   Implantable access syst  .........  .........  .........  ...........  ...........
                               perc.
   A4305  A                   Drug delivery system     .........  .........  .........  ...........  ...........
                               =50 ML.
   A4306  A                   Drug delivery system     .........  .........  .........  ...........  ...........
                               <=5 ML.
   A4310  A                   Insert tray w/o bag/     .........  .........  .........  ...........  ...........
                               cath.
   A4311  A                   Catheter w/o bag 2-way   .........  .........  .........  ...........  ...........
                               latex.
   A4312  A                   Cath w/o bag 2-way       .........  .........  .........  ...........  ...........
                               silicone.
   A4313  A                   Catheter w/bag 3-way...  .........  .........  .........  ...........  ...........
   A4314  A                   Cath w/drainage 2-way    .........  .........  .........  ...........  ...........
                               latex.
   A4315  A                   Cath w/drainage 2-way    .........  .........  .........  ...........  ...........
                               silcne.
   A4316  A                   Cath w/drainage 3-way..  .........  .........  .........  ...........  ...........
   A4320  A                   Irrigation tray........  .........  .........  .........  ...........  ...........
   A4321  A                   Cath therapeutic irrig   .........  .........  .........  ...........  ...........
                               agent.
   A4322  A                   Irrigation syringe.....  .........  .........  .........  ...........  ...........
   A4323  A                   Saline irrigation        .........  .........  .........  ...........  ...........
                               solution.
   A4326  A                   Male external catheter.  .........  .........  .........  ...........  ...........
   A4327  A                   Fem urinary collect dev  .........  .........  .........  ...........  ...........
                               cup.
   A4328  A                   Fem urinary collect      .........  .........  .........  ...........  ...........
                               pouch.
   A4329  A                   External catheter start  .........  .........  .........  ...........  ...........
                               set.
   A4330  A                   Stool collection pouch.  .........  .........  .........  ...........  ...........

[[Page 35375]]

 
   A4335  A                   Incontinence supply....  .........  .........  .........  ...........  ...........
   A4338  A                   Indwelling catheter      .........  .........  .........  ...........  ...........
                               latex.
   A4340  A                   Indwelling catheter      .........  .........  .........  ...........  ...........
                               special.
   A4344  A                   Cath indw foley 2 way    .........  .........  .........  ...........  ...........
                               silicn.
   A4346  A                   Cath indw foley 3 way..  .........  .........  .........  ...........  ...........
   A4347  A                   Male external catheter.  .........  .........  .........  ...........  ...........
   A4351  A                   Straight tip urine       .........  .........  .........  ...........  ...........
                               catheter.
   A4352  A                   Coude tip urinary        .........  .........  .........  ...........  ...........
                               catheter.
   A4353  A                   Intermittent urinary     .........  .........  .........  ...........  ...........
                               cath.
   A4354  A                   Cath insertion tray w/   .........  .........  .........  ...........  ...........
                               bag.
   A4355  A                   Bladder irrigation       .........  .........  .........  ...........  ...........
                               tubing.
   A4356  A                   Ext ureth clmp or compr  .........  .........  .........  ...........  ...........
                               dvc.
   A4357  A                   Bedside drainage bag...  .........  .........  .........  ...........  ...........
   A4358  A                   Urinary leg bag........  .........  .........  .........  ...........  ...........
   A4359  A                   Urinary suspensory w/o   .........  .........  .........  ...........  ...........
                               leg b.
   A4361  A                   Ostomy face plate......  .........  .........  .........  ...........  ...........
   A4362  A                   Solid skin barrier.....  .........  .........  .........  ...........  ...........
   A4363  A                   Liquid skin barrier....  .........  .........  .........  ...........  ...........
   A4364  A                   Ostomy/cath adhesive...  .........  .........  .........  ...........  ...........
   A4365  A                   Ostomy adhesive remover  .........  .........  .........  ...........  ...........
                               wipe.
   A4367  A                   Ostomy belt............  .........  .........  .........  ...........  ...........
   A4368  A                   Ostomy filter..........  .........  .........  .........  ...........  ...........
   A4397  A                   Irrigation supply        .........  .........  .........  ...........  ...........
                               sleeve.
   A4398  A                   Ostomy irrigation bag..  .........  .........  .........  ...........  ...........
   A4399  A                   Ostomy irrig cone/cath   .........  .........  .........  ...........  ...........
                               w brs.
   A4400  A                   Ostomy irrigation set..  .........  .........  .........  ...........  ...........
   A4402  A                   Lubricant per ounce....  .........  .........  .........  ...........  ...........
   A4404  A                   Ostomy ring each.......  .........  .........  .........  ...........  ...........
   A4421  A                   Ostomy supply misc.....  .........  .........  .........  ...........  ...........
   A4454  A                   Tape all types all       .........  .........  .........  ...........  ...........
                               sizes.
   A4455  A                   Adhesive remover per     .........  .........  .........  ...........  ...........
                               ounce.
   A4460  A                   Elastic compression      .........  .........  .........  ...........  ...........
                               bandage.
   A4462  A                   Abdmnl drssng holder/    .........  .........  .........  ...........  ...........
                               binder.
   A4465  A                   Non-elastic extremity    .........  .........  .........  ...........  ...........
                               binder.
   A4470  A                   Gravlee jet washer.....  .........  .........  .........  ...........  ...........
   A4480  A                   Vabra aspirator........  .........  .........  .........  ...........  ...........
   A4481  A                   Tracheostoma filter....  .........  .........  .........  ...........  ...........
   A4490  E                   Above knee surgical      .........  .........  .........  ...........  ...........
                               stocking.
   A4495  E                   Thigh length surg        .........  .........  .........  ...........  ...........
                               stocking.
   A4500  E                   Below knee surgical      .........  .........  .........  ...........  ...........
                               stocking.
   A4510  E                   Full length surg         .........  .........  .........  ...........  ...........
                               stocking.
   A4550  E                   Surgical trays.........  .........  .........  .........  ...........  ...........
   A4554  E                   Disposable underpads...  .........  .........  .........  ...........  ...........
   A4556  A                   Electrodes.............  .........  .........  .........  ...........  ...........
   A4557  A                   Lead wires.............  .........  .........  .........  ...........  ...........
   A4558  A                   Conductive paste or gel  .........  .........  .........  ...........  ...........
   A4560  A                   Pessary................  .........  .........  .........  ...........  ...........
   A4565  A                   Slings.................  .........  .........  .........  ...........  ...........
   A4570  A                   Splint.................  .........  .........  .........  ...........  ...........
   A4572  A                   Rib belt...............  .........  .........  .........  ...........  ...........
   A4575  E                   Hyperbaric o2 chamber    .........  .........  .........  ...........  ...........
                               disps.
   A4580  A                   Cast supplies (plaster)  .........  .........  .........  ...........  ...........
   A4590  A                   Special casting          .........  .........  .........  ...........  ...........
                               material.
   A4595  A                   TENS suppl 2 lead per    .........  .........  .........  ...........  ...........
                               month.
   A4611  A                   Heavy duty battery.....  .........  .........  .........  ...........  ...........
   A4612  A                   Battery cables.........  .........  .........  .........  ...........  ...........
   A4613  A                   Battery charger........  .........  .........  .........  ...........  ...........
   A4615  A                   Cannula nasal..........  .........  .........  .........  ...........  ...........
   A4616  A                   Tubing (oxygen) per      .........  .........  .........  ...........  ...........
                               foot.
   A4617  A                   Mouth piece............  .........  .........  .........  ...........  ...........
   A4618  A                   Breathing circuits.....  .........  .........  .........  ...........  ...........
   A4619  A                   Face tent..............  .........  .........  .........  ...........  ...........
   A4620  A                   Variable concentration   .........  .........  .........  ...........  ...........
                               mask.
   A4621  A                   Tracheotomy mask or      .........  .........  .........  ...........  ...........
                               collar.
   A4622  A                   Tracheostomy or          .........  .........  .........  ...........  ...........
                               larngectomy.
   A4623  A                   Tracheostomy inner       .........  .........  .........  ...........  ...........
                               cannula.
   A4624  A                   Tracheal suction tube..  .........  .........  .........  ...........  ...........
   A4625  A                   Trach care kit for new   .........  .........  .........  ...........  ...........
                               trach.
   A4626  A                   Tracheostomy cleaning    .........  .........  .........  ...........  ...........
                               brush.
   A4627  E                   Spacer bag/reservoir...  .........  .........  .........  ...........  ...........
   A4628  A                   Oropharyngeal suction    .........  .........  .........  ...........  ...........
                               cath.
   A4629  A                   Tracheostomy care kit..  .........  .........  .........  ...........  ...........
   A4630  A                   Repl bat t.e.n.s. own    .........  .........  .........  ...........  ...........
                               by pt.
   A4631  A                   Wheelchair battery.....  .........  .........  .........  ...........  ...........
   A4635  A                   Underarm crutch pad....  .........  .........  .........  ...........  ...........

[[Page 35376]]

 
   A4636  A                   Handgrip for cane etc..  .........  .........  .........  ...........  ...........
   A4637  A                   Repl tip cane/crutch/    .........  .........  .........  ...........  ...........
                               walker.
   A4640  A                   Alternating pressure     .........  .........  .........  ...........  ...........
                               pad.
   A4641  N                   Diagnostic imaging       .........  .........  .........  ...........  ...........
                               agent.
   A4642  N                   Satumomab pendetide per  .........  .........  .........  ...........  ...........
                               dose.
   A4643  N                   High dose contrast MRI.  .........  .........  .........  ...........  ...........
   A4644  N                   Contrast 100-199 MGs     .........  .........  .........  ...........  ...........
                               iodine.
   A4645  N                   Contrast 200-299 MGs     .........  .........  .........  ...........  ...........
                               iodine.
   A4646  N                   Contrast 300-399 MGs     .........  .........  .........  ...........  ...........
                               iodine.
   A4647  N                   Supp- paramagnetic       .........  .........  .........  ...........  ...........
                               contr mat.
   A4649  A                   Surgical supplies......  .........  .........  .........  ...........  ...........
   A4650  A                   Supp esrd centrifuge...  .........  .........  .........  ...........  ...........
   A4655  A                   Esrd syringe/needle....  .........  .........  .........  ...........  ...........
   A4660  A                   Esrd blood pressure      .........  .........  .........  ...........  ...........
                               device.
   A4663  A                   Esrd blood pressure      .........  .........  .........  ...........  ...........
                               cuff.
   A4670  E                   Auto blood pressure      .........  .........  .........  ...........  ...........
                               monitor.
   A4680  A                   Activated carbon         .........  .........  .........  ...........  ...........
                               filters.
   A4690  A                   Dialyzers..............  .........  .........  .........  ...........  ...........
   A4700  A                   Standard dialysate       .........  .........  .........  ...........  ...........
                               solution.
   A4705  A                   Bicarb dialysate         .........  .........  .........  ...........  ...........
                               solution.
   A4712  A                   Sterile water..........  .........  .........  .........  ...........  ...........
   A4714  A                   Treated water for        .........  .........  .........  ...........  ...........
                               dialysis.
   A4730  A                   Fistula cannulation set  .........  .........  .........  ...........  ...........
                               dial.
   A4735  A                   Local/topical            .........  .........  .........  ...........  ...........
                               anesthetics.
   A4740  A                   Esrd shunt accessory...  .........  .........  .........  ...........  ...........
   A4750  A                   Arterial or venous       .........  .........  .........  ...........  ...........
                               tubing.
   A4755  A                   Arterial and venous      .........  .........  .........  ...........  ...........
                               tubing.
   A4760  A                   Standard testing         .........  .........  .........  ...........  ...........
                               solution.
   A4765  A                   Dialysate concentrate..  .........  .........  .........  ...........  ...........
   A4770  A                   Blood testing supplies.  .........  .........  .........  ...........  ...........
   A4771  A                   Blood clotting time      .........  .........  .........  ...........  ...........
                               tube.
   A4772  A                   Dextrostick/glucose      .........  .........  .........  ...........  ...........
                               strips.
   A4773  A                   Hemostix...............  .........  .........  .........  ...........  ...........
   A4774  A                   Ammonia test paper.....  .........  .........  .........  ...........  ...........
   A4780  A                   Esrd sterilizing agent.  .........  .........  .........  ...........  ...........
   A4790  A                   Esrd cleansing agents..  .........  .........  .........  ...........  ...........
   A4800  A                   Heparin/antidote         .........  .........  .........  ...........  ...........
                               dialysis.
   A4820  A                   Supplies hemodialysis    .........  .........  .........  ...........  ...........
                               kit.
   A4850  A                   Rubber tipped hemostats  .........  .........  .........  ...........  ...........
   A4860  A                   Disposable catheter      .........  .........  .........  ...........  ...........
                               caps.
   A4870  A                   Plumbing/electrical      .........  .........  .........  ...........  ...........
                               work.
   A4880  A                   Water storage tanks....  .........  .........  .........  ...........  ...........
   A4890  A                   Contracts/repair/        .........  .........  .........  ...........  ...........
                               maintenance.
   A4900  A                   Capd supply kit........  .........  .........  .........  ...........  ...........
   A4901  A                   Ccpd supply kit........  .........  .........  .........  ...........  ...........
   A4905  A                   Ipd supply kit.........  .........  .........  .........  ...........  ...........
   A4910  A                   Esrd nonmedical          .........  .........  .........  ...........  ...........
                               supplies.
   A4912  A                   Gomco drain bottle.....  .........  .........  .........  ...........  ...........
   A4913  A                   Esrd supply............  .........  .........  .........  ...........  ...........
   A4914  A                   Preparation kit........  .........  .........  .........  ...........  ...........
   A4918  A                   Venous pressure clamp..  .........  .........  .........  ...........  ...........
   A4919  A                   Supp dialysis dialyzer   .........  .........  .........  ...........  ...........
                               holde.
   A4920  A                   Harvard pressure clamp.  .........  .........  .........  ...........  ...........
   A4921  A                   Measuring cylinder.....  .........  .........  .........  ...........  ...........
   A4927  A                   Gloves.................  .........  .........  .........  ...........  ...........
   A5051  A                   Pouch clsd w barr        .........  .........  .........  ...........  ...........
                               attached.
   A5052  A                   Clsd ostomy pouch w/o    .........  .........  .........  ...........  ...........
                               barr.
   A5053  A                   Clsd ostomy pouch        .........  .........  .........  ...........  ...........
                               faceplate.
   A5054  A                   Clsd ostomy pouch w/     .........  .........  .........  ...........  ...........
                               flange.
   A5055  A                   Stoma cap..............  .........  .........  .........  ...........  ...........
   A5061  A                   Pouch drainable w        .........  .........  .........  ...........  ...........
                               barrier at.
   A5062  A                   Drnble ostomy pouch w/o  .........  .........  .........  ...........  ...........
                               barr.
   A5063  A                   Drain ostomy pouch w/    .........  .........  .........  ...........  ...........
                               flange.
   A5064  E                   Drain ostomy pouch w/    .........  .........  .........  ...........  ...........
                               fceplte.
   A5065  E                   Drain ostomy pouch on    .........  .........  .........  ...........  ...........
                               fcplte.
   A5071  A                   Urinary pouch w/barrier  .........  .........  .........  ...........  ...........
   A5072  A                   Urinary pouch w/o        .........  .........  .........  ...........  ...........
                               barrier.
   A5073  A                   Urinary pouch on barr w/ .........  .........  .........  ...........  ...........
                               flng.
   A5074  E                   Urinary pouch w/         .........  .........  .........  ...........  ...........
                               faceplate.
   A5075  E                   Urinary pouch on         .........  .........  .........  ...........  ...........
                               faceplate.
   A5081  A                   Continent stoma plug...  .........  .........  .........  ...........  ...........
   A5082  A                   Continent stoma          .........  .........  .........  ...........  ...........
                               catheter.
   A5093  A                   Ostomy accessory convex  .........  .........  .........  ...........  ...........
                               inse.
   A5102  A                   Bedside drain btl w/wo   .........  .........  .........  ...........  ...........
                               tube.
   A5105  A                   Urinary suspensory.....  .........  .........  .........  ...........  ...........

[[Page 35377]]

 
   A5112  A                   Urinary leg bag........  .........  .........  .........  ...........  ...........
   A5113  A                   Latex leg strap........  .........  .........  .........  ...........  ...........
   A5114  A                   Foam/fabric leg strap..  .........  .........  .........  ...........  ...........
   A5119  A                   Skin barrier wipes box   .........  .........  .........  ...........  ...........
                               pr 50.
   A5121  A                   Solid skin barrier 6x6.  .........  .........  .........  ...........  ...........
   A5122  A                   Solid skin barrier 8x8.  .........  .........  .........  ...........  ...........
   A5123  A                   Skin barrier with        .........  .........  .........  ...........  ...........
                               flange.
   A5126  A                   Adhesive disc/foam pad.  .........  .........  .........  ...........  ...........
   A5131  A                   Appliance cleaner......  .........  .........  .........  ...........  ...........
   A5149  A                   Incontinence/ostomy      .........  .........  .........  ...........  ...........
                               supply.
   A5500  A                   Diab shoe for density    .........  .........  .........  ...........  ...........
                               insert.
   A5501  A                   Diabetic custom molded   .........  .........  .........  ...........  ...........
                               shoe.
   A5502  A                   Diabetic shoe density    .........  .........  .........  ...........  ...........
                               insert.
   A5503  A                   Diabetic shoe w/roller/  .........  .........  .........  ...........  ...........
                               rockr.
   A5504  A                   Diabetic shoe with       .........  .........  .........  ...........  ...........
                               wedge.
   A5505  A                   Diab shoe w/metatarsal   .........  .........  .........  ...........  ...........
                               bar.
   A5506  A                   Diabetic shoe w/off set  .........  .........  .........  ...........  ...........
                               heel.
   A5507  A                   Modification diabetic    .........  .........  .........  ...........  ...........
                               shoe.
   A6020  A                   Collagen wound dressing  .........  .........  .........  ...........  ...........
   A6025  E                   Silicone gel sheet,      .........  .........  .........  ...........  ...........
                               each.
   A6154  A                   Wound pouch each.......  .........  .........  .........  ...........  ...........
   A6196  A                   Alginate dressing <=16   .........  .........  .........  ...........  ...........
                               sq in.
   A6197  A                   Alginate drsg >16 <=48   .........  .........  .........  ...........  ...........
                               sq in.
   A6198  A                   alginate dressing > 48   .........  .........  .........  ...........  ...........
                               sq in.
   A6199  A                   Alginate drsg wound      .........  .........  .........  ...........  ...........
                               filler.
   A6203  A                   Composite drsg <= 16 sq  .........  .........  .........  ...........  ...........
                               in.
   A6204  A                   Composite drsg >16<=48   .........  .........  .........  ...........  ...........
                               sq in.
   A6205  A                   Composite drsg > 48 sq   .........  .........  .........  ...........  ...........
                               in.
   A6206  A                   Contact layer <= 16 sq   .........  .........  .........  ...........  ...........
                               in.
   A6207  A                   Contact layer >16<= 48   .........  .........  .........  ...........  ...........
                               sq in.
   A6208  A                   Contact layer > 48 sq    .........  .........  .........  ...........  ...........
                               in.
   A6209  A                   Foam drsg <=16 sq in w/  .........  .........  .........  ...........  ...........
                               o bdr.
   A6210  A                   Foam drg >16<=48 sq in   .........  .........  .........  ...........  ...........
                               w/o b.
   A6211  A                   Foam drg > 48 sq in w/o  .........  .........  .........  ...........  ...........
                               brdr.
   A6212  A                   Foam drg <=16 sq in w/   .........  .........  .........  ...........  ...........
                               border.
   A6213  A                   Foam drg >16<=48 sq in   .........  .........  .........  ...........  ...........
                               w/bdr.
   A6214  A                   Foam drg > 48 sq in w/   .........  .........  .........  ...........  ...........
                               border.
   A6215  A                   Foam dressing wound      .........  .........  .........  ...........  ...........
                               filler.
   A6216  A                   Non-sterile gauze<=16    .........  .........  .........  ...........  ...........
                               sq in.
   A6217  A                   Non-sterile gauze        .........  .........  .........  ...........  ...........
                               >16<=48 sq.
   A6218  A                   Non-sterile gauze > 48   .........  .........  .........  ...........  ...........
                               sq in.
   A6219  A                   Gauze <= 16 sq in w/     .........  .........  .........  ...........  ...........
                               border.
   A6220  A                   Gauze >16 <=48 sq in w/  .........  .........  .........  ...........  ...........
                               bordr.
   A6221  A                   Gauze > 48 sq in w/      .........  .........  .........  ...........  ...........
                               border.
   A6222  A                   Gauze <=16 in no w/sal   .........  .........  .........  ...........  ...........
                               w/o b.
   A6223  A                   Gauze >16<=48 no w/sal   .........  .........  .........  ...........  ...........
                               w/o b.
   A6224  A                   Gauze > 48 in no w/sal   .........  .........  .........  ...........  ...........
                               w/o b.
   A6228  A                   Gauze <= 16 sq in water/ .........  .........  .........  ...........  ...........
                               sal.
   A6229  A                   Gauze >16<=48 sq in      .........  .........  .........  ...........  ...........
                               watr/sal.
   A6230  A                   Gauze > 48 sq in water/  .........  .........  .........  ...........  ...........
                               salne.
   A6234  A                   Hydrocolld drg <=16 w/o  .........  .........  .........  ...........  ...........
                               bdr.
   A6235  A                   Hydrocolld drg >16<=48   .........  .........  .........  ...........  ...........
                               w/o b.
   A6236  A                   Hydrocolld drg > 48 in   .........  .........  .........  ...........  ...........
                               w/o b.
   A6237  A                   Hydrocolld drg <=16 in   .........  .........  .........  ...........  ...........
                               w/bdr.
   A6238  A                   Hydrocolld drg >16<=48   .........  .........  .........  ...........  ...........
                               w/bdr.
   A6239  A                   Hydrocolld drg > 48 in   .........  .........  .........  ...........  ...........
                               w/bdr.
   A6240  A                   Hydrocolld drg filler    .........  .........  .........  ...........  ...........
                               paste.
   A6241  A                   Hydrocolloid drg filler  .........  .........  .........  ...........  ...........
                               dry.
   A6242  A                   Hydrogel drg <=16 in w/  .........  .........  .........  ...........  ...........
                               o bdr.
   A6243  A                   Hydrogel drg >16<=48 w/  .........  .........  .........  ...........  ...........
                               o bdr.
   A6244  A                   Hydrogel drg >48 in w/o  .........  .........  .........  ...........  ...........
                               bdr.
   A6245  A                   Hydrogel drg <= 16 in w/ .........  .........  .........  ...........  ...........
                               bdr.
   A6246  A                   Hydrogel drg >16<=48 in  .........  .........  .........  ...........  ...........
                               w/b.
   A6247  A                   Hydrogel drg > 48 sq in  .........  .........  .........  ...........  ...........
                               w/b.
   A6248  A                   Hydrogel drsg gel        .........  .........  .........  ...........  ...........
                               filler.
   A6250  A                   Skin seal protect        .........  .........  .........  ...........  ...........
                               moisturizr.
   A6251  A                   Absorpt drg <=16 sq in   .........  .........  .........  ...........  ...........
                               w/o b.
   A6252  A                   Absorpt drg >16 <=48 w/  .........  .........  .........  ...........  ...........
                               o bdr.
   A6253  A                   Absorpt drg > 48 sq in   .........  .........  .........  ...........  ...........
                               w/o b.
   A6254  A                   Absorpt drg <=16 sq in   .........  .........  .........  ...........  ...........
                               w/bdr.
   A6255  A                   Absorpt drg >16<=48 in   .........  .........  .........  ...........  ...........
                               w/bdr.
   A6256  A                   Absorpt drg > 48 sq in   .........  .........  .........  ...........  ...........
                               w/bdr.
   A6257  A                   Transparent film <= 16   .........  .........  .........  ...........  ...........
                               sq in.
   A6258  A                   Transparent film         .........  .........  .........  ...........  ...........
                               >16<=48 in.
   A6259  A                   Transparent film > 48    .........  .........  .........  ...........  ...........
                               sq in.

[[Page 35378]]

 
   A6260  A                   Wound cleanser any type/ .........  .........  .........  ...........  ...........
                               size.
   A6261  A                   Wound filler gel/paste / .........  .........  .........  ...........  ...........
                               oz.
   A6262  A                   Wound filler dry form /  .........  .........  .........  ...........  ...........
                               gram.
   A6263  A                   Non-sterile elastic      .........  .........  .........  ...........  ...........
                               gauze/yd.
   A6264  A                   Non-sterile no elastic   .........  .........  .........  ...........  ...........
                               gauze.
   A6265  A                   Tape per 18 sq inches..  .........  .........  .........  ...........  ...........
   A6266  A                   Impreg gauze no h20/sal/ .........  .........  .........  ...........  ...........
                               yard.
   A6402  A                   Sterile gauze <= 16 sq   .........  .........  .........  ...........  ...........
                               in.
   A6403  A                   Sterile gauze >16 <= 48  .........  .........  .........  ...........  ...........
                               sq in.
   A6404  A                   Sterile gauze > 48 sq    .........  .........  .........  ...........  ...........
                               in.
   A6405  A                   Sterile elastic gauze /  .........  .........  .........  ...........  ...........
                               yd.
   A6406  A                   Sterile non-elastic      .........  .........  .........  ...........  ...........
                               gauze/yd.
   A9150  E                   Misc/exper non-          .........  .........  .........  ...........  ...........
                               prescript dru.
   A9160  E                   Podiatrist non-covered   .........  .........  .........  ...........  ...........
                               servi.
   A9170  E                   Chiropractor non-        .........  .........  .........  ...........  ...........
                               covered ser.
   A9190  E                   Misc/expe personal       .........  .........  .........  ...........  ...........
                               comfort i.
   A9270  E                   Non-covered item or      .........  .........  .........  ...........  ...........
                               service.
   A9300  E                   Exercise equipment.....  .........  .........  .........  ...........  ...........
   A9500  N                   Technetium TC 99m        .........  .........  .........  ...........  ...........
                               sestamibi.
   A9502  N                   Technetium TC99M         .........  .........  .........  ...........  ...........
                               tetrofosmin.
   A9503  N                   Technetium TC 99m        .........  .........  .........  ...........  ...........
                               medronate.
   A9505  N                   Thallous chloride TL     .........  .........  .........  ...........  ...........
                               201/mci.
   A9600  N                   Strontium-89 chloride..  .........  .........  .........  ...........  ...........
   B4034  A                   Enter feed supkit syr    .........  .........  .........  ...........  ...........
                               by day.
   B4035  A                   Enteral feed supp pump   .........  .........  .........  ...........  ...........
                               per d.
   B4036  A                   Enteral feed sup kit     .........  .........  .........  ...........  ...........
                               grav by.
   B4081  A                   Enteral ng tubing w/     .........  .........  .........  ...........  ...........
                               stylet.
   B4082  A                   Enteral ng tubing w/o    .........  .........  .........  ...........  ...........
                               stylet.
   B4083  A                   Enteral stomach tube     .........  .........  .........  ...........  ...........
                               levine.
   B4084  A                   Gastrostomy/jejunostomy  .........  .........  .........  ...........  ...........
                               tubi.
   B4085  A                   Gastrostomy tube w/ring  .........  .........  .........  ...........  ...........
                               each.
   B4150  A                   Enteral formulae         .........  .........  .........  ...........  ...........
                               category i.
   B4151  A                   Enteral formulae         .........  .........  .........  ...........  ...........
                               category i-.
   B4152  A                   Enteral formulae         .........  .........  .........  ...........  ...........
                               category ii.
   B4153  A                   Enteral formulae         .........  .........  .........  ...........  ...........
                               category ii.
   B4154  A                   Enteral formulae         .........  .........  .........  ...........  ...........
                               category IV.
   B4155  A                   Enteral formulae         .........  .........  .........  ...........  ...........
                               category v.
   B4156  A                   Enteral formulae         .........  .........  .........  ...........  ...........
                               category vi.
   B4164  A                   Parenteral 50% dextrose  .........  .........  .........  ...........  ...........
                               solu.
   B4168  A                   Parenteral sol amino     .........  .........  .........  ...........  ...........
                               acid 3..
   B4172  A                   Parenteral sol amino     .........  .........  .........  ...........  ...........
                               acid 5..
   B4176  A                   Parenteral sol amino     .........  .........  .........  ...........  ...........
                               acid 7-.
   B4178  A                   Parenteral sol amino     .........  .........  .........  ...........  ...........
                               acid >.
   B4180  A                   Parenteral sol carb >    .........  .........  .........  ...........  ...........
                               50%.
   B4184  A                   Parenteral sol lipids    .........  .........  .........  ...........  ...........
                               10%.
   B4186  A                   Parenteral sol lipids    .........  .........  .........  ...........  ...........
                               20%.
   B4189  A                   Parenteral sol amino     .........  .........  .........  ...........  ...........
                               acid &.
   B4193  A                   Parenteral sol 52-73 gm  .........  .........  .........  ...........  ...........
                               prot.
   B4197  A                   Parenteral sol 74-100    .........  .........  .........  ...........  ...........
                               gm pro.
   B4199  A                   Parenteral sol > 100gm   .........  .........  .........  ...........  ...........
                               prote.
   B4216  A                   Parenteral nutrition     .........  .........  .........  ...........  ...........
                               additiv.
   B4220  A                   Parenteral supply kit    .........  .........  .........  ...........  ...........
                               premix.
   B4222  A                   Parenteral supply kit    .........  .........  .........  ...........  ...........
                               homemi.
   B4224  A                   Parenteral               .........  .........  .........  ...........  ...........
                               administration ki.
   B5000  A                   Parenteral sol renal-    .........  .........  .........  ...........  ...........
                               amirosy.
   B5100  A                   Parenteral sol hepatic-  .........  .........  .........  ...........  ...........
                               fream.
   B5200  A                   Parenteral sol stres-    .........  .........  .........  ...........  ...........
                               brnch c.
   B9000  A                   Enter infusion pump w/o  .........  .........  .........  ...........  ...........
                               alrm.
   B9002  A                   Enteral infusion pump w/ .........  .........  .........  ...........  ...........
                                ala.
   B9004  A                   Parenteral infus pump    .........  .........  .........  ...........  ...........
                               portab.
   B9006  A                   Parenteral infus pump    .........  .........  .........  ...........  ...........
                               statio.
   B9998  A                   Enteral supp not         .........  .........  .........  ...........  ...........
                               otherwise c.
   B9999  A                   Parenteral supp not      .........  .........  .........  ...........  ...........
                               othrws c.
   D0120  E                   Periodic oral            .........  .........  .........  ...........  ...........
                               evaluation.
   D0140  E                   Limit oral eval problm   .........  .........  .........  ...........  ...........
                               focus.
   D0150  S                   Comprehensve oral              031       1.37     $70.45       $14.09       $14.09
                               evaluation.
   D0160  E                   Extensv oral eval prob   .........  .........  .........  ...........  ...........
                               focus.
   D0210  E                   Intraor complete film    .........  .........  .........  ...........  ...........
                               series.
   D0220  E                   Intraoral periapical     .........  .........  .........  ...........  ...........
                               first f.
   D0230  E                   Intraoral periapical ea  .........  .........  .........  ...........  ...........
                               add.
   D0240  S                   Intraoral occlusal film        031       1.37     $70.45       $14.09       $14.09
   D0250  S                   Extraoral first film...        031       1.37     $70.45       $14.09       $14.09
   D0260  S                   Extraoral ea additional        031       1.37     $70.45       $14.09       $14.09
                               film.
   D0270  S                   Dental bitewing single         031       1.37     $70.45       $14.09       $14.09
                               film.
   D0272  S                   Dental bitewings two           031       1.37     $70.45       $14.09       $14.09
                               films.

[[Page 35379]]

 
   D0274  S                   Dental bitewings four          031       1.37     $70.45       $14.09       $14.09
                               films.
   D0290  E                   Dental film skull/       .........  .........  .........  ...........  ...........
                               facial bon.
   D0310  E                   Dental saliography.....  .........  .........  .........  ...........  ...........
   D0320  E                   Dental tmj arthrogram    .........  .........  .........  ...........  ...........
                               incl i.
   D0321  E                   Dental other tmj films.  .........  .........  .........  ...........  ...........
   D0322  E                   Dental tomographic       .........  .........  .........  ...........  ...........
                               survey.
   D0330  E                   Dental panoramic film..  .........  .........  .........  ...........  ...........
   D0340  E                   Dental cephalometric     .........  .........  .........  ...........  ...........
                               film.
   D0415  E                   Bacteriologic study....  .........  .........  .........  ...........  ...........
   D0425  E                   Caries susceptibility    .........  .........  .........  ...........  ...........
                               test.
   D0460  S                   Pulp vitality test.....        031       1.37     $70.45       $14.09       $14.09
   D0470  E                   Diagnostic casts.......  .........  .........  .........  ...........  ...........
   D0471  S                   Diagnostic photographs.        031       1.37     $70.45       $14.09       $14.09
   D0501  S                   Histopathologic                031       1.37     $70.45       $14.09       $14.09
                               examinations.
   D0502  S                   Other oral pathology           031       1.37     $70.45       $14.09       $14.09
                               procedu.
   D0999  S                   Unspecified diagnostic         031       1.37     $70.45       $14.09       $14.09
                               proce.
   D1110  E                   Dental prophylaxis       .........  .........  .........  ...........  ...........
                               adult.
   D1120  E                   Dental prophylaxis       .........  .........  .........  ...........  ...........
                               child.
   D1201  E                   Topical fluor w prophy   .........  .........  .........  ...........  ...........
                               child.
   D1203  E                   Topical fluor w/o        .........  .........  .........  ...........  ...........
                               prophy chi.
   D1204  E                   Topical fluor w/o        .........  .........  .........  ...........  ...........
                               prophy adu.
   D1205  E                   Topical fluoride w/      .........  .........  .........  ...........  ...........
                               prophy a.
   D1310  E                   Nutri counsel-control    .........  .........  .........  ...........  ...........
                               caries.
   D1320  E                   Tobacco counseling.....  .........  .........  .........  ...........  ...........
   D1330  E                   Oral hygiene             .........  .........  .........  ...........  ...........
                               instruction.
   D1351  E                   Dental sealant per       .........  .........  .........  ...........  ...........
                               tooth.
   D1510  S                   Space maintainer fxd           031       1.37     $70.45       $14.09       $14.09
                               unilat.
   D1515  S                   Fixed bilat space              031       1.37     $70.45       $14.09       $14.09
                               maintainer.
   D1520  S                   Remove unilat space            031       1.37     $70.45       $14.09       $14.09
                               maintain.
   D1525  S                   Remove bilat space             031       1.37     $70.45       $14.09       $14.09
                               maintain.
   D1550  S                   Recement space                 031       1.37     $70.45       $14.09       $14.09
                               maintainer.
   D2110  E                   Amalgam one surface      .........  .........  .........  ...........  ...........
                               primary.
   D2120  E                   Amalgam two surfaces     .........  .........  .........  ...........  ...........
                               primary.
   D2130  E                   Amalgam three surfaces   .........  .........  .........  ...........  ...........
                               prima.
   D2131  E                   Amalgam four/more surf   .........  .........  .........  ...........  ...........
                               prima.
   D2140  E                   Amalgam one surface      .........  .........  .........  ...........  ...........
                               permanen.
   D2150  E                   Amalgam two surfaces     .........  .........  .........  ...........  ...........
                               permane.
   D2160  E                   Amalgam three surfaces   .........  .........  .........  ...........  ...........
                               perma.
   D2161  E                   Amalgam 4 or > surfaces  .........  .........  .........  ...........  ...........
                               perm.
   D2210  E                   Slcate cement per        .........  .........  .........  ...........  ...........
                               restorat.
   D2330  E                   Resin one surface-       .........  .........  .........  ...........  ...........
                               anterior.
   D2331  E                   Resin two surfaces-      .........  .........  .........  ...........  ...........
                               anterior.
   D2332  E                   Resin three surfaces-    .........  .........  .........  ...........  ...........
                               anterio.
   D2335  E                   Resin 4/> surf or w      .........  .........  .........  ...........  ...........
                               incis an.
   D2336  E                   Composite resin crown..  .........  .........  .........  ...........  ...........
   D2380  E                   Resin one surf poster    .........  .........  .........  ...........  ...........
                               primar.
   D2381  E                   Resin two surf poster    .........  .........  .........  ...........  ...........
                               primar.
   D2382  E                   Resin three/more surf    .........  .........  .........  ...........  ...........
                               post p.
   D2385  E                   Resin one surf poster    .........  .........  .........  ...........  ...........
                               perman.
   D2386  E                   Resin two surf poster    .........  .........  .........  ...........  ...........
                               perman.
   D2387  E                   Resin three/more surf    .........  .........  .........  ...........  ...........
                               post p.
   D2410  E                   Dental gold foil one     .........  .........  .........  ...........  ...........
                               surface.
   D2420  E                   Dental gold foil two     .........  .........  .........  ...........  ...........
                               surface.
   D2430  E                   Dental gold foil three   .........  .........  .........  ...........  ...........
                               surfa.
   D2510  E                   Dental inlay metalic 1   .........  .........  .........  ...........  ...........
                               surf.
   D2520  E                   Dental inlay metallic 2  .........  .........  .........  ...........  ...........
                               surf.
   D2530  E                   Dental inlay metl 3/     .........  .........  .........  ...........  ...........
                               more sur.
   D2543  E                   Dental onlay metallic 3  .........  .........  .........  ...........  ...........
                               surf.
   D2544  E                   Dental onlay metl 4/     .........  .........  .........  ...........  ...........
                               more sur.
   D2610  E                   Inlay porcelain/ceramic  .........  .........  .........  ...........  ...........
                               1 su.
   D2620  E                   Inlay porcelain/ceramic  .........  .........  .........  ...........  ...........
                               2 su.
   D2630  E                   Dental onlay porc 3/     .........  .........  .........  ...........  ...........
                               more sur.
   D2642  E                   Dental onlay porcelin 2  .........  .........  .........  ...........  ...........
                               surf.
   D2643  E                   Dental onlay porcelin 3  .........  .........  .........  ...........  ...........
                               surf.
   D2644  E                   Dental onlay porc 4/     .........  .........  .........  ...........  ...........
                               more sur.
   D2650  E                   Inlay composite/resin    .........  .........  .........  ...........  ...........
                               one su.
   D2651  E                   Inlay composite/resin    .........  .........  .........  ...........  ...........
                               two su.
   D2652  E                   Dental inlay resin 3/    .........  .........  .........  ...........  ...........
                               mre sur.
   D2662  E                   Dental onlay resin 2     .........  .........  .........  ...........  ...........
                               surface.
   D2663  E                   Dental onlay resin 3     .........  .........  .........  ...........  ...........
                               surface.
   D2664  E                   Dental onlay resin 4/    .........  .........  .........  ...........  ...........
                               mre sur.
   D2710  E                   Crown resin laboratory.  .........  .........  .........  ...........  ...........
   D2720  E                   Crown resin w/ high      .........  .........  .........  ...........  ...........
                               noble me.
   D2721  E                   Crown resin w/ base      .........  .........  .........  ...........  ...........
                               metal.
   D2722  E                   Crown resin w/ noble     .........  .........  .........  ...........  ...........
                               metal.

[[Page 35380]]

 
   D2740  E                   Crown porcelain/ceramic  .........  .........  .........  ...........  ...........
                               subs.
   D2750  E                   Crown porcelain w/ h     .........  .........  .........  ...........  ...........
                               noble m.
   D2751  E                   Crown porcelain fused    .........  .........  .........  ...........  ...........
                               base m.
   D2752  E                   Crown porcelain w/       .........  .........  .........  ...........  ...........
                               noble met.
   D2790  E                   Crown full cast high     .........  .........  .........  ...........  ...........
                               noble m.
   D2791  E                   Crown full cast base     .........  .........  .........  ...........  ...........
                               metal.
   D2792  E                   Crown full cast noble    .........  .........  .........  ...........  ...........
                               metal.
   D2810  E                   Crown 3/4 cast metallic  .........  .........  .........  ...........  ...........
   D2910  E                   Dental recement inlay..  .........  .........  .........  ...........  ...........
   D2920  E                   Dental recement crown..  .........  .........  .........  ...........  ...........
   D2930  E                   Prefab stnlss steel      .........  .........  .........  ...........  ...........
                               crwn pri.
   D2931  E                   Prefab stnlss steel      .........  .........  .........  ...........  ...........
                               crown pe.
   D2932  E                   Prefabricated resin      .........  .........  .........  ...........  ...........
                               crown.
   D2933  E                   Prefab stainless steel   .........  .........  .........  ...........  ...........
                               crown.
   D2940  E                   Dental sedative filling  .........  .........  .........  ...........  ...........
   D2950  E                   Core build-up incl any   .........  .........  .........  ...........  ...........
                               pins.
   D2951  E                   Tooth pin retention....  .........  .........  .........  ...........  ...........
   D2952  E                   Post and core cast +     .........  .........  .........  ...........  ...........
                               crown.
   D2954  E                   Prefab post/core +       .........  .........  .........  ...........  ...........
                               crown.
   D2955  E                   Post removal...........  .........  .........  .........  ...........  ...........
   D2960  E                   Laminate labial veneer.  .........  .........  .........  ...........  ...........
   D2961  E                   Lab labial veneer resin  .........  .........  .........  ...........  ...........
   D2962  E                   Lab labial veneer        .........  .........  .........  ...........  ...........
                               porcelain.
   D2970  S                   Temporary- fractured           031       1.37     $70.45       $14.09       $14.09
                               tooth.
   D2980  E                   Crown repair...........  .........  .........  .........  ...........  ...........
   D2999  S                   Dental unspec                  031       1.37     $70.45       $14.09       $14.09
                               restorative pr.
   D3110  E                   Pulp cap direct........  .........  .........  .........  ...........  ...........
   D3120  E                   Pulp cap indirect......  .........  .........  .........  ...........  ...........
   D3220  E                   Therapeutic pulpotomy..  .........  .........  .........  ...........  ...........
   D3230  E                   Pulpal therapy anterior  .........  .........  .........  ...........  ...........
                               prim.
   D3240  E                   Pulpal therapy           .........  .........  .........  ...........  ...........
                               posterior pri.
   D3310  E                   Anterior...............  .........  .........  .........  ...........  ...........
   D3320  E                   Root canal therapy 2     .........  .........  .........  ...........  ...........
                               canals.
   D3330  E                   Root canal therapy 3     .........  .........  .........  ...........  ...........
                               canals.
   D3346  E                   Retreat root canal       .........  .........  .........  ...........  ...........
                               anterior.
   D3347  E                   Retreat root canal       .........  .........  .........  ...........  ...........
                               bicuspid.
   D3348  E                   Retreat root canal       .........  .........  .........  ...........  ...........
                               molar.
   D3351  E                   Apexification/recalc     .........  .........  .........  ...........  ...........
                               initial.
   D3352  E                   Apexification/recalc     .........  .........  .........  ...........  ...........
                               interim.
   D3353  E                   Apexification/recalc     .........  .........  .........  ...........  ...........
                               final.
   D3410  E                   Apicoect/perirad surg    .........  .........  .........  ...........  ...........
                               anter.
   D3421  E                   Root surgery bicuspid..  .........  .........  .........  ...........  ...........
   D3425  E                   Root surgery molar.....  .........  .........  .........  ...........  ...........
   D3426  E                   Root surgery ea add      .........  .........  .........  ...........  ...........
                               root.
   D3430  E                   Retrograde filling.....  .........  .........  .........  ...........  ...........
   D3450  E                   Root amputation........  .........  .........  .........  ...........  ...........
   D3460  S                   Endodontic endosseous          031       1.37     $70.45       $14.09       $14.09
                               implan.
   D3470  E                   Intentional              .........  .........  .........  ...........  ...........
                               replantation.
   D3910  E                   Isolation- tooth w rubb  .........  .........  .........  ...........  ...........
                               dam.
   D3920  E                   Tooth splitting........  .........  .........  .........  ...........  ...........
   D3950  E                   Canal prep/fitting of    .........  .........  .........  ...........  ...........
                               dowel.
   D3960  E                   Bleaching of discolored  .........  .........  .........  ...........  ...........
                               toot.
   D3999  S                   Endodontic procedure...        031       1.37     $70.45       $14.09       $14.09
   D4210  E                   Gingivectomy/plasty per  .........  .........  .........  ...........  ...........
                               quad.
   D4211  E                   Gingivectomy/plasty per  .........  .........  .........  ...........  ...........
                               toot.
   D4220  E                   Gingival curettage per   .........  .........  .........  ...........  ...........
                               quadr.
   D4240  E                   Gingival flap proc w/    .........  .........  .........  ...........  ...........
                               planin.
   D4249  E                   Crown lengthen hard      .........  .........  .........  ...........  ...........
                               tissue.
   D4250  S                   Mucogingival surg per          031       1.37     $70.45       $14.09       $14.09
                               quadra.
   D4260  S                   Osseous surgery per            031       1.37     $70.45       $14.09       $14.09
                               quadrant.
   D4263  S                   Bone replce graft first        031       1.37     $70.45       $14.09       $14.09
                               site.
   D4264  S                   Bone replce graft each         031       1.37     $70.45       $14.09       $14.09
                               add.
   D4266  E                   Guided tiss regen        .........  .........  .........  ...........  ...........
                               resorble.
   D4267  E                   Guided tiss regen        .........  .........  .........  ...........  ...........
                               nonresorb.
   D4270  S                   Pedicle soft tissue            031       1.37     $70.45       $14.09       $14.09
                               graft pr.
   D4271  S                   Free soft tissue graft         031       1.37     $70.45       $14.09       $14.09
                               proc.
   D4273  S                   Subepithelial tissue           031       1.37     $70.45       $14.09       $14.09
                               graft.
   D4274  E                   Distal/proximal wedge    .........  .........  .........  ...........  ...........
                               proc.
   D4320  E                   Provision splnt          .........  .........  .........  ...........  ...........
                               intracoronal.
   D4321  E                   Provisional splint       .........  .........  .........  ...........  ...........
                               extracoro.
   D4341  E                   Periodontal scaling &    .........  .........  .........  ...........  ...........
                               root.
   D4355  S                   Full mouth debridement.        031       1.37     $70.45       $14.09       $14.09
   D4381  S                   Localized chemo                031       1.37     $70.45       $14.09       $14.09
                               delivery.
   D4910  E                   Periodontal maint        .........  .........  .........  ...........  ...........
                               procedures.
   D4920  E                   Unscheduled dressing     .........  .........  .........  ...........  ...........
                               change.

[[Page 35381]]

 
   D4999  E                   Unspecified periodontal  .........  .........  .........  ...........  ...........
                               proc.
   D5110  E                   Dentures complete        .........  .........  .........  ...........  ...........
                               maxillary.
   D5120  E                   Dentures complete        .........  .........  .........  ...........  ...........
                               mandible.
   D5130  E                   Dentures immediat        .........  .........  .........  ...........  ...........
                               maxillary.
   D5140  E                   Dentures immediat        .........  .........  .........  ...........  ...........
                               mandible.
   D5211  E                   Dentures maxill part     .........  .........  .........  ...........  ...........
                               resin.
   D5212  E                   Dentures mand part       .........  .........  .........  ...........  ...........
                               resin.
   D5213  E                   Dentures maxill part     .........  .........  .........  ...........  ...........
                               metal.
   D5214  E                   Dentures mandibl part    .........  .........  .........  ...........  ...........
                               metal.
   D5281  E                   Removable partial        .........  .........  .........  ...........  ...........
                               denture.
   D5410  E                   Dentures adjust cmplt    .........  .........  .........  ...........  ...........
                               maxil.
   D5411  E                   Dentures adjust cmplt    .........  .........  .........  ...........  ...........
                               mand.
   D5421  E                   Dentures adjust part     .........  .........  .........  ...........  ...........
                               maxill.
   D5422  E                   Dentures adjust part     .........  .........  .........  ...........  ...........
                               mandbl.
   D5510  E                   Dentur repr broken       .........  .........  .........  ...........  ...........
                               compl bas.
   D5520  E                   Replace denture teeth    .........  .........  .........  ...........  ...........
                               complt.
   D5610  E                   Dentures repair resin    .........  .........  .........  ...........  ...........
                               base.
   D5620  E                   Rep part denture cast    .........  .........  .........  ...........  ...........
                               frame.
   D5630  E                   Rep partial denture      .........  .........  .........  ...........  ...........
                               clasp.
   D5640  E                   Replace part denture     .........  .........  .........  ...........  ...........
                               teeth.
   D5650  E                   Add tooth to partial     .........  .........  .........  ...........  ...........
                               denture.
   D5660  E                   Add clasp to partial     .........  .........  .........  ...........  ...........
                               denture.
   D5710  E                   Dentures rebase cmplt    .........  .........  .........  ...........  ...........
                               maxil.
   D5711  E                   Dentures rebase cmplt    .........  .........  .........  ...........  ...........
                               mand.
   D5720  E                   Dentures rebase part     .........  .........  .........  ...........  ...........
                               maxill.
   D5721  E                   Dentures rebase part     .........  .........  .........  ...........  ...........
                               mandbl.
   D5730  E                   Denture reln cmplt       .........  .........  .........  ...........  ...........
                               maxil ch.
   D5731  E                   Denture reln cmplt mand  .........  .........  .........  ...........  ...........
                               chr.
   D5740  E                   Denture reln part maxil  .........  .........  .........  ...........  ...........
                               chr.
   D5741  E                   Denture reln part mand   .........  .........  .........  ...........  ...........
                               chr.
   D5750  E                   Denture reln cmplt max   .........  .........  .........  ...........  ...........
                               lab.
   D5751  E                   Denture reln cmplt mand  .........  .........  .........  ...........  ...........
                               lab.
   D5760  E                   Denture reln part maxil  .........  .........  .........  ...........  ...........
                               lab.
   D5761  E                   Denture reln part mand   .........  .........  .........  ...........  ...........
                               lab.
   D5810  E                   Denture interm cmplt     .........  .........  .........  ...........  ...........
                               maxill.
   D5811  E                   Denture interm cmplt     .........  .........  .........  ...........  ...........
                               mandbl.
   D5820  E                   Denture interm part      .........  .........  .........  ...........  ...........
                               maxill.
   D5821  E                   Denture interm part      .........  .........  .........  ...........  ...........
                               mandbl.
   D5850  E                   Denture tiss conditn     .........  .........  .........  ...........  ...........
                               maxill.
   D5851  E                   Denture tiss condtin     .........  .........  .........  ...........  ...........
                               mandbl.
   D5860  E                   Overdenture complete...  .........  .........  .........  ...........  ...........
   D5861  E                   Overdenture partial....  .........  .........  .........  ...........  ...........
   D5862  E                   Precision attachment...  .........  .........  .........  ...........  ...........
   D5899  E                   Removable prosthodontic  .........  .........  .........  ...........  ...........
                               proc.
   D5911  S                   Facial moulage                 031       1.37     $70.45       $14.09       $14.09
                               sectional.
   D5912  S                   Facial moulage complete        031       1.37     $70.45       $14.09       $14.09
   D5913  E                   Nasal prosthesis.......  .........  .........  .........  ...........  ...........
   D5914  E                   Auricular prosthesis...  .........  .........  .........  ...........  ...........
   D5915  E                   Orbital prosthesis.....  .........  .........  .........  ...........  ...........
   D5916  E                   Ocular prosthesis......  .........  .........  .........  ...........  ...........
   D5919  E                   Facial prosthesis......  .........  .........  .........  ...........  ...........
   D5922  E                   Nasal septal prosthesis  .........  .........  .........  ...........  ...........
   D5923  E                   Ocular prosthesis        .........  .........  .........  ...........  ...........
                               interim.
   D5924  E                   Cranial prosthesis.....  .........  .........  .........  ...........  ...........
   D5925  E                   Facial augmentation      .........  .........  .........  ...........  ...........
                               implant.
   D5926  E                   Replacement nasal        .........  .........  .........  ...........  ...........
                               prosthesis.
   D5927  E                   Auricular replacement..  .........  .........  .........  ...........  ...........
   D5928  E                   Orbital replacement....  .........  .........  .........  ...........  ...........
   D5929  E                   Facial replacement.....  .........  .........  .........  ...........  ...........
   D5931  E                   Surgical obturator.....  .........  .........  .........  ...........  ...........
   D5932  E                   Postsurgical obturator.  .........  .........  .........  ...........  ...........
   D5933  E                   Refitting of obturator.  .........  .........  .........  ...........  ...........
   D5934  E                   Mandibular flange        .........  .........  .........  ...........  ...........
                               prosthesis.
   D5935  E                   Mandibular denture       .........  .........  .........  ...........  ...........
                               prosth.
   D5936  E                   Temp obturator           .........  .........  .........  ...........  ...........
                               prosthesis.
   D5937  E                   Trismus appliance......  .........  .........  .........  ...........  ...........
   D5951  E                   Feeding aid............  .........  .........  .........  ...........  ...........
   D5952  E                   Pediatric speech aid...  .........  .........  .........  ...........  ...........
   D5953  E                   Adult speech aid.......  .........  .........  .........  ...........  ...........
   D5954  E                   Superimposed prosthesis  .........  .........  .........  ...........  ...........
   D5955  E                   Palatal lift prosthesis  .........  .........  .........  ...........  ...........
   D5958  E                   Intraoral con def inter  .........  .........  .........  ...........  ...........
                               plt.
   D5959  E                   Intraoral con def mod    .........  .........  .........  ...........  ...........
                               palat.
   D5960  E                   Modify speech aid        .........  .........  .........  ...........  ...........
                               prosthesis.
   D5982  E                   Surgical stent.........  .........  .........  .........  ...........  ...........

[[Page 35382]]

 
   D5983  S                   Radiation applicator...        031       1.37     $70.45       $14.09       $14.09
   D5984  S                   Radiation shield.......        031       1.37     $70.45       $14.09       $14.09
   D5985  S                   Radiation cone locator.        031       1.37     $70.45       $14.09       $14.09
   D5986  E                   Fluoride applicator....  .........  .........  .........  ...........  ...........
   D5987  S                   Commissure splint......        031       1.37     $70.45       $14.09       $14.09
   D5988  E                   Surgical splint........  .........  .........  .........  ...........  ...........
   D5999  E                   Maxillofacial            .........  .........  .........  ...........  ...........
                               prosthesis.
   D6010  E                   Odontics endosteal       .........  .........  .........  ...........  ...........
                               implant.
   D6020  E                   Odontics abutment        .........  .........  .........  ...........  ...........
                               placement.
   D6040  E                   Odontics eposteal        .........  .........  .........  ...........  ...........
                               implant.
   D6050  E                   Odontics transosteal     .........  .........  .........  ...........  ...........
                               implnt.
   D6055  E                   Implant connecting bar.  .........  .........  .........  ...........  ...........
   D6080  E                   Implant maintenance....  .........  .........  .........  ...........  ...........
   D6090  E                   Repair implant.........  .........  .........  .........  ...........  ...........
   D6095  E                   Odontics repr abutment.  .........  .........  .........  ...........  ...........
   D6100  E                   Removal of implant.....  .........  .........  .........  ...........  ...........
   D6199  E                   Implant procedure......  .........  .........  .........  ...........  ...........
   D6210  E                   Prosthodont high noble   .........  .........  .........  ...........  ...........
                               metal.
   D6211  E                   Bridge base metal cast.  .........  .........  .........  ...........  ...........
   D6212  E                   Bridge noble metal cast  .........  .........  .........  ...........  ...........
   D6240  E                   Bridge porcelain high    .........  .........  .........  ...........  ...........
                               noble.
   D6241  E                   Bridge porcelain base    .........  .........  .........  ...........  ...........
                               metal.
   D6242  E                   Bridge porcelain nobel   .........  .........  .........  ...........  ...........
                               metal.
   D6250  E                   Bridge resin w/high      .........  .........  .........  ...........  ...........
                               noble.
   D6251  E                   Bridge resin base metal  .........  .........  .........  ...........  ...........
   D6252  E                   Bridge resin w/noble     .........  .........  .........  ...........  ...........
                               metal.
   D6520  E                   Dental retainer two      .........  .........  .........  ...........  ...........
                               surfaces.
   D6530  E                   Retainer metallic 3+     .........  .........  .........  ...........  ...........
                               surface.
   D6543  E                   Dental retainr onlay 3   .........  .........  .........  ...........  ...........
                               surf.
   D6544  E                   Dental retainr onlay 4/  .........  .........  .........  ...........  ...........
                               more.
   D6545  E                   Dental retainr cast      .........  .........  .........  ...........  ...........
                               metl.
   D6720  E                   Retain crown resin w hi  .........  .........  .........  ...........  ...........
                               nble.
   D6721  E                   Crown resin w/base       .........  .........  .........  ...........  ...........
                               metal.
   D6722  E                   Crown resin w/noble      .........  .........  .........  ...........  ...........
                               metal.
   D6750  E                   Crown porcelain high     .........  .........  .........  ...........  ...........
                               noble.
   D6751  E                   Crown porcelain base     .........  .........  .........  ...........  ...........
                               metal.
   D6752  E                   Crown porcelain noble    .........  .........  .........  ...........  ...........
                               metal.
   D6780  E                   Crown 3/4 high noble     .........  .........  .........  ...........  ...........
                               metal.
   D6790  E                   Crown full high noble    .........  .........  .........  ...........  ...........
                               metal.
   D6791  E                   Crown full base metal    .........  .........  .........  ...........  ...........
                               cast.
   D6792  E                   Crown full noble metal   .........  .........  .........  ...........  ...........
                               cast.
   D6920  S                   Dental connector bar...        031       1.37     $70.45       $14.09       $14.09
   D6930  E                   Dental recement bridge.  .........  .........  .........  ...........  ...........
   D6940  E                   Stress breaker.........  .........  .........  .........  ...........  ...........
   D6950  E                   Precision attachment...  .........  .........  .........  ...........  ...........
   D6970  E                   Post & core plus         .........  .........  .........  ...........  ...........
                               retainer.
   D6971  E                   Cast post bridge         .........  .........  .........  ...........  ...........
                               retainer.
   D6972  E                   Prefab post & core plus  .........  .........  .........  ...........  ...........
                               reta.
   D6973  E                   Core build up for        .........  .........  .........  ...........  ...........
                               retainer.
   D6975  E                   Coping metal...........  .........  .........  .........  ...........  ...........
   D6980  E                   Bridge repair..........  .........  .........  .........  ...........  ...........
   D6999  E                   Fixed prosthodontic      .........  .........  .........  ...........  ...........
                               proc.
   D7110  S                   Oral surgery single            031       1.37     $70.45       $14.09       $14.09
                               tooth.
   D7120  S                   Each add tooth                 031       1.37     $70.45       $14.09       $14.09
                               extraction.
   D7130  S                   Tooth root removal.....        031       1.37     $70.45       $14.09       $14.09
   D7210  S                   Rem imp tooth w mucoper        031       1.37     $70.45       $14.09       $14.09
                               flp.
   D7220  S                   Impact tooth remov soft        031       1.37     $70.45       $14.09       $14.09
                               tiss.
   D7230  S                   Impact tooth remov part        031       1.37     $70.45       $14.09       $14.09
                               bony.
   D7240  S                   Impact tooth remov comp        031       1.37     $70.45       $14.09       $14.09
                               bony.
   D7241  S                   Impact tooth rem bony w/       031       1.37     $70.45       $14.09       $14.09
                               comp.
   D7250  S                   Tooth root removal.....        031       1.37     $70.45       $14.09       $14.09
   D7260  S                   Oral antral fistula            031       1.37     $70.45       $14.09       $14.09
                               closure.
   D7270  E                   Tooth reimplantation...  .........  .........  .........  ...........  ...........
   D7272  E                   Tooth transplantation..  .........  .........  .........  ...........  ...........
   D7280  E                   Exposure impact tooth    .........  .........  .........  ...........  ...........
                               orthod.
   D7281  E                   Exposure tooth aid       .........  .........  .........  ...........  ...........
                               eruption.
   D7285  E                   Biopsy of oral tissue    .........  .........  .........  ...........  ...........
                               hard.
   D7286  E                   Biopsy of oral tissue    .........  .........  .........  ...........  ...........
                               soft.
   D7290  E                   Repositioning of teeth.  .........  .........  .........  ...........  ...........
   D7291  S                   Transseptal fiberotomy.        031       1.37     $70.45       $14.09       $14.09
   D7310  E                   Alveoplasty w/           .........  .........  .........  ...........  ...........
                               extraction.
   D7320  E                   Alveoplasty w/o          .........  .........  .........  ...........  ...........
                               extraction.
   D7340  E                   Vestibuloplasty ridge    .........  .........  .........  ...........  ...........
                               extens.
   D7350  E                   Vestibuloplasty exten    .........  .........  .........  ...........  ...........
                               graft.
   D7410  E                   Rad exc lesion up to     .........  .........  .........  ...........  ...........
                               1.25 cm.

[[Page 35383]]

 
   D7420  E                   Lesion > 1.25 cm.......  .........  .........  .........  ...........  ...........
   D7430  E                   Exc benign tumor to      .........  .........  .........  ...........  ...........
                               1.25 cm.
   D7431  E                   Benign tumor exc > 1.25  .........  .........  .........  ...........  ...........
                               cm.
   D7440  E                   Malig tumor exc to 1.25  .........  .........  .........  ...........  ...........
                               cm.
   D7441  E                   Malig tumor > 1.25 cm..  .........  .........  .........  ...........  ...........
   D7450  E                   Rem odontogen cyst to    .........  .........  .........  ...........  ...........
                               1.25cm.
   D7451  E                   Rem odontogen cyst >     .........  .........  .........  ...........  ...........
                               1.25 cm.
   D7460  E                   Rem nonodonto cyst to    .........  .........  .........  ...........  ...........
                               1.25cm.
   D7461  E                   Rem nonodonto cyst >     .........  .........  .........  ...........  ...........
                               1.25 cm.
   D7465  E                   Lesion destruction.....  .........  .........  .........  ...........  ...........
   D7470  E                   Rem exostosis maxilla/   .........  .........  .........  ...........  ...........
                               mandib.
   D7480  E                   Partial ostectomy......  .........  .........  .........  ...........  ...........
   D7490  E                   Mandible resection.....  .........  .........  .........  ...........  ...........
   D7510  E                   I&d absc intraoral soft  .........  .........  .........  ...........  ...........
                               tiss.
   D7520  E                   I&d abscess extraoral..  .........  .........  .........  ...........  ...........
   D7530  E                   Removal fb skin/areolar  .........  .........  .........  ...........  ...........
                               tiss.
   D7540  E                   Removal of fb reaction.  .........  .........  .........  ...........  ...........
   D7550  E                   Removal of sloughed off  .........  .........  .........  ...........  ...........
                               bone.
   D7560  E                   Maxillary sinusotomy...  .........  .........  .........  ...........  ...........
   D7610  E                   Maxilla open reduct      .........  .........  .........  ...........  ...........
                               simple.
   D7620  E                   Clsd reduct simpl        .........  .........  .........  ...........  ...........
                               maxilla fx.
   D7630  E                   Open red simpl mandible  .........  .........  .........  ...........  ...........
                               fx.
   D7640  E                   Clsd red simpl mandible  .........  .........  .........  ...........  ...........
                               fx.
   D7650  E                   Open red simp malar/     .........  .........  .........  ...........  ...........
                               zygom fx.
   D7660  E                   Clsd red simp malar/     .........  .........  .........  ...........  ...........
                               zygom fx.
   D7670  E                   Open red simple          .........  .........  .........  ...........  ...........
                               alveolus fx.
   D7680  E                   Reduct simple facial     .........  .........  .........  ...........  ...........
                               bone fx.
   D7710  E                   Maxilla open reduct      .........  .........  .........  ...........  ...........
                               compound.
   D7720  E                   Clsd reduct compd        .........  .........  .........  ...........  ...........
                               maxilla fx.
   D7730  E                   Open reduct compd        .........  .........  .........  ...........  ...........
                               mandble fx.
   D7740  E                   Clsd reduct compd        .........  .........  .........  ...........  ...........
                               mandble fx.
   D7750  E                   Open red comp malar/     .........  .........  .........  ...........  ...........
                               zygma fx.
   D7760  E                   Clsd red comp malar/     .........  .........  .........  ...........  ...........
                               zygma fx.
   D7770  E                   Open reduc compd         .........  .........  .........  ...........  ...........
                               alveolus fx.
   D7780  E                   Reduct compnd facial     .........  .........  .........  ...........  ...........
                               bone fx.
   D7810  E                   Tmj open reduct-         .........  .........  .........  ...........  ...........
                               dislocation.
   D7820  E                   Closed tmp manipulation  .........  .........  .........  ...........  ...........
   D7830  E                   Tmj manipulation under   .........  .........  .........  ...........  ...........
                               anest.
   D7840  E                   Removal of tmj condyle.  .........  .........  .........  ...........  ...........
   D7850  E                   Tmj meniscectomy.......  .........  .........  .........  ...........  ...........
   D7852  E                   Tmj repair of joint      .........  .........  .........  ...........  ...........
                               disc.
   D7854  E                   Tmj excisn of joint      .........  .........  .........  ...........  ...........
                               membrane.
   D7856  E                   Tmj cutting of a muscle  .........  .........  .........  ...........  ...........
   D7858  E                   Tmj reconstruction.....  .........  .........  .........  ...........  ...........
   D7860  E                   Tmj cutting into joint.  .........  .........  .........  ...........  ...........
   D7865  E                   Tmj reshaping            .........  .........  .........  ...........  ...........
                               components.
   D7870  E                   Tmj aspiration joint     .........  .........  .........  ...........  ...........
                               fluid.
   D7872  E                   Tmj diagnostic           .........  .........  .........  ...........  ...........
                               arthroscopy.
   D7873  E                   Tmj arthroscopy lysis    .........  .........  .........  ...........  ...........
                               adhesn.
   D7874  E                   Tmj arthroscopy disc     .........  .........  .........  ...........  ...........
                               reposit.
   D7875  E                   Tmj arthroscopy          .........  .........  .........  ...........  ...........
                               synovectomy.
   D7876  E                   Tmj arthroscopy          .........  .........  .........  ...........  ...........
                               discectomy.
   D7877  E                   Tmj arthroscopy          .........  .........  .........  ...........  ...........
                               debridement.
   D7880  E                   Occlusal orthotic        .........  .........  .........  ...........  ...........
                               appliance.
   D7899  E                   Tmj unspecified therapy  .........  .........  .........  ...........  ...........
   D7910  E                   Dent sutur recent wnd    .........  .........  .........  ...........  ...........
                               to 5cm.
   D7911  E                   Dental suture wound to   .........  .........  .........  ...........  ...........
                               5 cm.
   D7912  E                   Suture complicate wnd >  .........  .........  .........  ...........  ...........
                               5 cm.
   D7920  E                   Dental skin graft......  .........  .........  .........  ...........  ...........
   D7940  S                   Reshaping bone                 031       1.37     $70.45       $14.09       $14.09
                               orthognathic.
   D7941  E                   Bone cutting ramus       .........  .........  .........  ...........  ...........
                               closed.
   D7942  E                   Bone cutting ramus open  .........  .........  .........  ...........  ...........
   D7943  E                   Cutting ramus open w/    .........  .........  .........  ...........  ...........
                               graft.
   D7944  E                   Bone cutting segmented.  .........  .........  .........  ...........  ...........
   D7945  E                   Bone cutting body        .........  .........  .........  ...........  ...........
                               mandible.
   D7946  E                   Reconstruction maxilla   .........  .........  .........  ...........  ...........
                               total.
   D7947  E                   Reconstruct maxilla      .........  .........  .........  ...........  ...........
                               segment.
   D7948  E                   Reconstruct midface no   .........  .........  .........  ...........  ...........
                               graft.
   D7949  E                   Reconstruct midface w/   .........  .........  .........  ...........  ...........
                               graft.
   D7950  E                   Mandible graft.........  .........  .........  .........  ...........  ...........
   D7955  E                   Repair maxillofacial     .........  .........  .........  ...........  ...........
                               defects.
   D7960  E                   Frenulectomy/            .........  .........  .........  ...........  ...........
                               frenulotomy.
   D7970  E                   Excision hyperplastic    .........  .........  .........  ...........  ...........
                               tissue.
   D7971  E                   Excision pericoronal     .........  .........  .........  ...........  ...........
                               gingiva.
   D7980  E                   Sialolithotomy.........  .........  .........  .........  ...........  ...........

[[Page 35384]]

 
   D7981  E                   Excision of salivary     .........  .........  .........  ...........  ...........
                               gland.
   D7982  E                   Sialodochoplasty.......  .........  .........  .........  ...........  ...........
   D7983  E                   Closure of salivary      .........  .........  .........  ...........  ...........
                               fistula.
   D7990  E                   Emergency tracheotomy..  .........  .........  .........  ...........  ...........
   D7991  E                   Dental coronoidectomy..  .........  .........  .........  ...........  ...........
   D7995  E                   Synthetic graft facial   .........  .........  .........  ...........  ...........
                               bones.
   D7996  E                   Implant mandible for     .........  .........  .........  ...........  ...........
                               augment.
   D7999  E                   Oral surgery procedure.  .........  .........  .........  ...........  ...........
   D8010  E                   Limited dental tx        .........  .........  .........  ...........  ...........
                               primary.
   D8020  E                   Limited dental tx        .........  .........  .........  ...........  ...........
                               transition.
   D8030  E                   Limited dental tx        .........  .........  .........  ...........  ...........
                               adolescent.
   D8040  E                   Limited dental tx adult  .........  .........  .........  ...........  ...........
   D8050  E                   Intercep dental tx       .........  .........  .........  ...........  ...........
                               primary.
   D8060  E                   Intercep dental tx       .........  .........  .........  ...........  ...........
                               transitn.
   D8070  E                   Compre dental tx         .........  .........  .........  ...........  ...........
                               transition.
   D8080  E                   Compre dental tx         .........  .........  .........  ...........  ...........
                               adolescent.
   D8090  E                   Compre dental tx adult.  .........  .........  .........  ...........  ...........
   D8210  E                   Orthodontic rem          .........  .........  .........  ...........  ...........
                               appliance tx.
   D8220  E                   Fixed appliance therapy  .........  .........  .........  ...........  ...........
                               habt.
   D8660  E                   Preorthodontic tx visit  .........  .........  .........  ...........  ...........
   D8670  E                   Periodic orthodontc tx   .........  .........  .........  ...........  ...........
                               visit.
   D8680  E                   Orthodontic retention..  .........  .........  .........  ...........  ...........
   D8690  E                   Orthodontic treatment..  .........  .........  .........  ...........  ...........
   D8999  E                   Orthodontic procedure..  .........  .........  .........  ...........  ...........
   D9110  N                   Tx dental pain minor     .........  .........  .........  ...........  ...........
                               proc.
   D9210  E                   Dent anesthesia w/o      .........  .........  .........  ...........  ...........
                               surgery.
   D9211  E                   Regional block           .........  .........  .........  ...........  ...........
                               anesthesia.
   D9212  E                   Trigeminal block         .........  .........  .........  ...........  ...........
                               anesthesia.
   D9215  E                   Local anesthesia.......  .........  .........  .........  ...........  ...........
   D9220  E                   General anesthesia.....  .........  .........  .........  ...........  ...........
   D9221  E                   General anesthesia ea    .........  .........  .........  ...........  ...........
                               ad 15m.
   D9230  N                   Analgesia..............  .........  .........  .........  ...........  ...........
   D9240  E                   Intravenous sedation...  .........  .........  .........  ...........  ...........
   D9310  E                   Dental consultation....  .........  .........  .........  ...........  ...........
   D9410  E                   Dental house call......  .........  .........  .........  ...........  ...........
   D9420  E                   Hospital call..........  .........  .........  .........  ...........  ...........
   D9430  E                   Office visit during      .........  .........  .........  ...........  ...........
                               hours.
   D9440  E                   Office visit after       .........  .........  .........  ...........  ...........
                               hours.
   D9610  E                   Dent therapeutic drug    .........  .........  .........  ...........  ...........
                               inject.
   D9630  S                   Other drugs/medicaments        031       1.37     $70.45       $14.09       $14.09
   D9910  E                   Dent appl desensitizing  .........  .........  .........  ...........  ...........
                               med.
   D9920  E                   Behavior management....  .........  .........  .........  ...........  ...........
   D9930  S                   Treatment of                   031       1.37     $70.45       $14.09       $14.09
                               complications.
   D9940  S                   Dental occlusal guard..        031       1.37     $70.45       $14.09       $14.09
   D9941  E                   Fabrication athletic     .........  .........  .........  ...........  ...........
                               guard.
   D9950  S                   Occlusion analysis.....        031       1.37     $70.45       $14.09       $14.09
   D9951  S                   Limited occlusal               031       1.37     $70.45       $14.09       $14.09
                               adjustment.
   D9952  S                   Complete occlusal              031       1.37     $70.45       $14.09       $14.09
                               adjustment.
   D9970  E                   Enamel microabrasion...  .........  .........  .........  ...........  ...........
   D9999  E                   Adjunctive procedure...  .........  .........  .........  ...........  ...........
   E0100  A                   Cane adjust/fixed with   .........  .........  .........  ...........  ...........
                               tip.
   E0105  A                   Cane adjust/fixed quad/  .........  .........  .........  ...........  ...........
                               3 pro.
   E0110  A                   Crutch forearm pair....  .........  .........  .........  ...........  ...........
   E0111  A                   Crutch forearm each....  .........  .........  .........  ...........  ...........
   E0112  A                   Crutch underarm pair     .........  .........  .........  ...........  ...........
                               wood.
   E0113  A                   Crutch underarm each     .........  .........  .........  ...........  ...........
                               wood.
   E0114  A                   Crutch underarm pair no  .........  .........  .........  ...........  ...........
                               wood.
   E0116  A                   Crutch underarm each no  .........  .........  .........  ...........  ...........
                               wood.
   E0130  A                   Walker rigid adjust/     .........  .........  .........  ...........  ...........
                               fixed ht.
   E0135  A                   Walker folding adjust/   .........  .........  .........  ...........  ...........
                               fixed.
   E0141  A                   Rigid walker wheeled wo  .........  .........  .........  ...........  ...........
                               seat.
   E0142  A                   Walker rigid wheeled     .........  .........  .........  ...........  ...........
                               with se.
   E0143  A                   Walker folding wheeled   .........  .........  .........  ...........  ...........
                               w/o s.
   E0145  A                   Walker whled seat/       .........  .........  .........  ...........  ...........
                               crutch att.
   E0146  A                   Folding walker wheels w  .........  .........  .........  ...........  ...........
                               seat.
   E0147  A                   Walker variable wheel    .........  .........  .........  ...........  ...........
                               resist.
   E0153  A                   Forearm crutch platform  .........  .........  .........  ...........  ...........
                               atta.
   E0154  A                   Walker platform          .........  .........  .........  ...........  ...........
                               attachment.
   E0155  A                   Walker rigd pick-up/     .........  .........  .........  ...........  ...........
                               wheel at.
   E0156  A                   Walker seat attachment.  .........  .........  .........  ...........  ...........
   E0157  A                   Walker crutch            .........  .........  .........  ...........  ...........
                               attachment.
   E0158  A                   Walker leg extensions..  .........  .........  .........  ...........  ...........
   E0159  A                   Brake for wheeled        .........  .........  .........  ...........  ...........
                               walker.
   E0160  A                   Sitz type bath or        .........  .........  .........  ...........  ...........
                               equipment.
   E0161  A                   Sitz bath/equipment w/   .........  .........  .........  ...........  ...........
                               faucet.

[[Page 35385]]

 
   E0162  A                   Sitz bath chair........  .........  .........  .........  ...........  ...........
   E0163  A                   Commode chair stationry  .........  .........  .........  ...........  ...........
                               fxd.
   E0164  A                   Commode chair mobile     .........  .........  .........  ...........  ...........
                               fixed a.
   E0165  A                   Commode chair stationry  .........  .........  .........  ...........  ...........
                               det.
   E0166  A                   Commode chair mobile     .........  .........  .........  ...........  ...........
                               detach.
   E0167  A                   Commode chair pail or    .........  .........  .........  ...........  ...........
                               pan.
   E0175  A                   Commode chair foot rest  .........  .........  .........  ...........  ...........
   E0176  A                   Air pressre pad/cushion  .........  .........  .........  ...........  ...........
                               nonp.
   E0177  A                   Water press pad/cushion  .........  .........  .........  ...........  ...........
                               nonp.
   E0178  A                   Gel pressre pad/cushion  .........  .........  .........  ...........  ...........
                               nonp.
   E0179  A                   Dry pressre pad/cushion  .........  .........  .........  ...........  ...........
                               nonp.
   E0180  A                   Press pad alternating w  .........  .........  .........  ...........  ...........
                               pump.
   E0181  A                   Press pad alternating w/ .........  .........  .........  ...........  ...........
                                pum.
   E0182  A                   Pressure pad             .........  .........  .........  ...........  ...........
                               alternating pum.
   E0184  A                   Dry pressure mattress..  .........  .........  .........  ...........  ...........
   E0185  A                   Gel pressure mattress    .........  .........  .........  ...........  ...........
                               pad.
   E0186  A                   Air pressure mattress..  .........  .........  .........  ...........  ...........
   E0187  A                   Water pressure mattress  .........  .........  .........  ...........  ...........
   E0188  E                   Synthetic sheepskin pad  .........  .........  .........  ...........  ...........
   E0189  E                   Lambswool sheepskin pad  .........  .........  .........  ...........  ...........
   E0191  A                   Protector heel or elbow  .........  .........  .........  ...........  ...........
   E0192  A                   Pad wheelchr low press/  .........  .........  .........  ...........  ...........
                               posit.
   E0193  A                   Powered air flotation    .........  .........  .........  ...........  ...........
                               bed.
   E0194  A                   Air fluidized bed......  .........  .........  .........  ...........  ...........
   E0196  A                   Gel pressure mattress..  .........  .........  .........  ...........  ...........
   E0197  A                   Air pressure pad for     .........  .........  .........  ...........  ...........
                               mattres.
   E0198  A                   Water pressure pad for   .........  .........  .........  ...........  ...........
                               mattr.
   E0199  A                   Dry pressure pad for     .........  .........  .........  ...........  ...........
                               mattres.
   E0200  A                   Heat lamp without stand  .........  .........  .........  ...........  ...........
   E0202  A                   Phototherapy light w/    .........  .........  .........  ...........  ...........
                               photom.
   E0205  A                   Heat lamp with stand...  .........  .........  .........  ...........  ...........
   E0210  A                   Electric heat pad        .........  .........  .........  ...........  ...........
                               standard.
   E0215  A                   Electric heat pad moist  .........  .........  .........  ...........  ...........
   E0217  A                   Water circ heat pad w    .........  .........  .........  ...........  ...........
                               pump.
   E0218  A                   Water circ cold pad w    .........  .........  .........  ...........  ...........
                               pump.
   E0220  A                   Hot water bottle.......  .........  .........  .........  ...........  ...........
   E0225  A                   Hydrocollator unit.....  .........  .........  .........  ...........  ...........
   E0230  A                   Ice cap or collar......  .........  .........  .........  ...........  ...........
   E0235  A                   Paraffin bath unit       .........  .........  .........  ...........  ...........
                               portable.
   E0236  A                   Pump for water           .........  .........  .........  ...........  ...........
                               circulating p.
   E0238  A                   Heat pad non-electric    .........  .........  .........  ...........  ...........
                               moist.
   E0239  A                   Hydrocollator unit       .........  .........  .........  ...........  ...........
                               portable.
   E0241  E                   Bath tub wall rail.....  .........  .........  .........  ...........  ...........
   E0242  E                   Bath tub rail floor....  .........  .........  .........  ...........  ...........
   E0243  E                   Toilet rail............  .........  .........  .........  ...........  ...........
   E0244  E                   Toilet seat raised.....  .........  .........  .........  ...........  ...........
   E0245  E                   Tub stool or bench.....  .........  .........  .........  ...........  ...........
   E0246  A                   Transfer tub rail        .........  .........  .........  ...........  ...........
                               attachment.
   E0249  A                   Pad water circulating    .........  .........  .........  ...........  ...........
                               heat u.
   E0250  A                   Hosp bed fixed ht w/     .........  .........  .........  ...........  ...........
                               mattres.
   E0251  A                   Hosp bed fixd ht w/o     .........  .........  .........  ...........  ...........
                               mattres.
   E0255  A                   Hospital bed var ht w/   .........  .........  .........  ...........  ...........
                               mattr.
   E0256  A                   Hospital bed var ht w/o  .........  .........  .........  ...........  ...........
                               matt.
   E0260  A                   Hosp bed semi-electr w/  .........  .........  .........  ...........  ...........
                               matt.
   E0261  A                   Hosp bed semi-electr w/  .........  .........  .........  ...........  ...........
                               o mat.
   E0265  A                   Hosp bed total electr w/ .........  .........  .........  ...........  ...........
                                mat.
   E0266  A                   Hosp bed total elec w/o  .........  .........  .........  ...........  ...........
                               matt.
   E0270  A                   Hospital bed             .........  .........  .........  ...........  ...........
                               institutional t.
   E0271  A                   Mattress innerspring...  .........  .........  .........  ...........  ...........
   E0272  A                   Mattress foam rubber...  .........  .........  .........  ...........  ...........
   E0273  A                   Bed board..............  .........  .........  .........  ...........  ...........
   E0274  A                   Over-bed table.........  .........  .........  .........  ...........  ...........
   E0275  A                   Bed pan standard.......  .........  .........  .........  ...........  ...........
   E0276  A                   Bed pan fracture.......  .........  .........  .........  ...........  ...........
   E0277  A                   Powered pres-redu air    .........  .........  .........  ...........  ...........
                               mattrs.
   E0280  A                   Bed cradle.............  .........  .........  .........  ...........  ...........
   E0290  A                   Hosp bed fx ht w/o       .........  .........  .........  ...........  ...........
                               rails w/m.
   E0291  A                   Hosp bed fx ht w/o rail  .........  .........  .........  ...........  ...........
                               w/o.
   E0292  A                   Hosp bed var ht w/o      .........  .........  .........  ...........  ...........
                               rail w/o.
   E0293  A                   Hosp bed var ht w/o      .........  .........  .........  ...........  ...........
                               rail w/.
   E0294  A                   Hosp bed semi-elect w/   .........  .........  .........  ...........  ...........
                               mattr.
   E0295  A                   Hosp bed semi-elect w/o  .........  .........  .........  ...........  ...........
                               matt.
   E0296  A                   Hosp bed total elect w/  .........  .........  .........  ...........  ...........
                               matt.
   E0297  A                   Hosp bed total elect w/  .........  .........  .........  ...........  ...........
                               o mat.
   E0305  A                   Rails bed side half      .........  .........  .........  ...........  ...........
                               length.

[[Page 35386]]

 
   E0310  A                   Rails bed side full      .........  .........  .........  ...........  ...........
                               length.
   E0315  A                   Bed accessory brd/tbl/   .........  .........  .........  ...........  ...........
                               supprt.
   E0325  A                   Urinal male jug-type...  .........  .........  .........  ...........  ...........
   E0326  A                   Urinal female jug-type.  .........  .........  .........  ...........  ...........
   E0350  A                   Control unit bowel       .........  .........  .........  ...........  ...........
                               system.
   E0352  A                   Disposable pack w/bowel  .........  .........  .........  ...........  ...........
                               syst.
   E0370  A                   Air elevator for heel..  .........  .........  .........  ...........  ...........
   E0371  A                   Nonpower mattress        .........  .........  .........  ...........  ...........
                               overlay.
   E0372  A                   Powered air mattress     .........  .........  .........  ...........  ...........
                               overlay.
   E0373  A                   Nonpowered pressure      .........  .........  .........  ...........  ...........
                               mattress.
   E0424  A                   Stationary compressed    .........  .........  .........  ...........  ...........
                               gas 02.
   E0425  A                   Gas system stationary    .........  .........  .........  ...........  ...........
                               compre.
   E0430  A                   Oxygen system gas        .........  .........  .........  ...........  ...........
                               portable.
   E0431  A                   Portable gaseous 02....  .........  .........  .........  ...........  ...........
   E0434  A                   Portable liquid 02.....  .........  .........  .........  ...........  ...........
   E0435  A                   Oxygen system liquid     .........  .........  .........  ...........  ...........
                               portabl.
   E0439  A                   Stationary liquid 02...  .........  .........  .........  ...........  ...........
   E0440  A                   Oxygen system liquid     .........  .........  .........  ...........  ...........
                               station.
   E0441  A                   Oxygen contents gas per/ .........  .........  .........  ...........  ...........
                               unit.
   E0442  A                   Oxygen contents liq per/ .........  .........  .........  ...........  ...........
                               unit.
   E0443  A                   Port 02 contents gas/    .........  .........  .........  ...........  ...........
                               unit.
   E0444  A                   Port 02 contents liq/    .........  .........  .........  ...........  ...........
                               unit.
   E0450  A                   Volume vent stationary/  .........  .........  .........  ...........  ...........
                               porta.
   E0452  A                   Intermit assis device w  .........  .........  .........  ...........  ...........
                               cpap.
   E0453  A                   Ventilator 12 hrs/less   .........  .........  .........  ...........  ...........
                               per d.
   E0455  A                   Oxygen tent excl croup/  .........  .........  .........  ...........  ...........
                               ped t.
   E0457  A                   Chest shell............  .........  .........  .........  ...........  ...........
   E0459  A                   Chest wrap.............  .........  .........  .........  ...........  ...........
   E0460  A                   Neg press vent portabl/  .........  .........  .........  ...........  ...........
                               statn.
   E0462  A                   Rocking bed w/ or w/o    .........  .........  .........  ...........  ...........
                               side r.
   E0480  A                   Percussor elect/pneum    .........  .........  .........  ...........  ...........
                               home m.
   E0500  A                   Ippb all types.........  .........  .........  .........  ...........  ...........
   E0550  A                   Humidif extens supple w  .........  .........  .........  ...........  ...........
                               ippb.
   E0555  A                   Humidifier for use w/    .........  .........  .........  ...........  ...........
                               regula.
   E0560  A                   Humidifier supplemental  .........  .........  .........  ...........  ...........
                               w/ i.
   E0565  A                   Compressor air power     .........  .........  .........  ...........  ...........
                               source.
   E0570  A                   Nebulizer with           .........  .........  .........  ...........  ...........
                               compression.
   E0575  A                   Nebulizer ultrasonic...  .........  .........  .........  ...........  ...........
   E0580  A                   Nebulizer for use w/     .........  .........  .........  ...........  ...........
                               regulat.
   E0585  A                   Nebulizer w/ compressor  .........  .........  .........  ...........  ...........
                               & he.
   E0600  A                   Suction pump portab hom  .........  .........  .........  ...........  ...........
                               modl.
   E0601  A                   Cont airway pressure     .........  .........  .........  ...........  ...........
                               device.
   E0605  A                   Vaporizer room type....  .........  .........  .........  ...........  ...........
   E0606  A                   Drainage board postural  .........  .........  .........  ...........  ...........
   E0607  A                   Blood glucose monitor    .........  .........  .........  ...........  ...........
                               home.
   E0608  A                   Apnea monitor..........  .........  .........  .........  ...........  ...........
   E0609  A                   Blood gluc mon w/        .........  .........  .........  ...........  ...........
                               special fea.
   E0610  A                   Pacemaker monitr         .........  .........  .........  ...........  ...........
                               audible/vis.
   E0615  A                   Pacemaker monitr         .........  .........  .........  ...........  ...........
                               digital/vis.
   E0621  A                   Patient lift sling or    .........  .........  .........  ...........  ...........
                               seat.
   E0625  A                   Patient lift bathroom    .........  .........  .........  ...........  ...........
                               or toi.
   E0627  A                   Seat lift incorp lift-   .........  .........  .........  ...........  ...........
                               chair.
   E0628  A                   Seat lift for pt furn-   .........  .........  .........  ...........  ...........
                               electr.
   E0629  A                   Seat lift for pt furn-   .........  .........  .........  ...........  ...........
                               non-el.
   E0630  A                   Patient lift hydraulic.  .........  .........  .........  ...........  ...........
   E0635  A                   Patient lift electric..  .........  .........  .........  ...........  ...........
   E0650  A                   Pneuma compresor non-    .........  .........  .........  ...........  ...........
                               segment.
   E0651  A                   Pneum compressor         .........  .........  .........  ...........  ...........
                               segmental.
   E0652  A                   Pneum compres w/cal      .........  .........  .........  ...........  ...........
                               pressure.
   E0655  A                   Pneumatic appliance      .........  .........  .........  ...........  ...........
                               half arm.
   E0660  A                   Pneumatic appliance      .........  .........  .........  ...........  ...........
                               full leg.
   E0665  A                   Pneumatic appliance      .........  .........  .........  ...........  ...........
                               full arm.
   E0666  A                   Pneumatic appliance      .........  .........  .........  ...........  ...........
                               half leg.
   E0667  A                   Seg pneumatic appl full  .........  .........  .........  ...........  ...........
                               leg.
   E0668  A                   Seg pneumatic appl full  .........  .........  .........  ...........  ...........
                               arm.
   E0669  A                   Seg pneumatic appli      .........  .........  .........  ...........  ...........
                               half leg.
   E0671  A                   Pressure pneum appl      .........  .........  .........  ...........  ...........
                               full leg.
   E0672  A                   Pressure pneum appl      .........  .........  .........  ...........  ...........
                               full arm.
   E0673  A                   Pressure pneum appl      .........  .........  .........  ...........  ...........
                               half leg.
   E0690  A                   Ultraviolet cabinet....  .........  .........  .........  ...........  ...........
   E0700  A                   Safety equipment.......  .........  .........  .........  ...........  ...........
   E0710  A                   Restraints any type....  .........  .........  .........  ...........  ...........
   E0720  A                   Tens two lead..........  .........  .........  .........  ...........  ...........
   E0730  A                   Tens four lead.........  .........  .........  .........  ...........  ...........
   E0731  A                   Conductive garment for   .........  .........  .........  ...........  ...........
                               tens/.

[[Page 35387]]

 
   E0740  A                   Incontinence treatment   .........  .........  .........  ...........  ...........
                               systm.
   E0744  A                   Neuromuscular stim for   .........  .........  .........  ...........  ...........
                               scoli.
   E0745  A                   Neuromuscular stim for   .........  .........  .........  ...........  ...........
                               shock.
   E0746  A                   Electromyograph          .........  .........  .........  ...........  ...........
                               biofeedback.
   E0747  A                   Elec osteogen stim not   .........  .........  .........  ...........  ...........
                               spine.
   E0748  A                   Elec osteogen stim       .........  .........  .........  ...........  ...........
                               spinal.
   E0749  A                   Elec osteogen stim       .........  .........  .........  ...........  ...........
                               implanted.
   E0751  A                   Pulse generator or       .........  .........  .........  ...........  ...........
                               receiver.
   E0753  A                   Neurostimulator          .........  .........  .........  ...........  ...........
                               electrodes.
   E0755  A                   Electronic salivary      .........  .........  .........  ...........  ...........
                               reflex s.
   E0760  A                   Osteogen ultrasound      .........  .........  .........  ...........  ...........
                               stimltor.
   E0776  A                   Iv pole................  .........  .........  .........  ...........  ...........
   E0781  A                   External ambulatory      .........  .........  .........  ...........  ...........
                               infus pu.
   E0782  A                   Non-programble infusion  .........  .........  .........  ...........  ...........
                               pump.
   E0783  A                   Programmable infusion    .........  .........  .........  ...........  ...........
                               pump.
   E0784  A                   Ext amb infusn pump      .........  .........  .........  ...........  ...........
                               insulin.
   E0791  A                   Parenteral infusion      .........  .........  .........  ...........  ...........
                               pump sta.
   E0840  A                   Tract frame attach       .........  .........  .........  ...........  ...........
                               headboard.
   E0850  A                   Traction stand free      .........  .........  .........  ...........  ...........
                               standing.
   E0855  A                   Cervical traction        .........  .........  .........  ...........  ...........
                               equipment.
   E0860  A                   Tract equip cervical     .........  .........  .........  ...........  ...........
                               tract.
   E0870  A                   Tract frame attach       .........  .........  .........  ...........  ...........
                               footboard.
   E0880  A                   Trac stand free stand    .........  .........  .........  ...........  ...........
                               extrem.
   E0890  A                   Traction frame attach    .........  .........  .........  ...........  ...........
                               pelvic.
   E0900  A                   Trac stand free stand    .........  .........  .........  ...........  ...........
                               pelvic.
   E0910  A                   Trapeze bar attached to  .........  .........  .........  ...........  ...........
                               bed.
   E0920  A                   Fracture frame attached  .........  .........  .........  ...........  ...........
                               to b.
   E0930  A                   Fracture frame free      .........  .........  .........  ...........  ...........
                               standing.
   E0935  A                   Exercise device passive  .........  .........  .........  ...........  ...........
                               moti.
   E0940  A                   Trapeze bar free         .........  .........  .........  ...........  ...........
                               standing.
   E0941  A                   Gravity assisted         .........  .........  .........  ...........  ...........
                               traction de.
   E0942  A                   Cervical head harness/   .........  .........  .........  ...........  ...........
                               halter.
   E0943  A                   Cervical pillow........  .........  .........  .........  ...........  ...........
   E0944  A                   Pelvic belt/harness/     .........  .........  .........  ...........  ...........
                               boot.
   E0945  A                   Belt/harness extremity.  .........  .........  .........  ...........  ...........
   E0946  A                   Fracture frame dual w    .........  .........  .........  ...........  ...........
                               cross.
   E0947  A                   Fracture frame           .........  .........  .........  ...........  ...........
                               attachmnts pe.
   E0948  A                   Fracture frame           .........  .........  .........  ...........  ...........
                               attachmnts ce.
   E0950  A                   Tray...................  .........  .........  .........  ...........  ...........
   E0951  A                   Loop heel..............  .........  .........  .........  ...........  ...........
   E0952  A                   Loop tie...............  .........  .........  .........  ...........  ...........
   E0953  A                   Pneumatic tire.........  .........  .........  .........  ...........  ...........
   E0954  A                   Wheelchair semi-         .........  .........  .........  ...........  ...........
                               pneumatic ca.
   E0958  A                   Whlchr att- conv 1 arm   .........  .........  .........  ...........  ...........
                               drive.
   E0959  A                   Amputee adapter........  .........  .........  .........  ...........  ...........
   E0961  A                   Wheelchair brake         .........  .........  .........  ...........  ...........
                               extension.
   E0962  A                   Wheelchair 1 inch        .........  .........  .........  ...........  ...........
                               cushion.
   E0963  A                   Wheelchair 2 inch        .........  .........  .........  ...........  ...........
                               cushion.
   E0964  A                   Wheelchair 3 inch        .........  .........  .........  ...........  ...........
                               cushion.
   E0965  A                   Wheelchair 4 inch        .........  .........  .........  ...........  ...........
                               cushion.
   E0966  A                   Wheelchair head rest     .........  .........  .........  ...........  ...........
                               extensi.
   E0967  A                   Wheelchair hand rims...  .........  .........  .........  ...........  ...........
   E0968  A                   Wheelchair commode seat  .........  .........  .........  ...........  ...........
   E0969  A                   Wheelchair narrowing     .........  .........  .........  ...........  ...........
                               device.
   E0970  A                   Wheelchair no. 2         .........  .........  .........  ...........  ...........
                               footplates.
   E0971  A                   Wheelchair anti-tipping  .........  .........  .........  ...........  ...........
                               devi.
   E0972  A                   Transfer board or        .........  .........  .........  ...........  ...........
                               device.
   E0973  A                   Wheelchair adjustabl     .........  .........  .........  ...........  ...........
                               height.
   E0974  A                   Wheelchair grade-aid...  .........  .........  .........  ...........  ...........
   E0975  A                   Wheelchair reinforced    .........  .........  .........  ...........  ...........
                               seat u.
   E0976  A                   Wheelchair reinforced    .........  .........  .........  ...........  ...........
                               back u.
   E0977  A                   Wheelchair wedge         .........  .........  .........  ...........  ...........
                               cushion.
   E0978  A                   Wheelchair belt w/       .........  .........  .........  ...........  ...........
                               airplane b.
   E0979  A                   Wheelchair belt with     .........  .........  .........  ...........  ...........
                               velcro.
   E0980  A                   Wheelchair safety vest.  .........  .........  .........  ...........  ...........
   E0990  A                   Whellchair elevating     .........  .........  .........  ...........  ...........
                               leg res.
   E0991  A                   Wheelchair upholstry     .........  .........  .........  ...........  ...........
                               seat.
   E0992  A                   Wheelchair solid seat    .........  .........  .........  ...........  ...........
                               insert.
   E0993  A                   Wheelchair back          .........  .........  .........  ...........  ...........
                               upholstery.
   E0994  A                   Wheelchair arm rest....  .........  .........  .........  ...........  ...........
   E0995  A                   Wheelchair calf rest...  .........  .........  .........  ...........  ...........
   E0996  A                   Wheelchair tire solid..  .........  .........  .........  ...........  ...........
   E0997  A                   Wheelchair caster w/ a   .........  .........  .........  ...........  ...........
                               fork.
   E0998  A                   Wheelchair caster w/o a  .........  .........  .........  ...........  ...........
                               fork.
   E0999  A                   Wheelchr pneumatic tire  .........  .........  .........  ...........  ...........
                               w/wh.

[[Page 35388]]

 
   E1000  A                   Wheelchair tire          .........  .........  .........  ...........  ...........
                               pneumatic ca.
   E1001  A                   Wheelchair wheel.......  .........  .........  .........  ...........  ...........
   E1031  A                   Rollabout chair with     .........  .........  .........  ...........  ...........
                               casters.
   E1050  A                   Whelchr fxd full length  .........  .........  .........  ...........  ...........
                               arms.
   E1060  A                   Wheelchair detachable    .........  .........  .........  ...........  ...........
                               arms.
   E1065  A                   Wheelchair power         .........  .........  .........  ...........  ...........
                               attachment.
   E1066  A                   Wheelchair battery       .........  .........  .........  ...........  ...........
                               charger.
   E1069  A                   Wheelchair deep cycle    .........  .........  .........  ...........  ...........
                               batter.
   E1070  A                   Wheelchair detachable    .........  .........  .........  ...........  ...........
                               foot r.
   E1083  A                   Hemi-wheelchair fixed    .........  .........  .........  ...........  ...........
                               arms.
   E1084  A                   Hemi-wheelchair          .........  .........  .........  ...........  ...........
                               detachable a.
   E1085  A                   Hemi-wheelchair fixed    .........  .........  .........  ...........  ...........
                               arms.
   E1086  A                   Hemi-wheelchair          .........  .........  .........  ...........  ...........
                               detachable a.
   E1087  A                   Wheelchair lightwt       .........  .........  .........  ...........  ...........
                               fixed arm.
   E1088  A                   Wheelchair lightweight   .........  .........  .........  ...........  ...........
                               det a.
   E1089  A                   Wheelchair lightwt       .........  .........  .........  ...........  ...........
                               fixed arm.
   E1090  A                   Wheelchair lightweight   .........  .........  .........  ...........  ...........
                               det a.
   E1091  A                   Wheelchair youth.......  .........  .........  .........  ...........  ...........
   E1092  A                   Wheelchair wide w/ leg   .........  .........  .........  ...........  ...........
                               rests.
   E1093  A                   Wheelchair wide w/ foot  .........  .........  .........  ...........  ...........
                               rest.
   E1100  A                   Whchr s-recl fxd arm     .........  .........  .........  ...........  ...........
                               leg res.
   E1110  A                   Wheelchair semi-recl     .........  .........  .........  ...........  ...........
                               detach.
   E1130  A                   Whlchr stand fxd arm ft  .........  .........  .........  ...........  ...........
                               rest.
   E1140  A                   Wheelchair standard      .........  .........  .........  ...........  ...........
                               detach a.
   E1150  A                   Wheelchair standard w/   .........  .........  .........  ...........  ...........
                               leg r.
   E1160  A                   Wheelchair fixed arms..  .........  .........  .........  ...........  ...........
   E1170  A                   Whlchr ampu fxd arm leg  .........  .........  .........  ...........  ...........
                               rest.
   E1171  A                   Wheelchair amputee w/o   .........  .........  .........  ...........  ...........
                               leg r.
   E1172  A                   Wheelchair amputee       .........  .........  .........  ...........  ...........
                               detach ar.
   E1180  A                   Wheelchair amputee w/    .........  .........  .........  ...........  ...........
                               foot r.
   E1190  A                   Wheelchair amputee w/    .........  .........  .........  ...........  ...........
                               leg re.
   E1195  A                   Wheelchair amputee       .........  .........  .........  ...........  ...........
                               heavy dut.
   E1200  A                   Wheelchair amputee       .........  .........  .........  ...........  ...........
                               fixed arm.
   E1210  A                   Whlchr moto ful arm leg  .........  .........  .........  ...........  ...........
                               rest.
   E1211  A                   Wheelchair motorized w/  .........  .........  .........  ...........  ...........
                               det.
   E1212  A                   Wheelchair motorized w   .........  .........  .........  ...........  ...........
                               full.
   E1213  A                   Wheelchair motorized w/  .........  .........  .........  ...........  ...........
                               det.
   E1220  A                   Whlchr special size/     .........  .........  .........  ...........  ...........
                               constrc.
   E1221  A                   Wheelchair spec size w   .........  .........  .........  ...........  ...........
                               foot.
   E1222  A                   Wheelchair spec size w/  .........  .........  .........  ...........  ...........
                               leg.
   E1223  A                   Wheelchair spec size w   .........  .........  .........  ...........  ...........
                               foot.
   E1224  A                   Wheelchair spec size w/  .........  .........  .........  ...........  ...........
                               leg.
   E1225  A                   Wheelchair spec sz semi- .........  .........  .........  ...........  ...........
                               recl.
   E1226  A                   Wheelchair spec sz full- .........  .........  .........  ...........  ...........
                               recl.
   E1227  A                   Wheelchair spec sz spec  .........  .........  .........  ...........  ...........
                               ht a.
   E1228  A                   Wheelchair spec sz spec  .........  .........  .........  ...........  ...........
                               ht b.
   E1230  A                   Power operated vehicle.  .........  .........  .........  ...........  ...........
   E1240  A                   Whchr litwt det arm leg  .........  .........  .........  ...........  ...........
                               rest.
   E1250  A                   Wheelchair lightwt       .........  .........  .........  ...........  ...........
                               fixed arm.
   E1260  A                   Wheelchair lightwt foot  .........  .........  .........  ...........  ...........
                               rest.
   E1270  A                   Wheelchair lightweight   .........  .........  .........  ...........  ...........
                               leg r.
   E1280  A                   Whchr h-duty det arm     .........  .........  .........  ...........  ...........
                               leg res.
   E1285  A                   Wheelchair heavy duty    .........  .........  .........  ...........  ...........
                               fixed.
   E1290  A                   Wheelchair hvy duty      .........  .........  .........  ...........  ...........
                               detach a.
   E1295  A                   Wheelchair heavy duty    .........  .........  .........  ...........  ...........
                               fixed.
   E1296  A                   Wheelchair special seat  .........  .........  .........  ...........  ...........
                               heig.
   E1297  A                   Wheelchair special seat  .........  .........  .........  ...........  ...........
                               dept.
   E1298  A                   Wheelchair spec seat     .........  .........  .........  ...........  ...........
                               depth/w.
   E1300  A                   Whirlpool portable.....  .........  .........  .........  ...........  ...........
   E1310  A                   Whirlpool non-portable.  .........  .........  .........  ...........  ...........
   E1340  A                   Repair for DME, per 15   .........  .........  .........  ...........  ...........
                               min.
   E1353  A                   Oxygen supplies          .........  .........  .........  ...........  ...........
                               regulator.
   E1355  A                   Oxygen supplies stand/   .........  .........  .........  ...........  ...........
                               rack.
   E1372  A                   Oxy suppl heater for     .........  .........  .........  ...........  ...........
                               nebuliz.
   E1375  A                   Oxygen suppl nebulizer   .........  .........  .........  ...........  ...........
                               porta.
   E1377  A                   Oxygen concentrator to   .........  .........  .........  ...........  ...........
                               244 c.
   E1378  A                   Oxygen concentrator to   .........  .........  .........  ...........  ...........
                               488 c.
   E1379  A                   Oxygen concentrator to   .........  .........  .........  ...........  ...........
                               732 c.
   E1380  A                   Oxygen concentrator to   .........  .........  .........  ...........  ...........
                               D976 c.
   E1381  A                   Oxygen concentrat to     .........  .........  .........  ...........  ...........
                               1220 cu.
   E1382  A                   Oxygen concentrat to     .........  .........  .........  ...........  ...........
                               1464 cu.
   E1383  A                   Oxygen concentrat to     .........  .........  .........  ...........  ...........
                               1708 cu.
   E1384  A                   Oxygen concentrat to     .........  .........  .........  ...........  ...........
                               1952 cu.
   E1385  A                   Oxygen concentrator >    .........  .........  .........  ...........  ...........
                               1952 c.
   E1399  A                   Durable medical          .........  .........  .........  ...........  ...........
                               equipment mi.

[[Page 35389]]

 
   E1400  A                   Oxygen concentrator < 2  .........  .........  .........  ...........  ...........
                               lite.
   E1401  A                   Oxygen concentrator 2-3  .........  .........  .........  ...........  ...........
                               lite.
   E1402  A                   Oxygen concentrator 3-4  .........  .........  .........  ...........  ...........
                               lite.
   E1403  A                   Oxygen concentrator 4-5  .........  .........  .........  ...........  ...........
                               lite.
   E1404  A                   Oxygen concentrator > 5  .........  .........  .........  ...........  ...........
                               lite.
   E1405  A                   O2/water vapor enrich w/ .........  .........  .........  ...........  ...........
                               heat.
   E1406  A                   O2/water vapor enrich w/ .........  .........  .........  ...........  ...........
                               o he.
   E1510  A                   Kidney dialysate         .........  .........  .........  ...........  ...........
                               delivry sys.
   E1520  A                   Heparin infusion pump    .........  .........  .........  ...........  ...........
                               for di.
   E1530  A                   Air bubble detector for  .........  .........  .........  ...........  ...........
                               dial.
   E1540  A                   Pressure alarm for       .........  .........  .........  ...........  ...........
                               dialysis.
   E1550  A                   Bath conductivity meter  .........  .........  .........  ...........  ...........
   E1560  A                   Blood leak detector for  .........  .........  .........  ...........  ...........
                               dial.
   E1570  A                   Adjustable chair for     .........  .........  .........  ...........  ...........
                               esrd pt.
   E1575  A                   Transducer protector/    .........  .........  .........  ...........  ...........
                               fluid b.
   E1580  A                   Unipuncture control      .........  .........  .........  ...........  ...........
                               system.
   E1590  A                   Hemodialysis machine...  .........  .........  .........  ...........  ...........
   E1592  A                   Auto interm peritoneal   .........  .........  .........  ...........  ...........
                               dialy.
   E1594  A                   Cycler dialysis machine  .........  .........  .........  ...........  ...........
   E1600  A                   Deliv/install equip for  .........  .........  .........  ...........  ...........
                               dial.
   E1610  A                   Reverse osmosis water    .........  .........  .........  ...........  ...........
                               purifi.
   E1615  A                   Deionizer water          .........  .........  .........  ...........  ...........
                               purification.
   E1620  A                   Blood pump for dialysis  .........  .........  .........  ...........  ...........
   E1625  A                   Water softening system.  .........  .........  .........  ...........  ...........
   E1630  A                   Reciprocating            .........  .........  .........  ...........  ...........
                               peritoneal dia.
   E1632  A                   Wearable artificial      .........  .........  .........  ...........  ...........
                               kidney.
   E1635  A                   Compact travel           .........  .........  .........  ...........  ...........
                               hemodialyzer.
   E1636  A                   Sorbent cartridges for   .........  .........  .........  ...........  ...........
                               dialy.
   E1640  A                   Replacement components   .........  .........  .........  ...........  ...........
                               for d.
   E1699  A                   Dialysis equipment       .........  .........  .........  ...........  ...........
                               unspecifi.
   E1700  A                   Jaw motion rehab system  .........  .........  .........  ...........  ...........
   E1701  A                   Repl cushions for jaw    .........  .........  .........  ...........  ...........
                               motion.
   E1702  A                   Repl measr scales jaw    .........  .........  .........  ...........  ...........
                               motion.
   E1800  A                   Adjust elbow ext/flex    .........  .........  .........  ...........  ...........
                               device.
   E1805  A                   Adjust wrist ext/flex    .........  .........  .........  ...........  ...........
                               device.
   E1810  A                   Adjust knee ext/flex     .........  .........  .........  ...........  ...........
                               device.
   E1815  A                   Adjust ankle ext/flex    .........  .........  .........  ...........  ...........
                               device.
   E1820  A                   Soft interface material  .........  .........  .........  ...........  ...........
   E1825  A                   Adjust finger ext/flex   .........  .........  .........  ...........  ...........
                               devc.
   E1830  A                   Adjust toe ext/flex      .........  .........  .........  ...........  ...........
                               device.
   G0001  A                   Drawing blood for        .........  .........  .........  ...........  ...........
                               specimen.
   G0002  N                   Temporary urinary        .........  .........  .........  ...........  ...........
                               catheter.
   G0004  X                   ECG transm phys review         956       1.09     $56.05       $54.47       $11.21
                               & int.
   G0005  X                   ECG 24 hour recording..        956       1.09     $56.05       $54.47       $11.21
   G0006  X                   ECG transmission &             956       1.09     $56.05       $54.47       $11.21
                               analysis.
   G0007  N                   ECG phy review &         .........  .........  .........  ...........  ...........
                               interpret.
   G0008  X                   Admin influenza virus          901       0.07      $3.60        $2.49        $0.72
                               vac.
   G0009  X                   Admin pneumococcal             901       0.07      $3.60        $2.49        $0.72
                               vaccine.
   G0010  X                   Admin hepatitis b              902       1.31     $67.36       $38.19       $13.47
                               vaccine.
   G0015  X                   Post symptom ECG               956       1.09     $56.05       $54.47       $11.21
                               tracing.
   G0016  N                   Post symptom ECG md      .........  .........  .........  ...........  ...........
                               review.
   G0025  X                   Collagen skin test kit.        881       0.22     $11.31        $6.78        $2.26
   G0026  A                   Fecal leukocyte          .........  .........  .........  ...........  ...........
                               examination.
   G0027  A                   Semen analysis.........  .........  .........  .........  ...........  ...........
   G0030  S                   PET imaging prev PET           760      14.89    $765.64      $419.46      $153.13
                               single.
   G0031  S                   PET imaging prev PET           760      14.89    $765.64      $419.46      $153.13
                               multple.
   G0032  S                   PET follow SPECT 78464         760      14.89    $765.64      $419.46      $153.13
                               singl.
   G0033  S                   PET follow SPECT 78464         760      14.89    $765.64      $419.46      $153.13
                               mult.
   G0034  S                   PET follow SPECT 76865         760      14.89    $765.64      $419.46      $153.13
                               singl.
   G0035  S                   PET follow SPECT 78465         760      14.89    $765.64      $419.46      $153.13
                               mult.
   G0036  S                   PET follow cornry angio        760      14.89    $765.64      $419.46      $153.13
                               sing.
   G0037  S                   PET follow cornry angio        760      14.89    $765.64      $419.46      $153.13
                               mult.
   G0038  S                   PET follow myocard perf        760      14.89    $765.64      $419.46      $153.13
                               sing.
   G0039  S                   PET follow myocard perf        760      14.89    $765.64      $419.46      $153.13
                               mult.
   G0040  S                   PET follow stress echo         760      14.89    $765.64      $419.46      $153.13
                               singl.
   G0041  S                   PET follow stress echo         760      14.89    $765.64      $419.46      $153.13
                               mult.
   G0042  S                   PET follow ventriculogm        760      14.89    $765.64      $419.46      $153.13
                               sing.
   G0043  S                   PET follow ventriculogm        760      14.89    $765.64      $419.46      $153.13
                               mult.
   G0044  S                   PET following rest ECG         760      14.89    $765.64      $419.46      $153.13
                               singl.
   G0045  S                   PET following rest ECG         760      14.89    $765.64      $419.46      $153.13
                               mult.
   G0046  S                   PET follow stress ECG          760      14.89    $765.64      $419.46      $153.13
                               singl.
   G0047  S                   PET follow stress ECG          760      14.89    $765.64      $419.46      $153.13
                               mult.
   G0050  S                   Residual urine by              747       1.65     $84.84       $54.47       $16.97
                               ultrasound.
   G0101  V                   CA screen;pelvic/breast        913  .........  .........  ...........  ...........
                               exam.
   G0104  S                   CA screen;flexi                446       2.54    $130.61       $64.86       $26.12
                               sigmoidscope.

[[Page 35390]]

 
   G0105  S                   Colorectal scrn; hi            426       6.74    $346.57      $185.32       $69.31
                               risk ind.
   G0106  S                   Colon CA screen;barium         736       1.85     $95.13       $53.79       $19.03
                               enema.
   G0107  A                   CA screen; fecal blood   .........  .........  .........  ...........  ...........
                               test.
   G0110  A                   Nett pulm-rehab educ;    .........  .........  .........  ...........  ...........
                               ind.
   G0111  A                   Nett pulm-rehab educ;    .........  .........  .........  ...........  ...........
                               group.
   G0112  A                   Nett;nutrition guid,     .........  .........  .........  ...........  ...........
                               initial.
   G0113  A                   Nett;nutrition           .........  .........  .........  ...........  ...........
                               guid,subseqnt.
   G0114  A                   Nett; psychosocial       .........  .........  .........  ...........  ...........
                               consult.
   G0115  A                   Nett; psychological      .........  .........  .........  ...........  ...........
                               testing.
   G0116  A                   Nett; psychosocial       .........  .........  .........  ...........  ...........
                               counsel.
   G0120  S                   Colon ca scrn; barium          736       1.85     $95.13       $53.79       $19.03
                               enema.
   G0121  E                   Colon ca scrn not hi     .........  .........  .........  ...........  ...........
                               rsk ind.
   G0122  E                   Colon ca scrn; barium    .........  .........  .........  ...........  ...........
                               enema.
   J0120  N                   Tetracyclin injection..  .........  .........  .........  ...........  ...........
   J0150  N                   Injection adenosine 6    .........  .........  .........  ...........  ...........
                               MG.
   J0170  N                   Adrenalin epinephrin     .........  .........  .........  ...........  ...........
                               inject.
   J0190  N                   Inj biperiden lactate/5  .........  .........  .........  ...........  ...........
                               mg.
   J0205  N                   Alglucerase injection..  .........  .........  .........  ...........  ...........
   J0207  N                   Amifostine.............  .........  .........  .........  ...........  ...........
   J0210  N                   Methyldopate hcl         .........  .........  .........  ...........  ...........
                               injection.
   J0256  N                   Alpha 1 proteinase       .........  .........  .........  ...........  ...........
                               inhibitor.
   J0270  E                   Alprostadil for          .........  .........  .........  ...........  ...........
                               injection.
   J0280  N                   Aminophyllin 250 MG inj  .........  .........  .........  ...........  ...........
   J0290  N                   Ampicillin 500 MG inj..  .........  .........  .........  ...........  ...........
   J0295  N                   Ampicillin sodium per    .........  .........  .........  ...........  ...........
                               1.5 gm.
   J0300  N                   Amobarbital 125 MG inj.  .........  .........  .........  ...........  ...........
   J0330  N                   Succinycholine chloride  .........  .........  .........  ...........  ...........
                               inj.
   J0340  N                   Nandrolon                .........  .........  .........  ...........  ...........
                               phenpropionate inj.
   J0350  N                   Injection anistreplase   .........  .........  .........  ...........  ...........
                               30 u.
   J0360  N                   Hydralazine hcl          .........  .........  .........  ...........  ...........
                               injection.
   J0380  N                   Inj metaraminol          .........  .........  .........  ...........  ...........
                               bitartrate.
   J0390  N                   Chloroquine injection..  .........  .........  .........  ...........  ...........
   J0400  N                   Inj trimethaphan         .........  .........  .........  ...........  ...........
                               camsylate.
   J0460  N                   Atropine sulfate         .........  .........  .........  ...........  ...........
                               injection.
   J0470  N                   Dimecaprol injection...  .........  .........  .........  ...........  ...........
   J0475  N                   Baclofen 10 MG           .........  .........  .........  ...........  ...........
                               injection.
   J0500  N                   Dicyclomine injection..  .........  .........  .........  ...........  ...........
   J0510  N                   Benzquinamide injection  .........  .........  .........  ...........  ...........
   J0515  N                   Inj benztropine          .........  .........  .........  ...........  ...........
                               mesylate.
   J0520  N                   Bethanechol chloride     .........  .........  .........  ...........  ...........
                               inject.
   J0530  N                   Penicillin g benzathine  .........  .........  .........  ...........  ...........
                               inj.
   J0540  N                   Penicillin g benzathine  .........  .........  .........  ...........  ...........
                               inj.
   J0550  N                   Penicillin g benzathine  .........  .........  .........  ...........  ...........
                               inj.
   J0560  N                   Penicillin g benzathine  .........  .........  .........  ...........  ...........
                               inj.
   J0570  N                   Penicillin g benzathine  .........  .........  .........  ...........  ...........
                               inj.
   J0580  N                   Penicillin g benzathine  .........  .........  .........  ...........  ...........
                               inj.
   J0585  N                   Botulinum toxin a per    .........  .........  .........  ...........  ...........
                               unit.
   J0590  N                   Ethylnorepinephrine hcl  .........  .........  .........  ...........  ...........
                               inj.
   J0600  N                   Edetate calcium          .........  .........  .........  ...........  ...........
                               disodium inj.
   J0610  N                   Calcium gluconate        .........  .........  .........  ...........  ...........
                               injection.
   J0620  N                   Calcium glycer & lact/   .........  .........  .........  ...........  ...........
                               10 ML.
   J0630  N                   Calcitonin salmon        .........  .........  .........  ...........  ...........
                               injection.
   J0635  N                   Calcitriol injection...  .........  .........  .........  ...........  ...........
   J0640  X                   Leucovorin calcium             064       4.15    $213.39      $138.99       $42.68
                               injection.
   J0670  N                   Inj mepivacaine HCL/10   .........  .........  .........  ...........  ...........
                               ml.
   J0690  N                   Cefazolin sodium         .........  .........  .........  ...........  ...........
                               injection.
   J0694  N                   Cefoxitin sodium         .........  .........  .........  ...........  ...........
                               injection.
   J0695  N                   Cefonocid sodium         .........  .........  .........  ...........  ...........
                               injection.
   J0696  N                   Ceftriaxone sodium       .........  .........  .........  ...........  ...........
                               injection.
   J0697  N                   Sterile cefuroxime       .........  .........  .........  ...........  ...........
                               injection.
   J0698  N                   Cefotaxime sodium        .........  .........  .........  ...........  ...........
                               injection.
   J0702  N                   Betamethasone acet&sod   .........  .........  .........  ...........  ...........
                               phosp.
   J0704  N                   Betamethasone sod phosp/ .........  .........  .........  ...........  ...........
                               4 MG.
   J0710  N                   Cephapirin sodium        .........  .........  .........  ...........  ...........
                               injection.
   J0713  N                   Inj ceftazidime per 500  .........  .........  .........  ...........  ...........
                               mg.
   J0715  N                   Ceftizoxime sodium/500   .........  .........  .........  ...........  ...........
                               MG.
   J0720  N                   Chloramphenicol sodium   .........  .........  .........  ...........  ...........
                               injec.
   J0725  N                   Chorionic gonadotropin/  .........  .........  .........  ...........  ...........
                               1000u.
   J0730  N                   Chlorpheniramin maleate  .........  .........  .........  ...........  ...........
                               inj.
   J0735  N                   Clonidine hydrochloride  .........  .........  .........  ...........  ...........
   J0740  N                   Cidofovir injection....  .........  .........  .........  ...........  ...........
   J0743  N                   Cilastatin sodium        .........  .........  .........  ...........  ...........
                               injection.
   J0745  N                   Inj codeine phosphate /  .........  .........  .........  ...........  ...........
                               30 MG.
   J0760  N                   Colchicine injection...  .........  .........  .........  ...........  ...........
   J0770  N                   Colistimethate sodium    .........  .........  .........  ...........  ...........
                               inj.

[[Page 35391]]

 
   J0780  N                   Prochlorperazine         .........  .........  .........  ...........  ...........
                               injection.
   J0800  N                   Corticotropin injection  .........  .........  .........  ...........  ...........
   J0810  N                   Cortisone injection....  .........  .........  .........  ...........  ...........
   J0835  N                   Inj cosyntropin per      .........  .........  .........  ...........  ...........
                               0.25 MG.
   J0850  N                   Cytomegalovirus imm IV / .........  .........  .........  ...........  ...........
                               vial.
   J0895  N                   Deferoxamine mesylate    .........  .........  .........  ...........  ...........
                               inj.
   J0900  N                   Testosterone enanthate   .........  .........  .........  ...........  ...........
                               inj.
   J0945  N                   Brompheniramine maleate  .........  .........  .........  ...........  ...........
                               inj.
   J0970  N                   Estradiol valerate       .........  .........  .........  ...........  ...........
                               injection.
   J1000  N                   Depo-estradiol           .........  .........  .........  ...........  ...........
                               cypionate inj.
   J1020  N                   Methylprednisolone 20    .........  .........  .........  ...........  ...........
                               MG inj.
   J1030  N                   Methylprednisolone 40    .........  .........  .........  ...........  ...........
                               MG inj.
   J1040  N                   Methylprednisolone 80    .........  .........  .........  ...........  ...........
                               MG inj.
   J1050  N                   Medroxyprogesterone inj  .........  .........  .........  ...........  ...........
   J1055  E                   Medrxyprogester acetate  .........  .........  .........  ...........  ...........
                               inj.
   J1060  N                   Testosterone cypionate   .........  .........  .........  ...........  ...........
                               1 ML.
   J1070  N                   Testosterone cypionat    .........  .........  .........  ...........  ...........
                               100 MG.
   J1080  N                   Testosterone cypionat    .........  .........  .........  ...........  ...........
                               200 MG.
   J1090  N                   Testosterone cypionate   .........  .........  .........  ...........  ...........
                               50 MG.
   J1095  N                   Inj dexamethasone        .........  .........  .........  ...........  ...........
                               acetate.
   J1100  N                   Dexamethosone sodium     .........  .........  .........  ...........  ...........
                               phos.
   J1110  N                   Inj dihydroergotamine    .........  .........  .........  ...........  ...........
                               mesylt.
   J1120  N                   Acetazolamid sodium      .........  .........  .........  ...........  ...........
                               injectio.
   J1160  N                   Digoxin injection......  .........  .........  .........  ...........  ...........
   J1165  N                   Phenytoin sodium         .........  .........  .........  ...........  ...........
                               injection.
   J1170  N                   Hydromorphone injection  .........  .........  .........  ...........  ...........
   J1180  N                   Dyphylline injection...  .........  .........  .........  ...........  ...........
   J1190  N                   Dexrazoxane HCl          .........  .........  .........  ...........  ...........
                               injection.
   J1200  N                   Diphenhydramine hcl      .........  .........  .........  ...........  ...........
                               injectio.
   J1205  N                   Chlorothiazide sodium    .........  .........  .........  ...........  ...........
                               inj.
   J1212  N                   Dimethyl sulfoxide 50%   .........  .........  .........  ...........  ...........
                               50 ML.
   J1230  N                   Methadone injection....  .........  .........  .........  ...........  ...........
   J1240  N                   Dimenhydrinate           .........  .........  .........  ...........  ...........
                               injection.
   J1245  N                   Dipyridamole injection.  .........  .........  .........  ...........  ...........
   J1250  N                   Inj dobutamine HCL/250   .........  .........  .........  ...........  ...........
                               mg.
   J1320  N                   Amitriptyline injection  .........  .........  .........  ...........  ...........
   J1325  N                   Epoprostenol injection.  .........  .........  .........  ...........  ...........
   J1330  N                   Ergonovine maleate       .........  .........  .........  ...........  ...........
                               injection.
   J1362  N                   Erythromycin glucep/250  .........  .........  .........  ...........  ...........
                               MG.
   J1364  N                   Erythro lactobionate/    .........  .........  .........  ...........  ...........
                               500 MG.
   J1380  N                   Estradiol valerate 10    .........  .........  .........  ...........  ...........
                               MG inj.
   J1390  N                   Estradiol valerate 20    .........  .........  .........  ...........  ...........
                               MG inj.
   J1410  N                   Inj estrogen conjugate   .........  .........  .........  ...........  ...........
                               25 MG.
   J1435  N                   Injection estrone per 1  .........  .........  .........  ...........  ...........
                               MG.
   J1436  N                   Etidronate disodium inj  .........  .........  .........  ...........  ...........
   J1440  N                   grastim 300 mcg          .........  .........  .........  ...........  ...........
                               injeciton.
   J1441  N                   Filgrastim 480 mcg       .........  .........  .........  ...........  ...........
                               injection.
   J1455  N                   Foscarnet sodium         .........  .........  .........  ...........  ...........
                               injection.
   J1460  N                   Gamma globulin 1 CC inj  .........  .........  .........  ...........  ...........
   J1470  N                   Gamma globulin 2 CC inj  .........  .........  .........  ...........  ...........
   J1480  N                   Gamma globulin 3 CC inj  .........  .........  .........  ...........  ...........
   J1490  N                   Gamma globulin 4 CC inj  .........  .........  .........  ...........  ...........
   J1500  N                   Gamma globulin 5 CC inj  .........  .........  .........  ...........  ...........
   J1510  N                   Gamma globulin 6 CC inj  .........  .........  .........  ...........  ...........
   J1520  N                   Gamma globulin 7 CC inj  .........  .........  .........  ...........  ...........
   J1530  N                   Gamma globulin 8 CC inj  .........  .........  .........  ...........  ...........
   J1540  N                   Gamma globulin 9 CC inj  .........  .........  .........  ...........  ...........
   J1550  N                   Gamma globulin 10 CC     .........  .........  .........  ...........  ...........
                               inj.
   J1560  N                   Gamma globulin > 10 CC   .........  .........  .........  ...........  ...........
                               inj.
   J1561  N                   Immune globulin 500 mg.  .........  .........  .........  ...........  ...........
   J1562  N                   Immune globulin 5 gms..  .........  .........  .........  ...........  ...........
   J1565  N                   RSV-ivig...............  .........  .........  .........  ...........  ...........
   J1570  N                   Ganciclovir sodium       .........  .........  .........  ...........  ...........
                               injection.
   J1580  N                   Garamycin gentamicin     .........  .........  .........  ...........  ...........
                               inj.
   J1600  N                   Gold sodium thiomaleate  .........  .........  .........  ...........  ...........
                               inj.
   J1610  N                   Glucagon hydrochloride/  .........  .........  .........  ...........  ...........
                               1 MG.
   J1620  N                   Gonadorelin hydroch/     .........  .........  .........  ...........  ...........
                               100 mcg.
   J1626  N                   Granisetron HCl          .........  .........  .........  ...........  ...........
                               injection.
   J1630  N                   Haloperidol injection..  .........  .........  .........  ...........  ...........
   J1631  N                   Haloperidol decanoate    .........  .........  .........  ...........  ...........
                               inj.
   J1642  N                   Inj heparin sodium per   .........  .........  .........  ...........  ...........
                               10 u.
   J1644  N                   Inj heparin sodium per   .........  .........  .........  ...........  ...........
                               1000u.
   J1645  N                   Dalteparin sodium......  .........  .........  .........  ...........  ...........
   J1650  N                   Inj enoxaparin sodium    .........  .........  .........  ...........  ...........
                               30 mg.
   J1670  N                   Tetanus immune globulin  .........  .........  .........  ...........  ...........
                               inj.

[[Page 35392]]

 
   J1690  N                   Prednisolone tebutate    .........  .........  .........  ...........  ...........
                               inj.
   J1700  N                   Hydrocortisone acetate   .........  .........  .........  ...........  ...........
                               inj.
   J1710  N                   Hydrocortisone sodium    .........  .........  .........  ...........  ...........
                               ph inj.
   J1720  N                   Hydrocortisone sodium    .........  .........  .........  ...........  ...........
                               succ i.
   J1730  N                   Diazoxide injection....  .........  .........  .........  ...........  ...........
   J1739  N                   Hydroxyprogesterone cap  .........  .........  .........  ...........  ...........
                               125.
   J1741  N                   Hydroxyprogesterone cap  .........  .........  .........  ...........  ...........
                               250.
   J1742  N                   Ibutilide fumarate       .........  .........  .........  ...........  ...........
                               injection.
   J1760  N                   Iron dextran 2 CC inj..  .........  .........  .........  ...........  ...........
   J1770  N                   Iron dextran 5 CC inj..  .........  .........  .........  ...........  ...........
   J1780  N                   Iron dextran 10 CC inj.  .........  .........  .........  ...........  ...........
   J1785  N                   Injection imiglucerase / .........  .........  .........  ...........  ...........
                               unit.
   J1790  N                   Droperidol injection...  .........  .........  .........  ...........  ...........
   J1800  N                   Propranolol injection..  .........  .........  .........  ...........  ...........
   J1810  N                   Droperidol/fentanyl inj  .........  .........  .........  ...........  ...........
   J1820  N                   Insulin injection......  .........  .........  .........  ...........  ...........
   J1825  N                   Interferon beta-1a.....  .........  .........  .........  ...........  ...........
   J1830  N                   Interferon beta-1b /     .........  .........  .........  ...........  ...........
                               .25 MG.
   J1840  N                   Kanamycin sulfate 500    .........  .........  .........  ...........  ...........
                               MG inj.
   J1850  N                   Kanamycin sulfate 75 MG  .........  .........  .........  ...........  ...........
                               inj.
   J1885  N                   Ketorolac tromethamine   .........  .........  .........  ...........  ...........
                               inj.
   J1890  N                   Cephalothin sodium       .........  .........  .........  ...........  ...........
                               injection.
   J1910  N                   Kutapressin injection..  .........  .........  .........  ...........  ...........
   J1930  N                   Propiomazine injection.  .........  .........  .........  ...........  ...........
   J1940  N                   Furosemide injection...  .........  .........  .........  ...........  ...........
   J1950  X                   Leuprolide acetate /           064       4.15    $213.39      $138.99       $42.68
                               3.75 MG.
   J1955  N                   Inj levocarnitine per 1  .........  .........  .........  ...........  ...........
                               gm.
   J1960  N                   Levorphanol tartrate     .........  .........  .........  ...........  ...........
                               inj.
   J1970  N                   Methotrimeprazine        .........  .........  .........  ...........  ...........
                               injection.
   J1980  N                   Hyoscyamine sulfate inj  .........  .........  .........  ...........  ...........
   J1990  N                   Chlordiazepoxide         .........  .........  .........  ...........  ...........
                               injection.
   J2000  N                   Lidocaine injection....  .........  .........  .........  ...........  ...........
   J2010  N                   Lincomycin injection...  .........  .........  .........  ...........  ...........
   J2060  N                   Lorazepam injection....  .........  .........  .........  ...........  ...........
   J2150  N                   Mannitol injection.....  .........  .........  .........  ...........  ...........
   J2175  N                   Meperidine hydrochl /    .........  .........  .........  ...........  ...........
                               100 MG.
   J2180  N                   Meperidine/promethazine  .........  .........  .........  ...........  ...........
                               inj.
   J2210  N                   Methylergonovin maleate  .........  .........  .........  ...........  ...........
                               inj.
   J2240  N                   Metocurine iodide        .........  .........  .........  ...........  ...........
                               injection.
   J2250  N                   Inj midazolam            .........  .........  .........  ...........  ...........
                               hydrochloride.
   J2260  N                   Inj milrinone lactate /  .........  .........  .........  ...........  ...........
                               5 ML.
   J2270  N                   Morphine sulfate         .........  .........  .........  ...........  ...........
                               injection.
   J2275  N                   Morphine sulfate         .........  .........  .........  ...........  ...........
                               injection.
   J2300  N                   Inj nalbuphine           .........  .........  .........  ...........  ...........
                               hydrochloride.
   J2310  N                   Inj naloxone             .........  .........  .........  ...........  ...........
                               hydrochloride.
   J2320  N                   Nandrolone decanoate 50  .........  .........  .........  ...........  ...........
                               MG.
   J2321  N                   Nandrolone decanoate     .........  .........  .........  ...........  ...........
                               100 MG.
   J2322  N                   Nandrolone decanoate     .........  .........  .........  ...........  ...........
                               200 MG.
   J2330  N                   Thiothixene injection..  .........  .........  .........  ...........  ...........
   J2350  N                   Niacinamide/niacin       .........  .........  .........  ...........  ...........
                               injection.
   J2360  N                   Orphenadrine injection.  .........  .........  .........  ...........  ...........
   J2370  N                   Phenylephrine hcl        .........  .........  .........  ...........  ...........
                               injection.
   J2400  N                   Chloroprocaine hcl       .........  .........  .........  ...........  ...........
                               injection.
   J2405  N                   Ondansetron hcl          .........  .........  .........  ...........  ...........
                               injection.
   J2410  N                   Oxymorphone hcl          .........  .........  .........  ...........  ...........
                               injection.
   J2430  N                   Pamidronate disodium /   .........  .........  .........  ...........  ...........
                               30 MG.
   J2440  N                   Papaverin hcl injection  .........  .........  .........  ...........  ...........
   J2460  N                   Oxytetracycline          .........  .........  .........  ...........  ...........
                               injection.
   J2480  N                   Hydrochlorides of opium  .........  .........  .........  ...........  ...........
                               inj.
   J2510  N                   Penicillin g procaine    .........  .........  .........  ...........  ...........
                               inj.
   J2512  N                   Inj pentagastrin per 2   .........  .........  .........  ...........  ...........
                               ML.
   J2515  N                   Pentobarbital sodium     .........  .........  .........  ...........  ...........
                               inj.
   J2540  N                   Penicillin g potassium   .........  .........  .........  ...........  ...........
                               inj.
   J2545  A                   Pentamidine isethionte/  .........  .........  .........  ...........  ...........
                               300mg.
   J2550  N                   Promethazine hcl         .........  .........  .........  ...........  ...........
                               injection.
   J2560  N                   Phenobarbital sodium     .........  .........  .........  ...........  ...........
                               inj.
   J2590  N                   Oxytocin injection.....  .........  .........  .........  ...........  ...........
   J2597  N                   Inj desmopressin         .........  .........  .........  ...........  ...........
                               acetate.
   J2640  N                   Prednisolone sodium ph   .........  .........  .........  ...........  ...........
                               inj.
   J2650  N                   Prednisolone acetate     .........  .........  .........  ...........  ...........
                               inj.
   J2670  N                   Totazoline hcl           .........  .........  .........  ...........  ...........
                               injection.
   J2675  N                   Inj progesterone per 50  .........  .........  .........  ...........  ...........
                               MG.
   J2680  N                   Fluphenazine decanoate   .........  .........  .........  ...........  ...........
                               25 MG.
   J2690  N                   Procainamide hcl         .........  .........  .........  ...........  ...........
                               injection.
   J2700  N                   Oxacillin sodium         .........  .........  .........  ...........  ...........
                               injeciton.

[[Page 35393]]

 
   J2710  N                   Neostigmine methylslfte  .........  .........  .........  ...........  ...........
                               inj.
   J2720  N                   Inj protamine sulfate/   .........  .........  .........  ...........  ...........
                               10 MG.
   J2725  N                   Inj protirelin per 250   .........  .........  .........  ...........  ...........
                               mcg.
   J2730  N                   Pralidoxime chloride     .........  .........  .........  ...........  ...........
                               inj.
   J2760  N                   Phentolaine mesylate     .........  .........  .........  ...........  ...........
                               inj.
   J2765  N                   Metoclopramide hcl       .........  .........  .........  ...........  ...........
                               injection.
   J2790  N                   Rho d immune globulin    .........  .........  .........  ...........  ...........
                               inj.
   J2800  N                   Methocarbamol injection  .........  .........  .........  ...........  ...........
   J2810  N                   Inj theophylline per 40  .........  .........  .........  ...........  ...........
                               MG.
   J2820  N                   Sargramostim injection.  .........  .........  .........  ...........  ...........
   J2860  N                   Secobarbital sodium inj  .........  .........  .........  ...........  ...........
   J2910  N                   Aurothioglucose          .........  .........  .........  ...........  ...........
                               injeciton.
   J2912  N                   Sodium chloride          .........  .........  .........  ...........  ...........
                               injection.
   J2920  N                   Methylprednisolone       .........  .........  .........  ...........  ...........
                               injection.
   J2930  N                   Methylprednisolone       .........  .........  .........  ...........  ...........
                               injection.
   J2950  N                   Promazine hcl injeciton  .........  .........  .........  ...........  ...........
   J2970  N                   Methicillin sodium       .........  .........  .........  ...........  ...........
                               injection.
   J2995  N                   Inj streptokinase /      .........  .........  .........  ...........  ...........
                               250000 IU.
   J2996  N                   Alteplase recombinant    .........  .........  .........  ...........  ...........
                               inj.
   J3000  N                   Streptomycin injection.  .........  .........  .........  ...........  ...........
   J3010  N                   Fentanyl citrate         .........  .........  .........  ...........  ...........
                               injeciton.
   J3030  N                   Sumatriptan succinate /  .........  .........  .........  ...........  ...........
                               6 MG.
   J3070  N                   Pentazocine hcl          .........  .........  .........  ...........  ...........
                               injeciton.
   J3080  N                   Chlorprothixene          .........  .........  .........  ...........  ...........
                               injection.
   J3105  N                   Terbutaline sulfate inj  .........  .........  .........  ...........  ...........
   J3120  N                   Testosterone enanthate   .........  .........  .........  ...........  ...........
                               inj.
   J3130  N                   Testosterone enanthate   .........  .........  .........  ...........  ...........
                               inj.
   J3140  N                   Testosterone suspension  .........  .........  .........  ...........  ...........
                               inj.
   J3150  N                   Testosteron propionate   .........  .........  .........  ...........  ...........
                               inj.
   J3230  N                   Chlorpromazine hcl       .........  .........  .........  ...........  ...........
                               injection.
   J3240  N                   Thyrotropin injection..  .........  .........  .........  ...........  ...........
   J3250  N                   Trimethobenzamide hcl    .........  .........  .........  ...........  ...........
                               inj.
   J3260  N                   Tobramycin sulfate       .........  .........  .........  ...........  ...........
                               injection.
   J3265  N                   Injection torsemide 10   .........  .........  .........  ...........  ...........
                               mg/ml.
   J3270  N                   Imipramine hcl           .........  .........  .........  ...........  ...........
                               injection.
   J3280  N                   Thiethylperazine         .........  .........  .........  ...........  ...........
                               maleate inj.
   J3301  N                   Triamcinolone acetonide  .........  .........  .........  ...........  ...........
                               inj.
   J3302  N                   Triamcinolone diacetate  .........  .........  .........  ...........  ...........
                               inj.
   J3303  N                   Triamcinolone            .........  .........  .........  ...........  ...........
                               hexacetonl inj.
   J3305  N                   Inj trimetrexate         .........  .........  .........  ...........  ...........
                               glucoronate.
   J3310  N                   Perphenazine injeciton.  .........  .........  .........  ...........  ...........
   J3320  N                   Spectinomycn di-hcl inj  .........  .........  .........  ...........  ...........
   J3350  N                   Urea injection.........  .........  .........  .........  ...........  ...........
   J3360  N                   Diazepam injection.....  .........  .........  .........  ...........  ...........
   J3364  N                   Urokinase 5000 IU        .........  .........  .........  ...........  ...........
                               injection.
   J3365  N                   Urokinase 250,000 IU     .........  .........  .........  ...........  ...........
                               inj.
   J3370  N                   Vancomycin hcl           .........  .........  .........  ...........  ...........
                               injeciton.
   J3390  N                   Methoxamine injection..  .........  .........  .........  ...........  ...........
   J3400  N                   Triflupromazine hcl inj  .........  .........  .........  ...........  ...........
   J3410  N                   Hydroxyzine hcl          .........  .........  .........  ...........  ...........
                               injeciton.
   J3420  N                   Vitamin b12 injection..  .........  .........  .........  ...........  ...........
   J3430  N                   Vitamin k phytonadione   .........  .........  .........  ...........  ...........
                               inj.
   J3450  N                   Mephentermine sulfate    .........  .........  .........  ...........  ...........
                               inj.
   J3470  N                   Hyaluronidase injection  .........  .........  .........  ...........  ...........
   J3475  N                   Inj magnesium sulfate..  .........  .........  .........  ...........  ...........
   J3480  N                   Inj potassium chloride.  .........  .........  .........  ...........  ...........
   J3490  N                   Drugs unclassified       .........  .........  .........  ...........  ...........
                               injection.
   J3520  E                   Edetate disodium per     .........  .........  .........  ...........  ...........
                               150 mg.
   J3530  N                   Nasal vaccine            .........  .........  .........  ...........  ...........
                               inhalation.
   J3535  E                   Metered dose inhaler     .........  .........  .........  ...........  ...........
                               drug.
   J3570  E                   Laetrile amygdalin vit   .........  .........  .........  ...........  ...........
                               B17.
   J7030  N                   Normal saline solution   .........  .........  .........  ...........  ...........
                               infus.
   J7040  N                   Normal saline solution   .........  .........  .........  ...........  ...........
                               infus.
   J7042  N                   5% dextrose/normal       .........  .........  .........  ...........  ...........
                               saline.
   J7050  N                   Normal saline solution   .........  .........  .........  ...........  ...........
                               infus.
   J7051  N                   Sterile saline/water...  .........  .........  .........  ...........  ...........
   J7060  N                   5% dextrose/water......  .........  .........  .........  ...........  ...........
   J7070  N                   D5w infusion...........  .........  .........  .........  ...........  ...........
   J7100  N                   Dextran 40 infusion....  .........  .........  .........  ...........  ...........
   J7110  N                   Dextran 75 infusion....  .........  .........  .........  ...........  ...........
   J7120  N                   Ringers lactate          .........  .........  .........  ...........  ...........
                               infusion.
   J7130  N                   Hypertonic saline        .........  .........  .........  ...........  ...........
                               solution.
   J7190  N                   Factor viii............  .........  .........  .........  ...........  ...........
   J7191  N                   Factor VIII (porcine)..  .........  .........  .........  ...........  ...........
   J7192  N                   Factor viii recombinant  .........  .........  .........  ...........  ...........

[[Page 35394]]

 
   J7194  N                   Factor ix complex......  .........  .........  .........  ...........  ...........
   J7196  N                   Othr hemophilia clot     .........  .........  .........  ...........  ...........
                               factors.
   J7197  N                   Antithrombin iii         .........  .........  .........  ...........  ...........
                               injection.
   J7300  E                   Intraut copper           .........  .........  .........  ...........  ...........
                               contraceptive.
   J7310  N                   Ganciclovir long act     .........  .........  .........  ...........  ...........
                               implant.
   J7500  N                   Azathiop po tab 50mg     .........  .........  .........  ...........  ...........
                               100s ea.
   J7501  N                   Azathioprine parenteral  .........  .........  .........  ...........  ...........
   J7503  N                   Cyclosporine parenteral  .........  .........  .........  ...........  ...........
   J7504  N                   Lymphocyte immune        .........  .........  .........  ...........  ...........
                               globulin.
   J7505  N                   Monoclonal antibodies..  .........  .........  .........  ...........  ...........
   J7506  N                   Prednisone oral........  .........  .........  .........  ...........  ...........
   J7507  N                   Tacrolimus oral per 1    .........  .........  .........  ...........  ...........
                               MG.
   J7508  N                   Tacrolimus oral per 5    .........  .........  .........  ...........  ...........
                               MG.
   J7509  N                   Methylprednisolone oral  .........  .........  .........  ...........  ...........
   J7510  N                   Prednisolone oral per 5  .........  .........  .........  ...........  ...........
                               mg.
   J7599  N                   Immunosuppressive drug   .........  .........  .........  ...........  ...........
                               noc.
   J7610  A                   Acetylcysteine 10%       .........  .........  .........  ...........  ...........
                               injection.
   J7615  A                   Acetylcysteine 20%       .........  .........  .........  ...........  ...........
                               injection.
   J7620  A                   Albuterol sulfate .083%/ .........  .........  .........  ...........  ...........
                               ml.
   J7625  A                   Albuterol sulfate .5%    .........  .........  .........  ...........  ...........
                               inj.
   J7627  A                   Bitolterolmesylate       .........  .........  .........  ...........  ...........
                               inhal sol.
   J7630  A                   Cromolyn sodium          .........  .........  .........  ...........  ...........
                               injeciton.
   J7640  A                   Epinephrine injection..  .........  .........  .........  ...........  ...........
   J7645  A                   Ipratropium bromide      .........  .........  .........  ...........  ...........
                               .02%/ml.
   J7650  A                   Isoetharine hcl .1% inj  .........  .........  .........  ...........  ...........
   J7651  A                   Isoetharine hcl .125%    .........  .........  .........  ...........  ...........
                               inj.
   J7652  A                   Isoetharine hcl .167%    .........  .........  .........  ...........  ...........
                               inj.
   J7653  A                   Isoetharine hcl .2%/     .........  .........  .........  ...........  ...........
                               inj.
   J7654  A                   Isoetharine hcl .25%     .........  .........  .........  ...........  ...........
                               inj.
   J7655  A                   Isoetharine hcl 1% inj.  .........  .........  .........  ...........  ...........
   J7660  A                   Isoproterenol hcl .5%    .........  .........  .........  ...........  ...........
                               inj.
   J7665  A                   Isoproterenol hcl 1%     .........  .........  .........  ...........  ...........
                               inj.
   J7670  A                   Metaproterenol sulfate   .........  .........  .........  ...........  ...........
                               .4%.
   J7672  A                   Metaproterenol sulfate   .........  .........  .........  ...........  ...........
                               .6%.
   J7675  A                   Metaproterenol sulfate   .........  .........  .........  ...........  ...........
                               5%.
   J7699  A                   Inhalation solution for  .........  .........  .........  ...........  ...........
                               DME.
   J7799  A                   Non-inhalation drug for  .........  .........  .........  ...........  ...........
                               DME.
   J8499  E                   Oral prescrip drug non   .........  .........  .........  ...........  ...........
                               chemo.
   J8530  N                   Cyclophosphamide oral    .........  .........  .........  ...........  ...........
                               25 MG.
   J8560  N                   Etoposide oral 50 MG...  .........  .........  .........  ...........  ...........
   J8600  N                   Melphalan oral 2 MG....  .........  .........  .........  ...........  ...........
   J8610  X                   Methotrexate oral 2.5          061       1.15     $59.13       $37.52       $11.83
                               MG.
   J8999  X                   Oral prescription drug         061       1.15     $59.13       $37.52       $11.83
                               chemo.
   J9000  X                   Doxorubic hcl 10 MG vl         062       1.78     $91.53       $36.61       $18.31
                               chemo.
\2\ J901  X                   Doxorubicin hcl 50 MG          063       2.94    $151.17      $110.97       $30.24
        0                      inj.
   J9015  X                   Aldesleukin/single use         061       1.15     $59.13       $37.52       $11.83
                               vial.
   J9020  X                   Asparaginase injection.        062       1.78     $91.53       $36.61       $18.31
   J9031  X                   Bcg live intravesical          063       2.94    $151.17      $110.97       $30.24
                               vac.
   J9040  X                   Bleomycin sulfate              063       2.94    $151.17      $110.97       $30.24
                               injection.
   J9045  X                   Carboplatin injection..        063       2.94    $151.17      $110.97       $30.24
   J9050  X                   Carmus bischl nitro inj        063       2.94    $151.17      $110.97       $30.24
   J9060  X                   Cisplatin 10 MG                062       1.78     $91.53       $36.61       $18.31
                               injection.
   J9062  X                   Cisplatin 50 MG                063       2.94    $151.17      $110.97       $30.24
                               injection.
   J9065  X                   Inj cladribine per 1 MG        062       1.78     $91.53       $36.61       $18.31
   J9070  X                   Cyclophosphamide 100 MG        061       1.15     $59.13       $37.52       $11.83
                               inj.
   J9080  X                   Cyclophosphamide 200 MG        061       1.15     $59.13       $37.52       $11.83
                               inj.
   J9090  X                   Cyclophosphamide 500 MG        061       1.15     $59.13       $37.52       $11.83
                               inj.
   J9091  X                   Cyclophosphamide 1.0           062       1.78     $91.53       $36.61       $18.31
                               grm inj.
   J9092  X                   Cyclophosphamide 2.0           062       1.78     $91.53       $36.61       $18.31
                               grm inj.
   J9093  X                   Cyclophosphamide               061       1.15     $59.13       $37.52       $11.83
                               lyophilized.
   J9094  X                   Cyclophosphamide               061       1.15     $59.13       $37.52       $11.83
                               lyophilized.
   J9095  X                   Cyclophosphamide               061       1.15     $59.13       $37.52       $11.83
                               lyophilized.
   J9096  X                   Cyclophosphamide               062       1.78     $91.53       $36.61       $18.31
                               lyophilized.
   J9097  X                   Cyclophosphamide               062       1.78     $91.53       $36.61       $18.31
                               lyophilized.
   J9100  X                   Cytarabine hcl 100 MG          061       1.15     $59.13       $37.52       $11.83
                               inj.
   J9110  X                   Cytarabine hcl 500 MG          061       1.15     $59.13       $37.52       $11.83
                               inj.
   J9120  X                   Dactinomycin                   061       1.15     $59.13       $37.52       $11.83
                               actinomycin d.
   J9130  X                   Dacarbazine 10 MG inj..        061       1.15     $59.13       $37.52       $11.83
   J9140  X                   Dacarbazine 200 MG inj.        061       1.15     $59.13       $37.52       $11.83
   J9150  X                   Daunorubicin...........        062       1.78     $91.53       $36.61       $18.31
   J9165  X                   Diethylstilbestrol             061       1.15     $59.13       $37.52       $11.83
                               injection.
   J9170  X                   Docetaxel..............        061       1.15     $59.13       $37.52       $11.83
   J9181  X                   Etoposide 10 MG inj....        061       1.15     $59.13       $37.52       $11.83
   J9182  X                   Etoposide 100 MG inj...        063       2.94    $151.17      $110.97       $30.24
   J9185  X                   Fludarabine phosphate          063       2.94    $151.17      $110.97       $30.24
                               inj.

[[Page 35395]]

 
   J9190  X                   Fluorouracil injection.        061       1.15     $59.13       $37.52       $11.83
   J9200  X                   Floxuridine injection..        063       2.94    $151.17      $110.97       $30.24
   J9201  X                   Gemcitabine HCl........        061       1.15     $59.13       $37.52       $11.83
   J9202  X                   Goserelin acetate              063       2.94    $151.17      $110.97       $30.24
                               implant.
   J9206  X                   Irinotecan injection...        061       1.15     $59.13       $37.52       $11.83
   J9208  X                   Ifosfomide injection...        063       2.94    $151.17      $110.97       $30.24
   J9209  X                   Mesna injection........        063       2.94    $151.17      $110.97       $30.24
   J9211  X                   Idarubicin hcl                 062       1.78     $91.53       $36.61       $18.31
                               injeciton.
   J9213  X                   Interferon alfa-2a inj.        062       1.78     $91.53       $36.61       $18.31
   J9214  X                   Interferon alfa-2b inj.        061       1.15     $59.13       $37.52       $11.83
   J9215  X                   Interferon alfa-n3 inj.        061       1.15     $59.13       $37.52       $11.83
   J9216  X                   Interferon gamma 1-b           063       2.94    $151.17      $110.97       $30.24
                               inj.
   J9217  X                   Leuprolide acetate             064       4.15    $213.39      $138.99       $42.68
                               suspnsion.
   J9218  X                   Leuprolide acetate             061       1.15     $59.13       $37.52       $11.83
                               injeciton.
   J9230  X                   Mechlorethamine hcl inj        061       1.15     $59.13       $37.52       $11.83
   J9245  X                   Inj melphalan hydrochl         064       4.15    $213.39      $138.99       $42.68
                               50 MG.
   J9250  X                   Methotrexate sodium inj        061       1.15     $59.13       $37.52       $11.83
   J9260  X                   Methotrexate sodium inj        061       1.15     $59.13       $37.52       $11.83
   J9265  X                   Paclitaxel injection...        062       1.78     $91.53       $36.61       $18.31
   J9266  X                   Pegaspargase/singl dose        061       1.15     $59.13       $37.52       $11.83
                               vial.
   J9268  X                   Pentostatin injection..        062       1.78     $91.53       $36.61       $18.31
   J9270  X                   Plicamycin                     063       2.94    $151.17      $110.97       $30.24
                               (mithramycin) inj.
   J9280  X                   Mitomycin 5 MG inj.....        063       2.94    $151.17      $110.97       $30.24
   J9290  X                   Mitomycin 20 MG inj....        064       4.15    $213.39      $138.99       $42.68
   J9291  X                   Mitomycin 40 MG inj....        064       4.15    $213.39      $138.99       $42.68
   J9293  X                   Mitoxantrone hydrochl /        064       4.15    $213.39      $138.99       $42.68
                               5 MG.
   J9320  X                   Streptozocin injection.        063       2.94    $151.17      $110.97       $30.24
   J9340  X                   Thiotepa injection.....        063       2.94    $151.17      $110.97       $30.24
   J9350  X                   Topotecan..............        061       1.15     $59.13       $37.52       $11.83
   J9360  X                   Vinblastine sulfate inj        061       1.15     $59.13       $37.52       $11.83
   J9370  X                   Vincristine sulfate 1          062       1.78     $91.53       $36.61       $18.31
                               MG inj.
   J9375  X                   Vincristine sulfate 2          063       2.94    $151.17      $110.97       $30.24
                               MG inj.
   J9380  X                   Vincristine sulfate 5          063       2.94    $151.17      $110.97       $30.24
                               MG inj.
   J9390  X                   Vinorelbine tartrate/10        061       1.15     $59.13       $37.52       $11.83
                               mg.
   J9600  X                   Porfimer sodium........        061       1.15     $59.13       $37.52       $11.83
   J9999  X                   Chemotherapy drug......        061       1.15     $59.13       $37.52       $11.83
   K0001  A                   Standard wheelchair....  .........  .........  .........  ...........  ...........
   K0002  A                   Stnd hemi (low seat)     .........  .........  .........  ...........  ...........
                               whlchr.
   K0003  A                   Lightweight wheelchair.  .........  .........  .........  ...........  ...........
   K0004  A                   High strength ltwt       .........  .........  .........  ...........  ...........
                               whlchr.
   K0005  A                   Ultralightweight         .........  .........  .........  ...........  ...........
                               wheelchair.
   K0006  A                   Heavy duty wheelchair..  .........  .........  .........  ...........  ...........
   K0007  A                   Extra heavy duty         .........  .........  .........  ...........  ...........
                               wheelchair.
   K0008  A                   Cstm manual wheelchair/  .........  .........  .........  ...........  ...........
                               base.
   K0009  A                   Other manual wheelchair/ .........  .........  .........  ...........  ...........
                               base.
   K0010  A                   Stnd wt frame power      .........  .........  .........  ...........  ...........
                               whlchr.
   K0011  A                   Stnd wt pwr whlchr w     .........  .........  .........  ...........  ...........
                               control.
   K0012  A                   Ltwt portbl power        .........  .........  .........  ...........  ...........
                               whlchr.
   K0013  A                   Custom power whlchr      .........  .........  .........  ...........  ...........
                               base.
   K0014  A                   Other power whlchr base  .........  .........  .........  ...........  ...........
   K0015  A                   Detach non-adjus hght    .........  .........  .........  ...........  ...........
                               armrst.
   K0016  A                   Detach adjust armrst     .........  .........  .........  ...........  ...........
                               cmplete.
   K0017  A                   Detach adjust armrest    .........  .........  .........  ...........  ...........
                               base.
   K0018  A                   Detach adjust armrst     .........  .........  .........  ...........  ...........
                               upper.
   K0019  A                   Arm pad each...........  .........  .........  .........  ...........  ...........
   K0020  A                   Fixed adjust armrest     .........  .........  .........  ...........  ...........
                               pair.
   K0021  A                   Anti-tipping device      .........  .........  .........  ...........  ...........
                               each.
   K0022  A                   Reinforced back          .........  .........  .........  ...........  ...........
                               upholstery.
   K0023  A                   Planr back insrt foam w/ .........  .........  .........  ...........  ...........
                               strp.
   K0024  A                   Plnr back insrt foam w/  .........  .........  .........  ...........  ...........
                               hrdwr.
   K0025  A                   Hook-on headrest         .........  .........  .........  ...........  ...........
                               extension.
   K0026  A                   Back upholst lgtwt       .........  .........  .........  ...........  ...........
                               whlchr.
   K0027  A                   Back upholst other       .........  .........  .........  ...........  ...........
                               whlchr.
   K0028  A                   Fully reclining back...  .........  .........  .........  ...........  ...........
   K0029  A                   Reinforced seat          .........  .........  .........  ...........  ...........
                               upholstery.
   K0030  A                   Solid plnr seat sngl     .........  .........  .........  ...........  ...........
                               dnsfoam.
   K0031  A                   Safety belt/pelvic       .........  .........  .........  ...........  ...........
                               strap.
   K0032  A                   Seat uphols lgtwt        .........  .........  .........  ...........  ...........
                               whlchr.
   K0033  A                   Seat upholstery other    .........  .........  .........  ...........  ...........
                               whlchr.
   K0034  A                   Heel loop each.........  .........  .........  .........  ...........  ...........
   K0035  A                   Heel loop with ankle     .........  .........  .........  ...........  ...........
                               strap.
   K0036  A                   Toe loop each..........  .........  .........  .........  ...........  ...........
   K0037  A                   High mount flip-up       .........  .........  .........  ...........  ...........
                               footrest.
   K0038  A                   Leg strap each.........  .........  .........  .........  ...........  ...........
   K0039  A                   Leg strap h style each.  .........  .........  .........  ...........  ...........

[[Page 35396]]

 
   K0040  A                   Adjustable angle         .........  .........  .........  ...........  ...........
                               footplate.
   K0041  A                   Large size footplate     .........  .........  .........  ...........  ...........
                               each.
   K0042  A                   Standard size footplate  .........  .........  .........  ...........  ...........
                               each.
   K0043  A                   Ftrst lower extension    .........  .........  .........  ...........  ...........
                               tube.
   K0044  A                   Ftrst upper hanger       .........  .........  .........  ...........  ...........
                               bracket.
   K0045  A                   Footrest complete        .........  .........  .........  ...........  ...........
                               assembly.
   K0046  A                   Elevat legrst low        .........  .........  .........  ...........  ...........
                               extension.
   K0047  A                   Elevat legrst up hangr   .........  .........  .........  ...........  ...........
                               brack.
   K0048  A                   Elevate legrest          .........  .........  .........  ...........  ...........
                               complete.
   K0049  A                   Calf pad each..........  .........  .........  .........  ...........  ...........
   K0050  A                   Ratchet assembly.......  .........  .........  .........  ...........  ...........
   K0051  A                   Cam relese assem ftrst/  .........  .........  .........  ...........  ...........
                               lgrst.
   K0052  A                   Swingaway detach         .........  .........  .........  ...........  ...........
                               footrest.
   K0053  A                   Elevate footrest         .........  .........  .........  ...........  ...........
                               articulate.
   K0054  A                   Seat wdth 10-12/15/17/   .........  .........  .........  ...........  ...........
                               20 wc.
   K0055  A                   Seat dpth 15/17/18 ltwt  .........  .........  .........  ...........  ...........
                               wc.
   K0056  A                   Seat ht <17 or >=21      .........  .........  .........  ...........  ...........
                               ltwt wc.
   K0057  A                   Seat wdth 19/20 hvy dty  .........  .........  .........  ...........  ...........
                               wc.
   K0058  A                   Seat dpth 17/18 power    .........  .........  .........  ...........  ...........
                               wc.
   K0059  A                   Plastic coated handrim   .........  .........  .........  ...........  ...........
                               each.
   K0060  A                   Steel handrim each.....  .........  .........  .........  ...........  ...........
   K0061  A                   Aluminum handrim each..  .........  .........  .........  ...........  ...........
   K0062  A                   Handrim 8-10 vert/obliq  .........  .........  .........  ...........  ...........
                               proj.
   K0063  A                   Hndrm 12-16 vert/obliq   .........  .........  .........  ...........  ...........
                               proj.
   K0064  A                   Zero pressure tube flat  .........  .........  .........  ...........  ...........
                               free.
   K0065  A                   Spoke protectors.......  .........  .........  .........  ...........  ...........
   K0066  A                   Solid tire any size      .........  .........  .........  ...........  ...........
                               each.
   K0067  A                   Pneumatic tire any size  .........  .........  .........  ...........  ...........
                               each.
   K0068  A                   Pneumatic tire tube      .........  .........  .........  ...........  ...........
                               each.
   K0069  A                   Rear whl complete solid  .........  .........  .........  ...........  ...........
                               tire.
   K0070  A                   Rear whl compl pneum     .........  .........  .........  ...........  ...........
                               tire.
   K0071  A                   Front castr compl pneum  .........  .........  .........  ...........  ...........
                               tire.
   K0072  A                   Frnt cstr cmpl sem-      .........  .........  .........  ...........  ...........
                               pneum tir.
   K0073  A                   Caster pin lock each...  .........  .........  .........  ...........  ...........
   K0074  A                   Pneumatic caster tire    .........  .........  .........  ...........  ...........
                               each.
   K0075  A                   Semi-pneumatic caster    .........  .........  .........  ...........  ...........
                               tire.
   K0076  A                   Solid caster tire each.  .........  .........  .........  ...........  ...........
   K0077  A                   Front caster assem       .........  .........  .........  ...........  ...........
                               complete.
   K0078  A                   Pneumatic caster tire    .........  .........  .........  ...........  ...........
                               tube.
   K0079  A                   Wheel lock extension     .........  .........  .........  ...........  ...........
                               pair.
   K0080  A                   Anti-rollback device     .........  .........  .........  ...........  ...........
                               pair.
   K0081  A                   Wheel lock assembly      .........  .........  .........  ...........  ...........
                               complete.
   K0082  A                   22 nf deep cycl acid     .........  .........  .........  ...........  ...........
                               battery.
   K0083  A                   22 nf gel cell battery   .........  .........  .........  ...........  ...........
                               each.
   K0084  A                   Grp 24 deep cycl acid    .........  .........  .........  ...........  ...........
                               battry.
   K0085  A                   Group 24 gel cell        .........  .........  .........  ...........  ...........
                               battery.
   K0086  A                   U-1 lead acid battery    .........  .........  .........  ...........  ...........
                               each.
   K0087  A                   U-1 gel cell battery     .........  .........  .........  ...........  ...........
                               each.
   K0088  A                   Battry chrgr acid/gel    .........  .........  .........  ...........  ...........
                               cell.
   K0089  A                   Battery charger dual     .........  .........  .........  ...........  ...........
                               mode.
   K0090  A                   Rear tire power          .........  .........  .........  ...........  ...........
                               wheelchair.
   K0091  A                   Rear tire tube power     .........  .........  .........  ...........  ...........
                               whlchr.
   K0092  A                   Rear assem cmplt powr    .........  .........  .........  ...........  ...........
                               whlchr.
   K0093  A                   Rear zero pressure tire  .........  .........  .........  ...........  ...........
                               tube.
   K0094  A                   Wheel tire for power     .........  .........  .........  ...........  ...........
                               base.
   K0095  A                   Wheel tire tube each     .........  .........  .........  ...........  ...........
                               base.
   K0096  A                   Wheel assem powr base    .........  .........  .........  ...........  ...........
                               complt.
   K0097  A                   Wheel zero presure tire  .........  .........  .........  ...........  ...........
                               tube.
   K0098  A                   Drive belt power         .........  .........  .........  ...........  ...........
                               wheelchair.
   K0099  A                   Front caster power       .........  .........  .........  ...........  ...........
                               whelchair.
   K0100  A                   Amputee adapter pair...  .........  .........  .........  ...........  ...........
   K0101  A                   One-arm drive            .........  .........  .........  ...........  ...........
                               attachment.
   K0102  A                   Crutch and cane holder.  .........  .........  .........  ...........  ...........
   K0103  A                   Transfer board < 25"...  .........  .........  .........  ...........  ...........
   K0104  A                   Cylinder tank carrier..  .........  .........  .........  ...........  ...........
   K0105  A                   Iv hanger..............  .........  .........  .........  ...........  ...........
   K0106  A                   Arm trough each........  .........  .........  .........  ...........  ...........
   K0107  A                   Wheelchair tray........  .........  .........  .........  ...........  ...........
   K0108  A                   Other accessories......  .........  .........  .........  ...........  ...........
   K0109  A                   Customize whlchr base    .........  .........  .........  ...........  ...........
                               frame.
   K0112  A                   Trunk vest supprt innr   .........  .........  .........  ...........  ...........
                               frame.
   K0113  A                   Trunk vest suprt w/o     .........  .........  .........  ...........  ...........
                               inr frm.
   K0114  A                   Whlchr back suprt inr    .........  .........  .........  ...........  ...........
                               frame.
   K0115  A                   Back module orthotic     .........  .........  .........  ...........  ...........
                               system.
   K0116  A                   Back & seat modul        .........  .........  .........  ...........  ...........
                               orthot sys.

[[Page 35397]]

 
   K0119  N                   Azathioprine oral tab    .........  .........  .........  ...........  ...........
                               50 MG.
   K0120  N                   Azathioprine prentrl     .........  .........  .........  ...........  ...........
                               100 MG.
   K0121  N                   Cyclosporine oral 25 MG  .........  .........  .........  ...........  ...........
   K0122  N                   Cyclosporine prentrl     .........  .........  .........  ...........  ...........
                               250 MG.
   K0123  N                   Imun/antitymocyt glob    .........  .........  .........  ...........  ...........
                               250 MG.
   K0137  A                   Skin barrier liquid per  .........  .........  .........  ...........  ...........
                               oz.
   K0138  A                   Skin barrier paste per   .........  .........  .........  ...........  ...........
                               oz.
   K0139  A                   Skin barrier powder per  .........  .........  .........  ...........  ...........
                               oz.
   K0168  A                   Disposable nebulizer     .........  .........  .........  ...........  ...........
                               set.
   K0169  A                   Disposable nebulizer     .........  .........  .........  ...........  ...........
                               small.
   K0170  A                   Non disposable           .........  .........  .........  ...........  ...........
                               nebulizer set.
   K0171  A                   Filtered nebulizer set.  .........  .........  .........  ...........  ...........
   K0172  A                   Disposable nebulizer     .........  .........  .........  ...........  ...........
                               unfill.
   K0173  A                   Disposable nebulizer     .........  .........  .........  ...........  ...........
                               prefill.
   K0174  A                   Reservoir bottle w       .........  .........  .........  ...........  ...........
                               nebulizer.
   K0175  A                   Disposable corrugated    .........  .........  .........  ...........  ...........
                               tubing.
   K0176  A                   Non dispos corrugated    .........  .........  .........  ...........  ...........
                               tubing.
   K0177  A                   Water collec dev w       .........  .........  .........  ...........  ...........
                               nebulizer.
   K0178  A                   Disposbl filter w        .........  .........  .........  ...........  ...........
                               compressor.
   K0179  A                   Non-dispos filter w/     .........  .........  .........  ...........  ...........
                               compress.
   K0180  A                   Aerosol mask with        .........  .........  .........  ...........  ...........
                               nebulizer.
   K0181  A                   Dome & mouthpiece w/     .........  .........  .........  ...........  ...........
                               nebuliz.
   K0182  A                   Water distilled w/       .........  .........  .........  ...........  ...........
                               nebulizer.
   K0183  A                   Nasal application        .........  .........  .........  ...........  ...........
                               device.
   K0184  A                   Nasal pillows/seals      .........  .........  .........  ...........  ...........
                               pair.
   K0185  A                   Pos airway pressure      .........  .........  .........  ...........  ...........
                               headgear.
   K0186  A                   Pos airway prssure       .........  .........  .........  ...........  ...........
                               chinstrap.
   K0187  A                   Pos airway pressure      .........  .........  .........  ...........  ...........
                               tubing.
   K0188  A                   Pos airway pressure      .........  .........  .........  ...........  ...........
                               filter.
   K0189  A                   Filter nondisposable w   .........  .........  .........  ...........  ...........
                               PAP.
   K0190  A                   Disposable canister w/   .........  .........  .........  ...........  ...........
                               pump.
   K0191  A                   Non-disposbl canister w/ .........  .........  .........  ...........  ...........
                               pump.
   K0192  A                   Tubing used w/ suction   .........  .........  .........  ...........  ...........
                               pump.
   K0193  A                   Airway pressure dev/w    .........  .........  .........  ...........  ...........
                               hmdfer.
   K0194  A                   Assist device w/         .........  .........  .........  ...........  ...........
                               humidifier.
   K0195  A                   Elevating whlchair leg   .........  .........  .........  ...........  ...........
                               rests.
   K0268  A                   Humidifier nonheated w   .........  .........  .........  ...........  ...........
                               PAP.
   K0269  A                   Aerosol compressor cpap  .........  .........  .........  ...........  ...........
                               dev.
   K0270  A                   Ultrasonic generator w   .........  .........  .........  ...........  ...........
                               nebul.
   K0277  A                   Skin barrier solid 4x4   .........  .........  .........  ...........  ...........
                               equiv.
   K0278  A                   Skin barrier with        .........  .........  .........  ...........  ...........
                               flange.
   K0279  A                   Skin barrier extended    .........  .........  .........  ...........  ...........
                               wear.
   K0280  A                   Extension drainage       .........  .........  .........  ...........  ...........
                               tubing.
   K0281  A                   Lubricant catheter       .........  .........  .........  ...........  ...........
                               insertion.
   K0283  A                   Saline solution          .........  .........  .........  ...........  ...........
                               dispenser.
   K0284  A                   External infusion pump   .........  .........  .........  ...........  ...........
                               reuse.
   K0400  A                   Skin support attachment  .........  .........  .........  ...........  ...........
                               each.
   K0401  A                   Diabetic deluxe shoe...  .........  .........  .........  ...........  ...........
   K0407  A                   Urinary cath skin        .........  .........  .........  ...........  ...........
                               attachment.
   K0408  A                   Urinary cath leg strap.  .........  .........  .........  ...........  ...........
   K0409  A                   Sterile H2O irrigation   .........  .........  .........  ...........  ...........
                               solut.
   K0410  A                   Male ext cath w/adh      .........  .........  .........  ...........  ...........
                               coating.
   K0411  A                   Male ext cath w/adh      .........  .........  .........  ...........  ...........
                               strip.
   K0412  N                   Mycophenolate mofetil    .........  .........  .........  ...........  ...........
                               25o mg.
   K0415  N                   RX antiemetic drg, oral  .........  .........  .........  ...........  ...........
                               NOS.
   K0416  N                   Rx antiemetic            .........  .........  .........  ...........  ...........
                               drg,rectal NOS.
   K0417  A                   Mech infus pump sht trm  .........  .........  .........  ...........  ...........
                               drug.
   K0418  N                   Oral cyclosporin.......  .........  .........  .........  ...........  ...........
   K0419  A                   Drainable plstic pch w   .........  .........  .........  ...........  ...........
                               fcplt.
   K0420  A                   Drainable rubber pch w   .........  .........  .........  ...........  ...........
                               fcplt.
   K0421  A                   drainable plstic pch w/  .........  .........  .........  ...........  ...........
                               o fp.
   K0422  A                   Drainable rubber pch w/  .........  .........  .........  ...........  ...........
                               o fp.
   K0423  A                   Urinary plstic pouch w   .........  .........  .........  ...........  ...........
                               fcplt.
   K0424  A                   Urinary rubber pouch w   .........  .........  .........  ...........  ...........
                               fcplt.
   K0425  A                   Urinary plstic pouch w/  .........  .........  .........  ...........  ...........
                               o fp.
   K0426  A                   Urinary hvy plstc pch w/ .........  .........  .........  ...........  ...........
                               o fp.
   K0427  A                   Urinary rubber pouch w/  .........  .........  .........  ...........  ...........
                               o fp.
   K0428  A                   Ostomy faceplt/silicone  .........  .........  .........  ...........  ...........
                               ring.
   K0429  A                   Skin barrier solid ext   .........  .........  .........  ...........  ...........
                               wear.
   K0430  A                   Skin barrier w flang ex  .........  .........  .........  ...........  ...........
                               wear.
   K0431  A                   Closed pouch w st wear   .........  .........  .........  ...........  ...........
                               bar.
   K0432  A                   Drainable pch w ex wear  .........  .........  .........  ...........  ...........
                               bar.
   K0433  A                   Drainable pch w st wear  .........  .........  .........  ...........  ...........
                               bar.
   K0434  A                   Drainable pch ex wear    .........  .........  .........  ...........  ...........
                               convex.
   K0435  A                   Urinary pouch w ex wear  .........  .........  .........  ...........  ...........
                               bar.

[[Page 35398]]

 
   K0436  A                   Urinary pouch w st wear  .........  .........  .........  ...........  ...........
                               bar.
   K0437  A                   Urine pch w ex wear bar  .........  .........  .........  ...........  ...........
                               conv.
   K0438  A                   Ostomy pouch liq         .........  .........  .........  ...........  ...........
                               deodorant.
   K0439  A                   Ostomy pouch solid       .........  .........  .........  ...........  ...........
                               deodorant.
   K0440  A                   Nasal prosthesis.......  .........  .........  .........  ...........  ...........
   K0441  A                   Midfacial prosthesis...  .........  .........  .........  ...........  ...........
   K0442  A                   Orbital prosthesis.....  .........  .........  .........  ...........  ...........
   K0443  A                   Upper facial prosthesis  .........  .........  .........  ...........  ...........
   K0444  A                   Hemi-facial prosthesis.  .........  .........  .........  ...........  ...........
   K0445  A                   Auricular prosthesis...  .........  .........  .........  ...........  ...........
   K0446  A                   Partial facial           .........  .........  .........  ...........  ...........
                               prosthesis.
   K0447  A                   Nasal septal prosthesis  .........  .........  .........  ...........  ...........
   K0448  A                   Unspec maxillofacial     .........  .........  .........  ...........  ...........
                               prosth.
   K0449  A                   Repair maxillofacial     .........  .........  .........  ...........  ...........
                               prosth.
   K0450  A                   Liq adhes for facial     .........  .........  .........  ...........  ...........
                               prosth.
   K0451  A                   Adhesive remover wipes.  .........  .........  .........  ...........  ...........
   K0452  A                   Wheelchair bearings....  .........  .........  .........  ...........  ...........
\2\ K045  N                   Amphotericin B.........  .........  .........  .........  ...........  ...........
        3
   K0455  A                   Pump uninterrupted       .........  .........  .........  ...........  ...........
                               infusion.
   K0501  A                   Aerosol compressor for   .........  .........  .........  ...........  ...........
                               svneb.
   K0503  A                   Acetylcysteine inh sol   .........  .........  .........  ...........  ...........
                               u d.
   K0504  A                   Albuterol inh sol con..  .........  .........  .........  ...........  ...........
   K0505  A                   Albuterol inh sol u d..  .........  .........  .........  ...........  ...........
   K0506  A                   Atropine inh sol con...  .........  .........  .........  ...........  ...........
   K0507  A                   Atropine inh sol u d...  .........  .........  .........  ...........  ...........
   K0508  A                   Bitolterol mes inh sol   .........  .........  .........  ...........  ...........
                               con.
   K0509  A                   Bitolterol mes inh sol   .........  .........  .........  ...........  ...........
                               u d.
   K0511  A                   Cromolyn sodium inh sol  .........  .........  .........  ...........  ...........
                               u d.
   K0512  A                   Dexamethasone inh sol    .........  .........  .........  ...........  ...........
                               con.
   K0513  A                   Dexamethasone inh sol u  .........  .........  .........  ...........  ...........
                               d.
   K0514  A                   Dornase alpha inh sol u  .........  .........  .........  ...........  ...........
                               d.
   K0515  A                   Glycopyrrolate inh sol   .........  .........  .........  ...........  ...........
                               con.
   K0516  A                   Glycopyrrolate inh sol   .........  .........  .........  ...........  ...........
                               u d.
   K0518  A                   Ipratropium brom inh     .........  .........  .........  ...........  ...........
                               sol u d.
   K0519  A                   Isoetharine HCl inh sol  .........  .........  .........  ...........  ...........
                               con.
   K0520  A                   Isoetharine HCl inh sol  .........  .........  .........  ...........  ...........
                               u d.
   K0521  A                   IsoproterenolHCl inh     .........  .........  .........  ...........  ...........
                               sol con.
   K0522  A                   IsoproterenolHCl inh     .........  .........  .........  ...........  ...........
                               sol u d.
   K0523  A                   Metaproterenol inh sol   .........  .........  .........  ...........  ...........
                               con.
   K0524  A                   Metaproterenol inh sol   .........  .........  .........  ...........  ...........
                               u d.
   K0525  A                   Terbutaline SO4 inh sol  .........  .........  .........  ...........  ...........
                               con.
   K0526  A                   Terbutaline SO4 inh sol  .........  .........  .........  ...........  ...........
                               u d.
   K0527  A                   Triamcinolone inh sol    .........  .........  .........  ...........  ...........
                               con.
   K0528  A                   Triamcinolone inh sol u  .........  .........  .........  ...........  ...........
                               d.
   K0529  A                   Sterile H20 or nss w lv  .........  .........  .........  ...........  ...........
                               neb.
   K0530  A                   Nebulizer not used w     .........  .........  .........  ...........  ...........
                               oxygen.
   L0100  A                   Cerv craniosten helmet   .........  .........  .........  ...........  ...........
                               mold.
   L0110  A                   Cerv craniostenosis hel  .........  .........  .........  ...........  ...........
                               non-.
   L0120  A                   Cerv flexible non-       .........  .........  .........  ...........  ...........
                               adjustable.
   L0130  A                   Flex thermoplastic       .........  .........  .........  ...........  ...........
                               collar mo.
   L0140  A                   Cervical semi-rigid      .........  .........  .........  ...........  ...........
                               adjustab.
   L0150  A                   Cerv semi-rig adj        .........  .........  .........  ...........  ...........
                               molded chn.
   L0160  A                   Cerv semi-rig wire occ/  .........  .........  .........  ...........  ...........
                               mand.
   L0170  A                   Cervical collar molded   .........  .........  .........  ...........  ...........
                               to pt.
   L0172  A                   Cerv col thermplas foam  .........  .........  .........  ...........  ...........
                               2 pi.
   L0174  A                   Cerv col foam 2 piece w  .........  .........  .........  ...........  ...........
                               thor.
   L0180  A                   Cer post col occ/man     .........  .........  .........  ...........  ...........
                               sup adj.
   L0190  A                   Cerv collar supp adj     .........  .........  .........  ...........  ...........
                               cerv ba.
   L0200  A                   Cerv col supp adj bar &  .........  .........  .........  ...........  ...........
                               thor.
   L0210  A                   Thoracic rib belt......  .........  .........  .........  ...........  ...........
   L0220  A                   Thor rib belt custom     .........  .........  .........  ...........  ...........
                               fabrica.
   L0300  A                   TLSO flex surgical       .........  .........  .........  ...........  ...........
                               support.
   L0310  A                   Tlso flexible custom     .........  .........  .........  ...........  ...........
                               fabrica.
   L0315  A                   Tlso flex elas rigid     .........  .........  .........  ...........  ...........
                               post pa.
   L0317  A                   Tlso flex hypext elas    .........  .........  .........  ...........  ...........
                               post p.
   L0320  A                   Tlso a-p contrl w apron  .........  .........  .........  ...........  ...........
                               frnt.
   L0330  A                   Tlso ant-pos-lateral     .........  .........  .........  ...........  ...........
                               control.
   L0340  A                   Tlso a-p-l-rotary with   .........  .........  .........  ...........  ...........
                               apron.
   L0350  A                   Tlso flex compress       .........  .........  .........  ...........  ...........
                               jacket cu.
   L0360  A                   Tlso flex compress       .........  .........  .........  ...........  ...........
                               jacket mo.
   L0370  A                   Tlso a-p-l-rotary        .........  .........  .........  ...........  ...........
                               hyperexten.
   L0380  A                   Tlso a-p-l-rot w/ pos    .........  .........  .........  ...........  ...........
                               extens.
   L0390  A                   Tlso a-p-l control       .........  .........  .........  ...........  ...........
                               molded.
   L0400  A                   Tlso a-p-l w interface   .........  .........  .........  ...........  ...........
                               mater.
   L0410  A                   Tlso a-p-l two piece     .........  .........  .........  ...........  ...........
                               constr.

[[Page 35399]]

 
   L0420  A                   Tlso a-p-l 2 piece w     .........  .........  .........  ...........  ...........
                               interfa.
   L0430  A                   Tlso a-p-l w interface   .........  .........  .........  ...........  ...........
                               custm.
   L0440  A                   Tlso a-p-l overlap frnt  .........  .........  .........  ...........  ...........
                               cust.
   L0500  A                   Lso flex surgical        .........  .........  .........  ...........  ...........
                               support.
   L0510  A                   Lso flexible custom      .........  .........  .........  ...........  ...........
                               fabricat.
   L0515  A                   Lso flex elas w/ rig     .........  .........  .........  ...........  ...........
                               post pa.
   L0520  A                   Lso a-p-l control with   .........  .........  .........  ...........  ...........
                               apron.
   L0530  A                   Lso ant-pos control w    .........  .........  .........  ...........  ...........
                               apron.
   L0540  A                   Lso lumbar flexion a-p-  .........  .........  .........  ...........  ...........
                               l.
   L0550  A                   Lso a-p-l control        .........  .........  .........  ...........  ...........
                               molded.
   L0560  A                   Lso a-p-l w interface..  .........  .........  .........  ...........  ...........
   L0565  A                   Lso a-p-l control        .........  .........  .........  ...........  ...........
                               custom.
   L0600  A                   Sacroiliac flex surg     .........  .........  .........  ...........  ...........
                               support.
   L0610  A                   Sacroiliac flexible      .........  .........  .........  ...........  ...........
                               custm fa.
   L0620  A                   Sacroiliac semi-rig w    .........  .........  .........  ...........  ...........
                               apron.
   L0700  A                   Ctlso a-p-l control      .........  .........  .........  ...........  ...........
                               molded.
   L0710  A                   Ctlso a-p-l control w/   .........  .........  .........  ...........  ...........
                               inter.
   L0810  A                   Halo cervical into jckt  .........  .........  .........  ...........  ...........
                               vest.
   L0820  A                   Halo cervical into body  .........  .........  .........  ...........  ...........
                               jack.
   L0830  A                   Halo cerv into           .........  .........  .........  ...........  ...........
                               milwaukee typ.
   L0860  A                   Magnetic resonanc image  .........  .........  .........  ...........  ...........
                               comp.
   L0900  A                   Torso/ptosis support...  .........  .........  .........  ...........  ...........
   L0910  A                   Torso & ptosis supp      .........  .........  .........  ...........  ...........
                               custm fa.
   L0920  A                   Torso/pendulous abd      .........  .........  .........  ...........  ...........
                               support.
   L0930  A                   Pendulous abdomen supp   .........  .........  .........  ...........  ...........
                               custm.
   L0940  A                   Torso/postsurgical       .........  .........  .........  ...........  ...........
                               support.
   L0950  A                   Post surg support        .........  .........  .........  ...........  ...........
                               custom fab.
   L0960  A                   Post surgical support    .........  .........  .........  ...........  ...........
                               pads.
   L0970  A                   Tlso corset front......  .........  .........  .........  ...........  ...........
   L0972  A                   Lso corset front.......  .........  .........  .........  ...........  ...........
   L0974  A                   Tlso full corset.......  .........  .........  .........  ...........  ...........
   L0976  A                   Lso full corset........  .........  .........  .........  ...........  ...........
   L0978  A                   Axillary crutch          .........  .........  .........  ...........  ...........
                               extension.
   L0980  A                   Peroneal straps pair...  .........  .........  .........  ...........  ...........
   L0982  A                   Stocking supp grips set  .........  .........  .........  ...........  ...........
                               of f.
   L0984  A                   Protective body sock     .........  .........  .........  ...........  ...........
                               each.
   L0999  A                   Add to spinal orthosis   .........  .........  .........  ...........  ...........
                               NOS.
   L1000  A                   Ctlso milwauke initial   .........  .........  .........  ...........  ...........
                               model.
   L1010  A                   Ctlso axilla sling.....  .........  .........  .........  ...........  ...........
   L1020  A                   Kyphosis pad...........  .........  .........  .........  ...........  ...........
   L1025  A                   Kyphosis pad floating..  .........  .........  .........  ...........  ...........
   L1030  A                   Lumbar bolster pad.....  .........  .........  .........  ...........  ...........
   L1040  A                   Lumbar or lumbar rib     .........  .........  .........  ...........  ...........
                               pad.
   L1050  A                   Sternal pad............  .........  .........  .........  ...........  ...........
   L1060  A                   Thoracic pad...........  .........  .........  .........  ...........  ...........
   L1070  A                   Trapezius sling........  .........  .........  .........  ...........  ...........
   L1080  A                   Outrigger..............  .........  .........  .........  ...........  ...........
   L1085  A                   Outrigger bil w/ vert    .........  .........  .........  ...........  ...........
                               extens.
   L1090  A                   Lumbar sling...........  .........  .........  .........  ...........  ...........
   L1100  A                   Ring flange plastic/     .........  .........  .........  ...........  ...........
                               leather.
   L1110  A                   Ring flange plas/        .........  .........  .........  ...........  ...........
                               leather mol.
   L1120  A                   Covers for upright each  .........  .........  .........  ...........  ...........
   L1200  A                   Furnsh initial orthosis  .........  .........  .........  ...........  ...........
                               only.
   L1210  A                   Lateral thoracic         .........  .........  .........  ...........  ...........
                               extension.
   L1220  A                   Anterior thoracic        .........  .........  .........  ...........  ...........
                               extension.
   L1230  A                   Milwaukee type           .........  .........  .........  ...........  ...........
                               superstructur.
   L1240  A                   Lumbar derotation pad..  .........  .........  .........  ...........  ...........
   L1250  A                   Anterior asis pad......  .........  .........  .........  ...........  ...........
   L1260  A                   Anterior thoracic        .........  .........  .........  ...........  ...........
                               derotation.
   L1270  A                   Abdominal pad..........  .........  .........  .........  ...........  ...........
   L1280  A                   Rib gusset (elastic)     .........  .........  .........  ...........  ...........
                               each.
   L1290  A                   Lateral trochanteric     .........  .........  .........  ...........  ...........
                               pad.
   L1300  A                   Body jacket mold to      .........  .........  .........  ...........  ...........
                               patient.
   L1310  A                   Post-operative body      .........  .........  .........  ...........  ...........
                               jacket.
   L1499  A                   Spinal orthosis NOS....  .........  .........  .........  ...........  ...........
   L1500  A                   Thkao mobility frame...  .........  .........  .........  ...........  ...........
   L1510  A                   Thkao standing frame...  .........  .........  .........  ...........  ...........
   L1520  A                   Thkao swivel walker....  .........  .........  .........  ...........  ...........
   L1600  A                   Abduct hip flex frejka   .........  .........  .........  ...........  ...........
                               w cvr.
   L1610  A                   Abduct hip flex frejka   .........  .........  .........  ...........  ...........
                               covr.
   L1620  A                   Abduct hip flex pavlik   .........  .........  .........  ...........  ...........
                               harne.
   L1630  A                   Abduct control hip semi- .........  .........  .........  ...........  ...........
                               flex.
   L1640  A                   Pelv band/spread bar     .........  .........  .........  ...........  ...........
                               thigh c.
   L1650  A                   HO abduction hip         .........  .........  .........  ...........  ...........
                               adjustable.
   L1660  A                   HO abduction static      .........  .........  .........  ...........  ...........
                               plastic.

[[Page 35400]]

 
   L1680  A                   Pelvic & hip control     .........  .........  .........  ...........  ...........
                               thigh c.
   L1685  A                   Post-op hip abduct       .........  .........  .........  ...........  ...........
                               custom fa.
   L1686  A                   HO post-op hip           .........  .........  .........  ...........  ...........
                               abduction.
   L1700  A                   Leg perthes orth         .........  .........  .........  ...........  ...........
                               toronto typ.
   L1710  A                   Legg perthes orth        .........  .........  .........  ...........  ...........
                               newington.
   L1720  A                   Legg perthes orthosis    .........  .........  .........  ...........  ...........
                               trilat.
   L1730  A                   Legg perthes orth        .........  .........  .........  ...........  ...........
                               scottish r.
   L1750  A                   Legg perthes sling.....  .........  .........  .........  ...........  ...........
   L1755  A                   Legg perthes patten      .........  .........  .........  ...........  ...........
                               bottom t.
   L1800  A                   Knee orthoses elas w     .........  .........  .........  ...........  ...........
                               stays.
   L1810  A                   Ko elastic with joints.  .........  .........  .........  ...........  ...........
   L1815  A                   Elastic with condylar    .........  .........  .........  ...........  ...........
                               pads.
   L1820  A                   Ko elas w/ condyle pads  .........  .........  .........  ...........  ...........
                               & jo.
   L1825  A                   Ko elastic knee cap....  .........  .........  .........  ...........  ...........
   L1830  A                   Ko immobilizer canvas    .........  .........  .........  ...........  ...........
                               longit.
   L1832  A                   Ko adj jnt pos rigid     .........  .........  .........  ...........  ...........
                               support.
   L1834  A                   Ko w/0 joint rigid       .........  .........  .........  ...........  ...........
                               molded to.
   L1840  A                   Ko derot ant cruciate    .........  .........  .........  ...........  ...........
                               custom.
   L1843  A                   Ko single upright        .........  .........  .........  ...........  ...........
                               custom fit.
   L1844  A                   Ko w/adj jt rot cntrl    .........  .........  .........  ...........  ...........
                               molded.
   L1845  A                   Ko w/ adj flex/ext       .........  .........  .........  ...........  ...........
                               rotat cus.
   L1846  A                   Ko w adj flex/ext rotat  .........  .........  .........  ...........  ...........
                               mold.
   L1850  A                   Ko swedish type........  .........  .........  .........  ...........  ...........
   L1855  A                   Ko plas doub upright     .........  .........  .........  ...........  ...........
                               jnt mol.
   L1858  A                   Ko polycentric           .........  .........  .........  ...........  ...........
                               pneumatic pad.
   L1860  A                   Ko supracondylar socket  .........  .........  .........  ...........  ...........
                               mold.
   L1870  A                   Ko doub upright lacers   .........  .........  .........  ...........  ...........
                               molde.
   L1880  A                   Ko doub upright cuffs/   .........  .........  .........  ...........  ...........
                               lacers.
   L1885  A                   Knee upright w/          .........  .........  .........  ...........  ...........
                               resistance.
   L1900  A                   Afo sprng wir drsflx     .........  .........  .........  ...........  ...........
                               calf bd.
   L1902  A                   Afo ankle gauntlet.....  .........  .........  .........  ...........  ...........
   L1904  A                   Afo molded ankle         .........  .........  .........  ...........  ...........
                               gauntlet.
   L1906  A                   Afo multiligamentus      .........  .........  .........  ...........  ...........
                               ankle su.
   L1910  A                   Afo sing bar clasp       .........  .........  .........  ...........  ...........
                               attach sh.
   L1920  A                   Afo sing upright w/      .........  .........  .........  ...........  ...........
                               adjust s.
   L1930  A                   Afo plastic............  .........  .........  .........  ...........  ...........
   L1940  A                   Afo molded to patient    .........  .........  .........  ...........  ...........
                               plasti.
   L1945  A                   Afo molded plas rig ant  .........  .........  .........  ...........  ...........
                               tib.
   L1950  A                   Afo spiral molded to pt  .........  .........  .........  ...........  ...........
                               plas.
   L1960  A                   Afo pos solid ank        .........  .........  .........  ...........  ...........
                               plastic mo.
   L1970  A                   Afo plastic molded w/    .........  .........  .........  ...........  ...........
                               ankle j.
   L1980  A                   Afo sing solid stirrup   .........  .........  .........  ...........  ...........
                               calf.
   L1990  A                   Afo doub solid stirrup   .........  .........  .........  ...........  ...........
                               calf.
   L2000  A                   Kafo sing fre stirr thi/ .........  .........  .........  ...........  ...........
                               calf.
   L2010  A                   Kafo sng solid stirrup   .........  .........  .........  ...........  ...........
                               w/o j.
   L2020  A                   Kafo dbl solid stirrup   .........  .........  .........  ...........  ...........
                               band/.
   L2030  A                   Kafo dbl solid stirrup   .........  .........  .........  ...........  ...........
                               w/o j.
   L2035  A                   KAFO plastic pediatric   .........  .........  .........  ...........  ...........
                               size.
   L2036  A                   Kafo plas doub free      .........  .........  .........  ...........  ...........
                               knee mol.
   L2037  A                   Kafo plas sing free      .........  .........  .........  ...........  ...........
                               knee mol.
   L2038  A                   Kafo w/o joint multi-    .........  .........  .........  ...........  ...........
                               axis an.
   L2039  A                   KAFO, plstic, medlat     .........  .........  .........  ...........  ...........
                               rotat con.
   L2040  A                   Hkafo torsion bil rot    .........  .........  .........  ...........  ...........
                               straps.
   L2050  A                   Hkafo torsion cable hip  .........  .........  .........  ...........  ...........
                               pelv.
   L2060  A                   Hkafo torsion ball       .........  .........  .........  ...........  ...........
                               bearing j.
   L2070  A                   Hkafo torsion unilat     .........  .........  .........  ...........  ...........
                               rot str.
   L2080  A                   Hkafo unilat torsion     .........  .........  .........  ...........  ...........
                               cable.
   L2090  A                   Hkafo unilat torsion     .........  .........  .........  ...........  ...........
                               ball br.
   L2102  A                   Afo tibial fx cast       .........  .........  .........  ...........  ...........
                               plstr mol.
   L2104  A                   Afo tib fx cast          .........  .........  .........  ...........  ...........
                               synthetic mo.
   L2106  A                   Afo tib fx cast plaster  .........  .........  .........  ...........  ...........
                               mold.
   L2108  A                   Afo tib fx cast molded   .........  .........  .........  ...........  ...........
                               to pt.
   L2112  A                   Afo tibial fracture      .........  .........  .........  ...........  ...........
                               soft.
   L2114  A                   Afo tib fx semi-rigid..  .........  .........  .........  ...........  ...........
   L2116  A                   Afo tibial fracture      .........  .........  .........  ...........  ...........
                               rigid.
   L2122  A                   Kafo fem fx cast         .........  .........  .........  ...........  ...........
                               plaster mol.
   L2124  A                   Kafo fem fx cast         .........  .........  .........  ...........  ...........
                               synthet mol.
   L2126  A                   Kafo fem fx cast         .........  .........  .........  ...........  ...........
                               thermoplas.
   L2128  A                   Kafo fem fx cast molded  .........  .........  .........  ...........  ...........
                               to p.
   L2132  A                   Kafo femoral fx cast     .........  .........  .........  ...........  ...........
                               soft.
   L2134  A                   Kafo fem fx cast semi-   .........  .........  .........  ...........  ...........
                               rigid.
   L2136  A                   Kafo femoral fx cast     .........  .........  .........  ...........  ...........
                               rigid.
   L2180  A                   Plas shoe insert w ank   .........  .........  .........  ...........  ...........
                               joint.
   L2182  A                   Drop lock knee.........  .........  .........  .........  ...........  ...........
   L2184  A                   Limited motion knee      .........  .........  .........  ...........  ...........
                               joint.

[[Page 35401]]

 
   L2186  A                   Adj motion knee jnt      .........  .........  .........  ...........  ...........
                               lerman t.
   L2188  A                   Quadrilateral brim.....  .........  .........  .........  ...........  ...........
   L2190  A                   Waist belt.............  .........  .........  .........  ...........  ...........
   L2192  A                   Pelvic band & belt       .........  .........  .........  ...........  ...........
                               thigh fla.
   L2200  A                   Limited ankle motion ea  .........  .........  .........  ...........  ...........
                               jnt.
   L2210  A                   Dorsiflexion assist      .........  .........  .........  ...........  ...........
                               each joi.
   L2220  A                   Dorsi & plantar flex     .........  .........  .........  ...........  ...........
                               ass/res.
   L2230  A                   Split flat caliper       .........  .........  .........  ...........  ...........
                               stirr & p.
   L2240  A                   Round caliper and plate  .........  .........  .........  ...........  ...........
                               atta.
   L2250  A                   Foot plate molded        .........  .........  .........  ...........  ...........
                               stirrup at.
   L2260  A                   Reinforced solid         .........  .........  .........  ...........  ...........
                               stirrup.
   L2265  A                   Long tongue stirrup....  .........  .........  .........  ...........  ...........
   L2270  A                   Varus/valgus strap       .........  .........  .........  ...........  ...........
                               padded/li.
   L2275  A                   Plastic mod low ext pad/ .........  .........  .........  ...........  ...........
                               line.
   L2280  A                   Molded inner boot......  .........  .........  .........  ...........  ...........
   L2300  A                   Abduction bar jointed    .........  .........  .........  ...........  ...........
                               adjust.
   L2310  A                   Abduction bar-straight.  .........  .........  .........  ...........  ...........
   L2320  A                   Non-molded lacer.......  .........  .........  .........  ...........  ...........
   L2330  A                   Lacer molded to patient  .........  .........  .........  ...........  ...........
                               mode.
   L2335  A                   Anterior swing band....  .........  .........  .........  ...........  ...........
   L2340  A                   Pre-tibial shell molded  .........  .........  .........  ...........  ...........
                               to p.
   L2350  A                   Prosthetic type socket   .........  .........  .........  ...........  ...........
                               molde.
   L2360  A                   Extended steel shank...  .........  .........  .........  ...........  ...........
   L2370  A                   Patten bottom..........  .........  .........  .........  ...........  ...........
   L2375  A                   Torsion ank & half       .........  .........  .........  ...........  ...........
                               solid sti.
   L2380  A                   Torsion straight knee    .........  .........  .........  ...........  ...........
                               joint.
   L2385  A                   Straight knee joint      .........  .........  .........  ...........  ...........
                               heavy du.
   L2390  A                   Offset knee joint each.  .........  .........  .........  ...........  ...........
   L2395  A                   Offset knee joint heavy  .........  .........  .........  ...........  ...........
                               duty.
   L2397  A                   Suspension sleeve lower  .........  .........  .........  ...........  ...........
                               ext.
   L2405  A                   Knee joint drop lock ea  .........  .........  .........  ...........  ...........
                               jnt.
   L2415  A                   Knee joint cam lock      .........  .........  .........  ...........  ...........
                               each joi.
   L2425  A                   Knee disc/dial lock/adj  .........  .........  .........  ...........  ...........
                               flex.
   L2430  A                   Knee jnt ratchet lock    .........  .........  .........  ...........  ...........
                               ea jnt.
   L2435  A                   Knee joint polycentric   .........  .........  .........  ...........  ...........
                               joint.
   L2492  A                   Knee lift loop drop      .........  .........  .........  ...........  ...........
                               lock rin.
   L2500  A                   Thi/glut/ischia wgt      .........  .........  .........  ...........  ...........
                               bearing.
   L2510  A                   Th/wght bear quad-lat    .........  .........  .........  ...........  ...........
                               brim m.
   L2520  A                   Th/wght bear quad-lat    .........  .........  .........  ...........  ...........
                               brim c.
   L2525  A                   Th/wght bear nar m-l     .........  .........  .........  ...........  ...........
                               brim mo.
   L2526  A                   Th/wght bear nar m-l     .........  .........  .........  ...........  ...........
                               brim cu.
   L2530  A                   Thigh/wght bear lacer    .........  .........  .........  ...........  ...........
                               non-mo.
   L2540  A                   Thigh/wght bear lacer    .........  .........  .........  ...........  ...........
                               molded.
   L2550  A                   Thigh/wght bear high     .........  .........  .........  ...........  ...........
                               roll cu.
   L2570  A                   Hip clevis type 2 posit  .........  .........  .........  ...........  ...........
                               jnt.
   L2580  A                   Pelvic control pelvic    .........  .........  .........  ...........  ...........
                               sling.
   L2600  A                   Hip clevis/thrust        .........  .........  .........  ...........  ...........
                               bearing fr.
   L2610  A                   Hip clevis/thrust        .........  .........  .........  ...........  ...........
                               bearing lo.
   L2620  A                   Pelvic control hip       .........  .........  .........  ...........  ...........
                               heavy dut.
   L2622  A                   Hip joint adjustable     .........  .........  .........  ...........  ...........
                               flexion.
   L2624  A                   Hip adj flex ext abduct  .........  .........  .........  ...........  ...........
                               cont.
   L2627  A                   Plastic mold recipro     .........  .........  .........  ...........  ...........
                               hip & c.
   L2628  A                   Metal frame recipro hip  .........  .........  .........  ...........  ...........
                               & ca.
   L2630  A                   Pelvic control band &    .........  .........  .........  ...........  ...........
                               belt u.
   L2640  A                   Pelvic control band &    .........  .........  .........  ...........  ...........
                               belt b.
   L2650  A                   Pelv & thor control      .........  .........  .........  ...........  ...........
                               gluteal.
   L2660  A                   Thoracic control         .........  .........  .........  ...........  ...........
                               thoracic ba.
   L2670  A                   Thorac cont paraspinal   .........  .........  .........  ...........  ...........
                               uprig.
   L2680  A                   Thorac cont lat support  .........  .........  .........  ...........  ...........
                               upri.
   L2750  A                   Plating chrome/nickel    .........  .........  .........  ...........  ...........
                               pr bar.
   L2755  A                   Carbon graphite          .........  .........  .........  ...........  ...........
                               lamination.
   L2760  A                   Extension per extension  .........  .........  .........  ...........  ...........
                               per.
   L2770  A                   Low ext orthosis per     .........  .........  .........  ...........  ...........
                               bar/jnt.
   L2780  A                   Non-corrosive finish...  .........  .........  .........  ...........  ...........
   L2785  A                   Drop lock retainer each  .........  .........  .........  ...........  ...........
   L2795  A                   Knee control full        .........  .........  .........  ...........  ...........
                               kneecap.
   L2800  A                   Knee cap medial or       .........  .........  .........  ...........  ...........
                               lateral p.
   L2810  A                   Knee control condylar    .........  .........  .........  ...........  ...........
                               pad.
   L2820  A                   Soft interface below     .........  .........  .........  ...........  ...........
                               knee se.
   L2830  A                   Soft interface above     .........  .........  .........  ...........  ...........
                               knee se.
   L2840  A                   Tibial length sock fx    .........  .........  .........  ...........  ...........
                               or equ.
   L2850  A                   Femoral lgth sock fx or  .........  .........  .........  ...........  ...........
                               equa.
   L2860  A                   Torsion mechanism knee/  .........  .........  .........  ...........  ...........
                               ankle.
   L2999  A                   Lower extremity          .........  .........  .........  ...........  ...........
                               orthosis NOS.
   L3000  A                   Ft insert ucb berkeley   .........  .........  .........  ...........  ...........
                               shell.

[[Page 35402]]

 
   L3001  A                   Foot insert remov        .........  .........  .........  ...........  ...........
                               molded spe.
   L3002  A                   Foot insert plastazote   .........  .........  .........  ...........  ...........
                               or eq.
   L3003  A                   Foot insert silicone     .........  .........  .........  ...........  ...........
                               gel eac.
   L3010  A                   Foot longitudinal arch   .........  .........  .........  ...........  ...........
                               suppo.
   L3020  A                   Foot longitud/           .........  .........  .........  ...........  ...........
                               metatarsal sup.
   L3030  A                   Foot arch support remov  .........  .........  .........  ...........  ...........
                               prem.
   L3040  A                   Ft arch suprt premold    .........  .........  .........  ...........  ...........
                               longit.
   L3050  A                   Foot arch supp premold   .........  .........  .........  ...........  ...........
                               metat.
   L3060  A                   Foot arch supp longitud/ .........  .........  .........  ...........  ...........
                               meta.
   L3070  A                   Arch suprt att to sho    .........  .........  .........  ...........  ...........
                               longit.
   L3080  A                   Arch supp att to shoe    .........  .........  .........  ...........  ...........
                               metata.
   L3090  A                   Arch supp att to shoe    .........  .........  .........  ...........  ...........
                               long/m.
   L3100  A                   Hallus-valgus nght       .........  .........  .........  ...........  ...........
                               dynamic s.
   L3140  A                   Abduction rotation bar   .........  .........  .........  ...........  ...........
                               shoe.
   L3150  A                   Abduct rotation bar w/o  .........  .........  .........  ...........  ...........
                               shoe.
   L3160  A                   Shoe styled positioning  .........  .........  .........  ...........  ...........
                               dev.
   L3170  A                   Foot plastic heel        .........  .........  .........  ...........  ...........
                               stabilizer.
   L3201  A                   Oxford w supinat/pronat  .........  .........  .........  ...........  ...........
                               inf.
   L3202  A                   Oxford w/ supinat/       .........  .........  .........  ...........  ...........
                               pronator c.
   L3203  A                   Oxford w/ supinator/     .........  .........  .........  ...........  ...........
                               pronator.
   L3204  A                   Hightop w/ supp/         .........  .........  .........  ...........  ...........
                               pronator inf.
   L3206  A                   Hightop w/ supp/         .........  .........  .........  ...........  ...........
                               pronator chi.
   L3207  A                   Hightop w/ supp/         .........  .........  .........  ...........  ...........
                               pronator jun.
   L3208  A                   Surgical boot each       .........  .........  .........  ...........  ...........
                               infant.
   L3209  A                   Surgical boot each       .........  .........  .........  ...........  ...........
                               child.
   L3211  A                   Surgical boot each       .........  .........  .........  ...........  ...........
                               junior.
   L3212  A                   Benesch boot pair        .........  .........  .........  ...........  ...........
                               infant.
   L3213  A                   Benesch boot pair child  .........  .........  .........  ...........  ...........
   L3214  A                   Benesch boot pair        .........  .........  .........  ...........  ...........
                               junior.
   L3215  A                   Orthopedic ftwear        .........  .........  .........  ...........  ...........
                               ladies oxf.
   L3216  A                   Orthoped ladies shoes    .........  .........  .........  ...........  ...........
                               dpth i.
   L3217  A                   Ladies shoes hightop     .........  .........  .........  ...........  ...........
                               depth i.
   L3218  A                   Ladies surgical boot     .........  .........  .........  ...........  ...........
                               each.
   L3219  A                   Orthopedic mens shoes    .........  .........  .........  ...........  ...........
                               oxford.
   L3221  A                   Orthopedic mens shoes    .........  .........  .........  ...........  ...........
                               dpth i.
   L3222  A                   Mens shoes hightop       .........  .........  .........  ...........  ...........
                               depth inl.
   L3223  A                   Mens surgical boot each  .........  .........  .........  ...........  ...........
   L3224  A                   Woman's shoe oxford      .........  .........  .........  ...........  ...........
                               brace.
   L3225  A                   Man's shoe oxford brace  .........  .........  .........  ...........  ...........
   L3230  A                   Custom shoes depth       .........  .........  .........  ...........  ...........
                               inlay.
   L3250  A                   Custom mold shoe remov   .........  .........  .........  ...........  ...........
                               prost.
   L3251  A                   Shoe molded to pt        .........  .........  .........  ...........  ...........
                               silicone s.
   L3252  A                   Shoe molded plastazote   .........  .........  .........  ...........  ...........
                               cust.
   L3253  A                   Shoe molded plastazote   .........  .........  .........  ...........  ...........
                               cust.
   L3254  A                   Orth foot non-stndard    .........  .........  .........  ...........  ...........
                               size/w.
   L3255  A                   Orth foot non-standard   .........  .........  .........  ...........  ...........
                               size/.
   L3257  A                   Orth foot add charge     .........  .........  .........  ...........  ...........
                               split s.
   L3260  A                   Ambulatory surgical      .........  .........  .........  ...........  ...........
                               boot eac.
   L3265  A                   Plastazote sandal each.  .........  .........  .........  ...........  ...........
   L3300  A                   Sho lift taper to        .........  .........  .........  ...........  ...........
                               metatarsal.
   L3310  A                   Shoe lift elev heel/     .........  .........  .........  ...........  ...........
                               sole neo.
   L3320  A                   Shoe lift elev heel/     .........  .........  .........  ...........  ...........
                               sole cor.
   L3330  A                   Lifts elevation metal    .........  .........  .........  ...........  ...........
                               extens.
   L3332  A                   Shoe lifts tapered to    .........  .........  .........  ...........  ...........
                               one-ha.
   L3334  A                   Shoe lifts elevation     .........  .........  .........  ...........  ...........
                               heel /i.
   L3340  A                   Shoe wedge sach........  .........  .........  .........  ...........  ...........
   L3350  A                   Shoe heel wedge........  .........  .........  .........  ...........  ...........
   L3360  A                   Shoe sole wedge outside  .........  .........  .........  ...........  ...........
                               sole.
   L3370  A                   Shoe sole wedge between  .........  .........  .........  ...........  ...........
                               sole.
   L3380  A                   Shoe clubfoot wedge....  .........  .........  .........  ...........  ...........
   L3390  A                   Shoe outflare wedge....  .........  .........  .........  ...........  ...........
   L3400  A                   Shoe metatarsal bar      .........  .........  .........  ...........  ...........
                               wedge ro.
   L3410  A                   Shoe metatarsal bar      .........  .........  .........  ...........  ...........
                               between.
   L3420  A                   Full sole/heel wedge     .........  .........  .........  ...........  ...........
                               btween.
   L3430  A                   Sho heel count plast     .........  .........  .........  ...........  ...........
                               reinfor.
   L3440  A                   Heel leather reinforced  .........  .........  .........  ...........  ...........
   L3450  A                   Shoe heel sach cushion   .........  .........  .........  ...........  ...........
                               type.
   L3455  A                   Shoe heel new leather    .........  .........  .........  ...........  ...........
                               standa.
   L3460  A                   Shoe heel new rubber     .........  .........  .........  ...........  ...........
                               standar.
   L3465  A                   Shoe heel thomas with    .........  .........  .........  ...........  ...........
                               wedge.
   L3470  A                   Shoe heel thomas extend  .........  .........  .........  ...........  ...........
                               to b.
   L3480  A                   Shoe heel pad & depress  .........  .........  .........  ...........  ...........
                               for.
   L3485  A                   Shoe heel pad removable  .........  .........  .........  ...........  ...........
                               for.
   L3500  A                   Ortho shoe add leather   .........  .........  .........  ...........  ...........
                               insol.
   L3510  A                   Orthopedic shoe add rub  .........  .........  .........  ...........  ...........
                               insl.

[[Page 35403]]

 
   L3520  A                   O shoe add felt w leath  .........  .........  .........  ...........  ...........
                               insl.
   L3530  A                   Ortho shoe add half      .........  .........  .........  ...........  ...........
                               sole.
   L3540  A                   Ortho shoe add full      .........  .........  .........  ...........  ...........
                               sole.
   L3550  A                   O shoe add standard toe  .........  .........  .........  ...........  ...........
                               tap.
   L3560  A                   O shoe add horseshoe     .........  .........  .........  ...........  ...........
                               toe tap.
   L3570  A                   O shoe add instep        .........  .........  .........  ...........  ...........
                               extension.
   L3580  A                   O shoe add instep        .........  .........  .........  ...........  ...........
                               velcro clo.
   L3590  A                   O shoe convert to sof    .........  .........  .........  ...........  ...........
                               counte.
   L3595  A                   Ortho shoe add march     .........  .........  .........  ...........  ...........
                               bar.
   L3600  A                   Trans shoe calip plate   .........  .........  .........  ...........  ...........
                               exist.
   L3610  A                   Trans shoe caliper       .........  .........  .........  ...........  ...........
                               plate new.
   L3620  A                   Trans shoe solid         .........  .........  .........  ...........  ...........
                               stirrup exi.
   L3630  A                   Trans shoe solid         .........  .........  .........  ...........  ...........
                               stirrup new.
   L3640  A                   Shoe dennis browne       .........  .........  .........  ...........  ...........
                               splint bo.
   L3649  A                   Orthopedic shoe          .........  .........  .........  ...........  ...........
                               modifica NOS.
   L3650  A                   Shlder fig 8 abduct      .........  .........  .........  ...........  ...........
                               restrain.
   L3660  A                   Abduct restrainer        .........  .........  .........  ...........  ...........
                               canvas&web.
   L3670  A                   Acromio/clavicular       .........  .........  .........  ...........  ...........
                               canvas&we.
   L3700  A                   Elbow orthoses elas w    .........  .........  .........  ...........  ...........
                               stays.
   L3710  A                   Elbow elastic with       .........  .........  .........  ...........  ...........
                               metal joi.
   L3720  A                   Forearm/arm cuffs free   .........  .........  .........  ...........  ...........
                               motio.
   L3730  A                   Forearm/arm cuffs ext/   .........  .........  .........  ...........  ...........
                               flex a.
   L3740  A                   Cuffs adj lock w/        .........  .........  .........  ...........  ...........
                               active con.
   L3800  A                   Whfo short opponen no    .........  .........  .........  ...........  ...........
                               attach.
   L3805  A                   Whfo long opponens no    .........  .........  .........  ...........  ...........
                               attach.
   L3810  A                   Whfo thumb abduction     .........  .........  .........  ...........  ...........
                               bar.
   L3815  A                   Whfo second m.p.         .........  .........  .........  ...........  ...........
                               abduction a.
   L3820  A                   Whfo ip ext asst w/ mp   .........  .........  .........  ...........  ...........
                               ext s.
   L3825  A                   Whfo m.p. extension      .........  .........  .........  ...........  ...........
                               stop.
   L3830  A                   Whfo m.p. extension      .........  .........  .........  ...........  ...........
                               assist.
   L3835  A                   Whfo m.p. spring         .........  .........  .........  ...........  ...........
                               extension a.
   L3840  A                   Whfo spring swivel       .........  .........  .........  ...........  ...........
                               thumb.
   L3845  A                   Whfo thumb ip ext ass w/ .........  .........  .........  ...........  ...........
                                mp.
   L3850  A                   Action wrist w/          .........  .........  .........  ...........  ...........
                               dorsiflex as.
   L3855  A                   Whfo adj m.p. flexion    .........  .........  .........  ...........  ...........
                               contro.
   L3860  A                   Whfo adj m.p. flex ctrl  .........  .........  .........  ...........  ...........
                               & i..
   L3890  A                   Torsion mechanism wrist/ .........  .........  .........  ...........  ...........
                               elbo.
   L3900  A                   Hinge extension/flex     .........  .........  .........  ...........  ...........
                               wrist/f.
   L3901  A                   Hinge ext/flex wrist     .........  .........  .........  ...........  ...........
                               finger.
   L3902  A                   Whfo ext power compress  .........  .........  .........  ...........  ...........
                               gas.
   L3904  A                   Whfo electric custom     .........  .........  .........  ...........  ...........
                               fitted.
   L3906  A                   Wrist gauntlet molded    .........  .........  .........  ...........  ...........
                               to pt.
   L3907  A                   Whfo wrst gauntlt thmb   .........  .........  .........  ...........  ...........
                               spica.
   L3908  A                   Wrist cock-up non-       .........  .........  .........  ...........  ...........
                               molded.
   L3910  A                   Whfo swanson design....  .........  .........  .........  ...........  ...........
   L3912  A                   Flex glove w/elastic     .........  .........  .........  ...........  ...........
                               finger.
   L3914  A                   WHO wrist extension      .........  .........  .........  ...........  ...........
                               cock-up.
   L3916  A                   Whfo wrist extens w/     .........  .........  .........  ...........  ...........
                               outrigg.
   L3918  A                   HFO knuckle bender.....  .........  .........  .........  ...........  ...........
   L3920  A                   Knuckle bender with      .........  .........  .........  ...........  ...........
                               outrigge.
   L3922  A                   Knuckle bend 2 seg to    .........  .........  .........  ...........  ...........
                               flex j.
   L3924  A                   Oppenheimer............  .........  .........  .........  ...........  ...........
   L3926  A                   Thomas suspension......  .........  .........  .........  ...........  ...........
   L3928  A                   Finger extension w/      .........  .........  .........  ...........  ...........
                               clock sp.
   L3930  A                   Finger extension with    .........  .........  .........  ...........  ...........
                               wrist.
   L3932  A                   Safety pin spring wire.  .........  .........  .........  ...........  ...........
   L3934  A                   Safety pin modified....  .........  .........  .........  ...........  ...........
   L3936  A                   Palmer.................  .........  .........  .........  ...........  ...........
   L3938  A                   Dorsal wrist...........  .........  .........  .........  ...........  ...........
   L3940  A                   Dorsal wrist w/          .........  .........  .........  ...........  ...........
                               outrigger at.
   L3942  A                   Reverse knuckle bender.  .........  .........  .........  ...........  ...........
   L3944  A                   Reverse knuckle bend w/  .........  .........  .........  ...........  ...........
                               outr.
   L3946  A                   HFO composite elastic..  .........  .........  .........  ...........  ...........
   L3948  A                   Finger knuckle bender..  .........  .........  .........  ...........  ...........
   L3950  A                   Oppenheimer w/ knuckle   .........  .........  .........  ...........  ...........
                               bend.
   L3952  A                   Oppenheimer w/ rev       .........  .........  .........  ...........  ...........
                               knuckle 2.
   L3954  A                   Spreading hand.........  .........  .........  .........  ...........  ...........
   L3956  A                   Add joint upper ext      .........  .........  .........  ...........  ...........
                               orthosis.
   L3960  A                   Sewho airplan desig      .........  .........  .........  ...........  ...........
                               abdu pos.
   L3962  A                   Sewho erbs palsey        .........  .........  .........  ...........  ...........
                               design abd.
   L3963  A                   Molded w/ articulating   .........  .........  .........  ...........  ...........
                               elbow.
   L3964  A                   Seo mobile arm sup att   .........  .........  .........  ...........  ...........
                               to wc.
   L3965  A                   Arm supp att to wc       .........  .........  .........  ...........  ...........
                               rancho ty.
   L3966  A                   Mobile arm supports      .........  .........  .........  ...........  ...........
                               reclinin.
   L3968  A                   Friction dampening arm   .........  .........  .........  ...........  ...........
                               supp.

[[Page 35404]]

 
   L3969  A                   Monosuspension arm/hand  .........  .........  .........  ...........  ...........
                               supp.
   L3970  A                   Elevat proximal arm      .........  .........  .........  ...........  ...........
                               support.
   L3972  A                   Offset/lat rocker arm w/ .........  .........  .........  ...........  ...........
                                ela.
   L3974  A                   Mobile arm support       .........  .........  .........  ...........  ...........
                               supinator.
   L3980  A                   Upp ext fx orthosis      .........  .........  .........  ...........  ...........
                               humeral.
   L3982  A                   Upper ext fx orthosis    .........  .........  .........  ...........  ...........
                               rad/ul.
   L3984  A                   Upper ext fx orthosis    .........  .........  .........  ...........  ...........
                               wrist.
   L3985  A                   Forearm hand fx orth w/  .........  .........  .........  ...........  ...........
                               wr h.
   L3986  A                   Humeral rad/ulna wrist   .........  .........  .........  ...........  ...........
                               fx or.
   L3995  A                   Sock fracture or equal   .........  .........  .........  ...........  ...........
                               each.
   L3999  A                   Upper limb orthosis NOS  .........  .........  .........  ...........  ...........
   L4000  A                   Repl girdle milwaukee    .........  .........  .........  ...........  ...........
                               orth.
   L4010  A                   Replace trilateral       .........  .........  .........  ...........  ...........
                               socket br.
   L4020  A                   Replace quadlat socket   .........  .........  .........  ...........  ...........
                               brim.
   L4030  A                   Replace socket brim      .........  .........  .........  ...........  ...........
                               cust fit.
   L4040  A                   Replace molded thigh     .........  .........  .........  ...........  ...........
                               lacer.
   L4045  A                   Replace non-molded       .........  .........  .........  ...........  ...........
                               thigh lac.
   L4050  A                   Replace molded calf      .........  .........  .........  ...........  ...........
                               lacer.
   L4055  A                   Replace non-molded calf  .........  .........  .........  ...........  ...........
                               lace.
   L4060  A                   Replace high roll cuff.  .........  .........  .........  ...........  ...........
   L4070  A                   Replace prox & dist      .........  .........  .........  ...........  ...........
                               upright.
   L4080  A                   Repl met band kafo-afo   .........  .........  .........  ...........  ...........
                               prox.
   L4090  A                   Repl met band kafo-afo   .........  .........  .........  ...........  ...........
                               calf/.
   L4100  A                   Repl leath cuff kafo     .........  .........  .........  ...........  ...........
                               prox th.
   L4110  A                   Repl leath cuff kafo-    .........  .........  .........  ...........  ...........
                               afo cal.
   L4130  A                   Replace pretibial shell  .........  .........  .........  ...........  ...........
   L4205  A                   Ortho dvc repair per 15  .........  .........  .........  ...........  ...........
                               min.
   L4210  A                   Orth dev repair/repl     .........  .........  .........  ...........  ...........
                               minor p.
\2\ L431  A                   Mult-podus/eq orth prep  .........  .........  .........  ...........  ...........
        0                      mgmt.
\2\ L432  A                   Low ext mgmt sys ft pos  .........  .........  .........  ...........  ...........
        0                      afo.
   L4350  A                   Pneumatic ankle cntrl    .........  .........  .........  ...........  ...........
                               splint.
   L4360  A                   Pneumatic walking        .........  .........  .........  ...........  ...........
                               splint.
   L4370  A                   Pneumatic full leg       .........  .........  .........  ...........  ...........
                               splint.
   L4380  A                   Pneumatic knee splint..  .........  .........  .........  ...........  ...........
\2\ L439  A                   Replace multi-podus      .........  .........  .........  ...........  ...........
        0                      splint.
   L4392  A                   Replace ankle contrac    .........  .........  .........  ...........  ...........
                               splint.
   L4394  A                   Replace foot drop spint  .........  .........  .........  ...........  ...........
   L4396  A                   Ankle contracture        .........  .........  .........  ...........  ...........
                               splint.
   L4398  A                   Foot drop splint         .........  .........  .........  ...........  ...........
                               recumbent.
   L5000  A                   Sho insert w arch toe    .........  .........  .........  ...........  ...........
                               filler.
   L5010  A                   Mold socket ank hgt w/   .........  .........  .........  ...........  ...........
                               toe f.
   L5020  A                   Tibial tubercle hgt w/   .........  .........  .........  ...........  ...........
                               toe f.
   L5050  A                   Ank symes mold sckt      .........  .........  .........  ...........  ...........
                               sach ft.
   L5060  A                   Symes met fr leath       .........  .........  .........  ...........  ...........
                               socket ar.
   L5100  A                   Molded socket shin sach  .........  .........  .........  ...........  ...........
                               foot.
   L5105  A                   Plast socket jts/thgh    .........  .........  .........  ...........  ...........
                               lacer.
   L5150  A                   Mold sckt ext knee shin  .........  .........  .........  ...........  ...........
                               sach.
   L5160  A                   Mold socket bent knee    .........  .........  .........  ...........  ...........
                               shin s.
   L5200  A                   Kne sing axis fric shin  .........  .........  .........  ...........  ...........
                               sach.
   L5210  A                   No knee/ankle joints w/  .........  .........  .........  ...........  ...........
                               ft b.
   L5220  A                   No knee joint with       .........  .........  .........  ...........  ...........
                               artic ali.
   L5230  A                   Fem focal defic          .........  .........  .........  ...........  ...........
                               constant fri.
   L5250  A                   Hip canad sing axi cons  .........  .........  .........  ...........  ...........
                               fric.
   L5270  A                   Tilt table locking hip   .........  .........  .........  ...........  ...........
                               sing.
   L5280  A                   Hemipelvect canad sing   .........  .........  .........  ...........  ...........
                               axis.
   L5300  A                   Bk sach soft cover &     .........  .........  .........  ...........  ...........
                               finish.
   L5310  A                   Knee disart sach soft    .........  .........  .........  ...........  ...........
                               cv/fin.
   L5320  A                   Ak open end sach soft    .........  .........  .........  ...........  ...........
                               cv/fin.
   L5330  A                   Hip canadian sach sft    .........  .........  .........  ...........  ...........
                               cv/fin.
   L5340  A                   Hemipelvectomy canad cv/ .........  .........  .........  ...........  ...........
                               fin.
   L5400  A                   Postop dress & 1 cast    .........  .........  .........  ...........  ...........
                               chg bk.
   L5410  A                   Postop dsg bk ea add     .........  .........  .........  ...........  ...........
                               cast ch.
   L5420  A                   Postop dsg & 1 cast chg  .........  .........  .........  ...........  ...........
                               ak/d.
   L5430  A                   Postop dsg ak ea add     .........  .........  .........  ...........  ...........
                               cast ch.
   L5450  A                   Postop app non-wgt bear  .........  .........  .........  ...........  ...........
                               dsg.
   L5460  A                   Postop app non-wgt bear  .........  .........  .........  ...........  ...........
                               dsg.
   L5500  A                   Init bk ptb plaster      .........  .........  .........  ...........  ...........
                               direct.
   L5505  A                   Init ak ischal plstr     .........  .........  .........  ...........  ...........
                               direct.
   L5510  A                   Prep BK ptb plaster      .........  .........  .........  ...........  ...........
                               molded.
   L5520  A                   Perp BK ptb thermopls    .........  .........  .........  ...........  ...........
                               direct.
   L5530  A                   Prep BK ptb thermopls    .........  .........  .........  ...........  ...........
                               molded.
   L5535  A                   Prep BK ptb open end     .........  .........  .........  ...........  ...........
                               socket.
   L5540  A                   Prep BK ptb laminated    .........  .........  .........  ...........  ...........
                               socket.
   L5560  A                   Prep AK ischial plast    .........  .........  .........  ...........  ...........
                               molded.
   L5570  A                   Prep AK ischial direct   .........  .........  .........  ...........  ...........
                               form.

[[Page 35405]]

 
   L5580  A                   Prep AK ischial thermo   .........  .........  .........  ...........  ...........
                               mold.
   L5585  A                   Prep AK ischial open     .........  .........  .........  ...........  ...........
                               end.
   L5590  A                   Prep AK ischial          .........  .........  .........  ...........  ...........
                               laminated.
   L5595  A                   Hip disartic sach        .........  .........  .........  ...........  ...........
                               thermopls.
   L5600  A                   Hip disart sach laminat  .........  .........  .........  ...........  ...........
                               mold.
   L5610  A                   Above knee hydracadence  .........  .........  .........  ...........  ...........
   L5611  A                   Ak 4 bar link w/fric     .........  .........  .........  ...........  ...........
                               swing.
   L5613  A                   Ak 4 bar ling w/hydraul  .........  .........  .........  ...........  ...........
                               swig.
   L5614  A                   4-bar link above knee w/ .........  .........  .........  ...........  ...........
                               swng.
   L5616  A                   Ak univ multiplex sys    .........  .........  .........  ...........  ...........
                               frict.
   L5617  A                   AK/BK self-aligning      .........  .........  .........  ...........  ...........
                               unit ea.
   L5618  A                   Test socket symes......  .........  .........  .........  ...........  ...........
   L5620  A                   Test socket below knee.  .........  .........  .........  ...........  ...........
   L5622  A                   Test socket knee         .........  .........  .........  ...........  ...........
                               disarticula.
   L5624  A                   Test socket above knee.  .........  .........  .........  ...........  ...........
   L5626  A                   Test socket hip          .........  .........  .........  ...........  ...........
                               disarticulat.
   L5628  A                   Test socket              .........  .........  .........  ...........  ...........
                               hemipelvectomy.
   L5629  A                   Below knee acrylic       .........  .........  .........  ...........  ...........
                               socket.
   L5630  A                   Syme typ expandabl wall  .........  .........  .........  ...........  ...........
                               sckt.
   L5631  A                   Ak/knee disartic         .........  .........  .........  ...........  ...........
                               acrylic soc.
   L5632  A                   Symes type ptb brim      .........  .........  .........  ...........  ...........
                               design s.
   L5634  A                   Symes type poster        .........  .........  .........  ...........  ...........
                               opening so.
   L5636  A                   Symes type medial        .........  .........  .........  ...........  ...........
                               opening so.
   L5637  A                   Below knee total         .........  .........  .........  ...........  ...........
                               contact.
   L5638  A                   Below knee leather       .........  .........  .........  ...........  ...........
                               socket.
   L5639  A                   Below knee wood socket.  .........  .........  .........  ...........  ...........
   L5640  A                   Knee disarticulat        .........  .........  .........  ...........  ...........
                               leather so.
   L5642  A                   Above knee leather       .........  .........  .........  ...........  ...........
                               socket.
   L5643  A                   Hip flex inner socket    .........  .........  .........  ...........  ...........
                               ext fr.
   L5644  A                   Above knee wood socket.  .........  .........  .........  ...........  ...........
   L5645  A                   Ak flexibl inner socket  .........  .........  .........  ...........  ...........
                               ext.
   L5646  A                   Below knee air cushion   .........  .........  .........  ...........  ...........
                               socke.
   L5647  A                   Below knee suction       .........  .........  .........  ...........  ...........
                               socket.
   L5648  A                   Above knee air cushion   .........  .........  .........  ...........  ...........
                               socke.
   L5649  A                   Isch containmt/narrow m- .........  .........  .........  ...........  ...........
                               l so.
   L5650  A                   Tot contact ak/knee      .........  .........  .........  ...........  ...........
                               disart s.
   L5651  A                   Ak flex inner socket     .........  .........  .........  ...........  ...........
                               ext fra.
   L5652  A                   Suction susp ak/knee     .........  .........  .........  ...........  ...........
                               disart.
   L5653  A                   Knee disart expand wall  .........  .........  .........  ...........  ...........
                               sock.
   L5654  A                   Socket insert symes....  .........  .........  .........  ...........  ...........
   L5655  A                   Socket insert below      .........  .........  .........  ...........  ...........
                               knee.
   L5656  A                   Socket insert knee       .........  .........  .........  ...........  ...........
                               articulat.
   L5658  A                   Socket insert above      .........  .........  .........  ...........  ...........
                               knee.
   L5660  A                   Sock insrt syme          .........  .........  .........  ...........  ...........
                               silicone gel.
   L5661  A                   Multi-durometer symes..  .........  .........  .........  ...........  ...........
   L5662  A                   Socket insert bk         .........  .........  .........  ...........  ...........
                               silicone ge.
   L5663  A                   Sock knee disartic       .........  .........  .........  ...........  ...........
                               silicone.
   L5664  A                   Socket insert ak         .........  .........  .........  ...........  ...........
                               silicone ge.
   L5665  A                   Multi-durometer below    .........  .........  .........  ...........  ...........
                               knee.
   L5666  A                   Below knee cuff          .........  .........  .........  ...........  ...........
                               suspension.
   L5667  A                   Socket insert w lock     .........  .........  .........  ...........  ...........
                               lower.
   L5668  A                   Socket insert w/o lock   .........  .........  .........  ...........  ...........
                               lower.
   L5669  A                   Below knee socket w/o    .........  .........  .........  ...........  ...........
                               lock.
   L5670  A                   Bk molded supracondylar  .........  .........  .........  ...........  ...........
                               susp.
   L5672  A                   Bk removable medial      .........  .........  .........  ...........  ...........
                               brim sus.
   L5674  A                   Bk latex sleeve          .........  .........  .........  ...........  ...........
                               suspension/e.
   L5675  A                   Bk latex sleeve susp/eq  .........  .........  .........  ...........  ...........
                               hvy.
   L5676  A                   Bk knee joints single    .........  .........  .........  ...........  ...........
                               axis p.
   L5677  A                   Bk knee joints           .........  .........  .........  ...........  ...........
                               polycentric p.
   L5678  A                   Bk joint covers pair...  .........  .........  .........  ...........  ...........
   L5680  A                   Bk thigh lacer non-      .........  .........  .........  ...........  ...........
                               molded.
   L5682  A                   Bk thigh lacer glut/     .........  .........  .........  ...........  ...........
                               ischia m.
   L5684  A                   Bk fork strap..........  .........  .........  .........  ...........  ...........
   L5686  A                   Bk back check..........  .........  .........  .........  ...........  ...........
   L5688  A                   Bk waist belt webbing..  .........  .........  .........  ...........  ...........
   L5690  A                   Bk waist belt padded     .........  .........  .........  ...........  ...........
                               and lin.
   L5692  A                   Ak pelvic control belt   .........  .........  .........  ...........  ...........
                               light.
   L5694  A                   Ak pelvic control belt   .........  .........  .........  ...........  ...........
                               pad/l.
   L5695  A                   Ak sleeve susp neoprene/ .........  .........  .........  ...........  ...........
                               equa.
   L5696  A                   Ak/knee disartic pelvic  .........  .........  .........  ...........  ...........
                               join.
   L5697  A                   Ak/knee disartic pelvic  .........  .........  .........  ...........  ...........
                               band.
   L5698  A                   Ak/knee disartic         .........  .........  .........  ...........  ...........
                               silesian ba.
   L5699  A                   Shoulder harness.......  .........  .........  .........  ...........  ...........
   L5700  A                   Replace socket below     .........  .........  .........  ...........  ...........
                               knee.
   L5701  A                   Replace socket above     .........  .........  .........  ...........  ...........
                               knee.

[[Page 35406]]

 
   L5702  A                   Replace socket hip.....  .........  .........  .........  ...........  ...........
   L5704  A                   Custom shape covr below  .........  .........  .........  ...........  ...........
                               knee.
   L5705  A                   Custm shape cover above  .........  .........  .........  ...........  ...........
                               knee.
   L5706  A                   Custm shape cvr knee     .........  .........  .........  ...........  ...........
                               disart.
   L5707  A                   Custm shape cover hip    .........  .........  .........  ...........  ...........
                               disart.
   L5710  A                   Kne-shin exo sng axi     .........  .........  .........  ...........  ...........
                               mnl loc.
   L5711  A                   Knee-shin exo mnl lock   .........  .........  .........  ...........  ...........
                               ultra.
   L5712  A                   Knee-shin exo frict swg  .........  .........  .........  ...........  ...........
                               & st.
   L5714  A                   Knee-shin exo variable   .........  .........  .........  ...........  ...........
                               frict.
   L5716  A                   Knee-shin exo mech       .........  .........  .........  ...........  ...........
                               stance ph.
   L5718  A                   Knee-shin exo frct swg   .........  .........  .........  ...........  ...........
                               & sta.
   L5722  A                   Knee-shin pneum swg      .........  .........  .........  ...........  ...........
                               frct exo.
   L5724  A                   Knee-shin exo fluid      .........  .........  .........  ...........  ...........
                               swing ph.
   L5726  A                   Knee-shin ext jnts fld   .........  .........  .........  ...........  ...........
                               swg e.
   L5728  A                   Knee-shin fluid swg &    .........  .........  .........  ...........  ...........
                               stance.
   L5780  A                   Knee-shin pneum/hydra    .........  .........  .........  ...........  ...........
                               pneum.
   L5785  A                   Exoskeletal bk ultralt   .........  .........  .........  ...........  ...........
                               mater.
   L5790  A                   Exoskeletal ak ultra-    .........  .........  .........  ...........  ...........
                               light m.
   L5795  A                   Exoskel hip ultra-light  .........  .........  .........  ...........  ...........
                               mate.
   L5810  A                   Endoskel knee-shin mnl   .........  .........  .........  ...........  ...........
                               lock.
   L5811  A                   Endo knee-shin mnl lck   .........  .........  .........  ...........  ...........
                               ultra.
   L5812  A                   Endo knee-shin frct swg  .........  .........  .........  ...........  ...........
                               & st.
   L5814  A                   Endo knee-shin hydral    .........  .........  .........  ...........  ...........
                               swg ph.
   L5816  A                   Endo knee-shin polyc     .........  .........  .........  ...........  ...........
                               mch sta.
   L5818  A                   Endo knee-shin frct swg  .........  .........  .........  ...........  ...........
                               & st.
   L5822  A                   Endo knee-shin pneum     .........  .........  .........  ...........  ...........
                               swg frc.
   L5824  A                   Endo knee-shin fluid     .........  .........  .........  ...........  ...........
                               swing p.
   L5826  A                   Miniature knee joint...  .........  .........  .........  ...........  ...........
   L5828  A                   Endo knee-shin fluid     .........  .........  .........  ...........  ...........
                               swg/sta.
   L5830  A                   Endo knee-shin pneum/    .........  .........  .........  ...........  ...........
                               swg pha.
   L5840  A                   Multi-axial knee/shin    .........  .........  .........  ...........  ...........
                               system.
   L5845  A                   Knee-shin sys stance     .........  .........  .........  ...........  ...........
                               flexion.
   L5846  A                   Knee-shin sys            .........  .........  .........  ...........  ...........
                               microprocessor.
   L5850  A                   Endo ak/hip knee extens  .........  .........  .........  ...........  ...........
                               assi.
   L5855  A                   Mech hip extension       .........  .........  .........  ...........  ...........
                               assist.
   L5910  A                   Endo below knee          .........  .........  .........  ...........  ...........
                               alignable sy.
   L5920  A                   Endo ak/hip alignable    .........  .........  .........  ...........  ...........
                               system.
   L5925  A                   Above knee manual lock.  .........  .........  .........  ...........  ...........
   L5930  A                   High activity knee       .........  .........  .........  ...........  ...........
                               frame.
   L5940  A                   Endo bk ultra-light      .........  .........  .........  ...........  ...........
                               material.
   L5950  A                   Endo ak ultra-light      .........  .........  .........  ...........  ...........
                               material.
   L5960  A                   Endo hip ultra-light     .........  .........  .........  ...........  ...........
                               materia.
   L5962  A                   Below knee flex cover    .........  .........  .........  ...........  ...........
                               system.
   L5964  A                   Above knee flex cover    .........  .........  .........  ...........  ...........
                               system.
   L5966  A                   Hip flexible cover       .........  .........  .........  ...........  ...........
                               system.
   L5970  A                   Foot external keel sach  .........  .........  .........  ...........  ...........
                               foot.
   L5972  A                   Flexible keel foot.....  .........  .........  .........  ...........  ...........
   L5974  A                   Foot single axis ankle/  .........  .........  .........  ...........  ...........
                               foot.
   L5976  A                   Energy storing foot....  .........  .........  .........  ...........  ...........
   L5978  A                   Ft prosth multiaxial     .........  .........  .........  ...........  ...........
                               ankl/ft.
   L5979  A                   Multi-axial ankle/ft     .........  .........  .........  ...........  ...........
                               prosth.
   L5980  A                   Flex foot system.......  .........  .........  .........  ...........  ...........
   L5981  A                   Flex-walk sys low ext    .........  .........  .........  ...........  ...........
                               prosth.
   L5982  A                   Exoskeletal axial        .........  .........  .........  ...........  ...........
                               rotation u.
   L5984  A                   Endoskeletal axial       .........  .........  .........  ...........  ...........
                               rotation.
   L5985  A                   Lwr ext dynamic prosth   .........  .........  .........  ...........  ...........
                               pylon.
   L5986  A                   Multi-axial rotation     .........  .........  .........  ...........  ...........
                               unit.
   L5987  A                   Shank ft w vert load     .........  .........  .........  ...........  ...........
                               pylon.
   L5999  A                   Lowr extremity prosthes  .........  .........  .........  ...........  ...........
                               NOS.
   L6000  A                   Par hand robin-aids      .........  .........  .........  ...........  ...........
                               thum rem.
   L6010  A                   Hand robin-aids little/  .........  .........  .........  ...........  ...........
                               ring.
   L6020  A                   Part hand robin-aids no  .........  .........  .........  ...........  ...........
                               fing.
   L6050  A                   Wrst MLd sck flx hng     .........  .........  .........  ...........  ...........
                               tri pad.
   L6055  A                   Wrst mold sock w/exp     .........  .........  .........  ...........  ...........
                               interfa.
   L6100  A                   Elb mold sock flex       .........  .........  .........  ...........  ...........
                               hinge pad.
   L6110  A                   Elbow mold sock          .........  .........  .........  ...........  ...........
                               suspension t.
   L6120  A                   Elbow mold doub splt     .........  .........  .........  ...........  ...........
                               soc ste.
   L6130  A                   Elbow stump activated    .........  .........  .........  ...........  ...........
                               lock h.
   L6200  A                   Elbow mold outsid lock   .........  .........  .........  ...........  ...........
                               hinge.
   L6205  A                   Elbow molded w/ expand   .........  .........  .........  ...........  ...........
                               inter.
   L6250  A                   Elbow inter loc elbow    .........  .........  .........  ...........  ...........
                               forarm.
   L6300  A                   Shlder disart int lock   .........  .........  .........  ...........  ...........
                               elbow.
   L6310  A                   Shoulder passive restor  .........  .........  .........  ...........  ...........
                               comp.
   L6320  A                   Shoulder passive restor  .........  .........  .........  ...........  ...........
                               cap.
   L6350  A                   Thoracic intern lock     .........  .........  .........  ...........  ...........
                               elbow.

[[Page 35407]]

 
   L6360  A                   Thoracic passive restor  .........  .........  .........  ...........  ...........
                               comp.
   L6370  A                   Thoracic passive restor  .........  .........  .........  ...........  ...........
                               cap.
   L6380  A                   Postop dsg cast chg      .........  .........  .........  ...........  ...........
                               wrst/elb.
   L6382  A                   Postop dsg cast chg elb  .........  .........  .........  ...........  ...........
                               dis/.
   L6384  A                   Postop dsg cast chg      .........  .........  .........  ...........  ...........
                               shlder/t.
   L6386  A                   Postop ea cast chg &     .........  .........  .........  ...........  ...........
                               realign.
   L6388  A                   Postop applicat rigid    .........  .........  .........  ...........  ...........
                               dsg on.
   L6400  A                   Below elbow prosth tiss  .........  .........  .........  ...........  ...........
                               shap.
   L6450  A                   Elb disart prosth tiss   .........  .........  .........  ...........  ...........
                               shap.
   L6500  A                   Above elbow prosth tiss  .........  .........  .........  ...........  ...........
                               shap.
   L6550  A                   Shldr disar prosth tiss  .........  .........  .........  ...........  ...........
                               shap.
   L6570  A                   Scap thorac prosth tiss  .........  .........  .........  ...........  ...........
                               shap.
   L6580  A                   Wrist/elbow bowden       .........  .........  .........  ...........  ...........
                               cable mol.
   L6582  A                   Wrist/elbow bowden cbl   .........  .........  .........  ...........  ...........
                               dir f.
   L6584  A                   Elbow fair lead cable    .........  .........  .........  ...........  ...........
                               molded.
   L6586  A                   Elbow fair lead cable    .........  .........  .........  ...........  ...........
                               dir fo.
   L6588  A                   Shdr fair lead cable     .........  .........  .........  ...........  ...........
                               molded.
   L6590  A                   Shdr fair lead cable     .........  .........  .........  ...........  ...........
                               direct.
   L6600  A                   Polycentric hinge pair.  .........  .........  .........  ...........  ...........
   L6605  A                   Single pivot hinge pair  .........  .........  .........  ...........  ...........
   L6610  A                   Flexible metal hinge     .........  .........  .........  ...........  ...........
                               pair.
   L6615  A                   Disconnect locking       .........  .........  .........  ...........  ...........
                               wrist uni.
   L6616  A                   Disconnect insert        .........  .........  .........  ...........  ...........
                               locking wr.
   L6620  A                   Flexion-friction wrist   .........  .........  .........  ...........  ...........
                               unit.
   L6623  A                   Spring-ass rot wrst w/   .........  .........  .........  ...........  ...........
                               latch.
   L6625  A                   Rotation wrst w/ cable   .........  .........  .........  ...........  ...........
                               lock.
   L6628  A                   Quick disconn hook       .........  .........  .........  ...........  ...........
                               adapter o.
   L6629  A                   Lamination collar w/     .........  .........  .........  ...........  ...........
                               couplin.
   L6630  A                   Stainless steel any      .........  .........  .........  ...........  ...........
                               wrist.
   L6632  A                   Latex suspension sleeve  .........  .........  .........  ...........  ...........
                               each.
   L6635  A                   Lift assist for elbow..  .........  .........  .........  ...........  ...........
   L6637  A                   Nudge control elbow      .........  .........  .........  ...........  ...........
                               lock.
   L6640  A                   Shoulder abduction       .........  .........  .........  ...........  ...........
                               joint pai.
   L6641  A                   Excursion amplifier      .........  .........  .........  ...........  ...........
                               pulley t.
   L6642  A                   Excursion amplifier      .........  .........  .........  ...........  ...........
                               lever ty.
   L6645  A                   Shoulder flexion-        .........  .........  .........  ...........  ...........
                               abduction j.
   L6650  A                   Shoulder universal       .........  .........  .........  ...........  ...........
                               joint.
   L6655  A                   Standard control cable   .........  .........  .........  ...........  ...........
                               extra.
   L6660  A                   Heavy duty control       .........  .........  .........  ...........  ...........
                               cable.
   L6665  A                   Teflon or equal cable    .........  .........  .........  ...........  ...........
                               lining.
   L6670  A                   Hook to hand cable       .........  .........  .........  ...........  ...........
                               adapter.
   L6672  A                   Harness chest/shlder     .........  .........  .........  ...........  ...........
                               saddle.
   L6675  A                   Harness figure of 8      .........  .........  .........  ...........  ...........
                               sing con.
   L6676  A                   Harness figure of 8      .........  .........  .........  ...........  ...........
                               dual con.
   L6680  A                   Test sock wrist disart/  .........  .........  .........  ...........  ...........
                               bel e.
   L6682  A                   Test sock elbw disart/   .........  .........  .........  ...........  ...........
                               above.
   L6684  A                   Test socket shldr        .........  .........  .........  ...........  ...........
                               disart/tho.
   L6686  A                   Suction socket.........  .........  .........  .........  ...........  ...........
   L6687  A                   Frame typ socket bel     .........  .........  .........  ...........  ...........
                               elbow/w.
   L6688  A                   Frame typ sock above     .........  .........  .........  ...........  ...........
                               elb/dis.
   L6689  A                   Frame typ socket         .........  .........  .........  ...........  ...........
                               shoulder di.
   L6690  A                   Frame typ sock           .........  .........  .........  ...........  ...........
                               interscap-tho.
   L6691  A                   Removable insert each..  .........  .........  .........  ...........  ...........
   L6692  A                   Silicone gel insert or   .........  .........  .........  ...........  ...........
                               equal.
   L6700  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #3.
   L6705  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #5.
   L6710  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #5x.
   L6715  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #5xa.
   L6720  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #6.
   L6725  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #7.
   L6730  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #7lo.
   L6735  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #8.
   L6740  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #8x.
   L6745  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #88x.
   L6750  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #10p.
   L6755  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #10x.
   L6765  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #12p.
   L6770  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #99x.
   L6775  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #555.
   L6780  A                   Terminal device model    .........  .........  .........  ...........  ...........
                               #ss555.
   L6790  A                   Hooks-accu hook or       .........  .........  .........  ...........  ...........
                               equal.
   L6795  A                   Hooks-2 load or equal..  .........  .........  .........  ...........  ...........
   L6800  A                   Hooks-aprl vc or equal.  .........  .........  .........  ...........  ...........
   L6805  A                   Modifier wrist flexion   .........  .........  .........  ...........  ...........
                               unit.
   L6806  A                   Trs grip vc or equal...  .........  .........  .........  ...........  ...........

[[Page 35408]]

 
   L6807  A                   Term device grip1/2 or   .........  .........  .........  ...........  ...........
                               equal.
   L6808  A                   Term device infant or    .........  .........  .........  ...........  ...........
                               child.
   L6809  A                   Trs super sport passive  .........  .........  .........  ...........  ...........
   L6810  A                   Pincher tool otto bock   .........  .........  .........  ...........  ...........
                               or eq.
   L6825  A                   Hands dorrance vo......  .........  .........  .........  ...........  ...........
   L6830  A                   Hand aprl vc...........  .........  .........  .........  ...........  ...........
   L6835  A                   Hand sierra vo.........  .........  .........  .........  ...........  ...........
   L6840  A                   Hand becker imperial...  .........  .........  .........  ...........  ...........
   L6845  A                   Hand becker lock grip..  .........  .........  .........  ...........  ...........
   L6850  A                   Term dvc-hand becker     .........  .........  .........  ...........  ...........
                               plylite.
   L6855  A                   Hand robin-aids vo.....  .........  .........  .........  ...........  ...........
   L6860  A                   Hand robin-aids vo soft  .........  .........  .........  ...........  ...........
   L6865  A                   Hand passive hand......  .........  .........  .........  ...........  ...........
   L6867  A                   Hand detroit infant      .........  .........  .........  ...........  ...........
                               hand.
   L6868  A                   Passive inf hand         .........  .........  .........  ...........  ...........
                               steeper/hos.
   L6870  A                   Hand child mitt........  .........  .........  .........  ...........  ...........
   L6872  A                   Hand nyu child hand....  .........  .........  .........  ...........  ...........
   L6873  A                   Hand mech inf steeper    .........  .........  .........  ...........  ...........
                               or equ.
   L6875  A                   Hand bock vc...........  .........  .........  .........  ...........  ...........
   L6880  A                   Hand bock vo...........  .........  .........  .........  ...........  ...........
   L6890  A                   Production glove.......  .........  .........  .........  ...........  ...........
   L6895  A                   Custom glove...........  .........  .........  .........  ...........  ...........
   L6900  A                   Hand restorat thumb/1    .........  .........  .........  ...........  ...........
                               finger.
   L6905  A                   Hand restoration         .........  .........  .........  ...........  ...........
                               multiple fi.
   L6910  A                   Hand restoration no      .........  .........  .........  ...........  ...........
                               fingers.
   L6915  A                   Hand restoration         .........  .........  .........  ...........  ...........
                               replacmnt g.
   L6920  A                   Wrist disarticul switch  .........  .........  .........  ...........  ...........
                               ctrl.
   L6925  A                   Wrist disart             .........  .........  .........  ...........  ...........
                               myoelectronic c.
   L6930  A                   Below elbow switch       .........  .........  .........  ...........  ...........
                               control.
   L6935  A                   Below elbow              .........  .........  .........  ...........  ...........
                               myoelectronic ct.
   L6940  A                   Elbow disarticulation    .........  .........  .........  ...........  ...........
                               switch.
   L6945  A                   Elbow disart             .........  .........  .........  ...........  ...........
                               myoelectronic c.
   L6950  A                   Above elbow switch       .........  .........  .........  ...........  ...........
                               control.
   L6955  A                   Above elbow              .........  .........  .........  ...........  ...........
                               myoelectronic ct.
   L6960  A                   Shldr disartic switch    .........  .........  .........  ...........  ...........
                               contro.
   L6965  A                   Shldr disartic           .........  .........  .........  ...........  ...........
                               myoelectronic.
   L6970  A                   Interscapular-thor       .........  .........  .........  ...........  ...........
                               switch ct.
   L6975  A                   Interscap-thor           .........  .........  .........  ...........  ...........
                               myoelectronic.
   L7010  A                   Hand otto back steeper/  .........  .........  .........  ...........  ...........
                               eq sw.
   L7015  A                   Hand sys teknik village  .........  .........  .........  ...........  ...........
                               swit.
   L7020  A                   Electronic greifer       .........  .........  .........  ...........  ...........
                               switch ct.
   L7025  A                   Electron hand            .........  .........  .........  ...........  ...........
                               myoelectronic.
   L7030  A                   Hand sys teknik vill     .........  .........  .........  ...........  ...........
                               myoelec.
   L7035  A                   Electron greifer         .........  .........  .........  ...........  ...........
                               myoelectro.
   L7040  A                   Prehensile actuator      .........  .........  .........  ...........  ...........
                               hosmer s.
   L7045  A                   Electron hook child      .........  .........  .........  ...........  ...........
                               michigan.
   L7170  A                   Electronic elbow hosmer  .........  .........  .........  ...........  ...........
                               swit.
   L7180  A                   Electronic elbow utah    .........  .........  .........  ...........  ...........
                               myoele.
   L7185  A                   Electron elbow           .........  .........  .........  ...........  ...........
                               adolescent sw.
   L7186  A                   Electron elbow child     .........  .........  .........  ...........  ...........
                               switch.
   L7190  A                   Elbow adolescent         .........  .........  .........  ...........  ...........
                               myoelectron.
   L7191  A                   Elbow child              .........  .........  .........  ...........  ...........
                               myoelectronic ct.
   L7260  A                   Electron wrist rotator   .........  .........  .........  ...........  ...........
                               otto.
   L7261  A                   Electron wrist rotator   .........  .........  .........  ...........  ...........
                               utah.
   L7266  A                   Servo control steeper    .........  .........  .........  ...........  ...........
                               or equ.
   L7272  A                   Analogue control unb or  .........  .........  .........  ...........  ...........
                               equa.
   L7274  A                   Proportional ctl 12      .........  .........  .........  ...........  ...........
                               volt uta.
   L7360  A                   Six volt bat otto bock/  .........  .........  .........  ...........  ...........
                               eq ea.
   L7362  A                   Battery chrgr six volt   .........  .........  .........  ...........  ...........
                               otto.
   L7364  A                   Twelve volt battery      .........  .........  .........  ...........  ...........
                               utah/equ.
   L7366  A                   Battery chrgr 12 volt    .........  .........  .........  ...........  ...........
                               utah/e.
   L7499  A                   Upper extremity          .........  .........  .........  ...........  ...........
                               prosthes NOS.
   L7500  A                   Prosthetic dvc repair    .........  .........  .........  ...........  ...........
                               hourly.
   L7510  A                   Prosthetic device        .........  .........  .........  ...........  ...........
                               repair rep.
   L7520  A                   Repair prosthesis per    .........  .........  .........  ...........  ...........
                               15 min.
   L7900  A                   Vacuum erection system.  .........  .........  .........  ...........  ...........
   L8000  A                   Mastectomy bra.........  .........  .........  .........  ...........  ...........
   L8010  A                   Mastectomy sleeve......  .........  .........  .........  ...........  ...........
   L8020  A                   Mastectomy form........  .........  .........  .........  ...........  ...........
   L8030  A                   Breast prosthesis        .........  .........  .........  ...........  ...........
                               silicone/e.
   L8039  A                   Breast prosthesis NOS..  .........  .........  .........  ...........  ...........
   L8100  A                   Compression stocking     .........  .........  .........  ...........  ...........
                               BK18-30.
   L8110  A                   Compression stocking     .........  .........  .........  ...........  ...........
                               BK30-40.
   L8120  A                   Compression stocking     .........  .........  .........  ...........  ...........
                               BK40-50.
   L8130  A                   Gc stocking thighlngth   .........  .........  .........  ...........  ...........
                               18-30.

[[Page 35409]]

 
   L8140  A                   Gc stocking thighlngth   .........  .........  .........  ...........  ...........
                               30-40.
   L8150  A                   Gc stocking thighlngth   .........  .........  .........  ...........  ...........
                               40-50.
   L8160  A                   Gc stocking full lngth   .........  .........  .........  ...........  ...........
                               18-30.
   L8170  A                   Gc stocking full lngth   .........  .........  .........  ...........  ...........
                               30-40.
   L8180  A                   Gc stocking full lngth   .........  .........  .........  ...........  ...........
                               40-50.
   L8190  A                   Gc stocking waistlngth   .........  .........  .........  ...........  ...........
                               18-30.
   L8200  A                   Gc stocking waistlngth   .........  .........  .........  ...........  ...........
                               40-50.
   L8210  A                   Gc stocking custom made  .........  .........  .........  ...........  ...........
   L8220  A                   Gc stocking lymphedema.  .........  .........  .........  ...........  ...........
   L8230  A                   Gc stocking garter belt  .........  .........  .........  ...........  ...........
   L8239  A                   G compression stocking   .........  .........  .........  ...........  ...........
                               NOS.
   L8300  A                   Truss single w/          .........  .........  .........  ...........  ...........
                               standard pad.
   L8310  A                   Truss double w/          .........  .........  .........  ...........  ...........
                               standard pad.
   L8320  A                   Truss addition to std    .........  .........  .........  ...........  ...........
                               pad wa.
   L8330  A                   Truss add to std pad     .........  .........  .........  ...........  ...........
                               scrotal.
   L8400  A                   Sheath below knee......  .........  .........  .........  ...........  ...........
   L8410  A                   Sheath above knee......  .........  .........  .........  ...........  ...........
   L8415  A                   Sheath upper limb......  .........  .........  .........  ...........  ...........
   L8417  A                   Pros sheath/sock w gel   .........  .........  .........  ...........  ...........
                               cushn.
   L8420  A                   Prosthetic sock multi    .........  .........  .........  ...........  ...........
                               ply BK.
   L8430  A                   Prosthetic sock multi    .........  .........  .........  ...........  ...........
                               ply AK.
   L8435  A                   Pros sock multi ply      .........  .........  .........  ...........  ...........
                               upper lm.
   L8440  A                   Shrinker below knee....  .........  .........  .........  ...........  ...........
   L8460  A                   Shrinker above knee....  .........  .........  .........  ...........  ...........
   L8465  A                   Shrinker upper limb....  .........  .........  .........  ...........  ...........
   L8470  A                   Pros sock single ply BK  .........  .........  .........  ...........  ...........
   L8480  A                   Pros sock single ply AK  .........  .........  .........  ...........  ...........
   L8485  A                   Pros sock single ply     .........  .........  .........  ...........  ...........
                               upper l.
   L8490  A                   Air seal suction reten   .........  .........  .........  ...........  ...........
                               systm.
   L8499  A                   Unlisted misc            .........  .........  .........  ...........  ...........
                               prosthetic ser.
   L8500  A                   Artificial larynx......  .........  .........  .........  ...........  ...........
   L8501  A                   Tracheostomy speaking    .........  .........  .........  ...........  ...........
                               valve.
   L8600  A                   Implant breast silicone/ .........  .........  .........  ...........  ...........
                               eq.
   L8603  A                   Collagen imp urinary     .........  .........  .........  ...........  ...........
                               2.5 CC.
   L8610  A                   Ocular implant.........  .........  .........  .........  ...........  ...........
   L8612  A                   Aqueous shunt            .........  .........  .........  ...........  ...........
                               prosthesis.
   L8613  A                   Ossicular implant......  .........  .........  .........  ...........  ...........
   L8614  A                   Cochlear device/system.  .........  .........  .........  ...........  ...........
   L8619  A                   Replace cochlear         .........  .........  .........  ...........  ...........
                               processor.
   L8630  A                   Metacarpophalangeal      .........  .........  .........  ...........  ...........
                               implant.
   L8641  A                   Metatarsal joint         .........  .........  .........  ...........  ...........
                               implant.
   L8642  A                   Hallux implant.........  .........  .........  .........  ...........  ...........
   L8658  A                   Interphalangeal joint    .........  .........  .........  ...........  ...........
                               implnt.
   L8670  A                   Vascular graft,          .........  .........  .........  ...........  ...........
                               synthetic.
   L8699  A                   Prosthetic implant NOS.  .........  .........  .........  ...........  ...........
   M0064  X                   Visit for drug                 090       0.85     $43.71       $12.20        $8.74
                               monitoring.
   M0075  E                   Cellular therapy.......  .........  .........  .........  ...........  ...........
   M0076  E                   Prolotherapy...........  .........  .........  .........  ...........  ...........
   M0100  E                   Intragastric             .........  .........  .........  ...........  ...........
                               hypothermia.
\2\ M010  E                   Foot care hygienic/pm..  .........  .........  .........  ...........  ...........
        1
   M0300  E                   IV chelationtherapy....  .........  .........  .........  ...........  ...........
   M0301  E                   Fabric wrapping of       .........  .........  .........  ...........  ...........
                               aneurysm.
   M0302  E                   Assessment of cardiac    .........  .........  .........  ...........  ...........
                               output.
   P2028  A                   Cephalin floculation     .........  .........  .........  ...........  ...........
                               test.
   P2029  A                   Congo red blood test...  .........  .........  .........  ...........  ...........
   P2031  E                   Hair analysis..........  .........  .........  .........  ...........  ...........
   P2033  A                   Blood thymol turbidity.  .........  .........  .........  ...........  ...........
   P2038  A                   Blood mucoprotein......  .........  .........  .........  ...........  ...........
   P3000  A                   Screen pap by tech w md  .........  .........  .........  ...........  ...........
                               supv.
   P3001  A                   Screening pap smear by   .........  .........  .........  ...........  ...........
                               phys.
   P7001  E                   Culture bacterial urine  .........  .........  .........  ...........  ...........
   P9010  N                   Whole blood for          .........  .........  .........  ...........  ...........
                               transfusion.
   P9011  N                   Blood split unit.......  .........  .........  .........  ...........  ...........
   P9012  N                   Cryoprecipitate each     .........  .........  .........  ...........  ...........
                               unit.
   P9013  N                   Unit/s blood fibrinogen  .........  .........  .........  ...........  ...........
\2\ P901  N                   Gamma globulin 1 ML....  .........  .........  .........  ...........  ...........
        4
\2\ P901  N                   Rh immune globulin 1 ML  .........  .........  .........  ...........  ...........
        5
   P9016  N                   Leukocyte poor blood,    .........  .........  .........  ...........  ...........
                               unit.
   P9017  N                   One donor fresh frozn    .........  .........  .........  ...........  ...........
                               plasma.
   P9018  N                   Plasma protein fract,    .........  .........  .........  ...........  ...........
                               unit.
   P9019  N                   Platelet concentrate     .........  .........  .........  ...........  ...........
                               unit.
   P9020  N                   Plaelet rich plasma      .........  .........  .........  ...........  ...........
                               unit.
   P9021  N                   Red blood cells unit...  .........  .........  .........  ...........  ...........
   P9022  N                   Washed red blood cells   .........  .........  .........  ...........  ...........
                               unit.
   P9603  N                   One-way allow prorated   .........  .........  .........  ...........  ...........
                               miles.

[[Page 35410]]

 
   P9604  N                   One-way allow prorated   .........  .........  .........  ...........  ...........
                               trip.
\2\ P961  E                   Urine specimen collect   .........  .........  .........  ...........  ...........
        0                      singl.
   P9615  E                   Urine specimen collect   .........  .........  .........  ...........  ...........
                               mult.
   Q0034  X                   Admin of influenza             901       0.07      $3.60        $2.49        $0.72
                               vaccine.
   Q0035  X                   Cardiokymography.......        950       0.35     $18.00       $15.82        $3.60
   Q0068  S                   Extracorpeal                   369       6.33    $325.49      $155.49       $65.10
                               plasmapheresis.
   Q0081  X                   Infusion ther other            906       1.93     $99.24       $57.18       $19.85
                               than che.
   Q0083  S                   Chemo by other than            987       2.09    $107.47       $65.09       $21.49
                               infusion.
   Q0084  S                   Chemotherapy by                989       1.91     $98.21       $44.52       $19.64
                               infusion.
   Q0085  S                   Chemo by both infusion         989       1.91     $98.21       $44.52       $19.64
                               and o.
   Q0086  A                   Physical therapy         .........  .........  .........  ...........  ...........
                               evaluation/.
   Q0091  S                   Obtaining screen pap           561       1.46     $75.07       $24.41       $15.01
                               smear.
   Q0092  N                   Set up port xray         .........  .........  .........  ...........  ...........
                               equipment.
   Q0111  A                   Wet mounts/ w            .........  .........  .........  ...........  ...........
                               preparations.
   Q0112  A                   Potassium hydroxide      .........  .........  .........  ...........  ...........
                               preps.
   Q0113  A                   Pinworm examinations...  .........  .........  .........  ...........  ...........
   Q0114  A                   Fern test..............  .........  .........  .........  ...........  ...........
   Q0115  A                   Post-coital mucous exam  .........  .........  .........  ...........  ...........
   Q0132  A                   Dispensing fee DME neb   .........  .........  .........  ...........  ...........
                               drug.
   Q0136  N                   Non esrd epoetin alpha   .........  .........  .........  ...........  ...........
                               inj.
   Q0144  E                   Azithromycin dihydrate,  .........  .........  .........  ...........  ...........
                               oral.
   Q0156  N                   Human albumin 5%.......  .........  .........  .........  ...........  ...........
   Q0157  N                   Human albumin 25%......  .........  .........  .........  ...........  ...........
   Q9920  A                   Epoetin with hct <= 20.  .........  .........  .........  ...........  ...........
   Q9921  A                   Epoetin with hct = 21..  .........  .........  .........  ...........  ...........
   Q9922  A                   Epoetin with hct = 22..  .........  .........  .........  ...........  ...........
   Q9923  A                   Epoetin with hct = 23..  .........  .........  .........  ...........  ...........
   Q9924  A                   Epoetin with hct = 24..  .........  .........  .........  ...........  ...........
   Q9925  A                   Epoetin with hct = 25..  .........  .........  .........  ...........  ...........
   Q9926  A                   Epoetin with hct = 26..  .........  .........  .........  ...........  ...........
   Q9927  A                   Epoetin with hct = 27..  .........  .........  .........  ...........  ...........
   Q9928  A                   Epoetin with hct = 28..  .........  .........  .........  ...........  ...........
   Q9929  A                   Epoetin with hct = 29..  .........  .........  .........  ...........  ...........
   Q9930  A                   Epoetin with hct = 30..  .........  .........  .........  ...........  ...........
   Q9931  A                   Epoetin with hct = 31..  .........  .........  .........  ...........  ...........
   Q9932  A                   Epoetin with hct = 32..  .........  .........  .........  ...........  ...........
   Q9933  A                   Epoetin with hct = 33..  .........  .........  .........  ...........  ...........
   Q9934  A                   Epoetin with hct = 34..  .........  .........  .........  ...........  ...........
   Q9935  A                   Epoetin with hct = 35..  .........  .........  .........  ...........  ...........
   Q9936  A                   Epoetin with hct = 36..  .........  .........  .........  ...........  ...........
   Q9937  A                   Epoetin with hct = 37..  .........  .........  .........  ...........  ...........
   Q9938  A                   Epoetin with hct = 38..  .........  .........  .........  ...........  ...........
   Q9939  A                   Epoetin with hct = 39..  .........  .........  .........  ...........  ...........
   Q9940  A                   Epoetin with hct >= 40.  .........  .........  .........  ...........  ...........
   R0070  N                   Transport portable x-    .........  .........  .........  ...........  ...........
                               ray.
   R0075  N                   Transport port x-ray     .........  .........  .........  ...........  ...........
                               multipl.
   R0076  N                   Transport portable EKG.  .........  .........  .........  ...........  ...........
   V2020  A                   Vision svcs frames       .........  .........  .........  ...........  ...........
                               purchases.
   V2025  E                   Eyeglasses delux frames  .........  .........  .........  ...........  ...........
   V2100  A                   Lens spher single plano  .........  .........  .........  ...........  ...........
                               4.00.
   V2101  A                   Single visn sphere 4.12- .........  .........  .........  ...........  ...........
                               7.00.
   V2102  A                   Singl visn sphere 7.12-  .........  .........  .........  ...........  ...........
                               20.00.
   V2103  A                   Spherocylindr 4.00d/12-  .........  .........  .........  ...........  ...........
                               2.00d.
   V2104  A                   Spherocylindr 4.00d/     .........  .........  .........  ...........  ...........
                               2.12-4d.
   V2105  A                   Spherocylinder 4.00d/    .........  .........  .........  ...........  ...........
                               4.25-6d.
   V2106  A                   Spherocylinder 4.00d/    .........  .........  .........  ...........  ...........
                               >6.00d.
   V2107  A                   Spherocylinder 4.25d/12- .........  .........  .........  ...........  ...........
                               2d.
   V2108  A                   Spherocylinder 4.25d/    .........  .........  .........  ...........  ...........
                               2.12-4d.
   V2109  A                   Spherocylinder 4.25d/    .........  .........  .........  ...........  ...........
                               4.25-6d.
   V2110  A                   Spherocylinder 4.25d/    .........  .........  .........  ...........  ...........
                               over 6d.
   V2111  A                   Spherocylindr 7.25d/.25- .........  .........  .........  ...........  ...........
                               2.25.
   V2112  A                   Spherocylindr 7.25d/     .........  .........  .........  ...........  ...........
                               2.25-4d.
   V2113  A                   Spherocylindr 7.25d/     .........  .........  .........  ...........  ...........
                               4.25-6d.
   V2114  A                   Spherocylinder over      .........  .........  .........  ...........  ...........
                               12.00d.
   V2115  A                   Lens lenticular bifocal  .........  .........  .........  ...........  ...........
   V2116  A                   Nonaspheric lens         .........  .........  .........  ...........  ...........
                               bifocal.
   V2117  A                   Aspheric lens bifocal..  .........  .........  .........  ...........  ...........
   V2118  A                   Lens aniseikonic single  .........  .........  .........  ...........  ...........
   V2199  A                   Lens single vision not   .........  .........  .........  ...........  ...........
                               oth c.
   V2200  A                   Lens spher bifoc plano   .........  .........  .........  ...........  ...........
                               4.00d.
   V2201  A                   Lens sphere bifocal      .........  .........  .........  ...........  ...........
                               4.12-7.0.
   V2202  A                   Lens sphere bifocal      .........  .........  .........  ...........  ...........
                               7.12-20..
   V2203  A                   Lens sphcyl bifocal      .........  .........  .........  ...........  ...........
                               4.00d/.1.
   V2204  A                   Lens sphcy bifocal       .........  .........  .........  ...........  ...........
                               4.00d/2.1.
   V2205  A                   Lens sphcy bifocal       .........  .........  .........  ...........  ...........
                               4.00d/4.2.

[[Page 35411]]

 
   V2206  A                   Lens sphcy bifocal       .........  .........  .........  ...........  ...........
                               4.00d/ove.
   V2207  A                   Lens sphcy bifocal 4.25- .........  .........  .........  ...........  ...........
                               7d/..
   V2208  A                   Lens sphcy bifocal 4.25- .........  .........  .........  ...........  ...........
                               7/2..
   V2209  A                   Lens sphcy bifocal 4.25- .........  .........  .........  ...........  ...........
                               7/4..
   V2210  A                   Lens sphcy bifocal 4.25- .........  .........  .........  ...........  ...........
                               7/ov.
   V2211  A                   Lens sphcy bifo 7.25-12/ .........  .........  .........  ...........  ...........
                               .25-.
   V2212  A                   Lens sphcyl bifo 7.25-   .........  .........  .........  ...........  ...........
                               12/2.2.
   V2213  A                   Lens sphcyl bifo 7.25-   .........  .........  .........  ...........  ...........
                               12/4.2.
   V2214  A                   Lens sphcyl bifocal      .........  .........  .........  ...........  ...........
                               over 12..
   V2215  A                   Lens lenticular bifocal  .........  .........  .........  ...........  ...........
   V2216  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               nonaspheric.
   V2217  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               aspheric bif.
   V2218  A                   Lens aniseikonic         .........  .........  .........  ...........  ...........
                               bifocal.
   V2219  A                   Lens bifocal seg width   .........  .........  .........  ...........  ...........
                               over.
   V2220  A                   Lens bifocal add over    .........  .........  .........  ...........  ...........
                               3.25d.
   V2299  A                   Lens bifocal speciality  .........  .........  .........  ...........  ...........
   V2300  A                   Lens sphere trifocal     .........  .........  .........  ...........  ...........
                               4.00d.
   V2301  A                   Lens sphere trifocal     .........  .........  .........  ...........  ...........
                               4.12-7..
   V2302  A                   Lens sphere trifocal     .........  .........  .........  ...........  ...........
                               7.12-20.
   V2303  A                   Lens sphcy trifocal 4.0/ .........  .........  .........  ...........  ...........
                               .12-.
   V2304  A                   Lens sphcy trifocal 4.0/ .........  .........  .........  ...........  ...........
                               2.25.
   V2305  A                   Lens sphcy trifocal 4.0/ .........  .........  .........  ...........  ...........
                               4.25.
   V2306  A                   Lens sphcyl trifocal     .........  .........  .........  ...........  ...........
                               4.00/>6.
   V2307  A                   Lens sphcy trifocal      .........  .........  .........  ...........  ...........
                               4.25-7/..
   V2308  A                   Lens sphc trifocal 4.25- .........  .........  .........  ...........  ...........
                               7/2..
   V2309  A                   Lens sphc trifocal 4.25- .........  .........  .........  ...........  ...........
                               7/4..
   V2310  A                   Lens sphc trifocal 4.25- .........  .........  .........  ...........  ...........
                               7/>6.
   V2311  A                   Lens sphc trifo 7.25-12/ .........  .........  .........  ...........  ...........
                               .25-.
   V2312  A                   Lens sphc trifo 7.25-12/ .........  .........  .........  ...........  ...........
                               2.25.
   V2313  A                   Lens sphc trifo 7.25-12/ .........  .........  .........  ...........  ...........
                               4.25.
   V2314  A                   Lens sphcyl trifocal     .........  .........  .........  ...........  ...........
                               over 12.
   V2315  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               trifocal.
   V2316  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               nonaspheric.
   V2317  A                   Lens lenticular          .........  .........  .........  ...........  ...........
                               aspheric tri.
   V2318  A                   Lens aniseikonic         .........  .........  .........  ...........  ...........
                               trifocal.
   V2319  A                   Lens trifocal seg width  .........  .........  .........  ...........  ...........
                               > 28.
   V2320  A                   Lens trifocal add over   .........  .........  .........  ...........  ...........
                               3.25d.
   V2399  A                   Lens trifocal            .........  .........  .........  ...........  ...........
                               speciality.
   V2410  A                   Lens variab asphericity  .........  .........  .........  ...........  ...........
                               sing.
   V2430  A                   Lens variable            .........  .........  .........  ...........  ...........
                               asphericity bi.
   V2499  A                   Variable asphericity     .........  .........  .........  ...........  ...........
                               lens.
   V2500  A                   Contact lens pmma        .........  .........  .........  ...........  ...........
                               spherical.
   V2501  A                   Cntct lens pmma-toric/   .........  .........  .........  ...........  ...........
                               prism.
   V2502  A                   Contact lens pmma        .........  .........  .........  ...........  ...........
                               bifocal.
   V2503  A                   Cntct lens pmma color    .........  .........  .........  ...........  ...........
                               vision.
   V2510  A                   Cntct gas permeable      .........  .........  .........  ...........  ...........
                               sphericl.
   V2511  A                   Cntct toric prism        .........  .........  .........  ...........  ...........
                               ballast.
   V2512  A                   Cntct lens gas permbl    .........  .........  .........  ...........  ...........
                               bifocl.
   V2513  A                   Contact lens extended    .........  .........  .........  ...........  ...........
                               wear.
   V2520  A                   Contact lens             .........  .........  .........  ...........  ...........
                               hydrophilic.
   V2521  A                   Cntct lens hydrophilic   .........  .........  .........  ...........  ...........
                               toric.
   V2522  A                   Cntct lens hydrophil     .........  .........  .........  ...........  ...........
                               bifocl.
   V2523  A                   Cntct lens hydrophil     .........  .........  .........  ...........  ...........
                               extend.
   V2530  A                   Contact lens gas         .........  .........  .........  ...........  ...........
                               impermeable.
   V2531  A                   Contact lens gas         .........  .........  .........  ...........  ...........
                               permeable.
   V2599  A                   Contact lens/es other    .........  .........  .........  ...........  ...........
                               type.
   V2600  A                   Hand held low vision     .........  .........  .........  ...........  ...........
                               aids.
   V2610  A                   Single lens spectacle    .........  .........  .........  ...........  ...........
                               mount.
   V2615  A                   Telescop/othr compound   .........  .........  .........  ...........  ...........
                               lens.
   V2623  A                   Plastic eye prosth       .........  .........  .........  ...........  ...........
                               custom.
   V2624  A                   Polishing artifical eye  .........  .........  .........  ...........  ...........
   V2625  A                   Enlargemnt of eye        .........  .........  .........  ...........  ...........
                               prosthesis.
   V2626  A                   Reduction of eye         .........  .........  .........  ...........  ...........
                               prosthesis.
   V2627  A                   Scleral cover shell....  .........  .........  .........  ...........  ...........
   V2628  A                   Fabrication & fitting..  .........  .........  .........  ...........  ...........
   V2629  A                   Prosthetic eye other     .........  .........  .........  ...........  ...........
                               type.
   V2630  N                   Anter chamber intraocul  .........  .........  .........  ...........  ...........
                               lens.
   V2631  N                   Iris support intraoclr   .........  .........  .........  ...........  ...........
                               lens.
   V2632  N                   Post chmbr intraocular   .........  .........  .........  ...........  ...........
                               lens.
   V2700  A                   Balance lens...........  .........  .........  .........  ...........  ...........
   V2710  A                   Glass/plastic slab off   .........  .........  .........  ...........  ...........
                               prism.
   V2715  A                   Prism lens/es..........  .........  .........  .........  ...........  ...........
   V2718  A                   Fresnell prism press-on  .........  .........  .........  ...........  ...........
                               lens.
   V2730  A                   Special base curve.....  .........  .........  .........  ...........  ...........
   V2740  A                   Rose tint plastic......  .........  .........  .........  ...........  ...........

[[Page 35412]]

 
   V2741  A                   Non-rose tint plastic..  .........  .........  .........  ...........  ...........
   V2742  A                   Rose tint glass........  .........  .........  .........  ...........  ...........
   V2743  A                   Non-rose tint glass....  .........  .........  .........  ...........  ...........
   V2744  A                   Tint photochromatic      .........  .........  .........  ...........  ...........
                               lens/es.
   V2750  A                   Anti-reflective coating  .........  .........  .........  ...........  ...........
   V2755  A                   UV lens/es.............  .........  .........  .........  ...........  ...........
   V2760  A                   Scratch resistant        .........  .........  .........  ...........  ...........
                               coating.
   V2770  A                   Occluder lens/es.......  .........  .........  .........  ...........  ...........
   V2780  A                   Oversize lens/es.......  .........  .........  .........  ...........  ...........
   V2781  A                   Progressive lens per     .........  .........  .........  ...........  ...........
                               lens.
   V2785  N                   Corneal tissue           .........  .........  .........  ...........  ...........
                               processing.
   V2799  A                   Miscellaneous vision     .........  .........  .........  ...........  ...........
                               service.
   V5008  E                   Hearing screening......  .........  .........  .........  ...........  ...........
   V5010  E                   Assessment for hearing   .........  .........  .........  ...........  ...........
                               aid.
   V5011  E                   Hearing aid fitting/     .........  .........  .........  ...........  ...........
                               checking.
   V5014  E                   Hearing aid repair/      .........  .........  .........  ...........  ...........
                               modifying.
   V5020  E                   Conformity evaluation..  .........  .........  .........  ...........  ...........
   V5030  E                   Body-worn hearing aid    .........  .........  .........  ...........  ...........
                               air.
   V5040  E                   Body-worn hearing aid    .........  .........  .........  ...........  ...........
                               bone.
   V5050  E                   Body-worn hearing aid    .........  .........  .........  ...........  ...........
                               in ear.
   V5060  E                   Behind ear hearing aid.  .........  .........  .........  ...........  ...........
   V5070  E                   Glasses air conduction.  .........  .........  .........  ...........  ...........
   V5080  E                   Glasses bone conduction  .........  .........  .........  ...........  ...........
   V5090  E                   Hearing aid dispensing   .........  .........  .........  ...........  ...........
                               fee.
   V5100  E                   Body-worn bilat hearing  .........  .........  .........  ...........  ...........
                               aid.
   V5110  E                   Hearing aid dispensing   .........  .........  .........  ...........  ...........
                               fee.
   V5120  E                   Body-worn binaur         .........  .........  .........  ...........  ...........
                               hearing aid.
   V5130  E                   In ear binaural hearing  .........  .........  .........  ...........  ...........
                               aid.
   V5140  E                   Behind ear binaur        .........  .........  .........  ...........  ...........
                               hearing ai.
   V5150  E                   Glasses binaural         .........  .........  .........  ...........  ...........
                               hearing aid.
   V5160  E                   Dispensing fee binaural  .........  .........  .........  ...........  ...........
   V5170  E                   Within ear cros hearing  .........  .........  .........  ...........  ...........
                               aid.
   V5180  E                   Behind ear cros hearing  .........  .........  .........  ...........  ...........
                               aid.
   V5190  E                   Glasses cros hearing     .........  .........  .........  ...........  ...........
                               aid.
   V5200  E                   Cros hearing aid         .........  .........  .........  ...........  ...........
                               dispens fee.
   V5210  E                   In ear bicros hearing    .........  .........  .........  ...........  ...........
                               aid.
   V5220  E                   Behind ear bicros        .........  .........  .........  ...........  ...........
                               hearing ai.
   V5230  E                   Glasses bicros hearing   .........  .........  .........  ...........  ...........
                               aid.
   V5240  E                   Dispensing fee bicros..  .........  .........  .........  ...........  ...........
   V5299  A                   Hearing service........  .........  .........  .........  ...........  ...........
   V5336  E                   Repair communication     .........  .........  .........  ...........  ...........
                               device.
   V5362  A                   Speech screening.......  .........  .........  .........  ...........  ...........
   V5363  A                   Language screening.....  .........  .........  .........  ...........  ...........
   V5364  A                   Dysphagia screening....  .........  .........  .........  ...........  ...........
----------------------------------------------------------------------------------------------------------------
\1\ This APC assignment will not apply to services furnished under a partial hospitalization program. Instead,
  services furnished as part of a partial hospitalization program are paid on a per-diem basis via APC 020.
\2\ This code was valid in 1996 and therefore was available for use in calculating weights. However, it has
  since been terminated and will not be paid upon implementation.
CPT codes and descriptions only are copyright 1997 American Medical Association. All rights reserved. Applicable
  FARS/DFARS apply.
Copyright 1994 American Dental Association. All rights reserved.

          

  

  

    48. On pages 47761 through 47833, Addendum C is corrected to read 
as follows:

          CPT codes and descriptions only are 
copyright 1997 American Medical Association. All rights reserved. 
Applicable FARS/DFARS apply.

Copyright 1994 American Dental Association. All rights reserved.

[[Page 35412]]



            Addendum C.--Proposed Hospital Outpatient Department (HOPD) Payment for Procedures by APC
----------------------------------------------------------------------------------------------------------------
                                                                             Proposed     National     Minimum
  APC      CPT           Description         Status indicator    Relative     payment    unadjusted   unadjusted
          HCPCS                                                   weight       rate     coinsurance  coinsurance
----------------------------------------------------------------------------------------------------------------
    031  DENTAL PROCEDURES                  S                         1.37      $70.45       $14.09       $14.09
    031    D0150  Comprehensve oral
                   evaluation.
    031    D0240  Intraoral occlusal film.
    031    D0250  Extraoral first film....
    031    D0260  Extraoral ea additional
                   film.
    031    D0270  Dental bitewing single
                   film.
    031    D0272  Dental bitewings two
                   films.
    031    D0274  Dental bitewings four
                   films.
    031    D0460  Pulp vitality test......
    031    D0471  Diagnostic photographs..
    031    D0501  Histopathologic
                   examinations.
    031    D0502  Other oral pathology
                   procedu.
    031    D0999  Unspecified diagnostic
                   proce.
    031    D1510  Space maintainer fxd
                   unilat.

[[Page 35413]]

 
    031    D1515  Fixed bilat space
                   maintainer.
    031    D1520  Remove unilat space
                   maintain.
    031    D1525  Remove bilat space
                   maintain.
    031    D1550  Recement space
                   maintainer.
    031    D2970  Temporary- fractured
                   tooth.
    031    D2999  Dental unspec
                   restorative pr.
    031    D3460  Endodontic endosseous
                   implan.
    031    D3999  Endodontic procedure....
    031    D4250  Mucogingival surg per
                   quadra.
    031    D4260  Osseous surgery per
                   quadrant.
    031    D4263  Bone replce graft first
                   site.
    031    D4264  Bone replce graft each
                   add.
    031    D4270  Pedicle soft tissue
                   graft pr.
    031    D4271  Free soft tissue graft
                   proc.
    031    D4273  Subepithelial tissue
                   graft.
    031    D4355  Full mouth debridement..
    031    D4381  Localized chemo delivery
    031    D5911  Facial moulage sectional
    031    D5912  Facial moulage complete.
    031    D5983  Radiation applicator....
    031    D5984  Radiation shield........
    031    D5985  Radiation cone locator..
    031    D5987  Commissure splint.......
    031    D6920  Dental connector bar....
    031    D7110  Oral surgery single
                   tooth.
    031    D7120  Each add tooth
                   extraction.
    031    D7130  Tooth root removal......
    031    D7210  Rem imp tooth w mucoper
                   flp.
    031    D7220  Impact tooth remov soft
                   tiss.
    031    D7230  Impact tooth remov part
                   bony.
    031    D7240  Impact tooth remov comp
                   bony.
    031    D7241  Impact tooth rem bony w/
                   comp.
    031    D7250  Tooth root removal......
    031    D7260  Oral antral fistula
                   closure.
    031    D7291  Transseptal fiberotomy..
    031    D7940  Reshaping bone
                   orthognathic.
    031    D9630  Other drugs/medicaments.
    031    D9930  Treatment of
                   complications.
    031    D9940  Dental occlusal guard...
    031    D9950  Occlusion analysis......
    031    D9951  Limited occlusal
                   adjustment.
    031    D9952  Complete occlusal
                   adjustment.
    061  LEVEL I CHEMOTHERAPEUTIC AGENTS    X                         1.15      $59.13       $37.52       $11.83
    061    J8610  Methotrexate oral 2.5 MG
    061    J8999  Oral prescription drug
                   chemo.
    061    J9015  Aldesleukin/single use
                   vial.
    061    J9070  Cyclophosphamide 100 MG
                   inj.
    061    J9080  Cyclophosphamide 200 MG
                   inj.
    061    J9090  Cyclophosphamide 500 MG
                   inj.
    061    J9093  Cyclophosphamide
                   lyophilized.
    061    J9094  Cyclophosphamide
                   lyophilized.
    061    J9095  Cyclophosphamide
                   lyophilized.
    061    J9100  Cytarabine hcl 100 MG
                   inj.
    061    J9110  Cytarabine hcl 500 MG
                   inj.
    061    J9120  Dactinomycin actinomycin
                   d.
    061    J9130  Dacarbazine 10 MG inj...
    061    J9140  Dacarbazine 200 MG inj..
    061    J9165  Diethylstilbestrol
                   injection.
    061    J9170  Docetaxel...............
    061    J9181  Etoposide 10 MG inj.....
    061    J9190  Fluorouracil injection..
    061    J9201  Gemcitabine HCl.........
    061    J9206  Irinotecan injection....
    061    J9214  Interferon alfa-2b inj..
    061    J9215  Interferon alfa-n3 inj..
    061    J9218  Leuprolide acetate
                   injeciton.
    061    J9230  Mechlorethamine hcl inj.
    061    J9250  Methotrexate sodium inj.
    061    J9260  Methotrexate sodium inj.
    061    J9266  Pegaspargase/singl dose
                   vial.
    061    J9350  Topotecan...............
    061    J9360  Vinblastine sulfate inj.
    061    J9390  Vinorelbine tartrate/10
                   mg.
    061    J9600  Porfimer sodium.........
    061    J9999  Chemotherapy drug.......

[[Page 35414]]

 
    062  LEVEL II CHEMOTHERAPEUTIC AGENTS   X                         1.78      $91.53       $36.61       $18.31
    062    J9000  Doxorubic hcl 10 MG vl
                   chemo.
    062    J9020  Asparaginase injection..
    062    J9060  Cisplatin 10 MG
                   injeciton.
    062    J9065  Inj cladribine per 1 MG.
    062    J9091  Cyclophosphamide 1.0 grm
                   inj.
    062    J9092  Cyclophosphamide 2.0 grm
                   inj.
    062    J9096  Cyclophosphamide
                   lyophilized.
    062    J9097  Cyclophosphamide
                   lyophilized.
    062    J9150  Daunorubicin............
    062    J9211  Idarubicin hcl injeciton
    062    J9213  Interferon alfa-2a inj..
    062    J9265  Paclitaxel injection....
    062    J9268  Pentostatin injection...
    062    J9370  Vincristine sulfate 1 MG
                   inj.
    063  LEVEL III CHEMOTHERAPEUTIC AGENTS  X                         2.94     $151.17      $110.97       $30.24
\2\ 063    J9010  Doxorubicin hcl 50 MG
                   inj.
    063    J9031  Bcg live intravesical
                   vac.
    063    J9040  Bleomycin sulfate
                   injection.
    063    J9045  Carboplatin injection...
    063    J9050  Carmus bischl nitro inj.
    063    J9062  Cisplatin 50 MG
                   injeciton.
    063    J9182  Etoposide 100 MG inj....
    063    J9185  Fludarabine phosphate
                   inj.
    063    J9200  Floxuridine injection...
    063    J9202  Goserelin acetate
                   implant.
    063    J9208  Ifosfomide injection....
    063    J9209  Mesna injection.........
    063    J9216  Interferon gamma 1-b inj
    063    J9270  Plicamycin (mithramycin)
                   inj.
    063    J9280  Mitomycin 5 MG inj......
    063    J9320  Streptozocin injection..
    063    J9340  Thiotepa injection......
    063    J9375  Vincristine sulfate 2 MG
                   inj.
    063    J9380  Vincristine sulfate 5 MG
                   inj.
    064  LEVEL IV CHEMOTHERAPEUTIC AGENTS   X                         4.15     $213.39      $138.99       $42.68
    064    J0640  Leucovorin calcium
                   injection.
    064    J1950  Leuprolide acetate /3.75
                   MG.
    064    J9217  Leuprolide acetate
                   suspnsion.
    064    J9245  Inj melphalan hydrochl
                   50 MG.
    064    J9290  Mitomycin 20 MG inj.....
    064    J9291  Mitomycin 40 MG inj.....
    064    J9293  Mitoxantrone hydrochl /
                   5 MG.
    089  NEUROPSYCHOLOGICAL TESTING         X                         4.06     $208.77       $46.10       $41.75
\1\ 089    96100  Psychological testing...
    089    96105  Assessment of aphasia...
    089    96110  Developmental test, lim.
    089    96111  Developmental test,
                   extend.
\1\ 089    96115  Neurobehavior status
                   exam.
\1\ 089    96117  Neuropsych test battery.
    090  MONITORING PSYCHIATRIC DRUGS       X                         0.85      $43.71       $12.20        $8.74
\1\ 090    90862  Medication management...
    090    M0064  Visit for drug
                   monitoring.
    091  BRIEF INDIVIDUAL PSYCHOTHERAPY     S                         1.09      $56.05       $14.01       $11.21
    091    90804  Psytx, office (20-30)...
    091    90805  Psytx, office (20-30) w/
                   e&m.
    091    90810  Intac psytx, office (20-
                   30).
    091    90811  Intac psytx, off 20-30 w/
                   e&m.
    091    90816  Psytx, hosp (20-30).....
    091    90817  Psytx, hosp (20-30) w/
                   e&m.
    091    90823  Intac psytx, hosp (20-
                   30).
    091    90824  Intac psytx, hsp 20-30 w/
                   e&m.
\1\ \2\    90843  Psychotherapy, 20-30 min
     091
\1\ 091    90899  Psychiatric service/
                   therapy.
    092  EXTENDED INDIVIDUAL PSYCHOTHERAPY  S                         1.63      $83.81       $21.47       $16.76
\1\ 092    90801  Psy dx interview........
    092    90802  Intac psy dx interview..
    092    90806  Psytx, office (45-50)...
    092    90807  Psytx, office (45-50) w/
                   e&m.
    092    90808  Psytx, office (75-80)...
    092    90809  Psytx, office (75-80) w/
                   e&m.
    092    90812  Intac psytx, office (45-
                   50).
    092    90813  Intac psytx, off 45-50 w/
                   e&m.
    092    90814  Intac psytx, office (75-
                   80).
    092    90815  Intac psytx, off 75-80 w/
                   e&m.

[[Page 35415]]

 
    092    90818  Psytx, hosp (45-50).....
    092    90819  Psytx, hosp (45-50) w/
                   e&m.
\1\ \2\    90820  Diagnostic interview....
     092
    092    90821  Psytx, hosp (75-80).....
    092    90822  Psytx, hosp (75-80) w/
                   e&m.
    092    90826  Intac psytx, hosp (45-
                   50).
    092    90827  Intac psytx, hsp 45-50 w/
                   e&m.
    092    90828  Intac psytx, hosp (75-
                   80).
    092    90829  Intac psytx, hsp 75-80 w/
                   e&m.
\1\ \2\    90835  Special interview.......
     092
\1\ \2\    90842  Psychotherapy, 75-80 min
     092
\1\ \2\    90844  Psychotherapy, 45-50 min
     092
\1\ 092    90845  Psychoanalysis..........
\1\ \2\    90855  Individual psychotherapy
     092
    092    90865  Narcosynthesis..........
\1\ 092    90880  Hypnotherapy............
    093  FAMILY PSYCHOTHERAPY               S                         1.56      $80.22       $20.11       $16.04
\1\ 093    90846  Family psytx w/o patient
\1\ 093    90847  Family psytx w/patient..
    094  GROUP PSYCHOTHERAPY                S                         1.31      $67.36       $19.89       $13.47
\1\ 094    90849  Multiple family group
                   psytx.
\1\ 094    90853  Group psychotherapy.....
\1\ 094    90857  Intac group psytx.......
    121  LEVEL I NEEDLE BIOPSY/ASPIRATION   T                         0.63      $32.39       $21.02        $6.48
    121    17999  Skin tissue procedure...
    121    19000  Drainage of breast
                   lesion.
    121    19001  Drain breast lesion add-
                   on.
    121    20615  Treatment of bone cyst..
    121    55000  Drainage of hydrocele...
    121    60001  Aspirate/inject thyriod
                   cyst.
    121    60699  Endocrine surgery
                   procedure.
    121    85095  Bone marrow aspiration..
    121    85102  Bone marrow biopsy......
    121    88170  Fine needle aspiration..
    121    88171  Fine needle aspiration..
    122  LEVEL II NEEDLE BIOPSY/ASPIRATION  T                         4.59     $236.02      $113.00       $47.20
    122    19100  Biopsy of breast........
    122    20206  Needle biopsy, muscle...
    122    32400  Needle biopsy chest
                   lining.
    122    32405  Biopsy, lung or
                   mediastinum.
    122    38505  Needle biopsy, lymph
                   node(s).
    122    42400  Biopsy of salivary gland
    122    47000  Needle biopsy of liver..
    122    47399  Liver surgery procedure.
    122    48102  Needle biopsy, pancreas.
    122    48999  Pancreas surgery
                   procedure.
    122    49180  Biopsy, abdominal mass..
    122    50200  Biopsy of kidney........
    122    50390  Drainage of kidney
                   lesion.
    122    54500  Biopsy of testis........
    122    54800  Biopsy of epididymis....
    122    60100  Biopsy of thyroid.......
    122    62269  Needle biopsy spinal
                   cord.
    122    67415  Aspiration orbital
                   contents.
    131  LEVEL I INCISION & DRAINAGE        T                         1.93      $99.24       $36.61       $19.85
    131    10040  Acne surgery of skin
                   abscess.
    131    10060  Drainage of skin abscess
    131    10061  Drainage of skin abscess
    131    10080  Drainage of pilonidal
                   cyst.
    131    10081  Drainage of pilonidal
                   cyst.
    131    10120  Remove foreign body.....
    131    10140  Drainage of hematoma/
                   fluid.
    131    10160  Puncture drainage of
                   lesion.
    131    10180  Complex drainage, wound.
    131    11976  Removal of contraceptive
                   cap.
    131    20000  Incision of abscess.....
    131    26010  Drainage of finger
                   abscess.
    131    26011  Drainage of finger
                   abscess.
    131    69000  Drain external ear
                   lesion.
    131    69005  Drain external ear
                   lesion.
    131    69020  Drain outer ear canal
                   lesion.
    132  LEVEL II INCISION & DRAINAGE       T                         5.63     $289.49      $132.89       $57.90
    132    19020  Incision of breast
                   lesion.
    132    20950  Record fluid
                   pressure,muscle.
    132    21501  Drain neck/chest lesion.

[[Page 35416]]

 
    132    21700  Revision of neck muscle.
    132    21720  Revision of neck muscle.
    132    21725  Revision of neck muscle.
    132    23030  Drain shoulder lesion...
    132    23031  Drain shoulder bursa....
    132    23930  Drainage of arm lesion..
    132    23931  Drainage of arm bursa...
    132    27301  Drain thigh/knee lesion.
    132    27603  Drain lower leg lesion..
    132    28001  Drainage of bursa of
                   foot.
    132    38300  Drainage lymph node
                   lesion.
    132    38305  Drainage lymph node
                   lesion.
    132    38999  Blood/lymph system
                   procedure.
    132    51080  Drainage of bladder
                   abscess.
    132    54015  Drain penis lesion......
    132    54115  Treatment of penis
                   lesion.
    132    55100  Drainage of scrotum
                   abscess.
    137  NAIL PROCEDURES                    T                         0.60      $30.85        $9.27        $6.17
\2\ 137    11700  Scraping of 1-5 nails...
\2\ 137    11701  Scraping of additional
                   nails.
\2\ 137    11710  Scraping of 1-5 nails...
\2\ 137    11711  Scraping of additional
                   nails.
    137    11719  Trim nail(s)............
    137    11720  Debride nail, 1-5.......
    137    11721  Debride nail, 6 or more.
    137    11740  Drain blood from under
                   nail.
    137    11755  Biopsy, nail unit.......
    141  LEVEL I DESTRUCTION OF LESION      T                         0.52      $26.74        $9.49        $5.35
    141    17000  Destroy benign/premal
                   lesion.
\2\ 141    17001  Destruction of add'l
                   lesions.
\2\ 141    17002  Destruction of add'l
                   lesions.
    141    17003  Destroy 2-14 lesions....
\2\ 141    17100  Destruction of skin
                   lesion.
\2\ 141    17101  Destruction of 2nd
                   lesion.
\2\ 141    17102  Destruction of add'l
                   lesions.
    141    17106  Destruction of skin
                   lesions.
    141    17110  Destruct lesion, 1-14...
    142  LEVEL II DESTRUCTION OF LESION     T                         2.94     $151.17       $54.24       $30.24
    142    17004  Destroy 15 & more
                   lesions.
\2\ 142    17104  Destruction of skin
                   lesions.
\2\ 142    17105  Destruction of skin
                   lesions.
    142    17107  Destruction of skin
                   lesions.
    142    17108  Destruction of skin
                   lesions.
    142    17111  Destruct lesion, 15 or
                   more.
    151  LEVEL I DEBRIDEMENT/DESTRUCTION    T                         1.63      $83.81       $33.22       $16.76
    151    11000  Debride infected skin...
    151    11001  Debride infect skin add-
                   on.
    151    11040  Debride skin partial....
    151    11041  Debride skin full.......
    151    11042  Debride skin/tissue.....
\2\ 151    11050  Trim skin lesion........
\2\ 151    11051  Trim 2 to 4 skin lesions
\2\ 151    11052  Trim over 4 skin lesions
    151    11055  Trim skin lesion........
    151    11056  Trim 2 to 4 skin lesions
    151    11057  Trim over 4 skin lesions
    151    11200  Removal of skin tags....
    151    11201  Remove skin tags add-on.
    151    11300  Shave skin lesion.......
    151    11301  Shave skin lesion.......
    151    11302  Shave skin lesion.......
    151    11303  Shave skin lesion.......
    151    11305  Shave skin lesion.......
    151    11306  Shave skin lesion.......
    151    11307  Shave skin lesion.......
    151    11308  Shave skin lesion.......
    151    11310  Shave skin lesion.......
    151    11311  Shave skin lesion.......
    151    11312  Shave skin lesion.......
    151    11313  Shave skin lesion.......
    151    11730  Removal of nail plate...
\2\ 151    11731  Removal of second nail
                   plate.
    151    11732  Remove additional nail
                   plate.
    151    11765  Excision of nail fold,
                   toe.
    151    11900  Injection into skin
                   lesions.

[[Page 35417]]

 
    151    11901  Added skin lesions
                   injection.
    151    15783  Abrasion treatment of
                   skin.
    151    15786  Abrasion, lesion, single
    151    15787  Abrasion, lesions, add-
                   on.
    151    15788  Chemical peel, face,
                   epiderm.
    151    15789  Chemical peel, face,
                   dermal.
    151    15792  Chemical peel, nonfacial
    151    15793  Chemical peel, nonfacial
    151    15810  Salabrasion.............
    151    15850  Removal of sutures......
    151    15851  Removal of sutures......
    151    15852  Dressing change,not for
                   burn.
    151    16000  Initial treatment of
                   burn(s).
    151    16020  Treatment of burn(s)....
    151    16025  Treatment of burn(s)....
    151    16030  Treatment of burn(s)....
\2\ 151    17200  Electrocautery of skin
                   tags.
\2\ 151    17201  Electrocautery added
                   lesions.
    151    17250  Chemical cautery, tissue
    151    17260  Destruction of skin
                   lesions.
    151    17261  Destruction of skin
                   lesions.
    151    17262  Destruction of skin
                   lesions.
    151    17263  Destruction of skin
                   lesions.
    151    17264  Destruction of skin
                   lesions.
    151    17266  Destruction of skin
                   lesions.
    151    17270  Destruction of skin
                   lesions.
    151    17271  Destruction of skin
                   lesions.
    151    17272  Destruction of skin
                   lesions.
    151    17273  Destruction of skin
                   lesions.
    151    17274  Destruction of skin
                   lesions.
    151    17276  Destruction of skin
                   lesions.
    151    17280  Destruction of skin
                   lesions.
    151    17281  Destruction of skin
                   lesions.
    151    17282  Destruction of skin
                   lesions.
    151    17283  Destruction of skin
                   lesions.
    151    17284  Destruction of skin
                   lesions.
    151    17286  Destruction of skin
                   lesions.
    151    17340  Cryotherapy of skin.....
    151    17360  Skin peel therapy.......
    151    17380  Hair removal by
                   electrolysis.
    151    42809  Remove pharynx foreign
                   body.
    151    69220  Clean out mastoid cavity
    152  LEVEL II DEBRIDEMENT/DESTRUCTION   T                        10.07     $517.80      $251.54      $103.56
    152    16010  Treatment of burn(s)....
    152    16015  Treatment of burn(s)....
    152    46900  Destruction, anal
                   lesion(s).
    152    46910  Destruction, anal
                   lesion(s).
    152    46916  Cryosurgery, anal
                   lesion(s).
    152    46917  Laser surgery, anal
                   lesion(s).
    152    46922  Excision of anal
                   lesion(s).
    152    46924  Destruction, anal
                   lesion(s).
    152    54050  Destruction, penis
                   lesion(s).
    152    54055  Destruction, penis
                   lesion(s).
    152    54056  Cryosurgery, penis
                   lesion(s).
    152    54057  Laser surg, penis
                   lesion(s).
    152    54060  Excision of penis
                   lesion(s).
    152    54065  Destruction, penis
                   lesion(s).
    152    56501  Destruction, vulva
                   lesion(s).
    152    56515  Destruction, vulva
                   lesion(s).
    161  LEVEL I EXCISION/BIOPSY            T                         3.43     $176.37       $75.71       $35.27
    161    11100  Biopsy of skin lesion...
    161    11101  Biopsy, skin add-on.....
    161    11400  Removal of skin lesion..
    161    11401  Removal of skin lesion..
    161    11402  Removal of skin lesion..
    161    11403  Removal of skin lesion..
    161    11420  Removal of skin lesion..
    161    11421  Removal of skin lesion..
    161    11422  Removal of skin lesion..
    161    11423  Removal of skin lesion..
    161    11440  Removal of skin lesion..
    161    11441  Removal of skin lesion..
    161    11442  Removal of skin lesion..
    161    11443  Removal of skin lesion..
    161    11600  Removal of skin lesion..

[[Page 35418]]

 
    161    11601  Removal of skin lesion..
    161    11602  Removal of skin lesion..
    161    11603  Removal of skin lesion..
    161    11620  Removal of skin lesion..
    161    11621  Removal of skin lesion..
    161    11622  Removal of skin lesion..
    161    11623  Removal of skin lesion..
    161    11640  Removal of skin lesion..
    161    11641  Removal of skin lesion..
    161    11642  Removal of skin lesion..
    161    11643  Removal of skin lesion..
    161    11750  Removal of nail bed.....
    161    20520  Removal of foreign body.
    161    21550  Biopsy of neck/chest....
    161    21920  Biopsy soft tissue of
                   back.
    161    23065  Biopsy shoulder tissues.
    161    24065  Biopsy arm/elbow soft
                   tissue.
    161    24200  Removal of arm foreign
                   body.
    161    25065  Biopsy forearm soft
                   tissues.
    161    27613  Biopsy lower leg soft
                   tissue.
    161    28190  Removal of foot foreign
                   body.
    161    56605  Biopsy of vulva/perineum
    161    56606  Biopsy of vulva/perineum
    161    58999  Genital surgery
                   procedure.
    161    69100  Biopsy of external ear..
    161    69105  Biopsy of external ear
                   canal.
    162  LEVEL II EXCISION/BIOPSY           T                         5.59     $287.44      $125.66       $57.49
    162    11043  Debride tissue/muscle...
    162    11044  Debride tissue/muscle/
                   bone.
    162    11404  Removal of skin lesion..
    162    11424  Removal of skin lesion..
    162    11444  Removal of skin lesion..
    162    11604  Removal of skin lesion..
    162    11770  Removal of pilonidal
                   lesion.
    162    16035  Incision of burn scab...
\2\ 162    16040  Burn wound excision.....
\2\ 162    16041  Burn wound excision.....
\2\ 162    16042  Burn wound excision.....
    162    17304  Chemosurgery of skin
                   lesion.
    162    17305  2nd stage chemosurgery..
    162    17306  3rd stage chemosurgery..
    162    17307  Followup skin lesion
                   therapy.
    162    17310  Extensive skin
                   chemosurgery.
    162    20200  Muscle biopsy...........
    162    20205  Deep muscle biopsy......
    162    20220  Bone biopsy, trocar/
                   needle.
    162    20225  Bone biopsy, trocar/
                   needle.
    162    20670  Removal of support
                   implant.
    162    23000  Removal of calcium
                   deposits.
    162    23075  Removal of shoulder
                   lesion.
    162    24075  Remove arm/elbow lesion.
    162    25075  Removal of forearm
                   lesion.
    162    27040  Biopsy of soft tissues..
    162    27323  Biopsy thigh soft
                   tissues.
    162    28043  Excision of foot lesion.
    162    37609  Temporal artery
                   procedure.
    162    37799  Vascular surgery
                   procedure.
    162    54100  Biopsy of penis.........
    162    54105  Biopsy of penis.........
    162    67350  Biopsy eye muscle.......
    162    67399  Eye muscle surgery
                   procedure.
    162    68100  Biopsy of eyelid lining.
    162    68110  Remove eyelid lining
                   lesion.
    162    68115  Remove eyelid lining
                   lesion.
    162    68135  Remove eyelid lining
                   lesion.
    162    68399  Eyelid lining surgery...
    163  LEVEL III EXCISION/BIOPSY          T                        10.48     $538.88      $260.80      $107.78
    163    10121  Remove foreign body.....
    163    11010  Debride skin, fx........
    163    11011  Debride skin/muscle, fx.
    163    11012  Debride skin/muscle/
                   bone, fx.
    163    11406  Removal of skin lesion..
    163    11426  Removal of skin lesion..
    163    11446  Removal of skin lesion..
    163    11450  Removal, sweat gland
                   lesion.

[[Page 35419]]

 
    163    11451  Removal, sweat gland
                   lesion.
    163    11462  Removal, sweat gland
                   lesion.
    163    11463  Removal, sweat gland
                   lesion.
    163    11470  Removal, sweat gland
                   lesion.
    163    11471  Removal, sweat gland
                   lesion.
    163    11606  Removal of skin lesion..
    163    11624  Removal of skin lesion..
    163    11626  Removal of skin lesion..
    163    11644  Removal of skin lesion..
    163    11646  Removal of skin lesion..
    163    11752  Remove nail bed/finger
                   tip.
    163    11771  Removal of pilonidal
                   lesion.
    163    11772  Removal of pilonidal
                   lesion.
    163    11971  Remove tissue
                   expander(s).
    163    15780  Abrasion treatment of
                   skin.
    163    15781  Abrasion treatment of
                   skin.
    163    15782  Abrasion treatment of
                   skin.
    163    15811  Salabrasion.............
    163    15838  Excise excessive skin
                   tissue.
    163    15920  Removal of tail bone
                   ulcer.
    163    15931  Remove sacrum pressure
                   sore.
    163    15933  Remove sacrum pressure
                   sore.
    163    15940  Removal of pressure sore
    163    15941  Removal of pressure sore
    163    15950  Remove thigh pressure
                   sore.
    163    15951  Remove thigh pressure
                   sore.
    163    15999  Removal of pressure sore
    163    20240  Bone biopsy, excisional.
    163    20245  Bone biopsy, excisional.
    163    20525  Removal of foreign body.
    163    20680  Removal of support
                   implant.
    163    21555  Remove lesion neck/chest
    163    21556  Remove lesion neck/chest
    163    21925  Biopsy soft tissue of
                   back.
    163    21930  Remove lesion, back or
                   flank.
    163    21935  Remove tumor of back....
    163    22900  Remove abdominal wall
                   lesion.
    163    22999  Abdomen surgery
                   procedure.
    163    23066  Biopsy shoulder tissues.
    163    23076  Removal of shoulder
                   lesion.
    163    23077  Remove tumor of shoulder
    163    23330  Remove shoulder foreign
                   body.
    163    23331  Remove shoulder foreign
                   body.
    163    24066  Biopsy arm/elbow soft
                   tissue.
    163    24076  Remove arm/elbow lesion.
    163    24077  Remove tumor of arm/
                   elbow.
    163    24201  Removal of arm foreign
                   body.
    163    25066  Biopsy forearm soft
                   tissues.
    163    25076  Removal of forearm
                   lesion.
    163    25077  Remove tumor, forearm/
                   wrist.
    163    26115  Removal of hand lesion..
    163    26116  Removal of hand lesion..
    163    26117  Remove tumor, hand/
                   finger.
    163    26320  Removal of implant from
                   hand.
    163    27041  Biopsy of soft tissues..
    163    27047  Remove hip/pelvis lesion
    163    27048  Remove hip/pelvis lesion
    163    27049  Remove tumor, hip/pelvis
    163    27324  Biopsy thigh soft
                   tissues.
    163    27327  Removal of thigh lesion.
    163    27328  Removal of thigh lesion.
    163    27329  Remove tumor, thigh/knee
    163    27372  Removal of foreign body.
    163    27614  Biopsy lower leg soft
                   tissue.
    163    27618  Remove lower leg lesion.
    163    27619  Remove lower leg lesion.
    163    28192  Removal of foot foreign
                   body.
    163    28193  Removal of foot foreign
                   body.
    163    69110  Partial removal external
                   ear.
    163    69145  Remove ear canal
                   lesion(s).
    163    69205  Clear outer ear canal...
    181  LEVEL I SKIN REPAIR                T                         2.17     $111.58       $44.07       $22.32
    181    11760  Reconstruction of nail
                   bed.
    181    11762  Reconstruction of nail
                   bed.
    181    11920  Correct skin color
                   defects.

[[Page 35420]]

 
    181    11921  Correct skin color
                   defects.
    181    11922  Correct skin color
                   defects.
    181    11950  Therapy for contour
                   defects.
    181    11951  Therapy for contour
                   defects.
    181    11952  Therapy for contour
                   defects.
    181    11954  Therapy for contour
                   defects.
    181    12001  Repair superficial
                   wound(s).
    181    12002  Repair superficial
                   wound(s).
    181    12004  Repair superficial
                   wound(s).
    181    12005  Repair superficial
                   wound(s).
    181    12006  Repair superficial
                   wound(s).
    181    12007  Repair superficial
                   wound(s).
    181    12011  Repair superficial
                   wound(s).
    181    12013  Repair superficial
                   wound(s).
    181    12014  Repair superficial
                   wound(s).
    181    12015  Repair superficial
                   wound(s).
    181    12016  Repair superficial
                   wound(s).
    181    12017  Repair superficial
                   wound(s).
    181    12018  Repair superficial
                   wound(s).
    181    12020  Closure of split wound..
    181    12021  Closure of split wound..
    181    12031  Layer closure of
                   wound(s).
    181    12032  Layer closure of
                   wound(s).
    181    12034  Layer closure of
                   wound(s).
    181    12035  Layer closure of
                   wound(s).
    181    12036  Layer closure of
                   wound(s).
    181    12041  Layer closure of
                   wound(s).
    181    12042  Layer closure of
                   wound(s).
    181    12044  Layer closure of
                   wound(s).
    181    12045  Layer closure of
                   wound(s).
    181    12046  Layer closure of
                   wound(s).
    181    12051  Layer closure of
                   wound(s).
    181    12052  Layer closure of
                   wound(s).
    181    12053  Layer closure of
                   wound(s).
    181    12054  Layer closure of
                   wound(s).
    181    12055  Layer closure of
                   wound(s).
    181    12056  Layer closure of
                   wound(s).
    181    20500  Injection of sinus tract
    182  LEVEL II SKIN REPAIR               T                         4.11     $211.34       $92.43       $42.27
    182    13100  Repair of wound or
                   lesion.
    182    13101  Repair of wound or
                   lesion.
    182    13120  Repair of wound or
                   lesion.
    182    13121  Repair of wound or
                   lesion.
    182    13131  Repair of wound or
                   lesion.
    182    13132  Repair of wound or
                   lesion.
    182    13150  Repair of wound or
                   lesion.
    182    13151  Repair of wound or
                   lesion.
    182    13152  Repair of wound or
                   lesion.
    182    13160  Late closure of wound...
    182    13300  Repair of wound or
                   lesion.
    182    43870  Repair stomach opening..
    183  LEVEL III SKIN REPAIR              T                        11.04     $567.68      $283.18      $113.54
    183    11960  Insert tissue
                   expander(s).
    183    11970  Replace tissue expander.
    183    12037  Layer closure of
                   wound(s).
    183    12047  Layer closure of
                   wound(s).
    183    12057  Layer closure of
                   wound(s).
    183    14000  Skin tissue
                   rearrangement.
    183    14001  Skin tissue
                   rearrangement.
    183    14020  Skin tissue
                   rearrangement.
    183    14021  Skin tissue
                   rearrangement.
    183    14040  Skin tissue
                   rearrangement.
    183    14041  Skin tissue
                   rearrangement.
    183    14060  Skin tissue
                   rearrangement.
    183    14061  Skin tissue
                   rearrangement.
    183    14300  Skin tissue
                   rearrangement.
    183    14350  Skin tissue
                   rearrangement.
    183    15000  Skin graft..............
    183    15050  Skin pinch graft........
    183    15100  Skin split graft........
    183    15101  Skin split graft add-on.
    183    15120  Skin split graft........
    183    15121  Skin split graft add-on.
    183    15200  Skin full graft.........
    183    15201  Skin full graft add-on..

[[Page 35421]]

 
    183    15220  Skin full graft.........
    183    15221  Skin full graft add-on..
    183    15240  Skin full graft.........
    183    15241  Skin full graft add-on..
    183    15260  Skin full graft.........
    183    15261  Skin full graft add-on..
    183    15350  Skin homograft..........
    183    15400  Skin heterograft........
    183    15570  Form skin pedicle flap..
    183    15572  Form skin pedicle flap..
    183    15574  Form skin pedicle flap..
    183    15576  Form skin pedicle flap..
    183    15580  Attach skin pedicle
                   graft.
    183    15600  Skin graft..............
    183    15610  Skin graft..............
    183    15620  Skin graft..............
    183    15625  Skin graft..............
    183    15630  Skin graft..............
    183    15650  Transfer skin pedicle
                   flap.
    183    15775  Hair transplant punch
                   grafts.
    183    15776  Hair transplant punch
                   grafts.
    183    15819  Plastic surgery, neck...
    183    15820  Revision of lower eyelid
    183    15821  Revision of lower eyelid
    183    15822  Revision of upper eyelid
    183    15823  Revision of upper eyelid
    183    15825  Removal of neck wrinkles
    183    15829  Removal of skin wrinkles
    183    15835  Excise excessive skin
                   tissue.
    183    20910  Remove cartilage for
                   graft.
    183    20912  Remove cartilage for
                   graft.
    183    20920  Removal of fascia for
                   graft.
    183    20922  Removal of fascia for
                   graft.
    183    20926  Removal of tissue for
                   graft.
    183    23921  Amputation follow-up
                   surgery.
    183    25929  Amputation follow-up
                   surgery.
    183    44312  Revision of ileostomy...
    183    44340  Revision of colostomy...
    183    65270  Repair of eye wound.....
    184  LEVEL IV SKIN REPAIR               T                        14.85     $763.59      $397.99      $152.72
    184    15732  Muscle-skin graft, head/
                   neck.
    184    15734  Muscle-skin graft, trunk
    184    15736  Muscle-skin graft, arm..
    184    15738  Muscle-skin graft, leg..
    184    15740  Island pedicle flap
                   graft.
    184    15750  Neurovascular pedicle
                   graft.
    184    15760  Composite skin graft....
    184    15770  Derma-fat-fascia graft..
    184    15824  Removal of forehead
                   wrinkles.
    184    15826  Removal of brow wrinkles
    184    15828  Removal of face wrinkles
    184    15831  Excise excessive skin
                   tissue.
    184    15832  Excise excessive skin
                   tissue.
    184    15833  Excise excessive skin
                   tissue.
    184    15834  Excise excessive skin
                   tissue.
    184    15836  Excise excessive skin
                   tissue.
    184    15837  Excise excessive skin
                   tissue.
    184    15839  Excise excessive skin
                   tissue.
    184    15840  Graft for face nerve
                   palsy.
    184    15841  Graft for face nerve
                   palsy.
    184    15842  Graft for face nerve
                   palsy.
    184    15845  Skin and muscle repair,
                   face.
    184    15876  Suction assisted
                   lipectomy.
    184    15877  Suction assisted
                   lipectomy.
    184    15878  Suction assisted
                   lipectomy.
    184    15879  Suction assisted
                   lipectomy.
    184    15922  Removal of tail bone
                   ulcer.
    184    15934  Remove sacrum pressure
                   sore.
    184    15935  Remove sacrum pressure
                   sore.
    184    15936  Remove sacrum pressure
                   sore.
    184    15937  Remove sacrum pressure
                   sore.
    184    15944  Removal of pressure sore
    184    15945  Removal of pressure sore
    184    15946  Removal of pressure sore
    184    15952  Remove thigh pressure
                   sore.

[[Page 35422]]

 
    184    15953  Remove thigh pressure
                   sore.
    184    15956  Remove thigh pressure
                   sore.
    184    15958  Remove thigh pressure
                   sore.
    197  INCISION/EXCISION BREAST           T                        11.94     $613.95      $308.26      $122.79
    197    19101  Biopsy of breast........
    197    19110  Nipple exploration......
    197    19112  Excise breast duct
                   fistula.
    197    19120  Removal of breast lesion
    197    19125  Excision, breast lesion.
    197    19126  Excision,addl breast
                   lesion.
    197    19140  Removal of breast tissue
    197    19290  Place needle wire,
                   breast.
    197    19291  Place needle wire,
                   breast.
    197    19396  Design custom breast
                   implant.
    197    19499  Breast surgery procedure
    198  BREAST RECONSTRUCTION/MASTECTOMY   T                        18.63     $957.95      $523.42      $191.59
    198    19160  Removal of breast tissue
    198    19162  Remove breast tissue,
                   nodes.
    198    19180  Removal of breast.......
    198    19182  Removal of breast.......
    198    19316  Suspension of breast....
    198    19318  Reduction of large
                   breast.
    198    19324  Enlarge breast..........
    198    19325  Enlarge breast with
                   implant.
    198    19328  Removal of breast
                   implant.
    198    19330  Removal of implant
                   material.
    198    19340  Immediate breast
                   prosthesis.
    198    19342  Delayed breast
                   prosthesis.
    198    19350  Breast reconstruction...
    198    19355  Correct inverted
                   nipple(s).
    198    19357  Breast reconstruction...
    198    19366  Breast reconstruction...
    198    19370  Surgery of breast
                   capsule.
    198    19371  Removal of breast
                   capsule.
    198    19380  Revise breast
                   reconstruction.
    200  ARTHROCENTESIS & LIGAMENT/TENDON   T                         1.76      $90.50       $39.10       $18.10
         INJECTION
    200    20550  Inj tendon/ligament/cyst
    200    20600  Drain/inject joint/bursa
    200    20605  Drain/inject joint/bursa
    200    20610  Drain/inject joint/bursa
    207  CLOSED TREATMENT FRACTURE FINGER/  T                         1.70      $87.41       $32.32       $17.48
         TOE/TRUNK
    207    21800  Treatment of rib
                   fracture.
    207    21820  Treat sternum fracture..
    207    21899  Neck/chest surgery
                   procedure.
    207    22305  Treat spine process
                   fracture.
    207    22310  Treat spine fracture....
    207    22315  Treat spine fracture....
    207    22899  Spine surgery procedure.
    207    23500  Treat clavicle fracture.
    207    23505  Treat clavicle fracture.
    207    23520  Treat clavicle
                   dislocation.
    207    23525  Treat clavicle
                   dislocation.
    207    23540  Treat clavicle
                   dislocation.
    207    23545  Treat clavicle
                   dislocation.
    207    23570  Treat shoulderblade
                   fracture.
    207    23575  Treat shoulderblade
                   fracture.
    207    23650  Treat shoulder
                   dislocation.
    207    23929  Shoulder surgery
                   procedure.
    207    26700  Treat knuckle
                   dislocation.
    207    26720  Treat finger fracture,
                   each.
    207    26725  Treat finger fracture,
                   each.
    207    26740  Treat finger fracture,
                   each.
    207    26750  Treat finger fracture,
                   each.
    207    26755  Treat finger fracture,
                   each.
    207    26770  Treat finger dislocation
    207    26989  Hand/finger surgery.....
    207    27200  Treat tail bone fracture
    207    27299  Pelvis/hip joint surgery
    207    28490  Treat big toe fracture..
    207    28495  Treat big toe fracture..
    207    28510  Treatment of toe
                   fracture.
    207    28515  Treatment of toe
                   fracture.
    207    28630  Treat toe dislocation...
    207    28660  Treat toe dislocation...
    207    28899  Foot/toes surgery
                   procedure.

[[Page 35423]]

 
    207    31585  Repair of larynx
                   fracture.
    207    31599  Larynx surgery procedure
    209  CLOSED TREATMENT FRACTURE/         T                         1.94      $99.75       $37.74       $19.95
         DISLOCATION/EXCEPT FINGER/TOE/
         TRUNK
    209    23600  Treat humerus fracture..
    209    23605  Treat humerus fracture..
    209    23620  Treat humerus fracture..
    209    23625  Treat humerus fracture..
    209    23665  Treat dislocation/
                   fracture.
    209    23675  Treat dislocation/
                   fracture.
    209    24500  Treat humerus fracture..
    209    24505  Treat humerus fracture..
    209    24530  Treat humerus fracture..
    209    24535  Treat humerus fracture..
    209    24560  Treat humerus fracture..
    209    24565  Treat humerus fracture..
    209    24576  Treat humerus fracture..
    209    24577  Treat humerus fracture..
    209    24600  Treat elbow dislocation.
    209    24620  Treat elbow fracture....
    209    24640  Treat elbow dislocation.
    209    24650  Treat radius fracture...
    209    24655  Treat radius fracture...
    209    24670  Treatment of ulna
                   fracture.
    209    24675  Treatment of ulna
                   fracture.
    209    24999  Upper arm/elbow surgery.
    209    25500  Treat fracture of radius
    209    25505  Treat fracture of radius
    209    25520  Repair fracture of
                   radius.
    209    25530  Treat fracture of ulna..
    209    25535  Treat fracture of ulna..
    209    25560  Treat fracture radius &
                   ulna.
    209    25565  Treat fracture radius &
                   ulna.
    209    25600  Treat fracture radius/
                   ulna.
    209    25605  Treat fracture radius/
                   ulna.
    209    25622  Treat wrist bone
                   fracture.
    209    25624  Treat wrist bone
                   fracture.
    209    25630  Treat wrist bone
                   fracture.
    209    25635  Treat wrist bone
                   fracture.
    209    25650  Repair wrist bone
                   fracture.
    209    25660  Treat wrist dislocation.
    209    25675  Treat wrist dislocation.
    209    25680  Treat wrist fracture....
    209    25690  Treat wrist dislocation.
    209    25999  Forearm or wrist surgery
    209    26600  Treat metacarpal
                   fracture.
    209    26605  Treat metacarpal
                   fracture.
    209    26607  Treat metacarpal
                   fracture.
    209    26641  Treat thumb dislocation.
    209    26645  Treat thumb fracture....
    209    26670  Treat hand dislocation..
    209    26706  Pin knuckle dislocation.
    209    26742  Treat finger fracture,
                   each.
    209    27193  Treat pelvic ring
                   fracture.
    209    27220  Treat hip socket
                   fracture.
    209    27230  Treat fracture of thigh.
    209    27238  Treatment of thigh
                   fracture.
    209    27246  Treatment of thigh
                   fracture.
    209    27250  Treat hip dislocation...
    209    27256  Treatment of hip
                   dislocation.
    209    27265  Treatment of hip
                   dislocation.
    209    27500  Treatment of thigh
                   fracture.
    209    27501  Treatment of thigh
                   fracture.
    209    27502  Treatment of thigh
                   fracture.
    209    27503  Treatment of thigh
                   fracture.
    209    27508  Treatment of thigh
                   fracture.
    209    27510  Treatment of thigh
                   fracture.
    209    27516  Repair of thigh growth
                   plate.
    209    27517  Repair of thigh growth
                   plate.
    209    27520  Treat kneecap fracture..
    209    27530  Treatment of knee
                   fracture.
    209    27532  Treatment of knee
                   fracture.
    209    27538  Treat knee fracture(s)..
    209    27550  Treat knee dislocation..
    209    27560  Treat kneecap
                   dislocation.
    209    27599  Leg surgery procedure...

[[Page 35424]]

 
    209    27750  Treatment of tibia
                   fracture.
    209    27752  Treatment of tibia
                   fracture.
    209    27760  Treatment of ankle
                   fracture.
    209    27762  Treatment of ankle
                   fracture.
    209    27780  Treatment of fibula
                   fracture.
    209    27781  Treatment of fibula
                   fracture.
    209    27786  Treatment of ankle
                   fracture.
    209    27788  Treatment of ankle
                   fracture.
    209    27808  Treatment of ankle
                   fracture.
    209    27810  Treatment of ankle
                   fracture.
    209    27816  Treatment of ankle
                   fracture.
    209    27818  Treatment of ankle
                   fracture.
    209    27824  Treat lower leg fracture
    209    27825  Treat lower leg fracture
    209    27830  Treat lower leg
                   dislocation.
    209    27840  Treat ankle dislocation.
    209    27899  Leg/ankle surgery
                   procedure.
    209    28400  Treatment of heel
                   fracture.
    209    28405  Treatment of heel
                   fracture.
    209    28430  Treatment of ankle
                   fracture.
    209    28435  Treatment of ankle
                   fracture.
    209    28450  Treat midfoot fracture,
                   each.
    209    28455  Treat midfoot fracture,
                   each.
    209    28470  Treat metatarsal
                   fracture.
    209    28475  Treat metatarsal
                   fracture.
    209    28530  Treat sesamoid bone
                   fracture.
    209    28540  Treat foot dislocation..
    209    28570  Treat foot dislocation..
    209    28600  Treat foot dislocation..
    209    31586  Repair of larynx
                   fracture.
    210  BONE/JOINT MANIPULATION UNDER      T                        10.06     $517.29      $279.34      $103.46
         ANESTHESIA
    210    22505  Manipulation of spine...
    210    23655  Treat shoulder
                   dislocation.
    210    23700  Fixation of shoulder....
    210    24605  Treat elbow dislocation.
    210    26675  Treat hand dislocation..
    210    26705  Treat knuckle
                   dislocation.
    210    26775  Treat finger dislocation
    210    27194  Treat pelvic ring
                   fracture.
    210    27252  Treat hip dislocation...
    210    27257  Treatment of hip
                   dislocation.
    210    27275  Manipulation of hip
                   joint.
    210    27552  Treat knee dislocation..
    210    27562  Treat kneecap
                   dislocation.
    210    27570  Fixation of knee joint..
    210    27831  Treat lower leg
                   dislocation.
    210    27842  Treat ankle dislocation.
    210    27860  Fixation of ankle joint.
    210    28545  Treat foot dislocation..
    210    28575  Treat foot dislocation..
    210    28605  Treat foot dislocation..
    210    28635  Treat toe dislocation...
    210    28665  Treat toe dislocation...
    216  OPEN/PERCUTANEOUS TREATMENT        T                        20.09   $1,033.03      $524.09      $206.61
         FRACTURE OR DISLOCATION
    216    21336  Repair nasal septal
                   fracture.
    216    21805  Treatment of rib
                   fracture.
    216    23515  Repair clavicle fracture
    216    23530  Repair clavicle
                   dislocation.
    216    23532  Repair clavicle
                   dislocation.
    216    23550  Repair clavicle
                   dislocation.
    216    23552  Repair clavicle
                   dislocation.
    216    23585  Repair scapula fracture.
    216    23615  Repair humerus fracture.
    216    23616  Repair humerus fracture.
    216    23630  Repair humerus fracture.
    216    23660  Repair shoulder
                   dislocation.
    216    23670  Repair dislocation/
                   fracture.
    216    23680  Repair dislocation/
                   fracture.
    216    24515  Repair humerus fracture.
    216    24516  Repair humerus fracture.
    216    24538  Treat humerus fracture..
    216    24545  Repair humerus fracture.
    216    24546  Repair humerus fracture.
    216    24566  Treat humerus fracture..
    216    24575  Repair humerus fracture.

[[Page 35425]]

 
    216    24579  Repair humerus fracture.
    216    24582  Treat humerus fracture..
    216    24586  Repair elbow fracture...
    216    24587  Repair elbow fracture...
    216    24615  Repair elbow dislocation
    216    24635  Repair elbow fracture...
    216    24665  Repair radius fracture..
    216    24666  Repair radius fracture..
    216    24685  Repair ulna fracture....
    216    25515  Repair fracture of
                   radius.
    216    25525  Repair fracture of
                   radius.
    216    25526  Repair fracture of
                   radius.
    216    25545  Repair fracture of ulna.
    216    25574  Treat fracture radius &
                   ulna.
    216    25575  Repair fracture radius/
                   ulna.
    216    25611  Repair fracture radius/
                   ulna.
    216    25620  Repair fracture radius/
                   ulna.
    216    25628  Repair wrist bone
                   fracture.
    216    25645  Repair wrist bone
                   fracture.
    216    25670  Repair wrist dislocation
    216    25676  Repair wrist dislocation
    216    25685  Repair wrist fracture...
    216    25695  Repair wrist dislocation
    216    26608  Treat metacarpal
                   fracture.
    216    26615  Repair metacarpal
                   fracture.
    216    26650  Repair thumb fracture...
    216    26665  Repair thumb fracture...
    216    26676  Pin hand dislocation....
    216    26685  Repair hand dislocation.
    216    26686  Repair hand dislocation.
    216    26715  Repair knuckle
                   dislocation.
    216    26727  Treat finger fracture,
                   each.
    216    26735  Repair finger fracture,
                   each.
    216    26746  Repair finger fracture,
                   each.
    216    26756  Pin finger fracture,
                   each.
    216    26765  Repair finger fracture,
                   each.
    216    26776  Pin finger dislocation..
    216    26785  Repair finger
                   dislocation.
    216    27202  Repair tail bone
                   fracture.
    216    27509  Treatment of thigh
                   fracture.
    216    27556  Repair of knee
                   dislocation.
    216    27566  Repair kneecap
                   dislocation.
    216    27615  Remove tumor, lower leg.
    216    27756  Repair of tibia fracture
    216    27758  Repair of tibia fracture
    216    27759  Repair of tibia fracture
    216    27766  Repair of ankle fracture
    216    27784  Repair of fibula
                   fracture.
    216    27792  Repair of ankle fracture
    216    27814  Repair of ankle fracture
    216    27822  Repair of ankle fracture
    216    27823  Repair of ankle fracture
    216    27826  Treat lower leg fracture
    216    27827  Treat lower leg fracture
    216    27828  Treat lower leg fracture
    216    27829  Treat lower leg joint...
    216    27832  Repair lower leg
                   dislocation.
    216    27846  Repair ankle dislocation
    216    27848  Repair ankle dislocation
    216    28406  Treatment of heel
                   fracture.
    216    28415  Repair of heel fracture.
    216    28420  Repair/graft heel
                   fracture.
    216    28436  Treatment of ankle
                   fracture.
    216    28445  Repair of ankle fracture
    216    28456  Repair midfoot fracture.
    216    28465  Repair midfoot
                   fracture,each.
    216    28476  Repair metatarsal
                   fracture.
    216    28485  Repair metatarsal
                   fracture.
    216    28496  Repair big toe fracture.
    216    28505  Repair big toe fracture.
    216    28525  Repair of toe fracture..
    216    28531  Treat sesamoid bone
                   fracture.
    216    28546  Treat foot dislocation..
    216    28555  Repair foot dislocation.
    216    28576  Treat foot dislocation..

[[Page 35426]]

 
    216    28585  Repair foot dislocation.
    216    28606  Treat foot dislocation..
    216    28615  Repair foot dislocation.
    216    28636  Treat toe dislocation...
    216    28645  Repair toe dislocation..
    216    28666  Treat toe dislocation...
    216    28675  Repair of toe
                   dislocation.
    217  ARTHROPLASTY                       T                        20.54   $1,056.17      $530.42      $211.23
    217    24360  Reconstruct elbow joint.
    217    24365  Reconstruct head of
                   radius.
\2\ 217    25330  Revise wrist joint......
\2\ 217    25331  Revise wrist joint......
    217    25332  Revise wrist joint......
    217    25447  Repair wrist joint(s)...
    217    25449  Remove wrist joint
                   implant.
    217    26530  Revise knuckle joint....
    217    26535  Revise finger joint.....
    217    27266  Treatment of hip
                   dislocation.
    217    27437  Revise kneecap..........
    217    27440  Revision of knee joint..
    217    27441  Revision of knee joint..
    217    27442  Revision of knee joint..
    217    27443  Revision of knee joint..
    217    27700  Revision of ankle joint.
    218  ARTHROPLASTY WITH PROSTHESIS       T                        27.80   $1,429.48      $720.71      $285.90
    218    21243  Reconstruction of jaw
                   joint.
    218    24361  Reconstruct elbow joint.
    218    24362  Reconstruct elbow joint.
    218    24363  Replace elbow joint.....
    218    24366  Reconstruct head of
                   radius.
    218    25441  Reconstruct wrist joint.
    218    25442  Reconstruct wrist joint.
    218    25443  Reconstruct wrist joint.
    218    25444  Reconstruct wrist joint.
    218    25445  Reconstruct wrist joint.
    218    25446  Wrist replacement.......
    218    26531  Revise knuckle with
                   implant.
    218    26536  Revise/implant finger
                   joint.
    218    27438  Revise kneecap with
                   implant.
    226  MAXILLOFACIAL PROSTHESES           T                         1.56      $80.22       $21.92       $16.04
    226    21076  Prepare face/oral
                   prosthesis.
    226    21077  Prepare face/oral
                   prosthesis.
    226    21079  Prepare face/oral
                   prosthesis.
    226    21080  Prepare face/oral
                   prosthesis.
    226    21081  Prepare face/oral
                   prosthesis.
    226    21082  Prepare face/oral
                   prosthesis.
    226    21083  Prepare face/oral
                   prosthesis.
    226    21084  Prepare face/oral
                   prosthesis.
    226    21086  Prepare face/oral
                   prosthesis.
    226    21087  Prepare face/oral
                   prosthesis.
    226    21088  Prepare face/oral
                   prosthesis.
    226    21089  Prepare face/oral
                   prosthesis.
    231  LEVEL I SKULL AND FACIAL BONE      T                        11.31     $581.56      $286.79      $116.31
         PROCEDURES
    231    21015  Resection of facial
                   tumor.
    231    21025  Excision of bone, lower
                   jaw.
    231    21026  Excision of facial
                   bone(s).
    231    21029  Contour of face bone
                   lesion.
    231    21030  Removal of face bone
                   lesion.
    231    21031  Remove exostosis,
                   mandible.
    231    21032  Remove exostosis,
                   maxilla.
    231    21040  Removal of jaw bone
                   lesion.
    231    21041  Removal of jaw bone
                   lesion.
    231    21100  Maxillofacial fixation..
    231    21110  Interdental fixation....
    231    21120  Reconstruction of chin..
    231    21125  Augmentation lower jaw
                   bone.
    231    21280  Revision of eyelid......
    231    21282  Revision of eyelid......
    231    21295  Revision of jaw muscle/
                   bone.
    231    21296  Revision of jaw muscle/
                   bone.
    231    21299  Cranio/maxillofacial
                   surgery.
    231    21300  Treatment of skull
                   fracture.
    231    21310  Treatment of nose
                   fracture.
    231    21315  Treatment of nose
                   fracture.
    231    21320  Treatment of nose
                   fracture.

[[Page 35427]]

 
    231    21325  Repair of nose fracture.
    231    21337  Repair nasal septal
                   fracture.
    231    21355  Repair cheek bone
                   fracture.
    231    21400  Treat eye socket
                   fracture.
    231    21401  Repair eye socket
                   fracture.
    231    21440  Repair dental ridge
                   fracture.
    231    21451  Treat lower jaw fracture
    231    21480  Reset dislocated jaw....
    231    21485  Reset dislocated jaw....
    231    21493  Treat hyoid bone
                   fracture.
    231    21494  Repair hyoid bone
                   fracture.
    231    21497  Interdental wiring......
    231    21499  Head surgery procedure..
    231    41822  Excision of gum lesion..
    231    41823  Excision of gum lesion..
    232  LEVEL II SKULL AND FACIAL BONE     T                        23.82   $1,224.82      $636.87      $244.96
         PROCEDURES
    232    21010  Incision of jaw joint...
    232    21034  Removal of face bone
                   lesion.
    232    21044  Removal of jaw bone
                   lesion.
    232    21050  Removal of jaw joint....
    232    21060  Remove jaw joint
                   cartilage.
    232    21070  Remove coronoid process.
    232    21121  Reconstruction of chin..
    232    21122  Reconstruction of chin..
    232    21123  Reconstruction of chin..
    232    21127  Augmentation lower jaw
                   bone.
    232    21181  Contour cranial bone
                   lesion.
    232    21206  Reconstruct upper jaw
                   bone.
    232    21208  Augmentation of facial
                   bones.
    232    21209  Reduction of facial
                   bones.
    232    21210  Face bone graft.........
    232    21215  Lower jaw bone graft....
    232    21230  Rib cartilage graft.....
    232    21235  Ear cartilage graft.....
    232    21240  Reconstruction of jaw
                   joint.
    232    21242  Reconstruction of jaw
                   joint.
    232    21244  Reconstruction of lower
                   jaw.
    232    21245  Reconstruction of jaw...
    232    21246  Reconstruction of jaw...
    232    21248  Reconstruction of jaw...
    232    21249  Reconstruction of jaw...
    232    21260  Revise eye sockets......
    232    21267  Revise eye sockets......
    232    21270  Augmentation cheek bone.
    232    21275  Revision orbitofacial
                   bones.
    232    21330  Repair of nose fracture.
    232    21335  Repair of nose fracture.
    232    21338  Repair nasoethmoid
                   fracture.
    232    21339  Repair nasoethmoid
                   fracture.
    232    21340  Repair of nose fracture.
    232    21343  Repair of sinus fracture
    232    21345  Repair of nose/jaw
                   fracture.
    232    21421  Treat mouth roof
                   fracture.
    232    21445  Repair dental ridge
                   fracture.
    232    21450  Treat lower jaw fracture
    232    21452  Treat lower jaw fracture
    232    21453  Treat lower jaw fracture
    232    21454  Treat lower jaw fracture
    232    21461  Repair lower jaw
                   fracture.
    232    21462  Repair lower jaw
                   fracture.
    232    21465  Repair lower jaw
                   fracture.
    232    21490  Repair dislocated jaw...
    232    67420  Explore/treat eye socket
    232    67430  Explore/treat eye socket
    232    67440  Explore/drain eye socket
    232    67450  Explore/biopsy eye
                   socket.
    251  LEVEL I MUSCULOSKELETAL            T                        13.88     $713.71      $365.89      $142.74
         PROCEDURES
    251    20005  Incision of deep abscess
    251    20250  Open bone biopsy........
    251    20251  Open bone biopsy........
    251    20650  Insert and remove bone
                   pin.
    251    20693  Adjust bone fixation
                   device.
    251    20694  Remove bone fixation
                   device.
    251    20975  Electrical bone
                   stimulation.
    251    23100  Biopsy of shoulder joint

[[Page 35428]]

 
    251    23140  Removal of bone lesion..
    251    23935  Drain arm/elbow bone
                   lesion.
    251    24100  Biopsy elbow joint
                   lining.
    251    24105  Removal of elbow bursa..
    251    24110  Remove humerus lesion...
    251    24120  Remove elbow lesion.....
    251    24310  Revision of arm tendon..
    251    24925  Amputation follow-up
                   surgery.
    251    25000  Incision of tendon
                   sheath.
    251    25020  Decompression of forearm
    251    25028  Drainage of forearm
                   lesion.
    251    25031  Drainage of forearm
                   bursa.
    251    25035  Treat forearm bone
                   lesion.
    251    25085  Incision of wrist
                   capsule.
    251    25100  Biopsy of wrist joint...
    251    25110  Remove wrist tendon
                   lesion.
    251    25115  Remove wrist/forearm
                   lesion.
    251    25116  Remove wrist/forearm
                   lesion.
    251    25248  Remove forearm foreign
                   body.
    251    25295  Release wrist/forearm
                   tendon.
    251    25907  Amputation follow-up
                   surgery.
    251    25922  Amputate hand at wrist..
    251    26990  Drainage of pelvis
                   lesion.
    251    26991  Drainage of pelvis bursa
    251    27000  Incision of hip tendon..
    251    27050  Biopsy of sacroiliac
                   joint.
    251    27052  Biopsy of hip joint.....
    251    27060  Removal of ischial bursa
    251    27062  Remove femur lesion/
                   bursa.
    251    27065  Removal of hip bone
                   lesion.
    251    27086  Remove hip foreign body.
    251    27087  Remove hip foreign body.
    251    27305  Incise thigh tendon &
                   fascia.
    251    27306  Incision of thigh tendon
    251    27307  Incision of thigh
                   tendons.
    251    27340  Removal of kneecap bursa
    251    27345  Removal of knee cyst....
    251    27380  Repair of kneecap tendon
    251    27381  Repair/graft kneecap
                   tendon.
    251    27385  Repair of thigh muscle..
    251    27386  Repair/graft of thigh
                   muscle.
    251    27390  Incision of thigh tendon
    251    27391  Incision of thigh
                   tendons.
    251    27392  Incision of thigh
                   tendons.
    251    27496  Decompression of thigh/
                   knee.
    251    27497  Decompression of thigh/
                   knee.
    251    27498  Decompression of thigh/
                   knee.
    251    27499  Decompression of thigh/
                   knee.
    251    27594  Amputation follow-up
                   surgery.
    251    27600  Decompression of lower
                   leg.
    251    27601  Decompression of lower
                   leg.
    251    27602  Decompression of lower
                   leg.
    251    27604  Drain lower leg bursa...
    251    27606  Incision of achilles
                   tendon.
    251    27607  Treat lower leg bone
                   lesion.
    251    27630  Removal of tendon lesion
    251    27656  Repair leg fascia defect
    251    27658  Repair of leg tendon,
                   each.
    251    27659  Repair of leg tendon,
                   each.
    251    27664  Repair of leg tendon,
                   each.
    251    27675  Repair lower leg tendons
    251    27704  Removal of ankle implant
    251    27707  Incision of fibula......
    251    27884  Amputation follow-up
                   surgery.
    251    27892  Decompression of leg....
    251    27893  Decompression of leg....
    251    27894  Decompression of leg....
    251    28002  Treatment of foot
                   infection.
    251    28003  Treatment of foot
                   infection.
    252  LEVEL II MUSCULOSKELETAL           T                        19.24     $989.32      $512.34      $197.86
         PROCEDURES
    252    20690  Apply bone fixation
                   device.
    252    20692  Apply bone fixation
                   device.
    252    20900  Removal of bone for
                   graft.
    252    20902  Removal of bone for
                   graft.
    252    20924  Removal of tendon for
                   graft.

[[Page 35429]]

 
    252    21502  Drain chest lesion......
    252    21600  Partial removal of rib..
    252    21610  Partial removal of rib..
    252    23040  Exploratory shoulder
                   surgery.
    252    23044  Exploratory shoulder
                   surgery.
    252    23101  Shoulder joint surgery..
    252    23105  Remove shoulder joint
                   lining.
    252    23106  Incision of collarbone
                   joint.
    252    23107  Explore,treat shoulder
                   joint.
    252    23145  Removal of bone lesion..
    252    23146  Removal of bone lesion..
    252    23150  Removal of humerus
                   lesion.
    252    23155  Removal of humerus
                   lesion.
    252    23156  Removal of humerus
                   lesion.
    252    23170  Remove collarbone lesion
    252    23172  Remove shoulder blade
                   lesion.
    252    23174  Remove humerus lesion...
    252    23180  Remove collar bone
                   lesion.
    252    23182  Remove shoulder blade
                   lesion.
    252    23184  Remove humerus lesion...
    252    23190  Partial removal of
                   scapula.
    252    23405  Incision of tendon &
                   muscle.
    252    23406  Incise tendon(s) &
                   muscle(s).
    252    24000  Exploratory elbow
                   surgery.
    252    24006  Release elbow joint.....
    252    24101  Explore/treat elbow
                   joint.
    252    24102  Remove elbow joint
                   lining.
    252    24115  Remove/graft bone lesion
    252    24116  Remove/graft bone lesion
    252    24125  Remove/graft bone lesion
    252    24126  Remove/graft bone lesion
    252    24130  Removal of head of
                   radius.
    252    24134  Removal of arm bone
                   lesion.
    252    24136  Remove radius bone
                   lesion.
    252    24138  Remove elbow bone lesion
    252    24140  Partial removal of arm
                   bone.
    252    24145  Partial removal of
                   radius.
    252    24147  Partial removal of elbow
    252    24160  Remove elbow joint
                   implant.
    252    24164  Remove radius head
                   implant.
    252    24301  Muscle/tendon transfer..
    252    24305  Arm tendon lengthening..
    252    24350  Repair of tennis elbow..
    252    24351  Repair of tennis elbow..
    252    24352  Repair of tennis elbow..
    252    24354  Repair of tennis elbow..
    252    24356  Revision of tennis elbow
    252    24400  Revision of humerus.....
    252    24410  Revision of humerus.....
    252    24495  Decompression of forearm
    252    25023  Decompression of forearm
    252    25040  Explore/treat wrist
                   joint.
    252    25101  Explore/treat wrist
                   joint.
    252    25105  Remove wrist joint
                   lining.
    252    25107  Remove wrist joint
                   cartilage.
    252    25118  Excise wrist tendon
                   sheath.
    252    25119  Partial removal of ulna.
    252    25120  Removal of forearm
                   lesion.
    252    25125  Remove/graft forearm
                   lesion.
    252    25126  Remove/graft forearm
                   lesion.
    252    25130  Removal of wrist lesion.
    252    25135  Remove & graft wrist
                   lesion.
    252    25136  Remove & graft wrist
                   lesion.
    252    25145  Remove forearm bone
                   lesion.
    252    25150  Partial removal of ulna.
    252    25151  Partial removal of
                   radius.
    252    25230  Partial removal of
                   radius.
    252    25240  Partial removal of ulna.
    252    25250  Removal of wrist
                   prosthesis.
    252    25251  Removal of wrist
                   prosthesis.
    252    25260  Repair forearm tendon/
                   muscle.
    252    25263  Repair forearm tendon/
                   muscle.
    252    25265  Repair forearm tendon/
                   muscle.
    252    25270  Repair forearm tendon/
                   muscle.
    252    25272  Repair forearm tendon/
                   muscle.

[[Page 35430]]

 
    252    25274  Repair forearm tendon/
                   muscle.
    252    25280  Revise wrist/forearm
                   tendon.
    252    25290  Incise wrist/forearm
                   tendon.
    252    25300  Fusion of tendons at
                   wrist.
    252    25301  Fusion of tendons at
                   wrist.
    252    25360  Revision of ulna........
    252    25365  Revise radius & ulna....
    252    25400  Repair radius or ulna...
    252    25415  Repair radius & ulna....
    252    27001  Incision of hip tendon..
    252    27003  Incision of hip tendon..
    252    27066  Removal of hip bone
                   lesion.
    252    27067  Remove/graft hip bone
                   lesion.
    252    27080  Removal of tail bone....
    252    27097  Revision of hip tendon..
    252    27098  Transfer tendon to
                   pelvis.
    252    27310  Exploration of knee
                   joint.
    252    27330  Biopsy knee joint lining
    252    27331  Explore/treat knee joint
    252    27332  Removal of knee
                   cartilage.
    252    27333  Removal of knee
                   cartilage.
    252    27334  Remove knee joint lining
    252    27335  Remove knee joint lining
    252    27350  Removal of kneecap......
    252    27355  Remove femur lesion.....
    252    27356  Remove femur lesion/
                   graft.
    252    27357  Remove femur lesion/
                   graft.
    252    27358  Remove femur lesion/
                   fixation.
    252    27360  Partial removal leg
                   bone(s).
    252    27393  Lengthening of thigh
                   tendon.
    252    27394  Lengthening of thigh
                   tendons.
    252    27396  Transplant of thigh
                   tendon.
    252    27403  Repair of knee cartilage
    252    27425  Lateral retinacular
                   release.
    252    27610  Explore/treat ankle
                   joint.
    252    27612  Exploration of ankle
                   joint.
    252    27620  Explore, treat ankle
                   joint.
    252    27625  Remove ankle joint
                   lining.
    252    27626  Remove ankle joint
                   lining.
    252    27635  Remove lower leg bone
                   lesion.
    252    27637  Remove/graft leg bone
                   lesion.
    252    27638  Remove/graft leg bone
                   lesion.
    252    27641  Partial removal of
                   fibula.
    252    27665  Repair of leg tendon,
                   each.
    252    27676  Repair lower leg tendons
    252    27680  Release of lower leg
                   tendon.
    252    27681  Release of lower leg
                   tendons.
    252    27685  Revision of lower leg
                   tendon.
    252    27686  Revise lower leg tendons
    252    27687  Revision of calf tendon.
    252    27695  Repair of ankle ligament
    252    27696  Repair of ankle
                   ligaments.
    252    27698  Repair of ankle ligament
    252    27709  Incision of tibia &
                   fibula.
    252    27730  Repair of tibia
                   epiphysis.
    252    27732  Repair of fibula
                   epiphysis.
    252    27734  Repair lower leg
                   epiphyses.
    252    27740  Repair of leg epiphyses.
    252    27889  Amputation of foot at
                   ankle.
    253  LEVEL III MUSCULOSKELETAL          T                        25.74   $1,323.55      $684.55      $264.71
         PROCEDURES
    253    23020  Release shoulder joint..
    253    23120  Partial removal, collar
                   bone.
    253    23130  Partial
                   removal,shoulderbone.
    253    23415  Release of shoulder
                   ligament.
    253    23480  Revision of collarbone..
    253    23485  Revision of collar bone.
    253    23490  Reinforce clavicle......
    253    23491  Reinforce shoulder bones
    253    23800  Fusion of shoulder joint
    253    23802  Fusion of shoulder joint
    253    24155  Removal of elbow joint..
    253    24320  Repair of arm tendon....
    253    24330  Revision of arm muscles.
    253    24331  Revision of arm muscles.
    253    24340  Repair of biceps tendon.

[[Page 35431]]

 
    253    24341  Repair tendon/muscle arm
    253    24342  Repair of ruptured
                   tendon.
    253    24420  Revision of humerus.....
    253    24430  Repair of humerus.......
    253    24435  Repair humerus with
                   graft.
    253    24470  Revision of elbow joint.
    253    24498  Reinforce humerus.......
    253    24800  Fusion of elbow joint...
    253    24802  Fusion/graft of elbow
                   joint.
    253    25310  Transplant forearm
                   tendon.
    253    25312  Transplant forearm
                   tendon.
    253    25315  Revise palsy hand
                   tendon(s).
    253    25316  Revise palsy hand
                   tendon(s).
    253    25320  Repair/revise wrist
                   joint.
    253    25335  Realignment of hand.....
    253    25337  Reconstruct ulna/
                   radioulnar.
    253    25350  Revision of radius......
    253    25355  Revision of radius......
    253    25370  Revise radius or ulna...
    253    25375  Revise radius & ulna....
    253    25425  Repair/graft radius or
                   ulna.
    253    25426  Repair/graft radius &
                   ulna.
    253    25440  Repair/graft wrist bone.
    253    25450  Revision of wrist joint.
    253    25455  Revision of wrist joint.
    253    25490  Reinforce radius........
    253    25491  Reinforce ulna..........
    253    25492  Reinforce radius and
                   ulna.
    253    25800  Fusion of wrist joint...
    253    25805  Fusion/graft of wrist
                   joint.
    253    25810  Fusion/graft of wrist
                   joint.
    253    25830  Fusion radioulnar jnt/
                   ulna.
    253    27033  Exploration of hip joint
    253    27100  Transfer of abdominal
                   muscle.
    253    27105  Transfer of spinal
                   muscle.
    253    27110  Transfer of iliopsoas
                   muscle.
    253    27111  Transfer of iliopsoas
                   muscle.
    253    27395  Lengthening of thigh
                   tendons.
    253    27397  Transplants of thigh
                   tendons.
    253    27400  Revise thigh muscles/
                   tendons.
    253    27405  Repair of knee ligament.
    253    27407  Repair of knee ligament.
    253    27409  Repair of knee ligaments
    253    27418  Repair degenerated
                   kneecap.
    253    27420  Revision of unstable
                   kneecap.
    253    27422  Revision of unstable
                   kneecap.
    253    27424  Revision/removal of
                   kneecap.
    253    27430  Revision of thigh
                   muscles.
    253    27435  Incision of knee joint..
    253    27640  Partial removal of tibia
    253    27647  Extensive ankle/heel
                   surgery.
    253    27650  Repair achilles tendon..
    253    27652  Repair/graft achilles
                   tendon.
    253    27654  Repair of achilles
                   tendon.
    253    27690  Revise lower leg tendon.
    253    27691  Revise lower leg tendon.
    253    27692  Revise additional leg
                   tendon.
    253    27705  Incision of tibia.......
    253    27742  Repair of leg epiphyses.
    253    27745  Reinforce tibia.........
    253    27870  Fusion of ankle joint...
    253    27871  Fusion of tibiofibular
                   joint.
    254  LEVEL IV MUSCULOSKELETAL           T                        32.70   $1,681.43      $922.98      $336.29
         PROCEDURES
    254    23410  Repair of tendon(s).....
    254    23412  Repair of tendon(s).....
    254    23420  Repair of shoulder......
    254    23430  Repair biceps tendon....
    254    23450  Repair shoulder capsule.
    254    23455  Repair shoulder capsule.
    254    23460  Repair shoulder capsule.
    254    23462  Repair shoulder capsule.
    254    23465  Repair shoulder capsule.
    254    23466  Repair shoulder capsule.
    254    27427  Reconstruction, knee....
    254    27428  Reconstruction, knee....

[[Page 35432]]

 
    254    27429  Reconstruction, knee....
    261  LEVEL I HAND MUSCULOSKELETAL       T                        10.41     $535.28      $259.00      $107.06
         PROCEDURES
    261    25111  Remove wrist tendon
                   lesion.
    261    25112  Reremove wrist tendon
                   lesion.
    261    25820  Fusion of hand bones....
    261    26020  Drain hand tendon sheath
    261    26025  Drainage of palm bursa..
    261    26030  Drainage of palm
                   bursa(s).
    261    26034  Treat hand bone lesion..
    261    26035  Decompress fingers/hand.
    261    26037  Decompress fingers/hand.
    261    26055  Incise finger tendon
                   sheath.
    261    26060  Incision of finger
                   tendon.
    261    26070  Explore/treat hand joint
    261    26075  Explore/treat finger
                   joint.
    261    26080  Explore/treat finger
                   joint.
    261    26100  Biopsy hand joint lining
    261    26105  Biopsy finger joint
                   lining.
    261    26110  Biopsy finger joint
                   lining.
    261    26130  Remove wrist joint
                   lining.
    261    26140  Revise finger joint,
                   each.
    261    26145  Tendon excision, palm/
                   finger.
    261    26160  Remove tendon sheath
                   lesion.
    261    26170  Removal of palm tendon,
                   each.
    261    26180  Removal of finger tendon
    261    26185  Remove finger bone......
    261    26200  Remove hand bone lesion.
    261    26210  Removal of finger lesion
    261    26215  Remove/graft finger
                   lesion.
    261    26230  Partial removal of hand
                   bone.
    261    26235  Partial removal, finger
                   bone.
    261    26236  Partial removal, finger
                   bone.
    261    26250  Extensive hand surgery..
    261    26260  Extensive finger surgery
    261    26261  Extensive finger surgery
    261    26262  Partial removal of
                   finger.
    261    26410  Repair hand tendon......
    261    26418  Repair finger tendon....
    261    26432  Repair finger tendon....
    261    26433  Repair finger tendon....
    261    26437  Realignment of tendons..
    261    26440  Release palm/finger
                   tendon.
    261    26445  Release hand/finger
                   tendon.
    261    26450  Incision of palm tendon.
    261    26455  Incision of finger
                   tendon.
    261    26460  Incise hand/finger
                   tendon.
    261    26471  Fusion of finger tendons
    261    26474  Fusion of finger tendons
    261    26476  Tendon lengthening......
    261    26477  Tendon shortening.......
    261    26478  Lengthening of hand
                   tendon.
    261    26479  Shortening of hand
                   tendon.
    261    26500  Hand tendon
                   reconstruction.
    261    26508  Release thumb
                   contracture.
    261    26520  Release knuckle
                   contracture.
    261    26525  Release finger
                   contracture.
    261    26540  Repair hand joint.......
    261    26542  Repair hand joint with
                   graft.
    261    26560  Repair of web finger....
    261    26587  Reconstruct extra finger
    261    26593  Release muscles of hand.
    261    26951  Amputation of finger/
                   thumb.
    261    26952  Amputation of finger/
                   thumb.
    262  LEVEL II HAND MUSCULOSKELETAL      T                        18.07     $929.16      $475.96      $185.83
         PROCEDURES
    262    25210  Removal of wrist bone...
    262    25215  Removal of wrist bones..
    262    25825  Fusion hand bones with
                   graft.
    262    26040  Release palm contracture
    262    26045  Release palm contracture
    262    26121  Release palm contracture
    262    26123  Release palm contracture
    262    26125  Release palm contracture
    262    26135  Revise finger joint,
                   each.
    262    26205  Remove/graft bone lesion
    262    26255  Extensive hand surgery..

[[Page 35433]]

 
    262    26350  Repair finger/hand
                   tendon.
    262    26352  Repair/graft hand tendon
    262    26356  Repair finger/hand
                   tendon.
    262    26357  Repair finger/hand
                   tendon.
    262    26358  Repair/graft hand tendon
    262    26370  Repair finger/hand
                   tendon.
    262    26372  Repair/graft hand tendon
    262    26373  Repair finger/hand
                   tendon.
    262    26390  Revise hand/finger
                   tendon.
    262    26392  Repair/graft hand tendon
    262    26412  Repair/graft hand tendon
    262    26415  Excision, hand/finger
                   tendon.
    262    26416  Graft hand or finger
                   tendon.
    262    26420  Repair/graft finger
                   tendon.
    262    26426  Repair finger/hand
                   tendon.
    262    26428  Repair/graft finger
                   tendon.
    262    26434  Repair/graft finger
                   tendon.
    262    26442  Release palm & finger
                   tendon.
    262    26449  Release forearm/hand
                   tendon.
    262    26480  Transplant hand tendon..
    262    26483  Transplant/graft hand
                   tendon.
    262    26485  Transplant palm tendon..
    262    26489  Transplant/graft palm
                   tendon.
    262    26490  Revise thumb tendon.....
    262    26492  Tendon transfer with
                   graft.
    262    26494  Hand tendon/muscle
                   transfer.
    262    26496  Revise thumb tendon.....
    262    26497  Finger tendon transfer..
    262    26498  Finger tendon transfer..
    262    26499  Revision of finger......
    262    26502  Hand tendon
                   reconstruction.
    262    26504  Hand tendon
                   reconstruction.
    262    26510  Thumb tendon transfer...
    262    26516  Fusion of knuckle joint.
    262    26517  Fusion of knuckle joints
    262    26518  Fusion of knuckle joints
    262    26541  Repair hand joint with
                   graft.
    262    26545  Reconstruct finger joint
    262    26546  Repair non-union hand...
    262    26548  Reconstruct finger joint
    262    26550  Construct thumb
                   replacement.
    262    26555  Positional change of
                   finger.
    262    26561  Repair of web finger....
    262    26562  Repair of web finger....
    262    26565  Correct metacarpal flaw.
    262    26567  Correct finger deformity
    262    26568  Lengthen metacarpal/
                   finger.
    262    26580  Repair hand deformity...
    262    26585  Repair finger deformity.
    262    26590  Repair finger deformity.
    262    26591  Repair muscles of hand..
    262    26596  Excision constricting
                   tissue.
    262    26597  Release of scar
                   contracture.
    262    26820  Thumb fusion with graft.
    262    26841  Fusion of thumb.........
    262    26842  Thumb fusion with graft.
    262    26843  Fusion of hand joint....
    262    26844  Fusion/graft of hand
                   joint.
    262    26850  Fusion of knuckle.......
    262    26852  Fusion of knuckle with
                   graft.
    262    26860  Fusion of finger joint..
    262    26861  Fusion of finger
                   joint,added.
    262    26862  Fusion/graft of finger
                   joint.
    262    26863  Fuse/graft added joint..
    262    26910  Amputate metacarpal bone
    271  LEVEL I FOOT MUSCULOSKELETAL       T                        14.12     $726.05      $365.44      $145.21
         PROCEDURES
    271    27605  Incision of achilles
                   tendon.
    271    28005  Treat foot bone lesion..
    271    28008  Incision of foot fascia.
    271    28010  Incision of toe tendon..
    271    28011  Incision of toe tendons.
    271    28020  Exploration of a foot
                   joint.
    271    28022  Exploration of a foot
                   joint.
    271    28024  Exploration of a toe
                   joint.
    271    28045  Excision of foot lesion.

[[Page 35434]]

 
    271    28046  Resection of tumor, foot
    271    28050  Biopsy of foot joint
                   lining.
    271    28052  Biopsy of foot joint
                   lining.
    271    28054  Biopsy of toe joint
                   lining.
    271    28080  Removal of foot lesion..
    271    28086  Excise foot tendon
                   sheath.
    271    28088  Excise foot tendon
                   sheath.
    271    28090  Removal of foot lesion..
    271    28092  Removal of toe lesions..
    271    28100  Removal of ankle/heel
                   lesion.
    271    28104  Removal of foot lesion..
    271    28108  Removal of toe lesions..
    271    28111  Part removal of
                   metatarsal.
    271    28112  Part removal of
                   metatarsal.
    271    28113  Part removal of
                   metatarsal.
    271    28114  Removal of metatarsal
                   heads.
    271    28116  Revision of foot........
    271    28118  Removal of heel bone....
    271    28119  Removal of heel spur....
    271    28120  Part removal of ankle/
                   heel.
    271    28122  Partial removal of foot
                   bone.
    271    28124  Partial removal of toe..
    271    28126  Partial removal of toe..
    271    28130  Removal of ankle bone...
    271    28140  Removal of metatarsal...
    271    28150  Removal of toe..........
    271    28153  Partial removal of toe..
    271    28160  Partial removal of toe..
    271    28171  Extensive foot surgery..
    271    28173  Extensive foot surgery..
    271    28175  Extensive foot surgery..
    271    28200  Repair of foot tendon...
    271    28208  Repair of foot tendon...
    271    28210  Repair/graft of foot
                   tendon.
    271    28220  Release of foot tendon..
    271    28222  Release of foot tendons.
    271    28225  Release of foot tendon..
    271    28226  Release of foot tendons.
    271    28230  Incision of foot
                   tendon(s).
    271    28232  Incision of toe tendon..
    271    28234  Incision of foot tendon.
    271    28240  Release of big toe......
    271    28270  Release of foot
                   contracture.
    271    28272  Release of toe joint,
                   each.
    271    28280  Fusion of toes..........
    271    28285  Repair of hammertoe.....
    271    28286  Repair of hammertoe.....
    271    28310  Revision of big toe.....
    271    28312  Revision of toe.........
    271    28313  Repair deformity of toe.
    271    28315  Removal of sesamoid bone
    271    28340  Resect enlarged toe
                   tissue.
    271    28341  Resect enlarged toe.....
    271    28737  Revision of foot bones..
    271    28750  Fusion of big toe joint.
    271    28755  Fusion of big toe joint.
    271    28810  Amputation toe &
                   metatarsal.
    271    28820  Amputation of toe.......
    271    28825  Partial amputation of
                   toe.
    271    29893  Scope, plantar
                   fasciotomy.
    272  LEVEL II FOOT MUSCULOSKELETAL      T                        16.11     $828.38      $411.09      $165.68
         PROCEDURES
    272    28060  Partial removal foot
                   fascia.
    272    28062  Removal of foot fascia..
    272    28070  Removal of foot joint
                   lining.
    272    28072  Removal of foot joint
                   lining.
    272    28102  Remove/graft foot lesion
    272    28103  Remove/graft foot lesion
    272    28106  Remove/graft foot lesion
    272    28107  Remove/graft foot lesion
    272    28202  Repair/graft of foot
                   tendon.
    272    28238  Revision of foot tendon.
    272    28250  Revision of foot fascia.
    272    28260  Release of midfoot joint
    272    28261  Revision of foot tendon.
    272    28262  Revision of foot and
                   ankle.

[[Page 35435]]

 
    272    28264  Release of midfoot joint
    272    28288  Partial removal of foot
                   bone.
    272    28300  Incision of heel bone...
    272    28302  Incision of ankle bone..
    272    28304  Incision of midfoot
                   bones.
    272    28305  Incise/graft midfoot
                   bones.
    272    28306  Incision of metatarsal..
    272    28307  Incision of metatarsal..
    272    28308  Incision of metatarsal..
    272    28309  Incision of metatarsals.
    272    28320  Repair of foot bones....
    272    28322  Repair of metatarsals...
    272    28344  Repair extra toe(s).....
    272    28345  Repair webbed toe(s)....
    272    28360  Reconstruct cleft foot..
    272    28705  Fusion of foot bones....
    272    28715  Fusion of foot bones....
    272    28725  Fusion of foot bones....
    272    28730  Fusion of foot bones....
    272    28735  Fusion of foot bones....
    272    28740  Fusion of foot bones....
    272    28760  Fusion of big toe joint.
    276  BUNION PROCEDURES                  T                        19.00     $976.98      $495.39      $195.40
    276    28110  Part removal of
                   metatarsal.
    276    28290  Correction of bunion....
    276    28292  Correction of bunion....
    276    28293  Correction of bunion....
    276    28294  Correction of bunion....
    276    28296  Correction of bunion....
    276    28297  Correction of bunion....
    276    28298  Correction of bunion....
    276    28299  Correction of bunion....
    280  DIAGNOSTIC ARTHROSCOPY             T                        22.15   $1,138.95      $581.72      $227.79
    280    29800  Jaw arthroscopy/surgery.
    280    29815  Shoulder arthroscopy....
    280    29830  Elbow arthroscopy.......
    280    29840  Wrist arthroscopy.......
    280    29870  Knee arthroscopy,
                   diagnostic.
    280    29909  Arthroscopy of joint....
    281  LEVEL I SURGICAL ARTHROSCOPY       T                        22.37   $1,150.27      $589.18      $230.05
    281    29804  Jaw arthroscopy/surgery.
    281    29819  Shoulder arthroscopy/
                   surgery.
    281    29820  Shoulder arthroscopy/
                   surgery.
    281    29821  Shoulder arthroscopy/
                   surgery.
    281    29822  Shoulder arthroscopy/
                   surgery.
    281    29823  Shoulder arthroscopy/
                   surgery.
    281    29825  Shoulder arthroscopy/
                   surgery.
    281    29826  Shoulder arthroscopy/
                   surgery.
    281    29834  Elbow arthroscopy/
                   surgery.
    281    29835  Elbow arthroscopy/
                   surgery.
    281    29836  Elbow arthroscopy/
                   surgery.
    281    29837  Elbow arthroscopy/
                   surgery.
    281    29838  Elbow arthroscopy/
                   surgery.
    281    29843  Wrist arthroscopy/
                   surgery.
    281    29844  Wrist arthroscopy/
                   surgery.
    281    29845  Wrist arthroscopy/
                   surgery.
    281    29846  Wrist arthroscopy/
                   surgery.
    281    29847  Wrist arthroscopy/
                   surgery.
    281    29848  Wrist endoscopy/surgery.
    281    29860  Hip arthroscopy, dx.....
    281    29861  Hip arthroscopy/surgery.
    281    29862  Hip arthroscopy/surgery.
    281    29863  Hip arthroscopy/surgery.
    281    29874  Knee arthroscopy/surgery
    281    29875  Knee arthroscopy/surgery
    281    29877  Knee arthroscopy/surgery
    281    29879  Knee arthroscopy/surgery
    281    29880  Knee arthroscopy/surgery
    281    29881  Knee arthroscopy/surgery
    281    29884  Knee arthroscopy/surgery
    281    29886  Knee arthroscopy/surgery
    281    29894  Ankle arthroscopy/
                   surgery.
    281    29895  Ankle arthroscopy/
                   surgery.
    281    29897  Ankle arthroscopy/
                   surgery.
    281    29898  Ankle arthroscopy/
                   surgery.

[[Page 35436]]

 
    282  LEVEL II SURGICAL ARTHROSCOPY      T                        23.65   $1,216.08      $609.97      $243.22
    282    29871  Knee arthroscopy/
                   drainage.
    282    29876  Knee arthroscopy/surgery
    282    29882  Knee arthroscopy/surgery
    282    29883  Knee arthroscopy/surgery
    282    29885  Knee arthroscopy/surgery
    282    29887  Knee arthroscopy/surgery
    282    29891  Ankle arthroscopy/
                   surgery.
    286  ARTHROSCOPICALLY-AIDED PROCEDURES  T                        27.69   $1,423.82      $791.90      $284.76
    286    29850  Knee arthroscopy/surgery
    286    29851  Knee arthroscopy/surgery
    286    29855  Tibial arthroscopy/
                   surgery.
    286    29856  Tibial arthroscopy/
                   surgery.
    286    29888  Knee arthroscopy/surgery
    286    29889  Knee arthroscopy/surgery
    286    29892  Ankle arthroscopy/
                   surgery.
    311  LEVEL I ENT PROCEDURES             T                         1.41      $72.50       $20.57       $14.50
    311    30000  Drainage of nose lesion.
    311    30020  Drainage of nose lesion.
    311    30100  Intranasal biopsy.......
    311    30110  Removal of nose polyp(s)
    311    30117  Removal of intranasal
                   lesion.
    311    30124  Removal of nose lesion..
    311    30210  Nasal sinus therapy.....
    311    30220  Insert nasal septal
                   button.
    311    30300  Remove nasal foreign
                   body.
    311    30560  Release of nasal
                   adhesions.
    311    31000  Irrigation maxillary
                   sinus.
    311    31002  Irrigation sphenoid
                   sinus.
    311    31603  Incision of windpipe....
    311    31605  Incision of windpipe....
    311    40490  Biopsy of lip...........
    311    40799  Lip surgery procedure...
    311    40800  Drainage of mouth lesion
    311    40801  Drainage of mouth lesion
    311    40804  Removal foreign body,
                   mouth.
    311    40805  Removal foreign body,
                   mouth.
    311    40806  Incision of lip fold....
    311    40808  Biopsy of mouth lesion..
    311    40810  Excision of mouth lesion
    311    40812  Excise/repair mouth
                   lesion.
    311    40820  Treatment of mouth
                   lesion.
    311    40899  Mouth surgery procedure.
    311    41000  Drainage of mouth lesion
    311    41005  Drainage of mouth lesion
    311    41100  Biopsy of tongue........
    311    41105  Biopsy of tongue........
    311    41108  Biopsy of floor of mouth
    311    41110  Excision of tongue
                   lesion.
    311    41115  Excision of tongue fold.
    311    41599  Tongue and mouth surgery
    311    41805  Removal foreign body,
                   gum.
    311    41806  Removal foreign
                   body,jawbone.
    311    41820  Excision, gum, each
                   quadrant.
    311    41821  Excision of gum flap....
    311    41825  Excision of gum lesion..
    311    41826  Excision of gum lesion..
    311    41828  Excision of gum lesion..
    311    41830  Removal of gum tissue...
    311    41850  Treatment of gum lesion.
    311    41870  Gum graft...............
    311    41872  Repair gum..............
    311    41874  Repair tooth socket.....
    311    41899  Dental surgery procedure
    311    42000  Drainage mouth roof
                   lesion.
    311    42100  Biopsy roof of mouth....
    311    42104  Excision lesion, mouth
                   roof.
    311    42106  Excision lesion, mouth
                   roof.
    311    42140  Excision of uvula.......
    311    42160  Treatment mouth roof
                   lesion.
    311    42280  Preparation, palate mold
    311    42281  Insertion, palate
                   prosthesis.
    311    42299  Palate/uvula surgery....
    311    42330  Removal of salivary
                   stone.
    311    42335  Removal of salivary
                   stone.

[[Page 35437]]

 
    311    42650  Dilation of salivary
                   duct.
    311    42660  Dilation of salivary
                   duct.
    311    42665  Ligation of salivary
                   duct.
    311    42699  Salivary surgery
                   procedure.
    311    69200  Clear outer ear canal...
    311    69210  Remove impacted ear wax.
    311    69222  Clean out mastoid cavity
    311    69399  Outer ear surgery
                   procedure.
    311    69400  Inflate middle ear canal
    311    69405  Catheterize middle ear
                   canal.
    311    69410  Inset middle ear baffle.
    311    69420  Incision of eardrum.....
    311    69424  Remove ventilating tube.
    311    69540  Remove ear lesion.......
    311    69610  Repair of eardrum.......
    311    69799  Middle ear surgery
                   procedure.
    311    92502  Ear and throat
                   examination.
    312  LEVEL II ENT PROCEDURES            T                         7.07     $363.54      $170.86       $72.71
    312    30801  Cauterization inner nose
    312    30802  Cauterization inner nose
    312    30930  Therapy fracture of nose
    312    31612  Puncture/clear windpipe.
    312    40830  Repair mouth laceration.
    312    40831  Repair mouth laceration.
    312    41250  Repair tongue laceration
    312    41251  Repair tongue laceration
    312    41252  Repair tongue laceration
    312    41500  Fixation of tongue......
    312    41510  Tongue to lip surgery...
    312    41800  Drainage of gum lesion..
    312    42300  Drainage of salivary
                   gland.
    312    42305  Drainage of salivary
                   gland.
    312    42310  Drainage of salivary
                   gland.
    312    42320  Drainage of salivary
                   gland.
    312    42405  Biopsy of salivary gland
    312    42700  Drainage of tonsil
                   abscess.
    312    42720  Drainage of throat
                   abscess.
    312    42800  Biopsy of throat........
    312    42802  Biopsy of throat........
    312    42804  Biopsy of upper nose/
                   throat.
    312    42806  Biopsy of upper nose/
                   throat.
    312    42808  Excise pharynx lesion...
    312    60000  Drain thyroid/tongue
                   cyst.
    312    69421  Incision of eardrum.....
    312    69433  Create eardrum opening..
    312    69436  Create eardrum opening..
    313  LEVEL III ENT PROCEDURES           T                        15.46     $794.95      $407.70      $158.99
    313    30115  Removal of nose polyp(s)
    313    30118  Removal of intranasal
                   lesion.
    313    30120  Revision of nose........
    313    30125  Removal of nose lesion..
    313    30130  Removal of turbinate
                   bones.
    313    30140  Removal of turbinate
                   bones.
    313    30150  Partial removal of nose.
    313    30160  Removal of nose.........
    313    30310  Remove nasal foreign
                   body.
    313    30320  Remove nasal foreign
                   body.
    313    30430  Revision of nose........
    313    30520  Repair of nasal septum..
    313    30540  Repair nasal defect.....
    313    30580  Repair upper jaw fistula
    313    30600  Repair mouth/nose
                   fistula.
    313    30620  Intranasal
                   reconstruction.
    313    30630  Repair nasal septum
                   defect.
    313    31020  Exploration maxillary
                   sinus.
    313    31030  Exploration maxillary
                   sinus.
    313    31032  Explore sinus, remove
                   polyps.
    313    31050  Exploration sphenoid
                   sinus.
    313    31051  Sphenoid sinus surgery..
    313    31070  Exploration of frontal
                   sinus.
    313    31200  Removal of ethmoid sinus
    313    31320  Diagnostic incision
                   larynx.
    313    31595  Larynx nerve surgery....
    313    31611  Surgery/speech
                   prosthesis.
    313    31613  Repair windpipe opening.

[[Page 35438]]

 
    313    31614  Repair windpipe opening.
    313    31820  Closure of windpipe
                   lesion.
    313    31825  Repair of windpipe
                   defect.
    313    31830  Revise windpipe scar....
    313    40500  Partial excision of lip.
    313    40510  Partial excision of lip.
    313    40520  Partial excision of lip.
    313    40525  Reconstruct lip with
                   flap.
    313    40527  Reconstruct lip with
                   flap.
    313    40530  Partial removal of lip..
    313    40650  Repair lip..............
    313    40652  Repair lip..............
    313    40654  Repair lip..............
    313    40814  Excise/repair mouth
                   lesion.
    313    40816  Excision of mouth lesion
    313    40818  Excise oral mucosa for
                   graft.
    313    40819  Excise lip or cheek fold
    313    40840  Reconstruction of mouth.
    313    40842  Reconstruction of mouth.
    313    41006  Drainage of mouth lesion
    313    41007  Drainage of mouth lesion
    313    41008  Drainage of mouth lesion
    313    41009  Drainage of mouth lesion
    313    41010  Incision of tongue fold.
    313    41015  Drainage of mouth lesion
    313    41016  Drainage of mouth lesion
    313    41017  Drainage of mouth lesion
    313    41018  Drainage of mouth lesion
    313    41112  Excision of tongue
                   lesion.
    313    41113  Excision of tongue
                   lesion.
    313    41114  Excision of tongue
                   lesion.
    313    41116  Excision of mouth lesion
    313    41120  Partial removal of
                   tongue.
    313    41520  Reconstruction, tongue
                   fold.
    313    41827  Excision of gum lesion..
    313    42107  Excision lesion, mouth
                   roof.
    313    42120  Remove palate/lesion....
    313    42180  Repair palate...........
    313    42182  Repair palate...........
    313    42200  Reconstruct cleft palate
    313    42205  Reconstruct cleft palate
    313    42215  Reconstruct cleft palate
    313    42220  Reconstruct cleft palate
    313    42235  Repair palate...........
    313    42260  Repair nose to lip
                   fistula.
    313    42325  Create salivary cyst
                   drain.
    313    42326  Create salivary cyst
                   drain.
    313    42340  Removal of salivary
                   stone.
    313    42408  Excision of salivary
                   cyst.
    313    42409  Drainage of salivary
                   cyst.
    313    42410  Excise parotid gland/
                   lesion.
    313    42440  Excision submaxillary
                   gland.
    313    42450  Excision sublingual
                   gland.
    313    42500  Repair salivary duct....
    313    42505  Repair salivary duct....
    313    42507  Parotid duct diversion..
    313    42508  Parotid duct diversion..
    313    42510  Parotid duct diversion..
    313    42600  Closure of salivary
                   fistula.
    313    42725  Drainage of throat
                   abscess.
    313    42810  Excision of neck cyst...
    313    42815  Excision of neck cyst...
    313    42900  Repair throat wound.....
    313    42950  Reconstruction of throat
    313    42955  Surgical opening of
                   throat.
    313    42962  Control throat bleeding.
    313    42972  Control nose/throat
                   bleeding.
    313    43020  Incision of esophagus...
    313    43030  Throat muscle surgery...
    313    69120  Removal of external ear.
    313    69140  Remove ear canal
                   lesion(s).
    313    69300  Revise external ear.....
    313    69440  Exploration of middle
                   ear.
    313    69450  Eardrum revision........
    313    69620  Repair of eardrum.......

[[Page 35439]]

 
    314  LEVEL IV ENT PROCEDURES            T                        25.15   $1,293.21      $687.72      $258.64
    314    30400  Reconstruction of nose..
    314    30410  Reconstruction of nose..
    314    30420  Reconstruction of nose..
    314    30435  Revision of nose........
    314    30450  Revision of nose........
    314    30460  Revision of nose........
    314    30462  Revision of nose........
    314    30545  Repair nasal defect.....
    314    31040  Exploration behind upper
                   jaw.
    314    31075  Exploration of frontal
                   sinus.
    314    31080  Removal of frontal sinus
    314    31081  Removal of frontal sinus
    314    31084  Removal of frontal sinus
    314    31085  Removal of frontal sinus
    314    31086  Removal of frontal sinus
    314    31087  Removal of frontal sinus
    314    31090  Exploration of sinuses..
    314    31201  Removal of ethmoid sinus
    314    31205  Removal of ethmoid sinus
    314    31300  Removal of larynx lesion
    314    31400  Revision of larynx......
    314    31420  Removal of epiglottis...
    314    31588  Revision of larynx......
    314    31590  Reinnervate larynx......
    314    31750  Repair of windpipe......
    314    31755  Repair of windpipe......
    314    40700  Repair cleft lip/nasal..
    314    40701  Repair cleft lip/nasal..
    314    40702  Repair cleft lip/nasal..
    314    40720  Repair cleft lip/nasal..
    314    40761  Repair cleft lip/nasal..
    314    40843  Reconstruction of mouth.
    314    40844  Reconstruction of mouth.
    314    40845  Reconstruction of mouth.
    314    42210  Reconstruct cleft palate
    314    42225  Reconstruct cleft palate
    314    42226  Lengthening of palate...
    314    42227  Lengthening of palate...
    314    42415  Excise parotid gland/
                   lesion.
    314    42420  Excise parotid gland/
                   lesion.
    314    42425  Excise parotid gland/
                   lesion.
    314    42509  Parotid duct diversion..
    314    42842  Extensive surgery of
                   throat.
    314    42844  Extensive surgery of
                   throat.
    314    42890  Partial removal of
                   pharynx.
    314    42892  Revision of pharyngeal
                   walls.
    314    69150  Extensive ear canal
                   surgery.
    314    69310  Rebuild outer ear canal.
    314    69320  Rebuild outer ear canal.
    314    69501  Mastoidectomy...........
    314    69502  Mastoidectomy...........
    314    69505  Remove mastoid
                   structures.
    314    69511  Extensive mastoid
                   surgery.
    314    69530  Extensive mastoid
                   surgery.
    314    69550  Remove ear lesion.......
    314    69552  Remove ear lesion.......
    314    69601  Mastoid surgery revision
    314    69602  Mastoid surgery revision
    314    69603  Mastoid surgery revision
    314    69604  Mastoid surgery revision
    314    69605  Mastoid surgery revision
    314    69631  Repair eardrum
                   structures.
    314    69632  Rebuild eardrum
                   structures.
    314    69633  Rebuild eardrum
                   structures.
    314    69635  Repair eardrum
                   structures.
    314    69636  Rebuild eardrum
                   structures.
    314    69637  Rebuild eardrum
                   structures.
    314    69641  Revise middle ear &
                   mastoid.
    314    69642  Revise middle ear &
                   mastoid.
    314    69643  Revise middle ear &
                   mastoid.
    314    69644  Revise middle ear &
                   mastoid.
    314    69645  Revise middle ear &
                   mastoid.
    314    69646  Revise middle ear &
                   mastoid.
    314    69650  Release middle ear bone.

[[Page 35440]]

 
    314    69660  Revise middle ear bone..
    314    69661  Revise middle ear bone..
    314    69662  Revise middle ear bone..
    314    69666  Repair middle ear
                   structures.
    314    69667  Repair middle ear
                   structures.
    314    69670  Remove mastoid air cells
    314    69676  Remove middle ear nerve.
    314    69700  Close mastoid fistula...
    314    69711  Remove/repair hearing
                   aid.
    314    69720  Release facial nerve....
    314    69725  Release facial nerve....
    314    69740  Repair facial nerve.....
    314    69745  Repair facial nerve.....
    314    69801  Incise inner ear........
    314    69802  Incise inner ear........
    314    69805  Explore inner ear.......
    314    69806  Explore inner ear.......
    314    69820  Establish inner ear
                   window.
    314    69840  Revise inner ear window.
    314    69905  Remove inner ear........
    314    69910  Remove inner ear &
                   mastoid.
    314    69915  Incise inner ear nerve..
    314    69949  Inner ear surgery
                   procedure.
    317  IMPLANTATION OF COCHLEAR DEVICE    T
    317    69930  Implant cochlear device.
    318  NASAL CAUTERIZATION/PACKING        T                         2.07     $106.44       $38.87       $21.29
    318    30901  Control of nosebleed....
    318    30903  Control of nosebleed....
    318    30905  Control of nosebleed....
    318    30906  Repeat control of
                   nosebleed.
    318    30999  Nasal surgery procedure.
    318    42960  Control throat bleeding.
    318    42970  Control nose/throat
                   bleeding.
    318    42999  Throat surgery procedure
    319  TONSIL/ADENOID PROCEDURES          T                        16.20     $833.00      $463.53      $166.60
    319    42820  Remove tonsils and
                   adenoids.
    319    42821  Remove tonsils and
                   adenoids.
    319    42825  Removal of tonsils......
    319    42826  Removal of tonsils......
    319    42830  Removal of adenoids.....
    319    42831  Removal of adenoids.....
    319    42835  Removal of adenoids.....
    319    42836  Removal of adenoids.....
    319    42860  Excision of tonsil tags.
    319    42870  Excision of lingual
                   tonsil.
    320  THORACENTESIS/LAVAGE PROCEDURES    T                         3.09     $158.89       $80.91       $31.78
    320    32000  Drainage of chest.......
    320    32002  Treatment of collapsed
                   lung.
    320    32020  Insertion of chest tube.
    320    32420  Puncture/clear lung.....
    320    32960  Therapeutic pneumothorax
    320    32999  Chest surgery procedure.
    320    33010  Drainage of heart sac...
    320    33011  Repeat drainage of heart
                   sac.
    320    33999  Cardiac surgery
                   procedure.
    320    49080  Puncture, peritoneal
                   cavity.
    320    49081  Removal of abdominal
                   fluid.
    331  LEVEL I ENDOSCOPY UPPER AIRWAY     T                         0.57      $29.31       $14.01        $5.86
    331    31231  Nasal endoscopy, dx.....
    331    31299  Sinus surgery procedure.
    331    31505  Diagnostic laryngoscopy.
    331    31575  Diagnostic laryngoscopy.
    331    31579  Diagnostic laryngoscopy.
    331    92511  Nasopharyngoscopy.......
    332  LEVEL II ENDOSCOPY UPPER AIRWAY    T                         9.67     $497.23      $242.72       $99.45
    332    31233  Nasal/sinus endoscopy,
                   dx.
    332    31235  Nasal/sinus endoscopy,
                   dx.
    332    31237  Nasal/sinus endoscopy,
                   surg.
    332    31238  Nasal/sinus endoscopy,
                   surg.
    332    31240  Nasal/sinus endoscopy,
                   surg.
    332    31510  Laryngoscopy with biopsy
    332    31511  Remove foreign body,
                   larynx.
    332    31512  Removal of larynx lesion
    332    31513  Injection into vocal
                   cord.
    332    31515  Laryngoscopy for
                   aspiration.

[[Page 35441]]

 
    332    31520  Diagnostic laryngoscopy.
    332    31525  Diagnostic laryngoscopy.
    332    31526  Diagnostic laryngoscopy.
    332    31528  Laryngoscopy and
                   dilatation.
    332    31529  Laryngoscopy and
                   dilatation.
    332    31576  Laryngoscopy with biopsy
    332    31577  Remove foreign body,
                   larynx.
    332    31578  Removal of larynx lesion
    332    31700  Insertion of airway
                   catheter.
    332    31717  Bronchial brush biopsy..
    332    31720  Clearance of airways....
    332    31730  Intro windpipe wire/tube
    333  LEVEL III ENDOSCOPY UPPER AIRWAY   T                        16.81     $864.37      $461.04      $172.87
    333    31239  Nasal/sinus endoscopy,
                   surg.
    333    31254  Revision of ethmoid
                   sinus.
    333    31255  Removal of ethmoid sinus
    333    31256  Exploration maxillary
                   sinus.
    333    31267  Endoscopy, maxillary
                   sinus.
    333    31276  Sinus surgical endoscopy
    333    31287  Nasal/sinus endoscopy,
                   surg.
    333    31288  Nasal/sinus endoscopy,
                   surg.
    333    31527  Laryngoscopy for
                   treatment.
    333    31530  Operative laryngoscopy..
    333    31531  Operative laryngoscopy..
    333    31535  Operative laryngoscopy..
    333    31536  Operative laryngoscopy..
    333    31540  Operative laryngoscopy..
    333    31541  Operative laryngoscopy..
    333    31560  Operative laryngoscopy..
    333    31561  Operative laryngoscopy..
    333    31570  Laryngoscopy with
                   injection.
    333    31571  Laryngoscopy with
                   injection.
    336  ENDOSCOPY LOWER AIRWAY             T                         7.24     $372.28      $195.49       $74.46
    336    31615  Visualization of
                   windpipe.
    336    31622  Dx bronchoscope/wash....
    336    31625  Bronchoscopy with biopsy
    336    31628  Bronchoscopy with biopsy
    336    31629  Bronchoscopy with biopsy
    336    31630  Bronchoscopy with repair
    336    31631  Bronchoscopy with
                   dilation.
    336    31635  Remove foreign body,
                   airway.
    336    31640  Bronchoscopy & remove
                   lesion.
    336    31641  Bronchoscopy, treat
                   blockage.
    336    31645  Bronchoscopy, clear
                   airways.
    336    31646  Bronchoscopy,reclear
                   airways.
    336    31656  Bronchoscopy,inject for
                   xray.
    336    31899  Airways surgical
                   procedure.
    339  INJECTION OF SCLEROSING SOLUTION   T                         0.98      $50.39       $19.66       $10.08
    339    36468  Injection(s); spider
                   veins.
    339    36469  Injection(s); spider
                   veins.
    339    36470  Injection therapy of
                   vein.
    339    36471  Injection therapy of
                   veins.
    339    45520  Treatment of rectal
                   prolapse.
    341  LEVEL I NEEDLE AND CATHETER        T                         0.09       $4.63        $2.49        $0.93
         PLACEMENT
    341    36410  Drawing blood...........
    341    36420  Establish access to vein
    341    36425  Establish access to vein
    342  LEVEL II NEEDLE AND CATHETER       T                         2.61     $134.21       $68.70       $26.84
         PLACEMENT
    342    36010  Place catheter in vein..
    342    36011  Place catheter in vein..
    342    36012  Place catheter in vein..
    342    36013  Place catheter in artery
    342    36014  Place catheter in artery
    342    36015  Place catheter in artery
    342    36100  Establish access to
                   artery.
    342    36120  Establish access to
                   artery.
    342    36140  Establish access to
                   artery.
    342    36160  Establish access to
                   aorta.
    342    36200  Place catheter in aorta.
    342    36500  Insertion of catheter,
                   vein.
    342    36620  Insertion catheter,
                   artery.
    342    36625  Insertion catheter,
                   artery.
    342    38794  Access thoracic lymph
                   duct.
    343  LEVEL III NEEDLE AND CATHETER      T                         8.76     $450.44      $240.24       $90.09
         PLACEMENT
    343    36215  Place catheter in artery

[[Page 35442]]

 
    343    36216  Place catheter in artery
    343    36217  Place catheter in artery
    343    36218  Place catheter in artery
    343    36245  Place catheter in artery
    343    36246  Place catheter in artery
    343    36247  Place catheter in artery
    343    36248  Place catheter in artery
    343    36481  Insertion of catheter,
                   vein.
    343    93508  Cath placement,
                   angiography.
    346  PLACEMENT TRANSVENOUS CATHS/       T                         4.63     $238.07      $121.59       $47.61
         CUTDOWN
    346    36488  Insertion of catheter,
                   vein.
    346    36489  Insertion of catheter,
                   vein.
    346    36490  Insertion of catheter,
                   vein.
    346    36491  Insertion of catheter,
                   vein.
    346    36493  Repositioning of cvc....
    346    36640  Insertion catheter,
                   artery.
    347  INJECTION PROCEDURES FOR           T                         2.57     $132.15       $62.38       $26.43
         INTERVENTIONAL RADIOLOGY
    347    19030  Injection for breast x-
                   ray.
    347    20501  Inject sinus tract for x-
                   ray.
    347    21116  Injection, jaw joint x-
                   ray.
    347    23350  Injection for shoulder x-
                   ray.
    347    24220  Injection for elbow x-
                   ray.
    347    25246  Injection for wrist x-
                   ray.
    347    27093  Injection for hip x-ray.
    347    27095  Injection for hip x-ray.
    347    27370  Injection for knee x-ray
    347    27648  Injection for ankle x-
                   ray.
    347    30200  Injection treatment of
                   nose.
    347    31708  Instill airway contrast
                   dye.
    347    31710  Insertion of airway
                   catheter.
    347    31715  Injection for bronchus x-
                   ray.
    347    36005  Injection, venography...
    347    38200  Injection for spleen x-
                   ray.
    347    38790  Injection for lymphatic
                   x-ray.
    347    42550  Injection for salivary x-
                   ray.
    347    47500  Injection for liver x-
                   rays.
    347    47505  Injection for liver x-
                   rays.
    347    49400  Air injection into
                   abdomen.
    347    49424  Assess cyst, contrast
                   inj.
    347    49427  Injection, abdominal
                   shunt.
    347    50392  Insert kidney drain.....
    347    50393  Insert ureteral tube....
    347    50394  Injection for kidney x-
                   ray.
    347    50395  Create passage to kidney
    347    50684  Injection for ureter x-
                   ray.
    347    50690  Injection for ureter x-
                   ray.
    347    51600  Injection for bladder x-
                   ray.
    347    51605  Preparation for bladder
                   xray.
    347    51610  Injection for bladder x-
                   ray.
    347    54230  Prepare penis study.....
    347    55300  Preparation,sperm duct x-
                   ray.
    347    58340  Catheter for
                   hysterography.
    347    62284  Injection for myelogram.
    347    62290  Inject for spine disk x-
                   ray.
    347    62291  Inject for spine disk x-
                   ray.
    347    68850  Injection for tear sac x-
                   ray.
    360  REMOVAL/REVISION, PACEMAKER/       T                         6.04     $310.58      $138.54       $62.12
         VASCULAR DEVICE
    360    33222  Pacemaker aicd pocket...
    360    33223  Pacemaker aicd pocket...
    360    36261  Revision of infusion
                   pump.
    360    36262  Removal of infusion pump
    360    36299  Vessel injection
                   procedure.
    360    36531  Revision of infusion
                   pump.
    360    36532  Removal of infusion pump
    360    36534  Revision of access port.
    360    36535  Removal of access port..
    360    37203  Transcatheter retrieval.
    367  VASCULAR LIGATION                  T                        17.02     $875.17      $441.15      $175.03
    367    30915  Ligation nasal sinus
                   artery.
    367    30920  Ligation upper jaw
                   artery.
    367    37618  Ligation of extremity
                   artery.
    367    37650  Revision of major vein..
    367    37700  Revise leg vein.........
    367    37720  Removal of leg vein.....
    367    37730  Removal of leg veins....

[[Page 35443]]

 
    367    37735  Removal of leg veins/
                   lesion.
    367    37760  Revision of leg veins...
    367    37780  Revision of leg vein....
    367    37785  Revise secondary
                   varicosity.
    368   VASCULAR REPAIR/FISTULA           T                        22.59   $1,161.58      $647.49      $232.32
         CONSTRUCTION
    368    35188  Repair blood vessel
                   lesion.
    368    35207  Repair blood vessel
                   lesion.
    368    35875  Removal of clot in graft
    368    35876  Removal of clot in graft
    368    36260  Insertion of infusion
                   pump.
    368    36530  Insertion of infusion
                   pump.
    368    36533  Insertion of access port
    368    36800  Insertion of cannula....
    368    36810  Insertion of cannula....
    368    36815  Insertion of cannula....
    368    36821  Artery-vein fusion......
    368    36825  Artery-vein graft.......
    368    36830  Artery-vein graft.......
    368    36832  Av fistula revision.....
    368    36835  Artery to vein shunt....
    368    36860  External cannula
                   declotting.
    368    36861  Cannula declotting......
    368    37607  Ligation of fistula.....
    369  BLOOD AND BLOOD PRODUCT EXCHANGE   T                         6.33     $325.49      $155.49       $65.10
    369    36430  Blood transfusion
                   service.
    369    36440  Blood transfusion
                   service.
    369    36450  Exchange transfusion
                   service.
    369    36455  Exchange transfusion
                   service.
    369    36460  Transfusion service,
                   fetal.
    369    36520  Plasma and/or cell
                   exchange.
    369    36522  Photopheresis...........
    369    38230  Bone marrow collection..
    369    38231  Stem cell collection....
    369    Q0068  Extracorpeal
                   plasmapheresis.
    396  LYMPH NODE EXCISIONS               T                        12.98     $667.43      $334.48      $133.49
    396    38308  Incision of lymph
                   channels.
    396    38500  Biopsy/removal,lymph
                   node(s).
    396    38510  Biopsy/removal,lymph
                   node(s).
    396    38520  Biopsy/removal,lymph
                   node(s).
    396    38525  Biopsy/removal,lymph
                   node(s).
    396    38530  Biopsy/removal,lymph
                   node(s).
    396    38550  Removal neck/armpit
                   lesion.
    397  THYROID/LYMPHADENECTOMY            T                        19.12     $983.15      $542.17      $196.63
         PROCEDURES
    397    38542  Explore deep node(s),
                   neck.
    397    38555  Removal neck/armpit
                   lesion.
    397    38740  Remove armpit lymph
                   nodes.
    397    38745  Remove armpits lymph
                   nodes.
    397    38760  Remove groin lymph nodes
    397    60200  Remove thyroid lesion...
    397    60210  Partial excision thyroid
    397    60220  Partial removal of
                   thyroid.
    397    60225  Partial removal of
                   thyroid.
    397    60240  Removal of thyroid......
    397    60280  Remove thyroid duct
                   lesion.
    397    60281  Remove thyroid duct
                   lesion.
    406  ESOPHAGEAL DILATION WITHOUT        T                         4.17     $214.42      $106.67       $42.88
         ENDOSCOPY
    406    43450  Dilate esophagus........
    406    43453  Dilate esophagus........
    406    43456  Dilate esophagus........
    406    43458  Dilation of esophagus...
    406    43499  Esophagus surgery
                   procedure.
    407  ESOPHAGOSCOPY                      T                         6.89     $354.28      $189.39       $70.86
    407    43204  Esophagus endoscopy &
                   inject.
    407    43205  Esophagus endoscopy/
                   ligation.
    407    43215  Esophagus endoscopy.....
    407    43216  Esophagus endoscopy/
                   lesion.
    407    43217  Esophagus endoscopy.....
    407    43220  Esophagus endoscopy,
                   dilation.
    407    43226  Esophagus endoscopy,
                   dilation.
    407    43227  Esophagus endoscopy,
                   repair.
    417  DIAGNOSTIC UPPER GI ENDOSCOPY      T                         6.35     $326.52      $179.22       $65.30
    417    43200  Esophagus endoscopy.....
    417    43202  Esophagus endoscopy,
                   biopsy.
    417    43234  Upper GI endoscopy, exam
    417    43235  Upper gi endoscopy,
                   diagnosis.

[[Page 35444]]

 
    417    43239  Upper GI endoscopy,
                   biopsy.
    417    43600  Biopsy of stomach.......
    417    44100  Biopsy of bowel.........
    418  THERAPEUTIC UPPER GI ENDOSCOPY     T                         7.44     $382.56      $213.57       $76.51
    418    43241  Upper GI endoscopy with
                   tube.
    418    43243  Upper GI endoscopy &
                   inject.
    418    43244  Upper GI endoscopy/
                   ligation.
    418    43245  Operative upper GI
                   endoscopy.
    418    43246  Place gastrostomy tube..
    418    43247  Operative upper GI
                   endoscopy.
    418    43248  Upper GI endoscopy/
                   guidewire.
    418    43249  Esophagus
                   endoscopy,dilation.
    418    43250  Upper GI endoscopy/tumor
    418    43251  Operative upper GI
                   endoscopy.
    418    43255  Operative upper GI
                   endoscopy.
    418    43750  Place gastrostomy tube..
    419  SMALL INTESTINE ENDOSCOPY          T                         6.83     $351.20      $164.08       $70.24
    419    44360  Small bowel endoscopy...
    419    44361  Small bowel
                   endoscopy,biopsy.
    419    44363  Small bowel endoscopy...
    419    44364  Small bowel endoscopy...
    419    44365  Small bowel endoscopy...
    419    44366  Small bowel endoscopy...
    419    44372  Small bowel endoscopy...
    419    44373  Small bowel endoscopy...
    419    44376  Small bowel endoscopy...
    419    44377  Small bowel endoscopy...
    419    44378  Small bowel endoscopy...
    419    44799  Intestine surgery
                   procedure.
    426  DIAGNOSTIC LOWER GI ENDOSCOPY      T                         6.74     $346.57      $185.32       $69.31
    426    44380  Small bowel endoscopy...
    426    44382  Small bowel endoscopy...
    426    44385  Endoscopy of bowel pouch
    426    44386  Endoscopy, bowel pouch,
                   biopsy.
    426    44388  Colon endoscopy.........
    426    44389  Colonoscopy with biopsy.
    426    45378  Diagnostic colonoscopy..
    426    45380  Colonoscopy and biopsy..
    426    G0105  Colorectal scrn; hi risk
                   ind.
    427  THERAPEUTIC LOWER GI ENDOSCOPY     T                         8.09     $415.99      $222.84       $83.20
    427    44390  Colonoscopy for foreign
                   body.
    427    44391  Colonoscopy for bleeding
    427    44392  Colonoscopy &
                   polypectomy.
    427    44394  Colonoscopy w/snare.....
    427    45355  Surgical colonoscopy....
    427    45379  Colonoscopy.............
    427    45382  Colonoscopy,control
                   bleeding.
    427    45384  Colonoscopy.............
    427    45385  Colonoscopy, lesion
                   removal.
    437  THERAPEUTIC ANOSCOPY               T                         6.54     $336.29      $173.79       $67.26
    437    46606  Anoscopy and biopsy.....
    437    46608  Anoscopy; remove foreign
                   body.
    437    46610  Anoscopy; remove lesion.
    437    46611  Anoscopy................
    437    46612  Anoscopy; remove lesions
    437    46614  Anoscopy; control
                   bleeding.
    437    46615  Anoscopy................
    446  DIAGNOSTIC SIGMOIDOSCOPY           T                         2.54     $130.61       $64.86       $26.12
    446    45300  Proctosigmoidoscopy.....
    446    45305  Proctosigmoidoscopy;
                   biopsy.
    446    45330  Sigmoidoscopy,
                   diagnostic.
    446    45331  Sigmoidoscopy and biopsy
    446    G0104  CA screen; flexi
                   sigmoidscope.
    447  THERAPEUTIC PROCTOSIGMOIDOSCOPY    T                         7.06     $363.03      $191.87       $72.61
    447    45303  Proctosigmoidoscopy.....
    447    45307  Proctosigmoidoscopy.....
    447    45308  Proctosigmoidoscopy.....
    447    45309  Proctosigmoidoscopy.....
    447    45315  Proctosigmoidoscopy.....
    447    45317  Proctosigmoidoscopy.....
    447    45320  Proctosigmoidoscopy.....
    447    45321  Proctosigmoidoscopy.....
    448  THERAPEUTIC FLEXIBLE               T                         5.28     $271.50      $139.22       $54.30
         SIGMOIDOSCOPY
    448    45332  Sigmoidoscopy...........
    448    45333  Sigmoidoscopy &
                   polypectomy.

[[Page 35445]]

 
    448    45334  Sigmoidoscopy for
                   bleeding.
    448    45337  Sigmoidoscopy,
                   decompression.
    448    45338  Sigmoidoscopy...........
    449  COMPLEX GI ENDOSCOPY               T                         7.63     $392.33      $213.57       $78.47
    449    43219  Esophagus endoscopy.....
    449    43228  Esophagus endoscopy,
                   ablation.
    449    43258  Operative upper GI
                   endoscopy.
    449    43259  Endoscopic ultrasound
                   exam.
    449    43272  Endoscopy, bile duct/
                   pancreas.
    449    44369  Small bowel endoscopy...
    449    44393  Colonoscopy, lesion
                   removal.
    449    45339  Sigmoidoscopy...........
    449    45383  Colonoscopy, lesion
                   removal.
    451  LEVEL I ANAL/RECTAL PROCEDURES     T                         2.42     $124.44       $53.56       $24.89
    451    46070  Incision of anal septum.
    451    46083  Incise external
                   hemorrhoid.
    451    46220  Removal of anal tab.....
    451    46221  Ligation of
                   hemorrhoid(s).
    451    46230  Removal of anal tabs....
    451    46320  Removal of hemorrhoid
                   clot.
    451    46500  Injection into
                   hemorrhoids.
    451    46934  Destruction of
                   hemorrhoids.
    451    46935  Destruction of
                   hemorrhoids.
    451    46936  Destruction of
                   hemorrhoids.
    451    46940  Treatment of anal
                   fissure.
    451    46942  Treatment of anal
                   fissure.
    451    46945  Ligation of hemorrhoids.
    451    46946  Ligation of hemorrhoids.
    452  LEVEL II ANAL/RECTAL PROCEDURES    T                         4.52     $232.42      $103.06       $46.48
    452    45000  Drainage of pelvic
                   abscess.
    452    45005  Drainage of rectal
                   abscess.
    452    45020  Drainage of rectal
                   abscess.
    452    45100  Biopsy of rectum........
    452    45900  Reduction of rectal
                   prolapse.
    452    45905  Dilation of anal
                   sphincter.
    452    45910  Dilation of rectal
                   narrowing.
    452    45915  Remove rectal
                   obstruction.
    452    45999  Rectum surgery procedure
    452    46030  Removal of rectal marker
    452    46040  Incision of rectal
                   abscess.
    452    46050  Incision of anal abscess
    452    46080  Incision of anal
                   sphincter.
    452    46210  Removal of anal crypt...
    452    46754  Removal of suture from
                   anus.
    452    46999  Anus surgery procedure..
    453  LEVEL III ANAL/RECTAL PROCEDURES   T                        16.26     $836.09      $440.47      $167.22
    453    45108  Removal of anorectal
                   lesion.
    453    45150  Excision of rectal
                   stricture.
    453    45160  Excision of rectal
                   lesion.
    453    45170  Excision of rectal
                   lesion.
    453    45190  Destruction, rectal
                   tumor.
    453    45500  Repair of rectum........
    453    45505  Repair of rectum........
    453    45560  Repair of rectocele.....
    453    46045  Incision of rectal
                   abscess.
    453    46060  Incision of rectal
                   abscess.
    453    46200  Removal of anal fissure.
    453    46211  Removal of anal crypts..
    453    46250  Hemorrhoidectomy........
    453    46255  Hemorrhoidectomy........
    453    46257  Remove hemorrhoids &
                   fissure.
    453    46258  Remove hemorrhoids &
                   fistula.
    453    46260  Hemorrhoidectomy........
    453    46261  Remove hemorrhoids &
                   fissure.
    453    46262  Remove hemorrhoids &
                   fistula.
    453    46270  Removal of anal fistula.
    453    46275  Removal of anal fistula.
    453    46280  Removal of anal fistula.
    453    46285  Removal of anal fistula.
    453    46288  Repair anal fistula.....
    453    46700  Repair of anal stricture
    453    46750  Repair of anal sphincter
    453    46753  Reconstruction of anus..
    453    46760  Repair of anal sphincter
    453    46761  Repair of anal sphincter

[[Page 35446]]

 
    453    46762  Implant artificial
                   sphincter.
    453    46937  Cryotherapy of rectal
                   lesion.
    453    46938  Cryotherapy of rectal
                   lesion.
    456  ENDOSCOPIC RETROGRADE CHOLANGIO-   T                         9.61     $494.15      $249.05       $98.83
         PANCREATOGRAPHY (ERCP)
    456    43260  Endoscopy, bile duct/
                   pancreas.
    456    43261  Endoscopy, bile duct/
                   pancreas.
    456    43262  Endoscopy, bile duct/
                   pancreas.
    456    43263  Endoscopy, bile duct/
                   pancreas.
    456    43264  Endoscopy, bile duct/
                   pancreas.
    456    43265  Endoscopy, bile duct/
                   pancreas.
    456    43267  Endoscopy, bile duct/
                   pancreas.
    456    43268  Endoscopy, bile duct/
                   pancreas.
    456    43269  Endoscopy, bile duct/
                   pancreas.
    456    43271  Endoscopy, bile duct/
                   pancreas.
    458  PERCUTANEOUS BILIARY ENDOSCOPIC    T                         6.81     $350.17      $181.70       $70.03
         PROCEDURES
    458    47510  Insert catheter, bile
                   duct.
    458    47511  Insert bile duct drain..
    458    47552  Biliary endoscopy, thru
                   skin.
    458    47553  Biliary endoscopy, thru
                   skin.
    458    47554  Biliary endoscopy, thru
                   skin.
    458    47555  Biliary endoscopy, thru
                   skin.
    458    47556  Biliary endoscopy, thru
                   skin.
    458    47630  Remove bile duct stone..
    459  PERITONEAL AND ABDOMINAL           T                        17.85     $917.85      $497.88      $183.57
         PROCEDURES
    459    49085  Remove abdomen foreign
                   body.
    459    49250  Excision of umbilicus...
    459    49420  Insert abdominal drain..
    459    49421  Insert abdominal drain..
    459    49423  Exchange drainage cath..
    459    49426  Revise abdomen-venous
                   shunt.
    466  HERNIA/HYDROCELE PROCEDURES        T                        20.67   $1,062.85      $556.64      $212.57
    466    49495  Repair inguinal hernia,
                   init.
    466    49496  Repair inguinal hernia,
                   init.
    466    49500  Repair inguinal hernia..
    466    49501  Repair inguinal hernia,
                   init.
    466    49505  Repair inguinal hernia..
    466    49507  Repair, inguinal hernia.
    466    49520  Rerepair inguinal hernia
    466    49521  Repair inguinal hernia,
                   rec.
    466    49525  Repair inguinal hernia..
    466    49540  Repair lumbar hernia....
    466    49550  Repair femoral hernia...
    466    49553  Repair femoral hernia,
                   init.
    466    49555  Repair femoral hernia...
    466    49557  Repair femoral hernia,
                   recur.
    466    49560  Repair abdominal hernia.
    466    49561  Repair incisional hernia
    466    49565  Rerepair abdominal
                   hernia.
    466    49566  Repair incisional hernia
    466    49568  Hernia repair w/mesh....
    466    49570  Repair epigastric hernia
    466    49572  Repair, epigastric
                   hernia.
    466    49580  Repair umbilical hernia.
    466    49582  Repair umbilical hernia.
    466    49585  Repair umbilical hernia.
    466    49587  Repair umbilical hernia.
    466    49590  Repair abdominal hernia.
    466    49600  Repair umbilical lesion.
    466    51500  Removal of bladder cyst.
    466    55040  Removal of hydrocele....
    466    55041  Removal of hydroceles...
    470  TUBE PROCEDURES                    T                         2.19     $112.61       $54.92       $22.52
    470    31502  Change of windpipe
                   airway.
    470    43760  Change gastrostomy tube.
    470    43761  Reposition gastrostomy
                   tube.
    470    43999  Stomach surgery
                   procedure.
    470    47525  Change bile duct
                   catheter.
    470    47530  Revise, reinsert bile
                   tube.
    470    47999  Bile tract surgery
                   procedure.
    470    49422  Remove perm cannula/
                   catheter.
    470    49429  Removal of shunt........
    470    49999  Abdomen surgery
                   procedure.
    470    50688  Change of ureter tube...
    470    51705  Change of bladder tube..
    470    51710  Change of bladder tube..

[[Page 35447]]

 
    521  LEVEL I CYSTOURETHROSCOPY AND      T                         4.89     $251.44      $110.06       $50.29
         OTHER GENITOURINARY PROCEDURES
    521    50398  Change kidney tube......
    521    52000  Cystoscopy..............
    521    52265  Cystoscopy & treatment..
    522  LEVEL II CYSTOURETHROSCOPY AND     T                        10.15     $521.91      $259.45      $104.38
         OTHER GENITOURINARY PROCEDURES
    522    50551  Kidney endoscopy........
    522    50553  Kidney endoscopy........
    522    50555  Kidney endoscopy &
                   biopsy.
    522    50557  Kidney endoscopy &
                   treatment.
    522    50559  Renal endoscopy;
                   radiotracer.
    522    50561  Kidney endoscopy &
                   treatment.
    522    52005  Cystoscopy & ureter
                   catheter.
    522    52007  Cystoscopy and biopsy...
    522    52010  Cystoscopy & duct
                   catheter.
    522    52204  Cystoscopy..............
    522    52214  Cystoscopy and treatment
    522    52224  Cystoscopy and treatment
    522    52260  Cystoscopy & treatment..
    522    52270  Cystoscopy & revise
                   urethra.
    522    52275  Cystoscopy & revise
                   urethra.
    522    52276  Cystoscopy and treatment
    522    52281  Cystoscopy and treatment
    522    52283  Cystoscopy and treatment
    522    52285  Cystoscopy and treatment
    522    52290  Cystoscopy and treatment
    522    52300  Cystoscopy and treatment
    522    52301  Cystoscopy and treatment
    522    52305  Cystoscopy and treatment
    522    52310  Cystoscopy and treatment
    522    52315  Cystoscopy and treatment
    522    52327  Cystoscopy, inject
                   material.
    522    52510  Dilation prostatic
                   urethra.
    522    53605  Dilate urethra stricture
    523  LEVEL III CYSTOURETHROSCOPY AND    T                        16.35     $840.72      $438.89      $168.14
         OTHER GENITOURINARY PROCEDURES
    523    50951  Endoscopy of ureter.....
    523    50953  Endoscopy of ureter.....
    523    50955  Ureter endoscopy &
                   biopsy.
    523    50957  Ureter endoscopy &
                   treatment.
    523    50959  Ureter endoscopy &
                   tracer.
    523    50961  Ureter endoscopy &
                   treatment.
    523    51020  Incise & treat bladder..
    523    51030  Incise & treat bladder..
    523    51040  Incise & drain bladder..
    523    51045  Incise bladder, drain
                   ureter.
    523    51050  Removal of bladder stone
    523    51065  Removal of ureter stone.
    523    51520  Removal of bladder
                   lesion.
    523    51880  Repair of bladder
                   opening.
    523    52234  Cystoscopy and treatment
    523    52235  Cystoscopy and treatment
    523    52240  Cystoscopy and treatment
    523    52250  Cystoscopy & radiotracer
    523    52277  Cystoscopy and treatment
    523    52282  Cystoscopy, implant
                   stent.
    523    52317  Remove bladder stone....
    523    52318  Remove bladder stone....
    523    52320  Cystoscopy and treatment
    523    52325  Cystoscopy, stone
                   removal.
    523    52330  Cystoscopy and treatment
    523    52332  Cystoscopy and treatment
    523    52334  Create passage to kidney
    523    52335  Endoscopy of urinary
                   tract.
    523    52336  Cystoscopy, stone
                   removal.
    523    52338  Cystoscopy and treatment
    523    52339  Cystoscopy and treatment
    523    52340  Cystoscopy and treatment
    523    52450  Incision of prostate....
    523    52500  Revision of bladder neck
    523    52606  Control postop bleeding.
    523    52640  Relieve bladder
                   contracture.
    523    52700  Drainage of prostate
                   abscess.
    523    55720  Drainage of prostate
                   abscess.
    523    55725  Drainage of prostate
                   abscess.
    523    55859  Percut/needle insert,
                   pros.

[[Page 35448]]

 
    524  LEVEL IV CYSTOURETHROSCOPY AND     T                        27.20   $1,398.62      $824.90      $279.72
         OTHER GENITOURINARY PROCEDURES
    524    52337  Cystoscopy, stone
                   removal.
    524    52601  Prostatectomy (TURP)....
    524    52612  Prostatectomy, first
                   stage.
    524    52614  Prostatectomy, second
                   stage.
    524    52620  Remove residual prostate
    524    52630  Remove prostate regrowth
    524    52647  Laser surgery of
                   prostate.
    524    52648  Laser surgery of
                   prostate.
    524    53850  Prostatic microwave
                   thermotx.
    524    53852  Prostatic rf thermotx...
    527  LITHOTRIPSY                        T                        43.48   $2,235.74    $1,372.95      $447.15
    527    50590  Fragmenting of kidney
                   stone.
    529  SIMPLE URINARY STUDIES AND         T                         2.33     $119.81       $59.66       $23.96
         PROCEDURES
    529    50396  Measure kidney pressure.
    529    50686  Measure ureter pressure.
    529    51725  Simple cystometrogram...
    529    51726  Complex cystometrogram..
    529    51736  Urine flow measurement..
    529    51741  Electro-uroflowmetry,
                   first.
    529    51772  Urethra pressure profile
    529    51784  Anal/urinary muscle
                   study.
    529    51785  Anal/urinary muscle
                   study.
    529    51792  Urinary reflex study....
    529    51795  Urine voiding pressure
                   study.
    529    51797  Intraabdominal pressure
                   test.
    529    54240  Penis study.............
    529    54250  Penis study.............
    530  GENITOURINARY PROCEDURES           T                         2.46     $126.49       $53.34       $25.30
    530    51000  Drainage of bladder.....
    530    51005  Drainage of bladder.....
    530    51010  Drainage of bladder.....
    530    51700  Irrigation of bladder...
    530    51720  Treatment of bladder
                   lesion.
    530    53600  Dilate urethra stricture
    530    53601  Dilate urethra stricture
    530    53620  Dilate urethra stricture
    530    53621  Dilate urethra stricture
\2\ 530    53640  Relieve bladder
                   retention.
    530    53660  Dilation of urethra.....
    530    53661  Dilation of urethra.....
    530    53675  Insert urinary catheter.
    530    53899  Urology surgery
                   procedure.
    530    54200  Treatment of penis
                   lesion.
    530    54220  Treatment of penis
                   lesion.
    530    54231  Dynamic cavernosometry..
    530    54235  Penile injection........
    530    54450  Preputial stretching....
    530    55899  Genital surgery
                   procedure.
    531  LEVEL I URETHRAL PROCEDURES        T                        18.59     $955.90      $531.55      $191.18
    531    51715  Endoscopic injection/
                   implant.
    531    53000  Incision of urethra.....
    531    53010  Incision of urethra.....
    531    53020  Incision of urethra.....
    531    53025  Incision of urethra.....
    531    53040  Drainage of urethra
                   abscess.
    531    53060  Drainage of urethra
                   abscess.
    531    53080  Drainage of urinary
                   leakage.
    531    53200  Biopsy of urethra.......
    531    53250  Removal of urethra gland
    531    53260  Treatment of urethra
                   lesion.
    531    53265  Treatment of urethra
                   lesion.
    531    53270  Removal of urethra gland
    531    53275  Repair of urethra defect
    531    53442  Remove perineal
                   prosthesis.
    531    53502  Repair of urethra injury
    531    53505  Repair of urethra injury
    531    53510  Repair of urethra injury
    531    53665  Dilation of urethra.....
    531    54000  Slitting of prepuce.....
    531    54001  Slitting of prepuce.....
    532  LEVEL II URETHRAL PROCEDURES       T                        23.02   $1,183.69      $588.50      $236.74
    532    53210  Removal of urethra......
    532    53215  Removal of urethra......
    532    53220  Treatment of urethra
                   lesion.
    532    53230  Removal of urethra
                   lesion.

[[Page 35449]]

 
    532    53235  Removal of urethra
                   lesion.
    532    53240  Surgery for urethra
                   pouch.
    532    53400  Revise urethra, 1st
                   stage.
    532    53405  Revise urethra, 2nd
                   stage.
    532    53410  Reconstruction of
                   urethra.
    532    53420  Reconstruct urethra,
                   stage 1.
    532    53425  Reconstruct urethra,
                   stage 2.
    532    53430  Reconstruction of
                   urethra.
    532    53447  Remove artificial
                   sphincter.
    532    53449  Correct artificial
                   sphincter.
    532    53450  Revision of urethra.....
    532    53460  Revision of urethra.....
    532    53515  Repair of urethra injury
    532    53520  Repair of urethra defect
    536  CIRCUMCISION                       T                        12.89     $662.80      $321.60      $132.56
    536    54150  Circumcision............
    536    54152  Circumcision............
    536    54160  Circumcision............
    536    54161  Circumcision............
    537  PENILE PROCEDURES                  T                        28.65   $1,473.18      $872.36      $294.64
    537    37790  Penile venous occlusion.
    537    54110  Treatment of penis
                   lesion.
    537    54111  Treat penis lesion,
                   graft.
    537    54112  Treat penis lesion,
                   graft.
    537    54120  Partial removal of penis
    537    54205  Treatment of penis
                   lesion.
    537    54300  Revision of penis.......
    537    54304  Revision of penis.......
    537    54308  Reconstruction of
                   urethra.
    537    54312  Reconstruction of
                   urethra.
    537    54316  Reconstruction of
                   urethra.
    537    54318  Reconstruction of
                   urethra.
    537    54322  Reconstruction of
                   urethra.
    537    54324  Reconstruction of
                   urethra.
    537    54326  Reconstruction of
                   urethra.
    537    54328  Revise penis, urethra...
    537    54340  Secondary urethral
                   surgery.
    537    54344  Secondary urethral
                   surgery.
    537    54348  Secondary urethral
                   surgery.
    537    54352  Reconstruct urethra,
                   penis.
    537    54360  Penis plastic surgery...
    537    54380  Repair penis............
    537    54385  Repair penis............
    537    54402  Remove penis prosthesis.
    537    54407  Remove multi-comp
                   prosthesis.
    537    54409  Revise penis prosthesis.
    537    54420  Revision of penis.......
    537    54435  Revision of penis.......
    537    54440  Repair of penis.........
    538  INSERTION OF PENILE PROSTHESIS     T                        48.41   $2,489.24    $1,563.47      $497.85
    538    53440  Correct bladder function
    538    53445  Correct urine flow
                   control.
    538    54400  Insert semi-rigid
                   prosthesis.
    538    54401  Insert self-contd
                   prosthesis.
    538    54405  Insert multi-comp
                   prosthesis.
    546  TESTES/EPIDIDYMIS PROCEDURES       T                        16.54     $850.49      $449.51      $170.10
    546    54505  Biopsy of testis........
    546    54510  Removal of testis lesion
    546    54520  Removal of testis.......
    546    54530  Removal of testis.......
    546    54550  Exploration for testis..
    546    54600  Reduce testis torsion...
    546    54620  Suspension of testis....
    546    54640  Suspension of testis....
    546    54660  Revision of testis......
    546    54670  Repair testis injury....
    546    54680  Relocation of testis(es)
    546    54700  Drainage of scrotum.....
    546    54820  Exploration of
                   epididymis.
    546    54830  Remove epididymis lesion
    546    54840  Remove epididymis lesion
    546    54860  Removal of epididymis...
    546    54861  Removal of epididymis...
    546    54900  Fusion of spermatic
                   ducts.
    546    54901  Fusion of spermatic
                   ducts.

[[Page 35450]]

 
    546    55060  Repair of hydrocele.....
    546    55110  Explore scrotum.........
    546    55120  Removal of scrotum
                   lesion.
    546    55150  Removal of scrotum......
    546    55175  Revision of scrotum.....
    546    55180  Revision of scrotum.....
    546    55200  Incision of sperm duct..
    546    55250  Removal of sperm duct(s)
    546    55400  Repair of sperm duct....
    546    55450  Ligation of sperm duct..
    546    55500  Removal of hydrocele....
    546    55520  Removal of sperm cord
                   lesion.
    546    55530  Revise spermatic cord
                   veins.
    546    55535  Revise spermatic cord
                   veins.
    546    55540  Revise hernia & sperm
                   veins.
    546    55680  Remove sperm pouch
                   lesion.
    547  PROSTATE BIOPSY                    T                         4.39     $225.73      $125.20       $45.15
    547    55700  Biopsy of prostate......
    547    55705  Biopsy of prostate......
    550  SURGICAL HYSTEROSCOPY              T                        16.46     $846.37      $445.22      $169.27
    550    56351  Hysteroscopy; biopsy....
    550    56352  Hysteroscopy; lysis.....
    550    56353  Hysteroscopy; resect
                   septum.
    550    56354  Hysteroscopy; remove
                   myoma.
    550    56355  Hysteroscopy; remove
                   impact.
    550    56356  Hysteroscopy; ablation..
    551  LEVEL I LAPAROSCOPY                T                        24.61   $1,265.45      $701.73      $253.09
    551    56300  Laparoscopy; diagnostic.
    551    56301  Laparoscopy; tubal
                   cautery.
    551    56302  Laparoscopy; tubal block
    551    56303  Laparoscopy; excise
                   lesions.
    551    56304  Laparoscopy; lysis......
    551    56305  Laparoscopy; biopsy.....
    551    56306  Laparoscopy; aspiration.
    551    56346  Laparoscopic gastrostomy
\2\ 551    56360  Peritoneoscopy..........
\2\ 551    56361  Peritoneoscopy w/biopsy.
    552  LEVEL II LAPAROSCOPY               T                        37.09   $1,907.17    $1,053.84      $381.43
    552    56307  Laparoscopy; remove
                   adnexa.
    552    56309  Laparoscopy; remove
                   myoma.
    552    56311  Laparoscopic lymph node
                   biop.
    552    56312  Laparoscopic
                   lymphadenectomy.
    552    56313  Laparoscopic
                   lymphadenectomy.
    552    56316  Laparoscopic hernia
                   repair.
    552    56317  Laparoscopic hernia
                   repair.
    552    56318  Laparoscopic orchiectomy
    552    56320  Laparoscopy, spermatic
                   veins.
    552    56343  Laparoscopic
                   salpingostomy.
    552    56344  Laparoscopic
                   fimbrioplasty.
    552    56362  Laparoscopy w/cholangio.
    552    56363  Laparoscopy w/biopsy....
    561  LEVEL I FEMALE REPRODUCTIVE        T                         1.46      $75.07       $24.41       $15.01
         PROCEDURES
    561    56405  I & D of vulva/perineum.
    561    56420  Drainage of gland
                   abscess.
    561    56441  Lysis of labial
                   lesion(s).
    561    57061  Destruction vagina
                   lesion(s).
    561    57100  Biopsy of vagina........
    561    57150  Treat vagina infection..
    561    57160  Insertion of pessary/
                   device.
    561    57170  Fitting of diaphragm/cap
    561    57180  Treat vaginal bleeding..
    561    57452  Examination of vagina...
    561    57454  Vagina examination &
                   biopsy.
    561    57500  Biopsy of cervix........
    561    57505  Endocervical curettage..
    561    57510  Cauterization of cervix.
    561    57511  Cryocautery of cervix...
    561    57513  Laser surgery of cervix.
    561    57800  Dilation of cervical
                   canal.
    561    58100  Biopsy of uterus lining.
    561    58301  Remove intrauterine
                   device.
    561    59200  Insert cervical dilator.
    561    Q0091  Obtaining screen pap
                   smear.
    562  LEVEL II FEMALE REPRODUCTIVE       T                        12.30     $632.47      $325.44      $126.49
         PROCEDURES
    562    56350  Hysteroscopy; diagnostic

[[Page 35451]]

 
    562    56399  Laparoscopy procedure...
    562    56440  Surgery for vulva lesion
    562    56700  Partial removal of hymen
    562    56720  Incision of hymen.......
    562    56740  Remove vagina gland
                   lesion.
    562    56800  Repair of vagina........
    562    56810  Repair of perineum......
    562    57000  Exploration of vagina...
    562    57010  Drainage of pelvic
                   abscess.
    562    57020  Drainage of pelvic fluid
    562    57065  Destruction vagina
                   lesion(s).
    562    57105  Biopsy of vagina........
    562    57130  Remove vagina lesion....
    562    57135  Remove vagina lesion....
    562    57200  Repair of vagina........
    562    57210  Repair vagina/perineum..
    562    57230  Repair of urethral
                   lesion.
    562    57400  Dilation of vagina......
    562    57410  Pelvic examination......
    562    57415  Removal vaginal foreign
                   body.
    562    57460  Cervix excision.........
    562    57700  Revision of cervix......
    562    57720  Revision of cervix......
    562    58345  Reopen fallopian tube...
    562    58350  Reopen fallopian tube...
    562    58970  Retrieval of oocyte.....
    562    59300  Episiotomy or vaginal
                   repair.
    562    59320  Revision of cervix......
    562    59871  Remove cerclage suture..
    563  LEVEL III FEMALE REPRODUCTIVE      T                        16.50     $848.43      $461.72      $169.69
         PROCEDURES
    563    56620  Partial removal of vulva
    563    56625  Complete removal of
                   vulva.
    563    57220  Revision of urethra.....
    563    57240  Repair bladder & vagina.
    563    57250  Repair rectum & vagina..
    563    57260  Repair of vagina........
    563    57265  Extensive repair of
                   vagina.
    563    57268  Repair of bowel bulge...
    563    57284  Repair paravaginal
                   defect.
    563    57288  Repair bladder defect...
    563    57289  Repair bladder & vagina.
    563    57291  Construction of vagina..
    563    57300  Repair rectum-vagina
                   fistula.
    563    57520  Conization of cervix....
    563    57522  Conization of cervix....
    563    57530  Removal of cervix.......
    563    57550  Removal of residual
                   cervix.
    563    57555  Remove cervix, repair
                   vagina.
    563    57556  Remove cervix, repair
                   bowel.
    563    58145  Removal of uterus lesion
    563    58800  Drainage of ovarian
                   cyst(s).
    563    58820  Open drain ovary abscess
    567  D & C                              T                        13.18     $677.72      $360.70      $135.54
    567    57820  D&c of residual cervix..
    567    58120  Dilation and curettage
                   (D&C).
    567    59160  D&C after delivery......
    568  INFERTILITY PROCEDURES             T                         2.79     $143.46       $55.60       $28.69
    568    55870  Electroejaculation......
    568    58321  Artificial insemination.
    568    58322  Artificial insemination.
    568    58323  Sperm washing...........
    568    58974  Transfer of embryo......
    568    58976  Transfer of embryo......
    578  PREGNANCY AND NEONATAL CARE        T                         1.17      $60.16       $32.77       $12.03
         PROCEDURES
    578    59000  Amniocentesis...........
    578    59012  Fetal cord puncture,
                   prenatal.
    578    59015  Chorion biopsy..........
    578    59020  Fetal contract stress
                   test.
    578    59025  Fetal non-stress test...
    578    59030  Fetal scalp blood sample
    578    59050  Fetal monitor w/report..
    578    59899  Maternity care procedure
    580  VAGINAL DELIVERY                   T                         4.31     $221.62       $44.32       $44.32
    580    59409  Obstetrical care........
    580    59412  Antepartum manipulation.

[[Page 35452]]

 
    580    59414  Deliver placenta........
    580    59612  Vbac delivery only......
    586  THERAPEUTIC ABORTION               T                        11.98     $616.01      $409.29      $123.20
    586    59840  Abortion................
    586    59841  Abortion................
    587  SPONTANEOUS ABORTION               T                        12.96     $666.40      $347.14      $133.28
    587    59812  Treatment of miscarriage
    587    59820  Care of miscarriage.....
    587    59821  Treatment of miscarriage
    587    59870  Evacuate mole of uterus.
    600  SPINAL TAP                         T                         2.41     $123.92       $61.47       $24.78
    600    62270  Spinal fluid tap,
                   diagnostic.
    600    62272  Drain spinal fluid......
    601  LEVEL I NERVOUS SYSTEM INJECTIONS  T                         3.00     $154.26       $74.13       $30.85
    601    64400  Injection for nerve
                   block.
    601    64402  Injection for nerve
                   block.
    601    64405  Injection for nerve
                   block.
    601    64408  Injection for nerve
                   block.
    601    64410  Injection for nerve
                   block.
    601    64412  Injection for nerve
                   block.
    601    64413  Injection for nerve
                   block.
    601    64415  Injection for nerve
                   block.
    601    64417  Injection for nerve
                   block.
    601    64418  Injection for nerve
                   block.
    601    64420  Injection for nerve
                   block.
    601    64421  Injection for nerve
                   block.
    601    64425  Injection for nerve
                   block.
    601    64430  Injection for nerve
                   block.
    601    64435  Injection for nerve
                   block.
    601    64440  Injection for nerve
                   block.
    601    64441  Injection for nerve
                   block.
    601    64442  Injection for nerve
                   block.
    601    64443  Inject, nerve block add-
                   on.
    601    64445  Injection for nerve
                   block.
    601    64450  Injection for nerve
                   block.
    601    64505  Injection for nerve
                   block.
    601    64508  Injection for nerve
                   block.
    601    64510  Injection for nerve
                   block.
    601    64520  Injection for nerve
                   block.
    601    64530  Injection for nerve
                   block.
    601    64600  Injection treatment of
                   nerve.
    601    64605  Injection treatment of
                   nerve.
    601    64610  Injection treatment of
                   nerve.
    601    64612  Destroy nerve, face
                   muscle.
    601    64613  Destroy nerve, spine
                   muscle.
    601    64620  Injection treatment of
                   nerve.
    601    64622  Injection treatment of
                   nerve.
    601    64623  Inject, tx of nerve add-
                   on.
    601    64630  Injection treatment of
                   nerve.
    601    64640  Injection treatment of
                   nerve.
    601    64680  Injection treatment of
                   nerve.
    601    64999  Nervous system surgery..
    602  LEVEL II NERVOUS SYSTEM            T                         3.19     $164.03       $87.01       $32.81
         INJECTIONS
    602    61000  Remove cranial cavity
                   fluid.
    602    61001  Remove cranial cavity
                   fluid.
    602    61020  Remove brain cavity
                   fluid.
    602    61026  Injection into brain
                   canal.
    602    61050  Remove brain canal fluid
    602    61055  Injection into brain
                   canal.
    602    61070  Brain canal shunt
                   procedure.
    602    62194  Replace/irrigate
                   catheter.
    602    62225  Replace/irrigate
                   catheter.
    602    62268  Drain spinal cord cyst..
    602    62273  Treat lumbar spine
                   lesion.
    602    62274  Inject spinal anesthetic
    602    62275  Inject spinal anesthetic
    602    62276  Inject spinal anesthetic
    602    62277  Inject spinal anesthetic
    602    62278  Inject spinal anesthetic
    602    62279  Inject spinal anesthetic
    602    62280  Treat spinal cord lesion
    602    62281  Treat spinal cord lesion
    602    62282  Treat spinal canal
                   lesion.
    602    62288  Injection into spinal
                   canal.
    602    62289  Injection into spinal
                   canal.

[[Page 35453]]

 
    602    62292  Injection into disk
                   lesion.
    602    62294  Injection into spinal
                   artery.
    602    62298  Injection into spinal
                   canal.
    616  IMPLANTATION OF NEUROSTIMULATOR    T                        11.85     $609.33      $329.06      $121.87
         ELECTRODES
    616    63650  Implant neuroelectrodes.
    616    64553  Implant neuroelectrodes.
    616    64555  Implant neuroelectrodes.
    616    64560  Implant neuroelectrodes.
    616    64565  Implant neuroelectrodes.
    616    64573  Implant neuroelectrodes.
    616    64575  Implant neuroelectrodes.
    616    64577  Implant neuroelectrodes.
    616    64580  Implant neuroelectrodes.
    617  REVISION/REMOVAL NEUROLOGICAL      T                        11.31     $581.56      $280.01      $116.31
         DEVICE
    617    62230  Replace/revise brain
                   shunt.
    617    62350  Implant spinal catheter.
    617    62355  Remove spinal canal
                   catheter.
    617    62365  Remove spine infusion
                   device.
    617    63660  Revise/remove
                   neuroelectrode.
    617    63688  Revise/remove
                   neuroreceiver.
    617    63744  Revision of spinal shunt
    617    63746  Removal of spinal shunt.
    617    64585  Revise/remove
                   neuroelectrode.
    617    64595  Revise/remove
                   neuroreceiver.
    618  IMPLANTATION OF NEUROLOGICAL       T                        24.78   $1,274.19      $808.18      $254.84
         DEVICE
    618    61215  Insert brain-fluid
                   device.
    618    61885  Implant neuroreceiver...
    618    62360  Insert spine infusion
                   device.
    618    62361  Implant spine infusion
                   pump.
    618    62362  Implant spine infusion
                   pump.
    618    63685  Implant neuroreceiver...
    618    64590  Implant neuroreceiver...
    631  LEVEL I NERVE PROCEDURES           T                        12.70     $653.03      $329.06      $130.61
    631    27315  Partial removal, thigh
                   nerve.
    631    27320  Partial removal, thigh
                   nerve.
    631    28030  Removal of foot nerve...
    631    28035  Decompression of tibia
                   nerve.
    631    61790  Treat trigeminal nerve..
    631    62287  Percutaneous diskectomy.
    631    63600  Remove spinal cord
                   lesion.
    631    63610  Stimulation of spinal
                   cord.
    631    63615  Remove lesion of spinal
                   cord.
    631    64702  Revise finger/toe nerve.
    631    64704  Revise hand/foot nerve..
    631    64708  Revise arm/leg nerve....
    631    64712  Revision of sciatic
                   nerve.
    631    64713  Revision of arm nerve(s)
    631    64714  Revise low back nerve(s)
    631    64716  Revision of cranial
                   nerve.
    631    64718  Revise ulnar nerve at
                   elbow.
    631    64719  Revise ulnar nerve at
                   wrist.
    631    64721  Carpal tunnel surgery...
    631    64722  Relieve pressure on
                   nerve(s).
    631    64726  Release foot/toe nerve..
    631    64727  Internal nerve revision.
    631    64732  Incision of brow nerve..
    631    64734  Incision of cheek nerve.
    631    64736  Incision of chin nerve..
    631    64738  Incision of jaw nerve...
    631    64740  Incision of tongue nerve
    631    64742  Incision of facial nerve
    631    64744  Incise nerve, back of
                   head.
    631    64746  Incise diaphragm nerve..
    631    64761  Incision of pelvis nerve
    631    64771  Sever cranial nerve.....
    631    64772  Incision of spinal nerve
    631    64774  Remove skin nerve lesion
    631    64776  Remove digit nerve
                   lesion.
    631    64778  Digit nerve surgery add-
                   on.
    631    64782  Remove limb nerve lesion
    631    64783  Limb nerve surgery add-
                   on.
    631    64784  Remove nerve lesion.....
    631    64787  Implant nerve end.......
    631    64788  Remove skin nerve lesion
    631    64790  Removal of nerve lesion.

[[Page 35454]]

 
    631    64795  Biopsy of nerve.........
\2\ 631    64830  Microrepair of nerve....
    632  LEVEL II NERVE PROCEDURES          T                        16.48     $847.40      $453.58      $169.48
    632    64786  Remove sciatic nerve
                   lesion.
    632    64792  Removal of nerve lesion.
    632    64831  Repair of digit nerve...
    632    64832  Repair nerve add-on.....
    632    64834  Repair of hand or foot
                   nerve.
    632    64835  Repair of hand or foot
                   nerve.
    632    64836  Repair of hand or foot
                   nerve.
    632    64837  Repair nerve add-on.....
    632    64840  Repair of leg nerve.....
    632    64856  Repair/transpose nerve..
    632    64857  Repair arm/leg nerve....
    632    64858  Repair sciatic nerve....
    632    64859  Nerve surgery...........
    632    64861  Repair of arm nerves....
    632    64862  Repair of low back
                   nerves.
    632    64864  Repair of facial nerve..
    632    64865  Repair of facial nerve..
    632    64870  Fusion of facial/other
                   nerve.
    632    64872  Subsequent repair of
                   nerve.
    632    64874  Repair & revise nerve
                   add-on.
    632    64876  Repair nerve; shorten
                   bone.
    632    64885  Nerve graft, head or
                   neck.
    632    64886  Nerve graft, head or
                   neck.
    632    64890  Nerve graft, hand or
                   foot.
    632    64891  Nerve graft, hand or
                   foot.
    632    64892  Nerve graft, arm or leg.
    632    64893  Nerve graft, arm or leg.
    632    64895  Nerve graft, hand or
                   foot.
    632    64896  Nerve graft, hand or
                   foot.
    632    64897  Nerve graft, arm or leg.
    632    64898  Nerve graft, arm or leg.
    632    64901  Nerve graft add-on......
    632    64902  Nerve graft add-on......
    632    64905  Nerve pedicle transfer..
    632    64907  Nerve pedicle transfer..
    648  LASER RETINAL PROCEDURES           T                         3.76     $193.34       $93.56       $38.67
    648    67105  Repair, detached retina.
    648    67145  Treatment of retina.....
    648    67210  Treatment of retinal
                   lesion.
    648    67228  Treatment of retinal
                   lesion.
    649  LASER EYE PROCEDURES EXCEPT        T                         4.37     $224.71      $111.64       $44.94
         RETINAL
    649    65855  Laser surgery of eye....
    649    65860  Incise inner eye
                   adhesions.
    649    66761  Revision of iris........
    649    66762  Revision of iris........
    649    66770  Removal of inner eye
                   lesion.
    649    66821  After cataract laser
                   surgery.
    649    66999  Eye surgery procedure...
    649    67031  Laser surgery, eye
                   strands.
    649    67299  Eye surgery procedure...
    651  LEVEL I ANTERIOR SEGMENT EYE       T                         6.85     $352.23      $171.99       $70.45
         PROCEDURES
    651    65272  Repair of eye wound.....
    651    65275  Repair of eye wound.....
    651    65286  Repair of eye wound.....
    651    65420  Removal of eye lesion...
    651    65436  Curette/treat cornea....
    651    65450  Treatment of corneal
                   lesion.
    651    65772  Correction of
                   astigmatism.
    651    65810  Drainage of eye.........
    651    65815  Drainage of eye.........
    651    65820  Relieve inner eye
                   pressure.
    651    66130  Remove eye lesion.......
    651    66500  Incision of iris........
    651    66505  Incision of iris........
    651    66600  Remove iris and lesion..
    651    66625  Removal of iris.........
    651    66630  Removal of iris.........
    651    66700  Destruction, ciliary
                   body.
    651    66710  Destruction, ciliary
                   body.
    651    66720  Destruction, ciliary
                   body.
    651    66820  Incision, secondary
                   cataract.
    651    66825  Reposition intraocular
                   lens.

[[Page 35455]]

 
    652  LEVEL II ANTERIOR SEGMENT EYE      T                        16.35     $840.72      $433.92      $168.14
         PROCEDURES
    652    65235  Remove foreign body from
                   eye.
    652    65280  Repair of eye wound.....
    652    65285  Repair of eye wound.....
    652    65400  Removal of eye lesion...
    652    65426  Removal of eye lesion...
    652    65770  Revise cornea with
                   implant.
    652    65775  Correction of
                   astigmatism.
    652    65850  Incision of eye.........
    652    65865  Incise inner eye
                   adhesions.
    652    65870  Incise inner eye
                   adhesions.
    652    65875  Incise inner eye
                   adhesions.
    652    65880  Incise inner eye
                   adhesions.
    652    65900  Remove eye lesion.......
    652    65920  Remove implant from eye.
    652    65930  Remove blood clot from
                   eye.
    652    66150  Glaucoma surgery........
    652    66155  Glaucoma surgery........
    652    66160  Glaucoma surgery........
    652    66165  Glaucoma surgery........
    652    66170  Glaucoma surgery........
    652    66172  Incision of eye.........
    652    66180  Implant eye shunt.......
    652    66185  Revise eye shunt........
    652    66225  Repair/graft eye lesion.
    652    66250  Follow-up surgery of eye
    652    66605  Removal of iris.........
    652    66635  Removal of iris.........
    652    66680  Repair iris & ciliary
                   body.
    652    66682  Repair iris and ciliary
                   body.
    652    66740  Destruction, ciliary
                   body.
    652    66830  Removal of lens lesion..
    652    68130  Remove eyelid lining
                   lesion.
    652    68330  Revise eyelid lining....
    652    68360  Revise eyelid lining....
    652    68362  Revise eyelid lining....
    667  CATARACT PROCEDURES                T                        20.35   $1,046.40      $538.11      $209.28
    667    66840  Removal of lens material
    667    66850  Removal of lens material
    667    66852  Removal of lens material
    667    66920  Extraction of lens......
    667    66930  Extraction of lens......
    667    66940  Extraction of lens......
    668  CATARACT PROCEDURES WITH IOL       T                        22.02   $1,132.27      $617.21      $226.45
         INSERT
    668    66983  Remove cataract, insert
                   lens.
    668    66984  Remove cataract, insert
                   lens.
    668    66985  Insert lens prosthesis..
    668    66986  Exchange lens prosthesis
    670  CORNEAL TRANSPLANT                 T                        30.78   $1,582.71      $885.92      $316.54
    670    65710  Corneal transplant......
    670    65730  Corneal transplant......
    670    65750  Corneal transplant......
    670    65755  Corneal transplant......
    676  POSTERIOR SEGMENT EYE PROCEDURES   T                         5.87     $301.84      $138.54       $60.37
    676    65260  Remove foreign body from
                   eye.
    676    65265  Remove foreign body from
                   eye.
    676    66220  Repair eye lesion.......
    676    67005  Partial removal of eye
                   fluid.
    676    67010  Partial removal of eye
                   fluid.
    676    67015  Release of eye fluid....
    676    67030  Incise inner eye strands
    676    67101  Repair, detached retina.
    676    67110  Repair detached retina..
    676    67115  Release, encircling
                   material.
    676    67120  Remove eye implant
                   material.
    676    67121  Remove eye implant
                   material.
    676    67141  Treatment of retina.....
    676    67208  Treatment of retinal
                   lesion.
    676    67218  Treatment of retinal
                   lesion.
    676    67227  Treatment of retinal
                   lesion.
    676    92018  New eye exam & treatment
    676    92019  Eye exam & treatment....
    677  STRABISMUS/MUSCLE PROCEDURES       T                        16.11     $828.38      $428.95      $165.68
    677    65290  Repair of eye socket
                   wound.
    677    67311  Revise eye muscle.......

[[Page 35456]]

 
    677    67312  Revise two eye muscles..
    677    67314  Revise eye muscle.......
    677    67316  Revise two eye muscles..
    677    67318  Revise eye muscle(s)....
    677    67320  Revise eye muscle(s) add-
                   on.
    677    67331  Eye surgery follow-up
                   add-on.
    677    67332  Rerevise eye muscles add-
                   on.
    677    67334  Revise eye muscle w/
                   suture.
    677    67335  Eye suture during
                   surgery.
    677    67340  Revise eye muscle add-on
    677    67343  Release eye tissue......
    681  LEVEL I EYE PROCEDURES             T                         1.65      $84.84       $30.51       $16.97
    681    65125  Revise ocular implant...
    681    65205  Remove foreign body from
                   eye.
    681    65210  Remove foreign body from
                   eye.
    681    65220  Remove foreign body from
                   eye.
    681    65222  Remove foreign body from
                   eye.
    681    65430  Corneal smear...........
    681    65435  Curette/treat cornea....
    681    65600  Revision of cornea......
    681    67345  Destroy nerve of eye
                   muscle.
    681    67500  Inject/treat eye socket.
    681    67505  Inject/treat eye socket.
    681    67515  Inject/treat eye socket.
    681    67599  Orbit surgery procedure.
    681    68200  Treat eyelid by
                   injection.
    681    68761  Close tear duct opening.
    681    68899  Tear duct system surgery
    682  LEVEL II EYE PROCEDURES            T                         3.41     $175.34       $80.68       $35.07
    682    67028  Injection eye drug......
    682    67700  Drainage of eyelid
                   abscess.
    682    67710  Incision of eyelid......
    682    67800  Remove eyelid lesion....
    682    67801  Remove eyelid lesions...
    682    67805  Remove eyelid lesions...
    682    67810  Biopsy of eyelid........
    682    67820  Revise eyelashes........
    682    67825  Revise eyelashes........
    682    67840  Remove eyelid lesion....
    682    67850  Treat eyelid lesion.....
    682    67875  Closure of eyelid by
                   suture.
    682    67915  Repair eyelid defect....
    682    67922  Repair eyelid defect....
    682    67930  Repair eyelid wound.....
    682    67938  Remove eyelid foreign
                   body.
    682    67999  Revision of eyelid......
    682    68020  Incise/drain eyelid
                   lining.
    682    68040  Treatment of eyelid
                   lesions.
    682    68400  Incise/drain tear gland.
    682    68420  Incise/drain tear sac...
    682    68440  Incise tear duct opening
    682    68530  Clearance of tear duct..
    682    68705  Revise tear duct opening
    682    68760  Close tear duct opening.
\2\ 682    68800  Dilate tear duct
                   opening(s).
    682    68801  Dilate tear duct opening
    682    68840  Explore/irrigate tear
                   ducts.
    683  LEVEL III EYE PROCEDURES           T                         9.56     $491.58      $252.44       $98.32
    683    65175  Removal of ocular
                   implant.
    683    65410  Biopsy of cornea........
    683    65800  Drainage of eye.........
    683    65805  Drainage of eye.........
    683    66020  Injection treatment of
                   eye.
    683    66030  Injection treatment of
                   eye.
    683    67025  Replace eye fluid.......
    683    67715  Incision of eyelid fold.
    683    67830  Revise eyelashes........
    683    67880  Revision of eyelid......
    683    67935  Repair eyelid wound.....
    683    68510  Biopsy of tear gland....
    683    68525  Biopsy of tear sac......
    683    68810  Probe nasolacrimal duct.
\2\ 683    68820  Explore tear duct system
\2\ 683    68825  Explore tear duct system
\2\ 683    68830  Reopen tear duct channel

[[Page 35457]]

 
    684  LEVEL IV EYE PROCEDURES            T                        13.26     $681.83      $341.94      $136.37
    684    65091  Revise eye..............
    684    65093  Revise eye with implant.
    684    65101  Removal of eye..........
    684    65103  Remove eye/insert
                   implant.
    684    65105  Remove eye/attach
                   implant.
    684    65130  Insert ocular implant...
    684    65135  Insert ocular implant...
    684    65140  Attach ocular implant...
    684    65150  Revise ocular implant...
    684    65155  Reinsert ocular implant.
    684    67250  Reinforce eye wall......
    684    67255  Reinforce/graft eye wall
    684    67400  Explore/biopsy eye
                   socket.
    684    67405  Explore/drain eye socket
    684    67412  Explore/treat eye socket
    684    67413  Explore/treat eye socket
    684    67550  Insert eye socket
                   implant.
    684    67560  Revise eye socket
                   implant.
    684    67808  Remove eyelid lesion(s).
    684    67835  Revise eyelashes........
    684    67882  Revision of eyelid......
    684    67900  Repair brow defect......
    684    67901  Repair eyelid defect....
    684    67902  Repair eyelid defect....
    684    67903  Repair eyelid defect....
    684    67904  Repair eyelid defect....
    684    67906  Repair eyelid defect....
    684    67908  Repair eyelid defect....
    684    67909  Revise eyelid defect....
    684    67911  Revise eyelid defect....
    684    67914  Repair eyelid defect....
    684    67916  Repair eyelid defect....
    684    67917  Repair eyelid defect....
    684    67921  Repair eyelid defect....
    684    67923  Repair eyelid defect....
    684    67924  Repair eyelid defect....
    684    67950  Revision of eyelid......
    684    67961  Revision of eyelid......
    684    67966  Revision of eyelid......
    684    67971  Reconstruction of eyelid
    684    67973  Reconstruction of eyelid
    684    67974  Reconstruction of eyelid
    684    67975  Reconstruction of eyelid
    684    68320  Revise/graft eyelid
                   lining.
    684    68325  Revise/graft eyelid
                   lining.
    684    68326  Revise/graft eyelid
                   lining.
    684    68328  Revise/graft eyelid
                   lining.
    684    68335  Revise/graft eyelid
                   lining.
    684    68340  Separate eyelid
                   adhesions.
    684    68500  Removal of tear gland...
    684    68505  Partial removal tear
                   gland.
    684    68520  Removal of tear sac.....
    684    68540  Remove tear gland lesion
    684    68550  Remove tear gland lesion
    684    68700  Repair tear ducts.......
    684    68720  Create tear sac drain...
    684    68745  Create tear duct drain..
    684    68750  Create tear duct drain..
    684    68770  Close tear system
                   fistula.
    684    68811  Probe nasolacrimal duct.
    684    68815  Probe nasolacrimal duct.
    690  VITRECTOMY                         T                        30.39   $1,562.65      $845.69      $312.53
    690    67027  Implant eye drug system.
    690    67036  Removal of inner eye
                   fluid.
    690    67038  Strip retinal membrane..
    690    67039  Laser treatment of
                   retina.
    690    67040  Laser treatment of
                   retina.
    690    67107  Repair detached retina..
    690    67108  Repair detached retina..
    690    67112  Re-repair detached
                   retina.
    700  PLAIN FILM                         X                         0.80      $41.14       $22.37        $8.23
    700    70030  X-ray eye for foreign
                   body.
    700    70100  X-ray exam of jaw.......
    700    70110  X-ray exam of jaw.......

[[Page 35458]]

 
    700    70120  X-ray exam of mastoids..
    700    70130  X-ray exam of mastoids..
    700    70134  X-ray exam of middle ear
    700    70140  X-ray exam of facial
                   bones.
    700    70150  X-ray exam of facial
                   bones.
    700    70160  X-ray exam of nasal
                   bones.
    700    70190  X-ray exam of eye
                   sockets.
    700    70200  X-ray exam of eye
                   sockets.
    700    70210  X-ray exam of sinuses...
    700    70220  X-ray exam of sinuses...
    700    70240  X-ray exam pituitary
                   saddle.
    700    70250  X-ray exam of skull.....
    700    70260  X-ray exam of skull.....
    700    70300  X-ray exam of teeth.....
    700    70310  X-ray exam of teeth.....
    700    70320  Full mouth x-ray of
                   teeth.
    700    70328  X-ray exam of jaw joint.
    700    70330  X-ray exam of jaw joints
    700    70350  X-ray head for
                   orthodontia.
    700    70355  Panoramic x-ray of jaws.
    700    70360  X-ray exam of neck......
    700    70380  X-ray exam of salivary
                   gland.
    700    71010  Chest x-ray.............
    700    71015  X-ray exam of chest.....
    700    71020  Chest x-ray.............
    700    71021  Chest x-ray.............
    700    71022  Chest x-ray.............
    700    71030  Chest x-ray.............
    700    71035  Chest x-ray.............
    700    71100  X-ray exam of ribs......
    700    71101  X-ray exam of ribs,
                   chest.
    700    71110  X-ray exam of ribs......
    700    71111  X-ray exam of ribs,
                   chest.
    700    71120  X-ray exam of breastbone
    700    71130  X-ray exam of breastbone
    700    72010  X-ray exam of spine.....
    700    72020  X-ray exam of spine.....
    700    72040  X-ray exam of neck spine
    700    72050  X-ray exam of neck spine
    700    72052  X-ray exam of neck spine
    700    72069  X-ray exam of trunk
                   spine.
    700    72070  X-ray exam of thorax
                   spine.
    700    72072  X-ray exam of thoracic
                   spine.
    700    72074  X-ray exam of thoracic
                   spine.
    700    72080  X-ray exam of trunk
                   spine.
    700    72090  X-ray exam of trunk
                   spine.
    700    72100  X-ray exam of lower
                   spine.
    700    72110  X-ray exam of lower
                   spine.
    700    72114  X-ray exam of lower
                   spine.
    700    72120  X-ray exam of lower
                   spine.
    700    72170  X-ray exam of pelvis....
    700    72190  X-ray exam of pelvis....
    700    72200  X-ray exam sacroiliac
                   joints.
    700    72202  X-ray exam sacroiliac
                   joints.
    700    72220  X-ray exam of tailbone..
    700    73000  X-ray exam of collarbone
    700    73010  X-ray exam of shoulder
                   blade.
    700    73020  X-ray exam of shoulder..
    700    73030  X-ray exam of shoulder..
    700    73050  X-ray exam of shoulders.
    700    73060  X-ray exam of humerus...
    700    73070  X-ray exam of elbow.....
    700    73080  X-ray exam of elbow.....
    700    73090  X-ray exam of forearm...
    700    73092  X-ray exam of arm,
                   infant.
    700    73100  X-ray exam of wrist.....
    700    73110  X-ray exam of wrist.....
    700    73120  X-ray exam of hand......
    700    73130  X-ray exam of hand......
    700    73140  X-ray exam of finger(s).
    700    73500  X-ray exam of hip.......
    700    73510  X-ray exam of hip.......
    700    73520  X-ray exam of hips......
    700    73530  X-ray exam of hip.......
    700    73540  X-ray exam of pelvis &
                   hips.

[[Page 35459]]

 
    700    73550  X-ray exam of thigh.....
    700    73560  X-ray exam of knee, 1 or
                   2.
    700    73562  X-ray exam of knee, 3...
    700    73564  X-ray exam of knee, 4+..
    700    73565  X-ray exam of knee......
    700    73590  X-ray exam of lower leg.
    700    73592  X-ray exam of leg,
                   infant.
    700    73600  X-ray exam of ankle.....
    700    73610  X-ray exam of ankle.....
    700    73620  X-ray exam of foot......
    700    73630  X-ray exam of foot......
    700    73650  X-ray exam of heel......
    700    73660  X-ray exam of toe(s)....
    700    74000  X-ray exam of abdomen...
    700    74010  X-ray exam of abdomen...
    700    74020  X-ray exam of abdomen...
    700    74022  X-ray exam series,
                   abdomen.
    700    74710  X-ray measurement of
                   pelvis.
    700    76010  X-ray, nose to rectum...
    700    76020  X-rays for bone age.....
    700    76040  X-rays, bone evaluation.
    700    76061  X-rays, bone survey.....
    700    76062  X-rays, bone survey.....
    700    76065  X-rays, bone evaluation.
    700    76066  Joint(s) survey, single
                   film.
    700    76076  Dual energy x-ray study.
    700    76078  Photodensitometry.......
    700    76098  X-ray exam, breast
                   specimen.
    700    76100  X-ray exam of body
                   section.
    700    76120  Cinematic x-rays........
    700    76125  Cinematic x-rays add-on.
    700    76150  X-ray exam, dry process.
    700    76499  Radiographic procedure..
    700    77417  Radiology port film(s)..
    700    78350  Bone mineral, single
                   photon.
    706  MISCELLANEOUS RADIOLOGICAL         X                         1.43      $73.53       $39.10       $14.71
         PROCEDURES
    706    70170  X-ray exam of tear duct.
    706    70373  Contrast x-ray of larynx
    706    70390  X-ray exam of salivary
                   duct.
    706    71040  Contrast x-ray of
                   bronchi.
    706    71060  Contrast x-ray of
                   bronchi.
    706    74190  X-ray exam of peritoneum
    706    74305  X-ray bile ducts,
                   pancreas.
    706    74320  Contrast x-ray of bile
                   ducts.
    706    74328  X-ray for bile duct
                   endoscopy.
    706    74329  X-ray for pancreas
                   endoscopy.
    706    74330  X-ray, bile/pancreas
                   endoscopy.
    706    74350  X-ray guide, stomach
                   tube.
    706    74355  X-ray guide, intestinal
                   tube.
    706    74470  X-ray exam of kidney
                   lesion.
    706    74740  X-ray female genital
                   tract.
    706    74742  X-ray fallopian tube....
    706    75801  Lymph vessel x-ray, arm/
                   leg.
    706    75803  Lymph vessel x-ray,arms/
                   legs.
    706    75805  Lymph vessel x-ray,
                   trunk.
    706    75807  Lymph vessel x-ray,
                   trunk.
    706    75809  Nonvascular shunt, x-ray
    706    75898  Follow-up angiogram.....
    706    76075  Dual energy x-ray study.
    706    76080  X-ray exam of fistula...
    706    76086  X-ray of mammary duct...
    706    76088  X-ray of mammary ducts..
    706    76095  Stereotactic breast
                   biopsy.
    706    76096  X-ray of needle wire,
                   breast.
    706    76101  Complex body section x-
                   ray.
    706    76102  Complex body section x-
                   rays.
    710  COMPUTERIZED AXIAL TOMOGRAPHY      S                         4.98     $256.07      $173.12       $51.21
    710    70450  CAT scan of head or
                   brain.
    710    70460  Contrast CAT scan of
                   head.
    710    70470  Contrast CAT scans of
                   head.
    710    70480  CAT scan of skull.......
    710    70481  Contrast CAT scan of
                   skull.
    710    70482  Contrast CAT scans of
                   skull.
    710    70486  CAT scan of face, jaw...
    710    70487  Contrast CAT scan, face/
                   jaw.

[[Page 35460]]

 
    710    70488  Contrast CAT scans face/
                   jaw.
    710    70490  CAT scan of neck tissue.
    710    70491  Contrast CAT of neck
                   tissue.
    710    70492  Contrast CAT of neck
                   tissue.
    710    71250  Cat scan of chest.......
    710    71260  Contrast CAT scan of
                   chest.
    710    71270  Contrast CAT scans of
                   chest.
    710    72125  CAT scan of neck spine..
    710    72126  Contrast CAT scan of
                   neck.
    710    72127  Contrast CAT scans of
                   neck.
    710    72128  CAT scan of thorax spine
    710    72129  Contrast CAT scan of
                   thorax.
    710    72130  Contrast CAT scans of
                   thorax.
    710    72131  CAT scan of lower spine.
    710    72132  Contrast CAT of lower
                   spine.
    710    72133  Contrast CAT scans,low
                   spine.
    710    72192  CAT scan of pelvis......
    710    72193  Contrast CAT scan of
                   pelvis.
    710    72194  Contrast CAT scans of
                   pelvis.
    710    73200  CAT scan of arm.........
    710    73201  Contrast CAT scan of arm
    710    73202  Contrast CAT scans of
                   arm.
    710    73700  CAT scan of leg.........
    710    73701  Contrast CAT scan of leg
    710    73702  Contrast CAT scans of
                   leg.
    710    74150  CAT scan of abdomen.....
    710    74160  Contrast CAT scan of
                   abdomen.
    710    74170  Contrast CAT scans,
                   abdomen.
    710    76355  CAT scan for
                   localization.
    710    76360  CAT scan for needle
                   biopsy.
    710    76365  CAT scan for cyst
                   aspiration.
    710    76370  CAT scan for therapy
                   guide.
    710    76375  3d/holograph reconstr
                   add-on.
    710    76380  CAT scan follow-up study
    716  FLUOROSCOPY                        X                         1.39      $71.47       $40.00       $14.29
    716    70370  Throat x-ray &
                   fluoroscopy.
    716    70371  Speech evaluation,
                   complex.
    716    71023  Chest x-ray and
                   fluoroscopy.
    716    71034  Chest x-ray &
                   fluoroscopy.
    716    71036  X-ray guidance for
                   biopsy.
\2\ 716    71038  X-ray guidance for
                   biopsy.
    716    71090  X-ray & pacemaker
                   insertion.
    716    74340  X-ray guide for GI tube.
    716    75989  Abscess drainage under x-
                   ray.
    716    76000  Fluoroscope examination.
    716    76001  Fluoroscope exam,
                   extensive.
    716    76003  Needle localization by x-
                   ray.
    720  MAGNETIC RESONANCE ANGIOGRAPHY     S                         6.37     $327.55      $204.98       $65.51
    720    70541  Magnetic image, head
                   (MRA).
    726  MAGNETIC RESONANCE IMAGING         S                         7.91     $406.73      $256.06       $81.35
    726    70336  Magnetic image jaw joint
    726    70540  Magnetic image, face,
                   neck.
    726    70551  Magnetic image, brain
                   (MRI).
    726    70552  Magnetic image, brain
                   (MRI).
    726    70553  Magnetic image, brain...
    726    71550  Magnetic image, chest...
    726    72141  Magnetic image, neck
                   spine.
    726    72142  Magnetic image, neck
                   spine.
    726    72146  Magnetic image, chest
                   spine.
    726    72147  Magnetic image, chest
                   spine.
    726    72148  Magnetic image, lumbar
                   spine.
    726    72149  Magnetic image, lumbar
                   spine.
    726    72156  Magnetic image, neck
                   spine.
    726    72157  Magnetic image, chest
                   spine.
    726    72158  Magnetic image, lumbar
                   spine.
    726    72196  Magnetic image, pelvis..
    726    73220  Magnetic image, arm,
                   hand.
    726    73221  Magnetic image, joint of
                   arm.
    726    73720  Magnetic image, leg,
                   foot.
    726    73721  Magnetic image, joint of
                   leg.
    726    74181  Magnetic image, abdomen
                   (MRI).
    726    75552  Magnetic image,
                   myocardium.
    726    75553  Magnetic image,
                   myocardium.
    726    75554  Cardiac MRI/function....
    726    75555  Cardiac MRI/limited
                   study.

[[Page 35461]]

 
    726    76093  Magnetic image, breast..
    726    76094  Magnetic image, both
                   breasts.
    726    76390  Mr spectroscopy.........
    726    76400  Magnetic image, bone
                   marrow.
    728  MYELOGRAPHY                        S                         3.50     $179.97       $91.98       $35.99
    728    70010  Contrast x-ray of brain.
    728    70015  Contrast x-ray of brain.
    728    72240  Contrast x-ray of neck
                   spine.
    728    72255  Contrast x-ray thorax
                   spine.
    728    72265  Contrast x-ray lower
                   spine.
    728    72270  Contrast x-ray of spine.
    728    72285  X-ray of neck spine disk
    728    72295  X-ray of lower spine
                   disk.
    730  ARTHOGRAPHY                        S                         2.30     $118.27       $65.77       $23.65
    730    70332  X-ray exam of jaw joint.
    730    73040  Contrast x-ray of
                   shoulder.
    730    73085  Contrast x-ray of elbow.
    730    73115  Contrast x-ray of wrist.
    730    73525  Contrast x-ray of hip...
    730    73580  Contrast x-ray of knee
                   joint.
    730    73615  Contrast x-ray of ankle.
    736  DIGESTIVE RADIOLOGY                S                         1.85      $95.13       $53.79       $19.03
    736    74210  Contrast xray exam of
                   throat.
    736    74220  Contrast xray exam,
                   esophagus.
    736    74230  Cinema xray throat/
                   esophagus.
    736    74240  X-ray exam upper GI
                   tract.
    736    74241  X-ray exam upper GI
                   tract.
    736    74245  X-ray exam upper GI
                   tract.
    736    74246  Contrast x-ray upper GI
                   tract.
    736    74247  Contrast x-ray upper GI
                   tract.
    736    74249  Contrast x-ray upper GI
                   tract.
    736    74250  X-ray exam of small
                   bowel.
    736    74251  X-ray exam of small
                   bowel.
    736    74260  X-ray exam of small
                   bowel.
    736    74270  Contrast x-ray exam of
                   colon.
    736    74280  Contrast x-ray exam of
                   colon.
    736    74283  Contrast x-ray exam of
                   colon.
    736    74290  Contrast x-ray,
                   gallbladder.
    736    74291  Contrast x-rays,
                   gallbladder.
    736    G0106  Colon CA screen; barium
                   enema.
    736    G0120  Colon ca scrn; barium
                   enema.
    737  DIAGNOSTIC UROGRAPHY               S                         2.69     $138.32       $81.81       $27.66
    737    74400  Contrast x-ray urinary
                   tract.
\2\ 737    74405  Contrast x-ray urinary
                   tract.
    737    74410  Contrast x-ray urinary
                   tract.
    737    74415  Contrast x-ray urinary
                   tract.
    737    74420  Contrast x-ray urinary
                   tract.
    737    74425  Contrast x-ray urinary
                   tract.
    737    74430  Contrast x-ray of
                   bladder.
    737    74440  X-ray exam male genital
                   tract.
    737    74445  X-ray exam of penis.....
    737    74450  X-ray exam urethra/
                   bladder.
    737    74455  X-ray exam urethra/
                   bladder.
    737    74775  X-ray exam of perineum..
    738  THERAPEUTIC RADIOLOGIC PROCEDURES  S                         3.74     $192.31      $104.86       $38.46
    738    74235  Remove esophagus
                   obstruction.
    738    74327  X-ray for bile stone
                   removal.
    738    74360  X-ray guide, GI dilation
    738    74363  X-ray, bile duct
                   dilation.
    738    74475  X-ray control catheter
                   insert.
    738    74480  X-ray control catheter
                   insert.
    738    74485  X-ray guide, GU dilation
    738    75980  Contrast x-ray exam bile
                   duct.
    738    75982  Contrast x-ray exam bile
                   duct.
    738    75984  X-ray control catheter
                   change.
    739  DIAGNOSTIC ANGIOGRAPHY AND         S                         5.33     $274.07      $150.74       $54.81
         VENOGRAPHY
    739    75600  Contrast x-ray exam of
                   aorta.
    739    75605  Contrast x-ray exam of
                   aorta.
    739    75625  Contrast x-ray exam of
                   aorta.
    739    75630  X-ray aorta, leg
                   arteries.
    739    75650  Artery x-rays, head &
                   neck.
    739    75658  X-ray exam of arm
                   arteries.
    739    75660  Artery x-rays, head &
                   neck.
    739    75662  Artery x-rays, head &
                   neck.
    739    75665  Artery x-rays, head &
                   neck.

[[Page 35462]]

 
    739    75671  Artery x-rays, head &
                   neck.
    739    75676  Artery x-rays, neck.....
    739    75680  Artery x-rays, neck.....
    739    75685  Artery x-rays, spine....
    739    75705  Artery x-rays, spine....
    739    75710  Artery x-rays, arm/leg..
    739    75716  Artery x-rays, arms/legs
    739    75722  Artery x-rays, kidney...
    739    75724  Artery x-rays, kidneys..
    739    75726  Artery x-rays, abdomen..
    739    75731  Artery x-rays, adrenal
                   gland.
    739    75733  Artery x-rays, adrenal
                   glands.
    739    75736  Artery x-rays, pelvis...
    739    75741  Artery x-rays, lung.....
    739    75743  Artery x-rays, lungs....
    739    75746  Artery x-rays, lung.....
    739    75756  Artery x-rays, chest....
    739    75774  Artery x-ray, each
                   vessel.
    739    75790  Visualize A-V shunt.....
    739    75810  Vein x-ray, spleen/liver
    739    75820  Vein x-ray, arm/leg.....
    739    75822  Vein x-ray, arms/legs...
    739    75825  Vein x-ray, trunk.......
    739    75827  Vein x-ray, chest.......
    739    75831  Vein x-ray, kidney......
    739    75833  Vein x-ray, kidneys.....
    739    75840  Vein x-ray, adrenal
                   gland.
    739    75842  Vein x-ray, adrenal
                   glands.
    739    75860  Vein x-ray, neck........
    739    75870  Vein x-ray, skull.......
    739    75872  Vein x-ray, skull.......
    739    75880  Vein x-ray, eye socket..
    739    75885  Vein x-ray, liver.......
    739    75887  Vein x-ray, liver.......
    739    75889  Vein x-ray, liver.......
    739    75891  Vein x-ray, liver.......
    746  MAMMOGRAPHY                        S                         0.69      $35.48       $19.44        $7.10
    746    76090  Mammogram, one breast...
    746    76091  Mammogram, both breasts.
    747  DIAGNOSTIC ULTRASOUND EXCEPT       S                         1.65      $84.84       $54.47       $16.97
         VASCULAR
    747    76506  Echo exam of head.......
    747    76511  Echo exam of eye........
    747    76512  Echo exam of eye........
    747    76513  Echo exam of eye, water
                   bath.
    747    76516  Echo exam of eye........
    747    76519  Echo exam of eye........
    747    76529  Echo exam of eye........
    747    76536  Echo exam of head and
                   neck.
    747    76604  Echo exam of chest......
    747    76645  Echo exam of breast.....
    747    76700  Echo exam of abdomen....
    747    76705  Echo exam of abdomen....
    747    76770  Echo exam abdomen back
                   wall.
    747    76775  Echo exam abdomen back
                   wall.
    747    76778  Echo exam kidney
                   transplant.
    747    76800  Echo exam spinal canal..
    747    76805  Echo exam of pregnant
                   uterus.
    747    76810  Echo exam of pregnant
                   uterus.
    747    76815  Echo exam of pregnant
                   uterus.
    747    76816  Echo exam followup or
                   repeat.
    747    76818  Fetal biophysical
                   profile.
    747    76830  Echo exam, transvaginal.
    747    76831  Echo exam, uterus.......
    747    76856  Echo exam of pelvis.....
    747    76857  Echo exam of pelvis.....
    747    76870  Echo exam of scrotum....
    747    76872  Echo exam, transrectal..
    747    76880  Echo exam of extremity..
    747    76885  Echo exam, infant hips..
    747    76886  Echo exam, infant hips..
    747    76970  Ultrasound exam follow-
                   up.
    747    76975  GI endoscopic ultrasound
    747    76986  Echo exam at surgery....
    747    76999  Echo examination
                   procedure.
    747    G0050  Residual urine by
                   ultrasound.

[[Page 35463]]

 
    749  GUIDANCE UNDER ULTRASOUND          X                         2.22     $114.15       $70.06       $22.83
    749    76930  Echo guide for heart sac
                   tap.
    749    76932  Echo guide for heart
                   biopsy.
    749    76934  Echo guide for chest tap
    749    76936  Echo guide for artery
                   repair.
    749    76938  Echo exam for drainage..
    749    76941  Echo guide for
                   transfusion.
    749    76942  Echo guide for biopsy...
    749    76945  Echo guide, villus
                   sampling.
    749    76946  Echo guide for
                   amniocentesis.
    749    76948  Echo guide, ova
                   aspiration.
    749    76950  Echo guidance
                   radiotherapy.
    749    76960  Echo guidance
                   radiotherapy.
    749    76965  Echo guidance
                   radiotherapy.
    750  THERAPEUTIC RADIATION TREATMENT    X                         0.96      $49.36       $25.99        $9.87
         PLANNING
    750    77261  Radiation therapy
                   planning.
    750    77262  Radiation therapy
                   planning.
    750    77263  Radiation therapy
                   planning.
    750    77336  Radiation physics
                   consult.
    750    77370  Radiation physics
                   consult.
    750    77399  External radiation
                   dosimetry.
    750    77431  Radiation therapy
                   management.
    750    77432  Stereotactic radiation
                   trmt.
    751  LEVEL I THERAPEUTIC RADIATION      X                         1.15      $59.13       $33.22       $11.83
         TREATMENT PREPARATION
    751    77299  Radiation therapy
                   planning.
    751    77300  Radiation therapy dose
                   plan.
    751    77305  Radiation therapy dose
                   plan.
    751    77310  Radiation therapy dose
                   plan.
    751    77315  Radiation therapy dose
                   plan.
    751    77321  Radiation therapy port
                   plan.
    751    77326  Radiation therapy dose
                   plan.
    751    77327  Radiation therapy dose
                   plan.
    751    77328  Radiation therapy dose
                   plan.
    751    77331  Special radiation
                   dosimetry.
    751    77332  Radiation treatment
                   aid(s).
    751    77333  Radiation treatment
                   aid(s).
    751    77334  Radiation treatment
                   aid(s).
    752  LEVEL II THERAPEUTIC RADIATION     X                         3.48     $178.94       $86.56       $35.79
         TREATMENT PREPARATION
    752    77280  Set radiation therapy
                   field.
    752    77285  Set radiation therapy
                   field.
    752    77290  Set radiation therapy
                   field.
    752    77295  Set radiation therapy
                   field.
    757  RADIATION THERAPY                  S                         2.26     $116.21       $52.43       $23.24
    757    61793  Focus radiation beam....
    757    77401  Radiation treatment
                   delivery.
    757    77402  Radiation treatment
                   delivery.
    757    77403  Radiation treatment
                   delivery.
    757    77404  Radiation treatment
                   delivery.
    757    77406  Radiation treatment
                   delivery.
    757    77407  Radiation treatment
                   delivery.
    757    77408  Radiation treatment
                   delivery.
    757    77409  Radiation treatment
                   delivery.
    757    77411  Radiation treatment
                   delivery.
    757    77412  Radiation treatment
                   delivery.
    757    77413  Radiation treatment
                   delivery.
    757    77414  Radiation treatment
                   delivery.
    757    77416  Radiation treatment
                   delivery.
    757    77470  Special radiation
                   treatment.
    758  HYPERTHERMIC THERAPIES             S                         5.08     $261.21      $137.18       $52.24
    758    77600  Hyperthermia treatment..
    758    77605  Hyperthermia treatment..
    758    77610  Hyperthermia treatment..
    758    77615  Hyperthermia treatment..
    758    77620  Hyperthermia treatment..
    759  BRACHYTHERAPY AND COMPLEX          S                         7.98     $410.33      $157.97       $82.07
         RADIOELEMENT APPLICATIONS
    759    77750  Infuse radioactive
                   materials.
    759    77761  Radioelement application
    759    77762  Radioelement application
    759    77763  Radioelement application
    759    77776  Radioelement application
    759    77777  Radioelement application
    759    77778  Radioelement application
    759    77781  High intensity
                   brachytherapy.
    759    77782  High intensity
                   brachytherapy.
    759    77783  High intensity
                   brachytherapy.

[[Page 35464]]

 
    759    77784  High intensity
                   brachytherapy.
    759    77789  Radioelement application
    759    77799  Radium/radioisotope
                   therapy.
    760  PET SCANS                          S                        14.89     $765.64      $419.46      $153.13
    760    78459  Heart muscle imaging
                   (PET).
    760    78608  Brain imaging (PET).....
    760    78609  Brain imaging (PET).....
    760    78810  Tumor imaging (PET).....
    760    G0030  PET imaging prev PET
                   single.
    760    G0031  PET imaging prev PET
                   multple.
    760    G0032  PET follow SPECT 78464
                   singl.
    760    G0033  PET follow SPECT 78464
                   mult.
    760    G0034  PET follow SPECT 76865
                   singl.
    760    G0035  PET follow SPECT 78465
                   mult.
    760    G0036  PET follow cornry angio
                   sing.
    760    G0037  PET follow cornry angio
                   mult.
    760    G0038  PET follow myocard perf
                   sing.
    760    G0039  PET follow myocard perf
                   mult.
    760    G0040  PET follow stress echo
                   singl.
    760    G0041  PET follow stress echo
                   mult.
    760    G0042  PET follow ventriculogm
                   sing.
    760    G0043  PET follow ventriculogm
                   mult.
    760    G0044  PET following rest ECG
                   singl.
    760    G0045  PET following rest ECG
                   mult.
    760    G0046  PET follow stress ECG
                   singl.
    760    G0047  PET follow stress ECG
                   mult.
    761  STANDARD NON-IMAGING NUCLEAR       S                         1.80      $92.56       $54.01       $18.51
         MEDICINE
    761    78000  Thyroid, single uptake..
    761    78099  Endocrine nuclear
                   procedure.
    761    78110  Plasma volume, single...
    761    78111  Plasma volume, multiple.
    761    78120  Red cell mass, single...
    761    78199  Blood/lymph nuclear exam
    761    78270  Vit B-12 absorption exam
    761    78271  Vit B-12 absorp exam, IF
    761    78272  Vit B-12 absorp,
                   combined.
    761    78282  GI protein loss exam....
    761    78299  GI nuclear procedure....
    761    78725  Kidney function study...
    761    78999  Nuclear diagnostic exam.
    762  COMPLEX NON-IMAGING NUCLEAR        S                         2.02     $103.87       $55.82       $20.77
         MEDICINE
    762    78001  Thyroid, multiple
                   uptakes.
    762    78003  Thyroid suppress/stimul.
    762    78121  Red cell mass, multiple.
    762    78122  Blood volume............
    762    78130  Red cell survival study.
    762    78135  Red cell survival
                   kinetics.
    762    78140  Red cell sequestration..
    762    78160  Plasma iron turnover....
    762    78162  Iron absorption exam....
    762    78170  Red cell iron
                   utilization.
    762    78172  Total body iron
                   estimation.
    762    78190  Platelet survival,
                   kinetics.
    762    78191  Platelet survival.......
    762    78414  Non-imaging heart
                   function.
    762    78455  Venous thrombosis study.
    762    78499  Cardiovascular nuclear
                   exam.
    771  STANDARD PLANAR NUCLEAR MEDICINE   S                         3.81     $195.91      $117.29       $39.18
    771    78006  Thyroid,imaging with
                   uptake.
    771    78010  Thyroid imaging.........
    771    78011  Thyroid imaging with
                   flow.
    771    78015  Thyroid met imaging.....
    771    78102  Bone marrow imaging, ltd
    771    78103  Bone marrow imaging,
                   mult.
    771    78104  Bone marrow imaging,
                   body.
    771    78185  Spleen imaging..........
    771    78201  Liver imaging...........
    771    78202  Liver imaging with flow.
    771    78215  Liver and spleen imaging
    771    78216  Liver & spleen image,
                   flow.
    771    78230  Salivary gland imaging..
    771    78231  Serial salivary imaging.
    771    78261  Gastric mucosa imaging..
    771    78290  Meckels divert exam.....
    771    78300  Bone imaging, limited
                   area.

[[Page 35465]]

 
    771    78305  Bone imaging, multiple
                   areas.
    771    78306  Bone imaging, whole body
    771    78399  Musculoskeletal nuclear
                   exam.
    771    78428  Cardiac shunt imaging...
    771    78445  Vascular flow imaging...
    771    78457  Venous thrombosis
                   imaging.
    771    78458  Ven thrombosis images,
                   bilat.
    771    78460  Heart muscle blood
                   single.
    771    78466  Heart infarct image.....
    771    78478  Heart wall motion add-on
    771    78480  Heart function add-on...
    771    78481  Heart first pass single.
    771    78580  Lung perfusion imaging..
    771    78586  Aerosol lung image,
                   single.
    771    78587  Aerosol lung image,
                   multiple.
    771    78591  Vent image, 1 breath, 1
                   proj.
    771    78593  Vent image, 1 proj, gas.
    771    78599  Respiratory nuclear exam
    771    78600  Brain imaging, ltd
                   static.
    771    78601  Brain ltd imaging & flow
    771    78605  Brain imaging, complete.
    771    78610  Brain flow imaging only.
    771    78660  Nuclear exam of tear
                   flow.
    771    78699  Nervous system nuclear
                   exam.
    771    78700  Kidney imaging, static..
    771    78701  Kidney imaging with flow
    771    78704  Imaging renogram........
    771    78707  Kidney flow & function
                   image.
    771    78715  Renal vascular flow exam
    771    78730  Urinary bladder
                   retention.
    771    78760  Testicular imaging......
    771    78761  Testicular imaging &
                   flow.
    771    78799  Genitourinary nuclear
                   exam.
    772  COMPLEX PLANAR NUCLEAR MEDICINE    S                         4.26     $219.05      $128.37       $43.81
    772    78007  Thyroid, image, mult
                   uptakes.
    772    78016  Thyroid met imaging/
                   studies.
\2\ 772    78017  Thyroid met imaging,
                   mult.
    772    78018  Thyroid, met imaging,
                   body.
    772    78070  Parathyroid nuclear
                   imaging.
    772    78075  Adrenal nuclear imaging.
    772    78195  Lymph system imaging....
    772    78220  Liver function study....
    772    78223  Hepatobiliary imaging...
    772    78232  Salivary gland function
                   exam.
    772    78258  Esophageal motility
                   study.
    772    78262  Gastroesophageal reflux
                   exam.
    772    78264  Gastric emptying study..
    772    78278  Acute GI blood loss
                   imaging.
    772    78291  Leveen/shunt patency
                   exam.
    772    78315  Bone imaging, 3 phase...
    772    78461  Heart muscle blood
                   multiple.
    772    78468  Heart infarct image, EF.
    772    78472  Gated heart, planar
                   single.
    772    78473  Gated heart, multiple...
    772    78483  Heart first pass
                   multiple.
    772    78584  Lung V/Q image single
                   breath.
    772    78585  Lung V/Q imaging........
    772    78594  Vent image, mult proj,
                   gas.
    772    78596  Lung differential
                   function.
    772    78606  Brain imaging comp &
                   flow.
    772    78615  Cerebral blood flow
                   imaging.
    772    78630  Cerebrospinal fluid scan
    772    78635  CSF ventriculography....
    772    78645  CSF shunt evaluation....
    772    78650  CSF leakage imaging.....
    772    78708  Kidney flow & function
                   image.
    772    78709  Kidney flow & function
                   image.
    772    78740  Ureteral reflux study...
    772    78800  Tumor imaging, limited
                   area.
    772    78801  Tumor imaging, mult
                   areas.
    772    78802  Tumor imaging, whole
                   body.
    772    78805  Abscess imaging, ltd
                   area.
    772    78806  Abscess imaging, whole
                   body.
    781  STANDARD SPECT NUCLEAR MEDICINE    S                         5.43     $279.21      $155.04       $55.84
    781    78205  Liver imaging (3D)......

[[Page 35466]]

 
    781    78320  Bone imaging (3D).......
    781    78464  Heart image (3D) single.
    781    78469  Heart infarct image (3D)
    781    78607  Brain imaging (3D)......
    781    78647  Cerebrospinal fluid scan
    781    78710  Kidney imaging (3D).....
    782  COMPLEX SPECT NUCLEAR MEDICINE     S                         9.00     $462.78      $267.13       $92.56
    782    78465  Heart image (3D)
                   multiple.
    782    78803  Tumor imaging (3D)......
    782    78807  Nuclear localization/
                   abscess.
    791  STANDARD THERAPEUTIC NUCLEAR       S                        14.74     $757.93      $539.91      $151.59
         MEDICINE
    791    79001  Repeat hyperthyroid
                   therapy.
    791    79100  Hematopoetic nuclear
                   therapy.
    791    79300  Interstitial nuclear
                   therapy.
    791    79400  Nonhemato nuclear
                   therapy.
    791    79420  Intravascular nuc
                   therapy.
    791    79440  Nuclear joint therapy...
    791    79999  Nuclear medicine therapy
    792  COMPLEX THERAPEUTIC NUCLEAR        S                         4.81     $247.33      $143.06       $49.47
         MEDICINE
    792    79000  Intial hyperthyroid
                   therapy.
    792    79020  Thyroid ablation........
    792    79030  Thyroid ablation,
                   carcinoma.
    792    79035  Thyroid metastatic
                   therapy.
    792    79200  Intracavitary nuc
                   treatment.
    861  IMMUNOLOGY TESTS                   X                         0.13       $6.68        $3.62        $1.34
    861    86485  Skin test, candida......
    861    86490  Coccidioidomycosis skin
                   test.
    861    86510  Histoplasmosis skin test
    861    86580  TB intradermal test.....
    861    86585  TB tine test............
    861    86586  Skin test, unlisted.....
    881  LEVEL I PATHOLOGY                  X                         0.22      $11.31        $6.78        $2.26
    881    88125  Forensic cytopathology..
    881    88199  Cytopathology procedure.
    881    88300  Surg path, gross........
    881    88311  Decalcify tissue........
    881    88313  Special stains..........
    881    88399  Surgical pathology
                   procedure.
    881    89350  Sputum specimen
                   collection.
    881    89360  Collect sweat for test..
    881    89399  Pathology lab procedure.
    881    G0025  Collagen skin test kit..
    882  LEVEL II PATHOLOGY                 X                         0.39      $20.05       $11.75        $4.01
    882    80500  Lab pathology
                   consultation.
    882    80502  Lab pathology
                   consultation.
    882    85060  Blood smear
                   interpretation.
    882    85097  Bone marrow
                   interpretation.
    882    86077  Physician blood bank
                   service.
    882    86078  Physician blood bank
                   service.
    882    86079  Physician blood bank
                   service.
    882    88104  Cytopathology, fluids...
    882    88106  Cytopathology, fluids...
    882    88107  Cytopathology, fluids...
    882    88108  Cytopath, concentrate
                   tech.
    882    88160  Cytopath smear, other
                   source.
    882    88161  Cytopath smear, other
                   source.
    882    88162  Cytopath smear, other
                   source.
    882    88172  Evaluation of smear.....
    882    88173  Interpretation of smear.
    882    88180  Cell marker study.......
    882    88182  Cell marker study.......
    882    88302  Tissue exam by
                   pathologist.
    882    88304  Tissue exam by
                   pathologist.
    882    88305  Tissue exam by
                   pathologist.
    882    88312  Special stains..........
    882    88314  Histochemical stain.....
    882    88318  Chemical histochemistry.
    882    88319  Enzyme histochemistry...
    882    88321  Microslide consultation.
    882    88323  Microslide consultation.
    882    88325  Comprehensive review of
                   data.
    882    88329  Pathology consult in
                   surgery.
    882    88331  Pathology consult in
                   surgery.
    882    88332  Pathology consult in
                   surgery.
    882    88342  Immunocytochemistry.....

[[Page 35467]]

 
    882    88346  Immunofluorescent study.
    882    88347  Immunofluorescent study.
    883  LEVEL III PATHOLOGY                X                         0.69      $35.48       $20.34        $7.10
    883    88307  Tissue exam by
                   pathologist.
    883    88309  Tissue exam by
                   pathologist.
    883    88348  Electron microscopy.....
    883    88349  Scanning electron
                   microscopy.
    883    88355  Analysis, skeletal
                   muscle.
    883    88356  Analysis, nerve.........
    883    88358  Analysis, tumor.........
    883    88362  Nerve teasing
                   preparations.
    883    88365  Tissue hybridization....
    900  CRITICAL CARE                      S                         7.54     $387.71      $145.09       $77.54
    900    99291  Critical care, first
                   hour.
    901  LEVEL I IMMUNIZATION               X                         0.07       $3.60        $2.49        $0.72
    901    90700  Dtap vaccine, im........
    901    90701  Dtp vaccine, im.........
    901    90702  Dt vaccine, im..........
    901    90703  Tetanus vaccine, im.....
    901    90704  Mumps vaccine, sc.......
    901    90705  Measles vaccine, sc.....
    901    90706  Rubella vaccine, sc.....
    901    90708  Measles-rubella vaccine
                   sc.
    901    90709  Rubella & mumps vaccine
                   sc.
    901    90710  Mmrv vaccine, sc........
\2\ 901    90711  Combined vaccine........
\2\ 901    90714  Typhoid immunization....
    901    90718  Td vaccine, im..........
    901    90719  Diphtheria vaccine, im..
\2\ 901    90724  Influenza immunization..
    901    90725  Cholera vaccine,
                   injectable.
\2\ 901    90730  Hepatitis A vaccine.....
    901    90732  Pneumococcal vaccine,
                   adult.
    901    90748  Hepb/hib vaccine, im....
    901    90749  Vaccine toxoid..........
    901    95149  Antigen therapy services
    901    95170  Antigen therapy services
    901    G0008  Admin influenza virus
                   vac.
    901    G0009  Admin pneumococcal
                   vaccine.
    901    Q0034  Admin of influenza
                   vaccine.
    902  LEVEL II IMMUNIZATION              X                         1.31      $67.36       $38.19       $13.47
    902    90707  Mmr vaccine, sc.........
    902    90712  Oral poliovirus vaccine.
    902    90713  Poliovirus, ipv, sc.....
    902    90716  Chicken pox vaccine, sc.
    902    90717  Yellow fever vaccine, sc
    902    90720  Dtp/hib vaccine, im.....
    902    90733  Meningococcal vaccine,
                   sc.
\2\ 902    90737  Influenza B immunization
\2\ 902    90741  Passive immunization,
                   ISG.
    902    90744  Hepb vaccine, ped/adol,
                   im.
    902    90745  Hepb vaccine, adol/risk,
                   im.
    902    90746  Hepb vaccine, adult, im.
    902    90747  Hepb vaccine, ill pat,
                   im.
    902    G0010  Admin hepatitis b
                   vaccine.
    903  LEVEL III IMMUNIZATION             X                         1.00      $51.42       $24.86       $10.28
    903    90721  Dtap/hib vaccine, im....
\2\ 903    90726  Rabies immunization.....
    903    90727  Plague vaccine, im......
\2\ 903    90728  BCG immunization........
    903    90735  Encephalitis vaccine, sc
\2\ 903    90742  Special passive
                   immunization.
    906  INFUSION THERAPY EXCEPT            X                         1.93      $99.24       $57.18       $19.85
         CHEMOTHERAPY
    906    36680  Insert needle, bone
                   cavity.
    906    90780  IV infusion therapy, 1
                   hour.
    906    90781  IV infusion, additional
                   hour.
    906    Q0081  Infusion ther other than
                   che.
    907  INTRAMUSCULAR INJECTIONS           X                         0.74      $38.05       $11.53        $7.61
    907    90782  Injection (SC)/(IM).....
    907    90783  Injection (IA)..........
    907    90784  Injection (IV)..........
    907    90788  Injection of antibiotic.
    907    90799  Therapeutic/diag
                   injection.
    919  ELECTROCONVULSIVE THERAPY          S                         3.09     $158.89       $80.00       $31.78
    919    90870  Electroconvulsive
                   therapy.

[[Page 35468]]

 
    919    90871  Electroconvulsive
                   therapy.
    920  BIOFEEDBACK AND OTHER TRAINING     S                         1.17      $60.16       $29.61       $12.03
\2\ 920    90900  Biofeedback,
                   electromyogram.
    920    90901  Biofeedback, any method.
\2\ 920    90902  Biofeedback, nerve
                   impulse.
\2\ 920    90904  Biofeedback, blood
                   pressure.
\2\ 920    90906  Biofeedback, blood flow.
\2\ 920    90908  Biofeedback, brain waves
\2\ 920    90910  Biofeedback, oculogram..
    920    90911  Biofeedback peri/uro/
                   rectal.
\2\ 920    90915  Biofeedback, unspecified
    921  DIABETES EDUCATION                 S
    921    99078  Group health education..
    926  DIALYSIS FOR OTHER THAN ESRD       S                         4.22     $216.99       $69.83       $43.40
         PATIENTS
    926    90935  Hemodialysis, one
                   evaluation.
    926    90937  Hemodialysis, repeated
                   eval..
    926    90945  Dialysis, one evaluation
    926    90947  Dialysis, repeated eval.
    926    90997  Hemoperfusion...........
    926    90999  Dialysis procedure......
    928  ALIMENTARY TESTS                   X                         2.91     $149.63       $79.78       $29.93
    928    89100  Sample intestinal
                   contents.
    928    89105  Sample intestinal
                   contents.
    928    89130  Sample stomach contents.
    928    89132  Sample stomach contents.
    928    89135  Sample stomach contents.
    928    89136  Sample stomach contents.
    928    89140  Sample stomach contents.
    928    89141  Sample stomach contents.
    928    91000  Esophageal intubation...
    928    91010  Esophagus motility study
    928    91011  Esophagus motility study
    928    91012  Esophagus motility study
    928    91020  Gastric motility........
    928    91030  Acid perfusion of
                   esophagus.
    928    91032  Esophagus, acid reflux
                   test.
    928    91033  Prolonged acid reflux
                   test.
    928    91052  Gastric analysis test...
    928    91055  Gastric intubation for
                   smear.
    928    91060  Gastric saline load test
    928    91065  Breath hydrogen test....
    928    91100  Pass intestine bleeding
                   tube.
    928    91105  Gastric intubation
                   treatment.
    928    91299  Gastroenterology
                   procedure.
    928    95075  Ingestion challenge test
    930  MINOR EYE EXAMINATIONS             X                         1.04      $53.48       $22.83       $10.70
    930    92060  Special eye evaluation..
    930    92065  Orthoptic/pleoptic
                   training.
    930    92081  Visual field
                   examination(s).
    930    92082  Visual field
                   examination(s).
    930    92083  Visual field
                   examination(s).
    930    92140  Glaucoma provocative
                   tests.
    930    92283  Color vision examination
    930    92284  Dark adaptation eye exam
    930    92285  Eye photography.........
    931  LEVEL I EYE TESTS                  X                         0.74      $38.05       $21.47        $7.61
    931    92120  Tonography & eye
                   evaluation.
    931    92130  Water provocation
                   tonography.
    931    92230  Eye exam with photos....
    931    92240  Icg angiography.........
    931    92250  Eye exam with photos....
    931    92499  Eye service or procedure
    932  LEVEL II EYE TESTS                 X                         2.41     $123.92       $63.73       $24.78
    932    92235  Eye exam with photos....
    932    92265  Eye muscle evaluation...
    932    92270  Electro-oculography.....
    932    92286  Internal eye photography
    932    92287  Internal eye photography
    936  FITTING OF VISION AIDS             X                         0.48      $24.68        $9.49        $4.94
    936    92311  Contact lens fitting....
    936    92312  Contact lens fitting....
    936    92313  Contact lens fitting....
    936    92315  Prescription of contact
                   lens.
    936    92316  Prescription of contact
                   lens.
    936    92317  Prescription of contact
                   lens.

[[Page 35469]]

 
    936    92325  Modification of contact
                   lens.
    936    92326  Replacement of contact
                   lens.
    936    92330  Fitting of artificial
                   eye.
    936    92352  Special spectacles
                   fitting.
    936    92353  Special spectacles
                   fitting.
    936    92354  Special spectacles
                   fitting.
    936    92355  Special spectacles
                   fitting.
    936    92358  Eye prosthesis service..
    936    92371  Repair & adjust
                   spectacles.
    940  OTORHINOLARYNGOLOGIC FUNCTION      X                         3.13     $160.94       $52.21       $32.19
         TESTS
    940    92512  Nasal function studies..
    940    92516  Facial nerve function
                   test.
    940    92520  Laryngeal function
                   studies.
    940    92541  Spontaneous nystagmus
                   test.
    940    92542  Positional nystagmus
                   test.
    940    92543  Caloric vestibular test.
    940    92544  Optokinetic nystagmus
                   test.
    940    92545  Oscillating tracking
                   test.
    940    92546  Sinusoidal rotational
                   test.
    940    92547  Supplemental electrical
                   test.
    940    92548  Posturography...........
    940    92584  Electrocochleography....
    940    92587  Evoked auditory test....
    940    92588  Evoked auditory test....
    941  LEVEL I AUDIOMETRY                 X                         0.74      $38.05       $13.33        $7.61
    941    92552  Pure tone audiometry,
                   air.
    941    92553  Audiometry, air & bone..
    941    92555  Speech threshold
                   audiometry.
    941    92556  Speech audiometry,
                   complete.
    941    92567  Tympanometry............
    941    92599  ENT procedure/service...
    942  LEVEL II AUDIOMETRY                X                         1.46      $75.07       $22.15       $15.01
    942    92557  Comprehensive hearing
                   test.
    942    92561  Bekesy audiometry,
                   diagnosis.
    942    92562  Loudness balance test...
    942    92563  Tone decay hearing test.
    942    92564  Sisi hearing test.......
    942    92565  Stenger test, pure tone.
    942    92568  Acoustic reflex testing.
    942    92569  Acoustic reflex decay
                   test.
    942    92571  Filtered speech hearing
                   test.
    942    92572  Staggered spondaic word
                   test.
    942    92573  Lombard test............
    942    92575  Sensorineural acuity
                   test.
    942    92576  Synthetic sentence test.
    942    92577  Stenger test, speech....
    942    92579  Visual audiometry (vra).
    942    92582  Conditioning play
                   audiometry.
    942    92583  Select picture
                   audiometry.
    942    92589  Auditory function
                   test(s).
    942    92596  Ear protector evaluation
    947  RESUSCITATION AND CARDIOVERSION    S                         4.11     $211.34      $106.22       $42.27
    947    31500  Insert emergency airway.
    947    92950  Heart/lung
                   resuscitation(CPR.
    947    92953  Temporary external
                   pacing.
    947    92960  Heart electroconversion.
    947    99440  Newborn resuscitation...
    948  CARDIAC REHABILITATION             X                         0.81      $41.65       $16.95        $8.33
    948    93797  Cardiac rehab...........
    948    93798  Cardiac rehab/monitor...
    949  CARDIOVASCULAR STRESS TEST         X                         1.43      $73.53       $61.92       $14.71
    949    93017  Cardiovascular stress
                   test.
    949    93024  Cardiac drug stress test
    950  ELECTROCARDIOGRAM (ECG)            X                         0.35      $18.00       $15.82        $3.60
    950    93005  Electrocardiogram,
                   tracing.
    950    93041  Rhythm ECG, tracing.....
    950    Q0035  Cardiokymography........
    956  CONTINUOUS ECG AND BLOOD PRESSURE  X                         1.09      $56.05       $54.47       $11.21
         MONITORING
    956    93012  Transmission of ecg.....
    956    93224  ECG monitor/report, 24
                   hrs.
    956    93225  ECG monitor/record, 24
                   hrs.
    956    93226  ECG monitor/report, 24
                   hrs.
    956    93230  ECG monitor/report, 24
                   hrs.
    956    93231  ECG monitor/record, 24
                   hrs.
    956    93232  ECG monitor/report, 24
                   hrs.

[[Page 35470]]

 
    956    93235  ECG monitor/report, 24
                   hrs.
    956    93236  ECG monitor/report, 24
                   hrs.
    956    93268  ECG record/review.......
    956    93270  ECG recording...........
    956    93271  ECG/monitoring and
                   anaylysis.
    956    93278  ECG/signal-averaged.....
    956    G0004  ECG transm phys review &
                   int.
    956    G0005  ECG 24 hour recording...
    956    G0006  ECG transmission &
                   analysis.
    956    G0015  Post symptom ECG tracing
    957  ECHOCARDIOGRAPHY                   S                         4.04     $207.74      $114.13       $41.55
    957    76825  Echo exam of fetal heart
    957    76826  Echo exam of fetal heart
    957    76827  Echo exam of fetal heart
    957    76828  Echo exam of fetal heart
    957    93303  Echo transthoracic......
    957    93304  Echo transthoracic......
    957    93307  Echo exam of heart......
    957    93308  Echo exam of heart......
    957    93312  Echo transesophageal....
    957    93313  Echo transesophageal....
    957    93315  Echo transesophageal....
    957    93316  Echo transesophageal....
    957    93320  Doppler echo exam, heart
    957    93321  Doppler echo exam, heart
    957    93325  Doppler color flow add-
                   on.
    957    93350  Echo transthoracic......
    958  DIAGNOSTIC CARDIAC                 S                        23.74   $1,220.71      $705.57      $244.14
         CATHETERIZATION
    958    93501  Right heart
                   catheterization.
    958    93503  Insert/place heart
                   catheter.
    958    93505  Biopsy of heart lining..
    958    93510  Left heart
                   catheterization.
    958    93511  Left heart
                   catheterization.
    958    93514  Left heart
                   catheterization.
    958    93524  Left heart
                   catheterization.
    958    93526  Rt & Lt heart catheters.
    958    93527  Rt & Lt heart catheters.
    958    93528  Rt & Lt heart catheters.
    958    93529  Rt, Lt heart
                   catheterization.
    958    93530  Rt heart cath,
                   congenital.
    958    93531  R & l heart cath,
                   congenital.
    958    93532  R & l heart cath,
                   congenital.
    958    93533  R & l heart cath,
                   congenital.
    958    93536  Insert circulation assi.
    960  CARDIAC ELECTROPHYSIOLOGIC TESTS/  S                         4.80     $246.82      $143.74       $49.36
         PROCEDURES
    960    93600  Bundle of His recording.
    960    93602  Intra-atrial recording..
    960    93603  Right ventricular
                   recording.
    960    93607  Right ventricular
                   recording.
    960    93609  Mapping of tachycardia..
    960    93610  Intra-atrial pacing.....
    960    93612  Intraventricular pacing.
    960    93615  Esophageal recording....
    960    93616  Esophageal recording....
    960    93618  Heart rhythm pacing.....
    960    93619  Electrophysiology
                   evaluation.
    960    93620  Electrophysiology
                   evaluation.
    960    93621  Electrophysiology
                   evaluation.
    960    93622  Electrophysiology
                   evaluation.
    960    93623  Stimulation, pacing
                   heart.
    960    93624  Electrophysiologic study
    960    93631  Heart pacing, mapping...
    960    93640  Evaluation heart device.
    960    93641  Electrophysiology
                   evaluation.
    960    93642  Electrophysiology
                   evaluation.
    960    93650  Ablate heart dysrhythm
                   focus.
    960    93651  Ablate heart dysrhythm
                   focus.
    960    93652  Ablate heart dysrhythm
                   focus.
    960    93660  Tilt table evaluation...
    960    93724  Analyze pacemaker system
    966  ELECTRONIC ANALYSIS OF PACEMAKERS/ X                         0.39      $20.05       $12.43        $4.01
         OTHER DEVICES
    966    62367  Analyze spine infusion
                   pump.
    966    62368  Analyze spine infusion
                   pump.
\2\ 966    63690  Analysis of
                   neuroreceiver.
\2\ 966    63691  Analysis of
                   neuroreceiver.

[[Page 35471]]

 
    966    93731  Analyze pacemaker system
    966    93732  Analyze pacemaker system
    966    93733  Telephone analysis,
                   pacemaker.
    966    93734  Analyze pacemaker system
    966    93735  Analyze pacemaker system
    966    93736  Telephone analysis,
                   pacemaker.
    966    93737  Analyze cardio/
                   defibrillator.
    966    93738  Analyze cardio/
                   defibrillator.
    967  NON-INVASIVE VASCULAR STUDIES      X                         1.70      $87.41       $57.40       $17.48
    967    93720  Total body
                   plethysmography.
    967    93721  Plethysmography tracing.
    967    93740  Temperature gradient
                   studies.
    967    93799  Cardiovascular procedure
    967    93922  Extremity study.........
    967    93923  Extremity study.........
    967    93924  Extremity study.........
    967    93965  Extremity study.........
    968  VASCULAR ULTRASOUND                X                         2.39     $122.89       $79.55       $24.58
    968    93875  Extracranial study......
    968    93880  Extracranial study......
    968    93882  Extracranial study......
    968    93886  Intracranial study......
    968    93888  Intracranial study......
    968    93925  Lower extremity study...
    968    93926  Lower extremity study...
    968    93930  Upper extremity study...
    968    93931  Upper extremity study...
    968    93970  Extremity study.........
    968    93971  Extremity study.........
    968    93975  Vascular study..........
    968    93976  Vascular study..........
    968    93978  Vascular study..........
    968    93979  Vascular study..........
    968    93980  Penile vascular study...
    968    93981  Penile vascular study...
    968    93990  Doppler flow testing....
    969  HYPERBARIC OXYGEN                  S                         2.65     $136.26      $141.70       $27.25
    969    99183  Hyperbaric oxygen
                   therapy.
    971  LEVEL I PULMONARY TESTS            X                         0.98      $50.39       $26.44       $10.08
    971    94010  Breathing capacity test.
    971    94060  Evaluation of wheezing..
\2\ 971    94160  Vital capacity screening
    971    94200  Lung function test (MBC/
                   MVV).
    971    94250  Expired gas collection..
    971    94260  Thoracic gas volume.....
    971    94360  Measure airflow
                   resistance.
    971    94375  Respiratory flow volume
                   loop.
    971    94400  CO2 breathing response
                   curve.
    971    94450  Hypoxia response curve..
    971    94762  Measure blood oxygen
                   level.
    971    94770  Exhaled carbon dioxide
                   test.
    971    94799  Pulmonary service/
                   procedure.
    972  LEVEL II PULMONARY TESTS           X                         1.00      $51.42       $29.38       $10.28
    972    94240  Residual lung capacity..
    972    94350  Lung nitrogen washout
                   curve.
    972    94370  Breath airway closing
                   volume.
    972    94680  Exhaled air analysis: O2
    972    94681  Exhaled air analysis:
                   O2,CO2.
    972    94690  Exhaled air analysis....
    972    94720  Monoxide diffusing
                   capacity.
    972    94725  Membrane diffusion
                   capacity.
    973  LEVEL III PULMONARY TESTS          S                         1.81      $93.07       $55.82       $18.61
    973    94070  Evaluation of wheezing..
    973    94620  Pulmonary stress test/
                   simple.
    973    94750  Pulmonary compliance
                   study.
    973    94772  Breath recording, infant
    973    95070  Bronchial allergy tests.
    973    95071  Bronchial allergy tests.
    976  PULMONARY THERAPY                  S                         0.44      $22.62       $14.69        $4.53
    976    94640  Airway inhalation
                   treatment.
    976    94642  Aerosol inhalation
                   treatment.
    976    94650  Pressure breathing
                   (IPPB).
    976    94651  Pressure breathing
                   (IPPB).
    976    94657  Cont. ventilator........
    976    94660  Pos airway pressure,
                   CPAP.

[[Page 35472]]

 
    976    94662  Neg pressure
                   ventilation, cnp.
    976    94664  Aerosol or vapor
                   inhalations.
    976    94665  Aerosol or vapor
                   inhalations.
    976    94667  Chest wall manipulation.
    976    94668  Chest wall manipulation.
    977  ALLERGY TESTS                      X                         0.56      $28.80       $11.30        $5.76
    977    95004  Allergy skin tests......
    977    95010  Sensitivity skin tests..
    977    95015  Sensitivity skin tests..
    977    95024  Allergy skin tests......
    977    95027  Skin end point titration
    977    95028  Allergy skin tests......
    977    95044  Allergy patch tests.....
    977    95052  Photo patch test........
    977    95056  Photosensitivity tests..
    977    95060  Eye allergy tests.......
    977    95065  Nose allergy test.......
    977    95078  Provocative testing.....
    977    95180  Rapid desensitization...
    977    95199  Allergy immunology
                   services.
    978  ALLERGY INJECTIONS                 X                         0.30      $15.43        $3.39        $3.09
    978    95115  Immunotherapy, one
                   injection.
    978    95117  Immunotherapy injections
    978    95144  Antigen therapy services
    978    95145  Antigen therapy services
    978    95146  Antigen therapy services
    978    95147  Antigen therapy services
    978    95148  Antigen therapy services
    978    95165  Antigen therapy services
    979  EXTENDED EEG STUDIES AND SLEEP     S                        10.15     $521.91      $287.25      $104.38
         STUDIES
    979    95805  Multiple sleep latency
                   test.
    979    95806  Sleep study, unattended.
    979    95807  Sleep study, attended...
    979    95808  Polysomnography, 1-3....
    979    95810  Polysomnography, 4 or
                   more.
    979    95811  Polysomnography w/cpap..
    979    95812  Electroencephalogram
                   (EEG).
    979    95813  Electroencephalogram
                   (EEG).
    979    95827  Night
                   electroencephalogram.
    979    95951  EEG monitoring/
                   videorecord.
    979    95953  EEG monitoring/computer.
    979    95954  EEG monitoring/giving
                   drugs.
    979    95958  EEG monitoring/function
                   test.
    980  ELECTROENCEPHALOGRAM               S                         2.15     $110.55       $57.86       $22.11
    980    95816  Electroencephalogram
                   (EEG).
    980    95819  Electroencephalogram
                   (EEG).
    980    95822  Sleep
                   electroencephalogram.
    980    95824  Electroencephalography..
    980    95829  Surgery
                   electrocorticogram.
    980    95955  EEG during surgery......
    981  LEVEL I NERVE AND MUSCLE TESTS     X                         1.22      $62.73       $34.35       $12.55
    981    92275  Electroretinography.....
    981    95857  Tensilon test...........
    981    95867  Muscle test, head or
                   neck.
    981    95869  Muscle test, thor
                   paraspinal.
    981    95870  Muscle test, non-
                   paraspinal.
    981    95900  Motor nerve conduction
                   test.
    981    95921  Autonomic nervous func
                   test.
    981    95922  Autonomic nervous func
                   test.
    981    95923  Autonomic nervous func
                   test.
    981    95926  Somatosensory testing...
    981    95927  Somatosensory testing...
    981    95930  Visual evoked potential
                   test.
    981    95933  Blink reflex test.......
    981    95934  `h' reflex test.........
    981    95936  `h' reflex test.........
    981    95937  Neuromuscular junction
                   test.
    981    95950  Ambulatory eeg
                   monitoring.
    982  LEVEL II NERVE AND MUSCLE TESTS    X                         1.37      $70.45       $38.42       $14.09
    982    92585  Auditory evoked
                   potential.
    982    95858  Tensilon test & myogram.
    982    95860  Muscle test, one limb...
    982    95861  Muscle test, two limbs..
    982    95863  Muscle test, 3 limbs....
    982    95864  Muscle test, 4 limbs....

[[Page 35473]]

 
    982    95868  Muscle test, head or
                   neck.
    982    95872  Muscle test, one fiber..
    982    95875  Limb exercise test......
    982    95903  Motor nerve conduction
                   test.
    982    95904  Sense nerve conduction
                   test.
    982    95925  Somatosensory testing...
    987  SUBCUTANEOUS OR INTRAMUSCULAR      S                         2.09     $107.47       $65.09       $21.49
         CHEMOTHERAPY
    987    96400  Chemotherapy, (SC)/(IM).
    987    96405  Intralesional chemo
                   admin.
    987    96406  Intralesional chemo
                   admin.
    987    96549  Chemotherapy,
                   unspecified.
    987    Q0083  Chemo by other than
                   infusion.
    988  CHEMOTHERAPY EXCEPT BY EXTENDED    S                         4.02     $206.71      $110.29       $41.34
         INFUSION
    988    96408  Chemotherapy, push
                   technique.
    988    96410  Chemotherapy, infusion
                   method.
    988    96412  Chemotx infuse method
                   add-on.
    988    96420  Chemotherapy, push
                   technique.
    988    96422  Chemotherapy, infusion
                   method.
    988    96423  Chemotx infuse method
                   add-on.
    989  CHEMOTHERAPY BY EXTENDED INFUSION  S                         1.91      $98.21       $44.52       $19.64
    989    96414  Chemotx infuse method
                   add-on.
    989    96425  Chemotherapy, infusion
                   method.
    989    96440  Chemotherapy,
                   intracavitary.
    989    96445  Chemotherapy,
                   intracavitary.
    989    96450  Chemotherapy, into CNS..
    989    96542  Chemotherapy injection..
    989    Q0084  Chemotherapy by infusion
    989    Q0085  Chemo by both infusion
                   and o.
    990  PHOTOCHEMOTHERAPY                  S                         0.43      $22.11        $8.14        $4.42
    990    96900  Ultraviolet light
                   therapy.
    990    96910  Photochemotherapy with
                   UV-B.
    990    96912  Photochemotherapy with
                   UV-A.
    990    96913  Photochemotherapy, UV-A
                   or B.
    990    96999  Dermatological procedure
    997  MANIPULATION THERAPY               S                         0.69      $35.48        $7.46        $7.10
\2\ 997    97250  Myofascial release......
\2\ 997    97260  Regional manipulation...
\2\ 997    97261  Supplemental
                   manipulations.
    997    98925  Osteopathic manipulation
    997    98926  Osteopathic manipulation
    997    98927  Osteopathic manipulation
    997    98928  Osteopathic manipulation
    997    98929  Osteopathic manipulation
    997    98940  Chiropractic
                   manipulation.
    997    98941  Chiropractic
                   manipulation.
    997    98942  Chiropractic
                   manipulation.
    999  THERAPEUTIC PHLEBOTOMY             X                         0.43      $22.11       $11.07        $4.42
    999    99195  Phlebotomy..............
----------------------------------------------------------------------------------------------------------------
\1\ This APC assignment will not apply to services furnished under a partial hospitalization program. Instead,
  services furnished as part of a partial hospitalization program are paid on a per-diem basis via APC 020.
\2\ This code was valid in 1996 and therefore was available for use in calculating weights. However, it has
  since been terminated and will not be paid upon implementation.
CPT codes and descriptions only are copyright 1997 American Medical Association. All rights reserved. Applicable
  FARS/DFARS apply.
Copyright 1994 American Dental Association. All rights reserved.

          

  

  

    49. On page 47834, Addendum D is corrected to read as follows:
    

[[Page 35473]]


                                      Addendum D.--Summary of Medical APCs
----------------------------------------------------------------------------------------------------------------
                                  APC                                     Code             Description
----------------------------------------------------------------------------------------------------------------
911  Low Level Clinic Visits
                                                                          99201  Office/outpatient visit, new
                                                                          99202  Office/outpatient visit, new
                                                                          99211  Office/outpatient visit, est
                                                                          99212  Office/outpatient visit, est
                                                                          99241  Office consultation
                                                                          99242  Office consultation
                                                                          99271  Confirmatory consultation
                                                                          99272  Confirmatory consultation
913  Mid Level Clinic Visits
                                                                          92002  Eye exam, new patient
                                                                          92012  Eye exam established pt
                                                                          99203  Office/outpatient visit, new

[[Page 35474]]

 
                                                                          99213  Office/outpatient visit, est
                                                                          99243  Office consultation
                                                                          99273  Confirmatory consultation
                                                                          G0101  Cancer Screening Exam, Women
915  High Level Clinic Visits
                                                                          92004  Eye exam, new patient
                                                                          92014  Eye exam & treatment
                                                                          99204  Office/outpatient visit, new
                                                                          99205  Office/outpatient visit, new
                                                                          99214  Office/outpatient visit, est
                                                                          99215  Office/outpatient visit, est
                                                                          99244  Office consultation
                                                                          99245  Office consultation
                                                                          99274  Confirmatory consultation
                                                                          99275  Confirmatory consultation
951  Low Level Emergency Visits
                                                                          99281  Emergency dept visit
                                                                          99282  Emergency dept visit
953  Mid Level Emergency Visits
                                                                          99283  Emergency dept visit
955  High Level Emergency Visits
                                                                          99284  Emergency dept visit
                                                                          99285  Emergency dept visit
----------------------------------------------------------------------------------------------------------------
Note: CPT codes and descriptions only are copyright 1997 American Medical Association. All rights reserved.
  Applicable FARS/DFARS apply.

    50. On pages 47996 through 48005, Addendum G is corrected to read 
as follows:

  
[[Page 35474]]


 Addendum G.--CPT Codes Which Would Be Paid Only as Inpatient Procedures
------------------------------------------------------------------------
 CPT\1\
HCPCS\2\     HOPD status indicator                Description
------------------------------------------------------------------------
   00174  C                            Anesth, pharyngeal surgery
   00176  C                            Anesth, pharyngeal surgery
   00192  C                            Anesth, facial bone surgery
   00214  C                            Anesth, skull drainage
   00215  C                            Anesth, skull fracture
   00404  C                            Anesth, surgery of breast
   00406  C                            Anesth, surgery of breast
   00452  C                            Anesth, surgery of shoulder
   00474  C                            Anesth, surgery of rib(s)
   00524  C                            Anesth, chest drainage
   00530  C                            Anesth, pacemaker insertion
   00540  C                            Anesth, chest surgery
   00542  C                            Anesth, release of lung
   00544  C                            Anesth, chest lining removal
   00546  C                            Anesth, lung, chest wall surg
   00560  C                            Anesth, open heart surgery
   00562  C                            Anesth, open heart surgery
   00580  C                            Anesth, heart/lung transplant
   00604  C                            Anesth, surgery of vertebra
   00622  C                            Anesth, removal of nerves
   00632  C                            Anesth, removal of nerves
   00634  C                            Anesth for chemonucleolysis
   00670  C                            Anesth, spine, cord surgery
   00792  C                            Anesth, part liver removal
   00794  C                            Anesth, pancreas removal
   00796  C                            Anesth, for liver transplant
   00802  C                            Anesth, fat layer removal
   00844  C                            Anesth, pelvis surgery
   00846  C                            Anesth, hysterectomy
   00848  C                            Anesth, pelvic organ surg
   00850  C                            Anesth, cesarean section
   00855  C                            Anesth, hysterectomy
   00857  C                            Analgesia, labor & c-section
   00864  C                            Anesth, removal of bladder
   00865  C                            Anesth, removal of prostate
   00866  C                            Anesth, removal of adrenal
   00868  C                            Anesth, kidney transplant
   00882  C                            Anesth, major vein ligation
   00884  C                            Anesth, major vein revision
   00904  C                            Anesth, perineal surgery
   00908  C                            Anesth, removal of prostate
   00928  C                            Anesth, removal of testis
   00932  C                            Anesth, amputation of penis
   00934  C                            Anesth, penis, nodes removal
   00936  C                            Anesth, penis, nodes removal
   00944  C                            Anesth, vaginal hysterectomy
   00955  C                            Analgesia, vaginal delivery
   01140  C                            Anesth, amputation at pelvis
   01150  C                            Anesth, pelvic tumor surgery
   01190  C                            Anesth, pelvis nerve removal
   01212  C                            Anesth, hip disarticulation
   01214  C                            Anesth, replacement of hip
   01232  C                            Anesth, amputation of femur
   01234  C                            Anesth, radical femur surg
   01272  C                            Anesth, femoral artery surg
   01274  C                            Anesth, femoral embolectomy
   01402  C                            Anesth, replacement of knee
   01404  C                            Anesth, amputation at knee
   01442  C                            Anesth, knee artery surg
   01444  C                            Anesth, knee artery repair
   01486  C                            Anesth, ankle replacement
   01502  C                            Anesth, lowerleg embolectomy
   01632  C                            Anesth, surgery of shoulder
   01634  C                            Anesth, shoulder joint amput
   01636  C                            Anesth, forequarter amput
   01638  C                            Anesth, shoulder replacement
   01652  C                            Anesth, shoulder vessel surg
   01654  C                            Anesth, shoulder vessel surg
   01656  C                            Anesth, arm-leg vessel surg
   01756  C                            Anesth, radical humerus surg
   01772  C                            Anesth, upperarm embolectomy
   01782  C                            Anesth, upperarm vein repair
   01842  C                            Anesth, lowerarm embolectomy
   01852  C                            Anesth, lowerarm vein repair
   01902  C                            Anesth, burr holes, skull
   01904  C                            Anesth, skull x-ray inject
   01916  C                            Anesth, head arteriogram
   01918  C                            Anesth, limb arteriogram
   01921  C                            Anesth, vessel surgery
   01990  C                            Support for organ donor
   15755  C                            Microvascular flap graft
   15756  C                            Free muscle flap, microvasc
   15757  C                            Free skin flap, microvasc
   15758  C                            Free fascial flap, microvasc
   19200  C                            Removal of breast
   19220  C                            Removal of breast
   19240  C                            Removal of breast
   19260  C                            Removal of chest wall lesion
   19271  C                            Revision of chest wall
   19272  C                            Extensive chest wall surgery
   19361  C                            Breast reconstruction
   19364  C                            Breast reconstruction
   19367  C                            Breast reconstruction
   19368  C                            Breast reconstruction
   19369  C                            Breast reconstruction
   20100  C                            Explore wound, neck
   20101  C                            Explore wound, chest
   20102  C                            Explore wound, abdomen
   20103  C                            Explore wound, extremity
   20150  C                            Excise epiphyseal bar
   20660  C                            Apply,remove fixation device
   20661  C                            Application of head brace
   20662  C                            Application of pelvis brace
   20663  C                            Application of thigh brace
   20664  C                            Halo brace application
   20802  C                            Replantation, arm, complete
   20805  C                            Replant forearm, complete
   20808  C                            Replantation, hand, complete
   20816  C                            Replantation digit, complete
   20822  C                            Replantation digit, complete
   20824  C                            Replantation thumb, complete
   20827  C                            Replantation thumb, complete
   20838  C                            Replantation, foot, complete
   20930  C                            Spinal bone allograft
   20931  C                            Spinal bone allograft
   20936  C                            Spinal bone autograft
   20937  C                            Spinal bone autograft
   20938  C                            Spinal bone autograft
   20955  C                            Fibula bone graft, microvasc
   20956  C                            Iliac bone graft, microvasc
   20957  C                            Mt bone graft, microvasc
   20960  C                            Microvascular rib graft
   20962  C                            Other bone graft, microvasc
   20969  C                            Bone/skin graft, microvasc

[[Page 35475]]

 
   20970  C                            Bone/skin graft, iliac crest
   20971  C                            Bone-skin graft, rib
   20972  C                            Bone-skin graft, metatarsal
   20973  C                            Bone-skin graft, great toe
   21045  C                            Extensive jaw surgery
   21137  C                            Reduction of forehead
   21138  C                            Reduction of forehead
   21139  C                            Reduction of forehead
   21141  C                            Reconstruct midface, lefort
   21142  C                            Reconstruct midface, lefort
   21143  C                            Reconstruct midface, lefort
   21145  C                            Reconstruct midface, lefort
   21146  C                            Reconstruct midface, lefort
   21147  C                            Reconstruct midface, lefort
   21150  C                            Reconstruct midface, lefort
   21151  C                            Reconstruct midface, lefort
   21154  C                            Reconstruct midface, lefort
   21155  C                            Reconstruct midface, lefort
   21159  C                            Reconstruct midface, lefort
   21160  C                            Reconstruct midface, lefort
   21172  C                            Reconstruct orbit/forehead
   21175  C                            Reconstruct orbit/forehead
   21179  C                            Reconstruct entire forehead
   21180  C                            Reconstruct entire forehead
   21182  C                            Reconstruct cranial bone
   21183  C                            Reconstruct cranial bone
   21184  C                            Reconstruct cranial bone
   21188  C                            Reconstruction of midface
   21193  C                            Reconstruct lower jaw bone
   21194  C                            Reconstruct lower jaw bone
   21195  C                            Reconstruct lower jaw bone
   21196  C                            Reconstruct lower jaw bone
   21198  C                            Reconstruct lower jaw bone
   21247  C                            Reconstruct lower jaw bone
   21255  C                            Reconstruct lower jaw bone
   21256  C                            Reconstruction of orbit
   21261  C                            Revise eye sockets
   21263  C                            Revise eye sockets
   21268  C                            Revise eye sockets
   21344  C                            Repair of sinus fracture
   21346  C                            Repair of nose/jaw fracture
   21347  C                            Repair of nose/jaw fracture
   21348  C                            Repair of nose/jaw fracture
   21356  C                            Repair cheek bone fracture
   21360  C                            Repair cheek bone fracture
   21365  C                            Repair cheek bone fracture
   21366  C                            Repair cheek bone fracture
   21385  C                            Repair eye socket fracture
   21386  C                            Repair eye socket fracture
   21387  C                            Repair eye socket fracture
   21390  C                            Repair eye socket fracture
   21395  C                            Repair eye socket fracture
   21406  C                            Repair eye socket fracture
   21407  C                            Repair eye socket fracture
   21408  C                            Repair eye socket fracture
   21422  C                            Repair mouth roof fracture
   21423  C                            Repair mouth roof fracture
   21431  C                            Treat craniofacial fracture
   21432  C                            Repair craniofacial fracture
   21433  C                            Repair craniofacial fracture
   21435  C                            Repair craniofacial fracture
   21436  C                            Repair craniofacial fracture
   21470  C                            Repair lower jaw fracture
   21495  C                            Repair hyoid bone fracture
   21510  C                            Drainage of bone lesion
   21557  C                            Remove tumor, neck or chest
   21615  C                            Removal of rib
   21616  C                            Removal of rib and nerves
   21620  C                            Partial removal of sternum
   21627  C                            Sternal debridement
   21630  C                            Extensive sternum surgery
   21632  C                            Extensive sternum surgery
   21705  C                            Revision of neck muscle/rib
   21740  C                            Reconstruction of sternum
   21750  C                            Repair of sternum separation
   21810  C                            Treatment of rib fracture(s)
   21825  C                            Repair sternum fracture
   22100  C                            Remove part of neck vertebra
   22101  C                            Remove part, thorax vertebra
   22102  C                            Remove part, lumbar vertebra
   22103  C                            Remove extra spine segment
   22110  C                            Remove part of neck vertebra
   22112  C                            Remove part, thorax vertebra
   22114  C                            Remove part, lumbar vertebra
   22116  C                            Remove extra spine segment
   22210  C                            Revision of neck spine
   22212  C                            Revision of thorax spine
   22214  C                            Revision of lumbar spine
   22216  C                            Revise, extra spine segment
   22220  C                            Revision of neck spine
   22222  C                            Revision of thorax spine
   22224  C                            Revision of lumbar spine
   22226  C                            Revise, extra spine segment
   22325  C                            Repair of spine fracture
   22326  C                            Repair neck spine fracture
   22327  C                            Repair thorax spine fracture
   22328  C                            Repair each add spine fx
   22548  C                            Neck spine fusion
   22554  C                            Neck spine fusion
   22556  C                            Thorax spine fusion
   22558  C                            Lumbar spine fusion
   22585  C                            Additional spinal fusion
   22590  C                            Spine & skull spinal fusion
   22595  C                            Neck spinal fusion
   22600  C                            Neck spine fusion
   22610  C                            Thorax spine fusion
   22612  C                            Lumbar spine fusion
   22614  C                            Spine fusion, extra segment
   22630  C                            Lumbar spine fusion
   22632  C                            Spine fusion, extra segment
   22800  C                            Fusion of spine
   22802  C                            Fusion of spine
   22804  C                            Fusion of spine
   22808  C                            Fusion of spine
   22810  C                            Fusion of spine
   22812  C                            Fusion of spine
   22818  C                            Kyphectomy, 1-2 segments
   22819  C                            Kyphectomy, 3 & more segment
   22830  C                            Exploration of spinal fusion
   22840  C                            Insert spine fixation device
   22841  C                            Insert spine fixation device
   22842  C                            Insert spine fixation device
   22843  C                            Insert spine fixation device
   22844  C                            Insert spine fixation device
   22845  C                            Insert spine fixation device
   22846  C                            Insert spine fixation device
   22847  C                            Insert spine fixation device
   22848  C                            Insert pelvic fixationdevice
   22849  C                            Reinsert spinal fixation
   22850  C                            Remove spine fixation device
   22851  C                            Apply spine prosth device
   22852  C                            Remove spine fixation device
   22855  C                            Remove spine fixation device
   23035  C                            Drain shoulder bone lesion
   23125  C                            Removal of collarbone
   23195  C                            Removal of head of humerus
   23200  C                            Removal of collar bone
   23210  C                            Removal of shoulderblade
   23220  C                            Partial removal of humerus
   23221  C                            Partial removal of humerus
   23222  C                            Partial removal of humerus
   23332  C                            Remove shoulder foreign body
   23395  C                            Muscle transfer, shoulder/arm
   23397  C                            Muscle transfers
   23400  C                            Fixation of shoulder blade
   23440  C                            Removal/transplant tendon
   23470  C                            Reconstruct shoulder joint
   23472  C                            Reconstruct shoulder joint
   23900  C                            Amputation of arm & girdle
   23920  C                            Amputation at shoulder joint
   24149  C                            Radical resection of elbow
   24150  C                            Extensive humerus surgery
   24151  C                            Extensive humerus surgery
   24152  C                            Extensive radius surgery
   24153  C                            Extensive radius surgery
   24900  C                            Amputation of upper arm
   24920  C                            Amputation of upper arm
   24930  C                            Amputation follow-up surgery
   24931  C                            Amputate upper arm & implant
   24935  C                            Revision of amputation
   24940  C                            Revision of upper arm
   25170  C                            Extensive forearm surgery
   25390  C                            Shorten radius/ulna
   25391  C                            Lengthen radius/ulna
   25392  C                            Shorten radius & ulna
   25393  C                            Lengthen radius & ulna
   25405  C                            Repair/graft radius or ulna
   25420  C                            Repair/graft radius & ulna
   25900  C                            Amputation of forearm
   25905  C                            Amputation of forearm
   25909  C                            Amputation follow-up surgery
   25915  C                            Amputation of forearm
   25920  C                            Amputate hand at wrist
   25924  C                            Amputation follow-up surgery
   25927  C                            Amputation of hand
   25931  C                            Amputation follow-up surgery
   26551  C                            Great toe-hand transfer
   26552  C                            Construct thumb replacement
   26553  C                            Single toe-hand transfer
   26554  C                            Double toe-hand transfer
   26556  C                            Toe joint transfer
   26557  C                            Construct finger replacement
   26558  C                            Added finger surgery
   26559  C                            Added finger surgery
   26992  C                            Drainage of bone lesion
   27005  C                            Incision of hip tendon
   27006  C                            Incision of hip tendons
   27025  C                            Incision of hip/thigh fascia
   27030  C                            Drainage of hip joint
   27035  C                            Denervation of hip joint
   27036  C                            Excision of hip joint/muscle
   27054  C                            Removal of hip joint lining
   27070  C                            Partial removal of hip bone
   27071  C                            Partial removal of hip bone
   27075  C                            Extensive hip surgery
   27076  C                            Extensive hip surgery
   27077  C                            Extensive hip surgery
   27078  C                            Extensive hip surgery
   27079  C                            Extensive hip surgery
   27090  C                            Removal of hip prosthesis
   27091  C                            Removal of hip prosthesis
   27120  C                            Reconstruction of hip socket
   27122  C                            Reconstruction of hip socket
   27125  C                            Partial hip replacement
   27130  C                            Total hip replacement
   27132  C                            Total hip replacement
   27134  C                            Revise hip joint replacement
   27137  C                            Revise hip joint replacement
   27138  C                            Revise hip joint replacement
   27140  C                            Transplant of femur ridge
   27146  C                            Incision of hip bone
   27147  C                            Revision of hip bone
   27151  C                            Incision of hip bones
   27156  C                            Revision of hip bones
   27158  C                            Revision of pelvis
   27161  C                            Incision of neck of femur
   27165  C                            Incision/fixation of femur
   27170  C                            Repair/graft femur head/neck

[[Page 35476]]

 
   27175  C                            Treat slipped epiphysis
   27176  C                            Treat slipped epiphysis
   27177  C                            Repair slipped epiphysis
   27178  C                            Repair slipped epiphysis
   27179  C                            Revise head/neck of femur
   27181  C                            Repair slipped epiphysis
   27185  C                            Revision of femur epiphysis
   27187  C                            Reinforce hip bones
   27215  C                            Pelvic fracture(s) treatment
   27216  C                            Treat pelvic ring fracture
   27217  C                            Treat pelvic ring fracture
   27218  C                            Treat pelvic ring fracture
   27222  C                            Treat hip socket fracture
   27226  C                            Treat hip wall fracture
   27227  C                            Treat hip fracture(s)
   27228  C                            Treat hip fracture(s)
   27232  C                            Treat fracture of thigh
   27235  C                            Repair of thigh fracture
   27236  C                            Repair of thigh fracture
   27240  C                            Treatment of thigh fracture
   27244  C                            Repair of thigh fracture
   27245  C                            Repair of thigh fracture
   27248  C                            Repair of thigh fracture
   27253  C                            Repair of hip dislocation
   27254  C                            Repair of hip dislocation
   27258  C                            Repair of hip dislocation
   27259  C                            Repair of hip dislocation
   27280  C                            Fusion of sacroiliac joint
   27282  C                            Fusion of pubic bones
   27284  C                            Fusion of hip joint
   27286  C                            Fusion of hip joint
   27290  C                            Amputation of leg at hip
   27295  C                            Amputation of leg at hip
   27303  C                            Drainage of bone lesion
   27365  C                            Extensive leg surgery
   27445  C                            Revision of knee joint
   27446  C                            Revision of knee joint
   27447  C                            Total knee replacement
   27448  C                            Incision of thigh
   27450  C                            Incision of thigh
   27454  C                            Realignment of thigh bone
   27455  C                            Realignment of knee
   27457  C                            Realignment of knee
   27465  C                            Shortening of thigh bone
   27466  C                            Lengthening of thigh bone
   27468  C                            Shorten/lengthen thighs
   27470  C                            Repair of thigh
   27472  C                            Repair/graft of thigh
   27475  C                            Surgery to stop leg growth
   27477  C                            Surgery to stop leg growth
   27479  C                            Surgery to stop leg growth
   27485  C                            Surgery to stop leg growth
   27486  C                            Revise knee joint replace
   27487  C                            Revise knee joint replace
   27488  C                            Removal of knee prosthesis
   27495  C                            Reinforce thigh
   27506  C                            Repair of thigh fracture
   27507  C                            Treatment of thigh fracture
   27511  C                            Treatment of thigh fracture
   27513  C                            Treatment of thigh fracture
   27514  C                            Repair of thigh fracture
   27519  C                            Repair of thigh growth plate
   27524  C                            Repair of kneecap fracture
   27535  C                            Treatment of knee fracture
   27536  C                            Repair of knee fracture
   27540  C                            Repair of knee fracture
   27557  C                            Repair of knee dislocation
   27558  C                            Repair of knee dislocation
   27580  C                            Fusion of knee
   27590  C                            Amputate leg at thigh
   27591  C                            Amputate leg at thigh
   27592  C                            Amputate leg at thigh
   27596  C                            Amputation follow-up surgery
   27598  C                            Amputate lower leg at knee
   27645  C                            Extensive lower leg surgery
   27646  C                            Extensive lower leg surgery
   27702  C                            Reconstruct ankle joint
   27703  C                            Reconstruction, ankle joint
   27712  C                            Realignment of lower leg
   27715  C                            Revision of lower leg
   27720  C                            Repair of tibia
   27722  C                            Repair/graft of tibia
   27724  C                            Repair/graft of tibia
   27725  C                            Repair of lower leg
   27727  C                            Repair of lower leg
   27880  C                            Amputation of lower leg
   27881  C                            Amputation of lower leg
   27882  C                            Amputation of lower leg
   27886  C                            Amputation follow-up surgery
   27888  C                            Amputation of foot at ankle
   28800  C                            Amputation of midfoot
   28805  C                            Amputation thru metatarsal
   31225  C                            Removal of upper jaw
   31230  C                            Removal of upper jaw
   31290  C                            Nasal/sinus endoscopy, surg
   31291  C                            Nasal/sinus endoscopy, surg
   31292  C                            Nasal/sinus endoscopy, surg
   31293  C                            Nasal/sinus endoscopy, surg
   31294  C                            Nasal/sinus endoscopy, surg
   31360  C                            Removal of larynx
   31365  C                            Removal of larynx
   31367  C                            Partial removal of larynx
   31368  C                            Partial removal of larynx
   31370  C                            Partial removal of larynx
   31375  C                            Partial removal of larynx
   31380  C                            Partial removal of larynx
   31382  C                            Partial removal of larynx
   31390  C                            Removal of larynx & pharynx
   31395  C                            Reconstruct larynx & pharynx
   31580  C                            Revision of larynx
   31582  C                            Revision of larynx
   31584  C                            Repair of larynx fracture
   31587  C                            Revision of larynx
   31600  C                            Incision of windpipe
   31601  C                            Incision of windpipe
   31610  C                            Incision of windpipe
   31725  C                            Clearance of airways
   31760  C                            Repair of windpipe
   31766  C                            Reconstruction of windpipe
   31770  C                            Repair/graft of bronchus
   31775  C                            Reconstruct bronchus
   31780  C                            Reconstruct windpipe
   31781  C                            Reconstruct windpipe
   31785  C                            Remove windpipe lesion
   31786  C                            Remove windpipe lesion
   31800  C                            Repair of windpipe injury
   31805  C                            Repair of windpipe injury
   32005  C                            Treat lung lining chemically
   32035  C                            Exploration of chest
   32036  C                            Exploration of chest
   32095  C                            Biopsy through chest wall
   32100  C                            Exploration/biopsy of chest
   32110  C                            Explore/repair chest
   32120  C                            Re-exploration of chest
   32124  C                            Explore chest,free adhesions
   32140  C                            Removal of lung lesion(s)
   32141  C                            Remove/treat lung lesions
   32150  C                            Removal of lung lesion(s)
   32151  C                            Remove lung foreign body
   32160  C                            Open chest heart massage
   32200  C                            Open drainage, lung lesion
   32201  C                            Percut drainage, lung lesion
   32215  C                            Treat chest lining
   32220  C                            Release of lung
   32225  C                            Partial release of lung
   32310  C                            Removal of chest lining
   32320  C                            Free/remove chest lining
   32402  C                            Open biopsy chest lining
   32440  C                            Removal of lung
   32442  C                            Sleeve pneumonectomy
   32445  C                            Removal of lung
   32480  C                            Partial removal of lung
   32482  C                            Bilobectomy
   32484  C                            Segmentectomy
   32486  C                            Sleeve lobectomy
   32488  C                            Completion pneumonectomy
   32491  C                            Lung volume reduction
   32500  C                            Partial removal of lung
   32501  C                            Repair bronchus (add-on)
   32520  C                            Remove lung & revise chest
   32522  C                            Remove lung & revise chest
   32525  C                            Remove lung & revise chest
   32540  C                            Removal of lung lesion
   32601  C                            Thoracoscopy, diagnostic
   32602  C                            Thoracoscopy, diagnostic
   32603  C                            Thoracoscopy, diagnostic
   32604  C                            Thoracoscopy, diagnostic
   32605  C                            Thoracoscopy, diagnostic
   32606  C                            Thoracoscopy, diagnostic
   32650  C                            Thoracoscopy, surgical
   32651  C                            Thoracoscopy, surgical
   32652  C                            Thoracoscopy, surgical
   32653  C                            Thoracoscopy, surgical
   32654  C                            Thoracoscopy, surgical
   32655  C                            Thoracoscopy, surgical
   32656  C                            Thoracoscopy, surgical
   32657  C                            Thoracoscopy, surgical
   32658  C                            Thoracoscopy, surgical
   32659  C                            Thoracoscopy, surgical
   32660  C                            Thoracoscopy, surgical
   32661  C                            Thoracoscopy, surgical
   32662  C                            Thoracoscopy, surgical
   32663  C                            Thoracoscopy, surgical
   32664  C                            Thoracoscopy, surgical
   32665  C                            Thoracoscopy, surgical
   32800  C                            Repair lung hernia
   32810  C                            Close chest after drainage
   32815  C                            Close bronchial fistula
   32820  C                            Reconstruct injured chest
   32850  C                            Donor pneumonectomy
   32851  C                            Lung transplant, single
   32852  C                            Lung transplant w/bypass
   32853  C                            Lung transplant, double
   32854  C                            Lung transplant w/bypass
   32900  C                            Removal of rib(s)
   32905  C                            Revise & repair chest wall
   32906  C                            Revise & repair chest wall
   32940  C                            Revision of lung
   33015  C                            Incision of heart sac
   33020  C                            Incision of heart sac
   33025  C                            Incision of heart sac
   33030  C                            Partial removal of heart sac
   33031  C                            Partial removal of heart sac
   33050  C                            Removal of heart sac lesion
   33120  C                            Removal of heart lesion
   33130  C                            Removal of heart lesion
   33200  C                            Insertion of heart pacemaker
   33201  C                            Insertion of heart pacemaker
   33206  C                            Insertion of heart pacemaker
   33207  C                            Insertion of heart pacemaker
   33208  C                            Insertion of heart pacemaker
   33210  C                            Insertion of heart electrode
   33211  C                            Insertion of heart electrode
   33212  C                            Insertion of pulse generator
   33213  C                            Insertion of pulse generator
   33214  C                            Upgrade of pacemaker system
   33216  C                            Revision implanted electrode
   33217  C                            Insert/revise electrode
   33218  C                            Repair pacemaker electrodes

[[Page 35477]]

 
   33220  C                            Repair pacemaker electrode
   33233  C                            Removal of pacemaker system
   33234  C                            Removal of pacemaker system
   33235  C                            Removal pacemaker electrode
   33236  C                            Remove electrode/thoracotomy
   33237  C                            Remove electrode/thoracotomy
   33238  C                            Remove electrode/thoracotomy
   33240  C                            Insert/replace pulse gener
   33241  C                            Remove pulse generator only
   33242  C                            Repair pulse generator/leads
   33243  C                            Remove generator/thoracotomy
   33244  C                            Remove generator
   33245  C                            Implant heart defibrillator
   33246  C                            Implant heart defibrillator
   33247  C                            Insert/replace leads
   33249  C                            Insert/replace leads/gener
   33250  C                            Ablate heart dysrhythm focus
   33251  C                            Ablate heart dysrhythm focus
   33253  C                            Reconstruct atria
   33261  C                            Ablate heart dysrhythm focus
   33300  C                            Repair of heart wound
   33305  C                            Repair of heart wound
   33310  C                            Exploratory heart surgery
   33315  C                            Exploratory heart surgery
   33320  C                            Repair major blood vessel(s)
   33321  C                            Repair major vessel
   33322  C                            Repair major blood vessel(s)
   33330  C                            Insert major vessel graft
   33332  C                            Insert major vessel graft
   33335  C                            Insert major vessel graft
   33400  C                            Repair of aortic valve
   33401  C                            Valvuloplasty, open
   33403  C                            Valvuloplasty, w/cp bypass
   33404  C                            Prepare heart-aorta conduit
   33405  C                            Replacement of aortic valve
   33406  C                            Replacement, aortic valve
   33411  C                            Replacement of aortic valve
   33412  C                            Replacement of aortic valve
   33413  C                            Replacement, aortic valve
   33414  C                            Repair, aortic valve
   33415  C                            Revision, subvalvular tissue
   33416  C                            Revise ventricle muscle
   33417  C                            Repair of aortic valve
   33420  C                            Revision of mitral valve
   33422  C                            Revision of mitral valve
   33425  C                            Repair of mitral valve
   33426  C                            Repair of mitral valve
   33427  C                            Repair of mitral valve
   33430  C                            Replacement of mitral valve
   33460  C                            Revision of tricuspid valve
   33463  C                            Valvuloplasty, tricuspid
   33464  C                            Valvuloplasty, tricuspid
   33465  C                            Replace tricuspid valve
   33468  C                            Revision of tricuspid valve
   33470  C                            Revision of pulmonary valve
   33471  C                            Valvotomy, pulmonary valve
   33472  C                            Revision of pulmonary valve
   33474  C                            Revision of pulmonary valve
   33475  C                            Replacement, pulmonary valve
   33476  C                            Revision of heart chamber
   33478  C                            Revision of heart chamber
   33496  C                            Repair, prosth valve clot
   33500  C                            Repair heart vessel fistula
   33501  C                            Repair heart vessel fistula
   33502  C                            Coronary artery correction
   33503  C                            Coronary artery graft
   33504  C                            Coronary artery graft
   33505  C                            Repair artery w/tunnel
   33506  C                            Repair artery, translocation
   33510  C                            CABG, vein, single
   33511  C                            CABG, vein, two
   33512  C                            CABG, vein, three
   33513  C                            CABG, vein, four
   33514  C                            CABG, vein, five
   33516  C                            CABG, vein, six+
   33517  C                            CABG, artery-vein, single
   33518  C                            CABG, artery-vein, two
   33519  C                            CABG, artery-vein, three
   33521  C                            CABG, artery-vein, four
   33522  C                            CABG, artery-vein, five
   33523  C                            CABG, artery-vein, six+
   33530  C                            Coronary artery, bypass/reop
   33533  C                            CABG, arterial, single
   33534  C                            CABG, arterial, two
   33535  C                            CABG, arterial, three
   33536  C                            CABG, arterial, four+
   33542  C                            Removal of heart lesion
   33545  C                            Repair of heart damage
   33572  C                            Open coronary endarterectomy
   33600  C                            Closure of valve
   33602  C                            Closure of valve
   33606  C                            Anastomosis/artery-aorta
   33608  C                            Repair anomaly w/conduit
   33610  C                            Repair by enlargement
   33611  C                            Repair double ventricle
   33612  C                            Repair double ventricle
   33615  C                            Repair (simple fontan)
   33617  C                            Repair by modified fontan
   33619  C                            Repair single ventricle
   33641  C                            Repair heart septum defect
   33645  C                            Revision of heart veins
   33647  C                            Repair heart septum defects
   33660  C                            Repair of heart defects
   33665  C                            Repair of heart defects
   33670  C                            Repair of heart chambers
   33681  C                            Repair heart septum defect
   33684  C                            Repair heart septum defect
   33688  C                            Repair heart septum defect
   33690  C                            Reinforce pulmonary artery
   33692  C                            Repair of heart defects
   33694  C                            Repair of heart defects
   33697  C                            Repair of heart defects
   33702  C                            Repair of heart defects
   33710  C                            Repair of heart defects
   33720  C                            Repair of heart defect
   33722  C                            Repair of heart defect
   33730  C                            Repair heart-vein defect(s)
   33732  C                            Repair heart-vein defect
   33735  C                            Revision of heart chamber
   33736  C                            Revision of heart chamber
   33737  C                            Revision of heart chamber
   33750  C                            Major vessel shunt
   33755  C                            Major vessel shunt
   33762  C                            Major vessel shunt
   33764  C                            Major vessel shunt & graft
   33766  C                            Major vessel shunt
   33767  C                            Major vessel shunt
   33770  C                            Repair great vessels defect
   33771  C                            Repair great vessels defect
   33774  C                            Repair great vessels defect
   33775  C                            Repair great vessels defect
   33776  C                            Repair great vessels defect
   33777  C                            Repair great vessels defect
   33778  C                            Repair great vessels defect
   33779  C                            Repair great vessels defect
   33780  C                            Repair great vessels defect
   33781  C                            Repair great vessels defect
   33786  C                            Repair arterial trunk
   33788  C                            Revision of pulmonary artery
   33800  C                            Aortic suspension
   33802  C                            Repair vessel defect
   33803  C                            Repair vessel defect
   33813  C                            Repair septal defect
   33814  C                            Repair septal defect
   33820  C                            Revise major vessel
   33822  C                            Revise major vessel
   33824  C                            Revise major vessel
   33840  C                            Remove aorta constriction
   33845  C                            Remove aorta constriction
   33851  C                            Remove aorta constriction
   33852  C                            Repair septal defect
   33853  C                            Repair septal defect
   33860  C                            Ascending aorta graft
   33861  C                            Ascending aorta graft
   33863  C                            Ascending aorta graft
   33870  C                            Transverse aortic arch graft
   33875  C                            Thoracic aorta graft
   33877  C                            Thoracoabdominal graft
   33910  C                            Remove lung artery emboli
   33915  C                            Remove lung artery emboli
   33916  C                            Surgery of great vessel
   33917  C                            Repair pulmonary artery
   33918  C                            Repair pulmonary atresia
   33919  C                            Repair pulmonary atresia
   33920  C                            Repair pulmonary atresia
   33922  C                            Transect pulmonary artery
   33924  C                            Remove pulmonary shunt
   33930  C                            Removal of donor heart/lung
   33935  C                            Transplantation, heart/lung
   33940  C                            Removal of donor heart
   33945  C                            Transplantation of heart
   33960  C                            External circulation assist
   33961  C                            External circulation assist
   33970  C                            Aortic circulation assist
   33971  C                            Aortic circulation assist
   33973  C                            Insert balloon device
   33974  C                            Remove intra-aortic balloon
   33975  C                            Implant ventricular device
   33976  C                            Implant ventricular device
   33977  C                            Remove ventricular device
   33978  C                            Remove ventricular device
   34001  C                            Removal of artery clot
   34051  C                            Removal of artery clot
   34101  C                            Removal of artery clot
   34111  C                            Removal of arm artery clot
   34151  C                            Removal of artery clot
   34201  C                            Removal of artery clot
   34203  C                            Removal of leg artery clot
   34401  C                            Removal of vein clot
   34421  C                            Removal of vein clot
   34451  C                            Removal of vein clot
   34471  C                            Removal of vein clot
   34490  C                            Removal of vein clot
   34501  C                            Repair valve, femoral vein
   34502  C                            Reconstruct, vena cava
   34510  C                            Transposition of vein valve
   34520  C                            Cross-over vein graft
   34530  C                            Leg vein fusion
   35001  C                            Repair defect of artery
   35002  C                            Repair artery rupture, neck
   35005  C                            Repair defect of artery
   35011  C                            Repair defect of artery
   35013  C                            Repair artery rupture, arm
   35021  C                            Repair defect of artery
   35022  C                            Repair artery rupture, chest
   35045  C                            Repair defect of arm artery
   35081  C                            Repair defect of artery
   35082  C                            Repair artery rupture, aorta
   35091  C                            Repair defect of artery
   35092  C                            Repair artery rupture, aorta
   35102  C                            Repair defect of artery

[[Page 35478]]

 
   35103  C                            Repair artery rupture, groin
   35111  C                            Repair defect of artery
   35112  C                            Repair artery rupture, spleen
   35121  C                            Repair defect of artery
   35122  C                            Repair artery rupture, belly
   35131  C                            Repair defect of artery
   35132  C                            Repair artery rupture, groin
   35141  C                            Repair defect of artery
   35142  C                            Repair artery rupture, thigh
   35151  C                            Repair defect of artery
   35152  C                            Repair artery rupture, knee
   35161  C                            Repair defect of artery
   35162  C                            Repair artery rupture
   35180  C                            Repair blood vessel lesion
   35182  C                            Repair blood vessel lesion
   35184  C                            Repair blood vessel lesion
   35189  C                            Repair blood vessel lesion
   35190  C                            Repair blood vessel lesion
   35201  C                            Repair blood vessel lesion
   35206  C                            Repair blood vessel lesion
   35211  C                            Repair blood vessel lesion
   35216  C                            Repair blood vessel lesion
   35221  C                            Repair blood vessel lesion
   35226  C                            Repair blood vessel lesion
   35231  C                            Repair blood vessel lesion
   35236  C                            Repair blood vessel lesion
   35241  C                            Repair blood vessel lesion
   35246  C                            Repair blood vessel lesion
   35251  C                            Repair blood vessel lesion
   35256  C                            Repair blood vessel lesion
   35261  C                            Repair blood vessel lesion
   35266  C                            Repair blood vessel lesion
   35271  C                            Repair blood vessel lesion
   35276  C                            Repair blood vessel lesion
   35281  C                            Repair blood vessel lesion
   35286  C                            Repair blood vessel lesion
   35301  C                            Rechanneling of artery
   35311  C                            Rechanneling of artery
   35321  C                            Rechanneling of artery
   35331  C                            Rechanneling of artery
   35341  C                            Rechanneling of artery
   35351  C                            Rechanneling of artery
   35355  C                            Rechanneling of artery
   35361  C                            Rechanneling of artery
   35363  C                            Rechanneling of artery
   35371  C                            Rechanneling of artery
   35372  C                            Rechanneling of artery
   35381  C                            Rechanneling of artery
   35390  C                            Reoperation, carotid add-on
   35400  C                            Angioscopy
   35450  C                            Repair arterial blockage
   35452  C                            Repair arterial blockage
   35454  C                            Repair arterial blockage
   35456  C                            Repair arterial blockage
   35458  C                            Repair arterial blockage
   35459  C                            Repair arterial blockage
   35460  C                            Repair venous blockage
   35470  C                            Repair arterial blockage
   35471  C                            Repair arterial blockage
   35472  C                            Repair arterial blockage
   35473  C                            Repair arterial blockage
   35474  C                            Repair arterial blockage
   35475  C                            Repair arterial blockage
   35476  C                            Repair venous blockage
   35480  C                            Atherectomy, open
   35481  C                            Atherectomy, open
   35482  C                            Atherectomy, open
   35483  C                            Atherectomy, open
   35484  C                            Atherectomy, open
   35485  C                            Atherectomy, open
   35490  C                            Atherectomy, percutaneous
   35491  C                            Atherectomy, percutaneous
   35492  C                            Atherectomy, percutaneous
   35493  C                            Atherectomy, percutaneous
   35494  C                            Atherectomy, percutaneous
   35495  C                            Atherectomy, percutaneous
   35501  C                            Artery bypass graft
   35506  C                            Artery bypass graft
   35507  C                            Artery bypass graft
   35508  C                            Artery bypass graft
   35509  C                            Artery bypass graft
   35511  C                            Artery bypass graft
   35515  C                            Artery bypass graft
   35516  C                            Artery bypass graft
   35518  C                            Artery bypass graft
   35521  C                            Artery bypass graft
   35526  C                            Artery bypass graft
   35531  C                            Artery bypass graft
   35533  C                            Artery bypass graft
   35536  C                            Artery bypass graft
   35541  C                            Artery bypass graft
   35546  C                            Artery bypass graft
   35548  C                            Artery bypass graft
   35549  C                            Artery bypass graft
   35551  C                            Artery bypass graft
   35556  C                            Artery bypass graft
   35558  C                            Artery bypass graft
   35560  C                            Artery bypass graft
   35563  C                            Artery bypass graft
   35565  C                            Artery bypass graft
   35566  C                            Artery bypass graft
   35571  C                            Artery bypass graft
   35582  C                            Vein bypass graft
   35583  C                            Vein bypass graft
   35585  C                            Vein bypass graft
   35587  C                            Vein bypass graft
   35601  C                            Artery bypass graft
   35606  C                            Artery bypass graft
   35612  C                            Artery bypass graft
   35616  C                            Artery bypass graft
   35621  C                            Artery bypass graft
   35623  C                            Bypass graft, not vein
   35626  C                            Artery bypass graft
   35631  C                            Artery bypass graft
   35636  C                            Artery bypass graft
   35641  C                            Artery bypass graft
   35642  C                            Artery bypass graft
   35645  C                            Artery bypass graft
   35646  C                            Artery bypass graft
   35650  C                            Artery bypass graft
   35651  C                            Artery bypass graft
   35654  C                            Artery bypass graft
   35656  C                            Artery bypass graft
   35661  C                            Artery bypass graft
   35663  C                            Artery bypass graft
   35665  C                            Artery bypass graft
   35666  C                            Artery bypass graft
   35671  C                            Artery bypass graft
   35681  C                            Composite bypass graft
   35691  C                            Arterial transposition
   35693  C                            Arterial transposition
   35694  C                            Arterial transposition
   35695  C                            Arterial transposition
   35700  C                            Reoperation, bypass graft
   35701  C                            Exploration, carotid artery
   35721  C                            Exploration, femoral artery
   35741  C                            Exploration popliteal artery
   35761  C                            Exploration of artery/vein
   35800  C                            Explore neck vessels
   35820  C                            Explore chest vessels
   35840  C                            Explore abdominal vessels
   35860  C                            Explore limb vessels
   35870  C                            Repair vessel graft defect
   35901  C                            Excision, graft, neck
   35903  C                            Excision, graft, extremity
   35905  C                            Excision, graft, thorax
   35907  C                            Excision, graft, abdomen
   36510  C                            Insertion of catheter, vein
   36660  C                            Insertion catheter, artery
   36822  C                            Insertion of cannula(s)
   36834  C                            Repair A-V aneurysm
   37140  C                            Revision of circulation
   37145  C                            Revision of circulation
   37160  C                            Revision of circulation
   37180  C                            Revision of circulation
   37181  C                            Splice spleen/kidney veins
   37195  C                            Thrombolytic therapy, stroke
   37200  C                            Transcatheter biopsy
   37201  C                            Transcatheter therapy infuse
   37202  C                            Transcatheter therapy infuse
   37204  C                            Transcatheter occlusion
   37205  C                            Transcatheter stent
   37206  C                            Transcatheter stent add-on
   37207  C                            Transcatheter stent
   37208  C                            Transcatheter stent add-on
   37209  C                            Exchange arterial catheter
   37250  C                            Intravascular us
   37251  C                            Intravascular us
   37565  C                            Ligation of neck vein
   37600  C                            Ligation of neck artery
   37605  C                            Ligation of neck artery
   37606  C                            Ligation of neck artery
   37615  C                            Ligation of neck artery
   37616  C                            Ligation of chest artery
   37617  C                            Ligation of abdomen artery
   37620  C                            Revision of major vein
   37660  C                            Revision of major vein
   37788  C                            Revascularization, penis
   38100  C                            Removal of spleen, total
   38101  C                            Removal of spleen, partial
   38102  C                            Removal of spleen, total
   38115  C                            Repair of ruptured spleen
   38240  C                            Bone marrow/stem transplant
   38241  C                            Bone marrow/stem transplant
   38380  C                            Thoracic duct procedure
   38381  C                            Thoracic duct procedure
   38382  C                            Thoracic duct procedure
   38562  C                            Removal, pelvic lymph nodes
   38564  C                            Removal, abdomen lymph nodes
   38700  C                            Removal of lymph nodes, neck
   38720  C                            Removal of lymph nodes, neck
   38724  C                            Removal of lymph nodes, neck
   38746  C                            Remove thoracic lymph nodes
   38747  C                            Remove abdominal lymph nodes
   38765  C                            Remove groin lymph nodes
   38770  C                            Remove pelvis lymph nodes
   38780  C                            Remove abdomen lymph nodes
   39000  C                            Exploration of chest
   39010  C                            Exploration of chest
   39200  C                            Removal chest lesion
   39220  C                            Removal chest lesion
   39400  C                            Visualization of chest
   39499  C                            Chest procedure
   39501  C                            Repair diaphragm laceration
   39502  C                            Repair paraesophageal hernia
   39503  C                            Repair of diaphragm hernia
   39520  C                            Repair of diaphragm hernia
   39530  C                            Repair of diaphragm hernia
   39531  C                            Repair of diaphragm hernia
   39540  C                            Repair of diaphragm hernia
   39541  C                            Repair of diaphragm hernia
   39545  C                            Revision of diaphragm
   39599  C                            Diaphragm surgery procedure

[[Page 35479]]

 
   41130  C                            Partial removal of tongue
   41135  C                            Tongue and neck surgery
   41140  C                            Removal of tongue
   41145  C                            Tongue removal; neck surgery
   41150  C                            Tongue, mouth, jaw surgery
   41153  C                            Tongue, mouth, neck surgery
   41155  C                            Tongue, jaw, & neck surgery
   42145  C                            Repair, palate, pharynx/uvula
   42426  C                            Excise parotid gland/lesion
   42845  C                            Extensive surgery of throat
   42880  C                            Excise nose/throat lesion
   42894  C                            Revision of pharyngeal walls
   42953  C                            Repair throat, esophagus
   42961  C                            Control throat bleeding
   42971  C                            Control nose/throat bleeding
   43045  C                            Incision of esophagus
   43100  C                            Excision of esophagus lesion
   43101  C                            Excision of esophagus lesion
   43107  C                            Removal of esophagus
   43108  C                            Removal of esophagus
   43112  C                            Removal of esophagus
   43113  C                            Removal of esophagus
   43116  C                            Partial removal of esophagus
   43117  C                            Partial removal of esophagus
   43118  C                            Partial removal of esophagus
   43121  C                            Partial removal of esophagus
   43122  C                            Parital removal of esophagus
   43123  C                            Partial removal of esophagus
   43124  C                            Removal of esophagus
   43130  C                            Removal of esophagus pouch
   43135  C                            Removal of esophagus pouch
   43300  C                            Repair of esophagus
   43305  C                            Repair esophagus and fistula
   43310  C                            Repair of esophagus
   43312  C                            Repair esophagus and fistula
   43320  C                            Fuse esophagus & stomach
   43324  C                            Revise esophagus & stomach
   43325  C                            Revise esophagus & stomach
   43326  C                            Revise esophagus & stomach
   43330  C                            Repair of esophagus
   43331  C                            Repair of esophagus
   43340  C                            Fuse esophagus & intestine
   43341  C                            Fuse esophagus & intestine
   43350  C                            Surgical opening, esophagus
   43351  C                            Surgical opening, esophagus
   43352  C                            Surgical opening, esophagus
   43360  C                            Gastrointestinal repair
   43361  C                            Gastrointestinal repair
   43400  C                            Ligate esophagus veins
   43401  C                            Esophagus surgery for veins
   43405  C                            Ligate/staple esophagus
   43410  C                            Repair esophagus wound
   43415  C                            Repair esophagus wound
   43420  C                            Repair esophagus opening
   43425  C                            Repair esophagus opening
   43460  C                            Pressure treatment esophagus
   43496  C                            Free jejunum flap, microvasc
   43500  C                            Surgical opening of stomach
   43501  C                            Surgical repair of stomach
   43502  C                            Surgical repair of stomach
   43510  C                            Surgical opening of stomach
   43520  C                            Incision of pyloric muscle
   43605  C                            Biopsy of stomach
   43610  C                            Excision of stomach lesion
   43611  C                            Excision of stomach lesion
   43620  C                            Removal of stomach
   43621  C                            Removal of stomach
   43622  C                            Removal of stomach
   43631  C                            Removal of stomach, partial
   43632  C                            Removal stomach, partial
   43633  C                            Removal stomach, partial
   43634  C                            Removal stomach, partial
   43635  C                            Partial removal of stomach
   43638  C                            Partial removal of stomach
   43639  C                            Removal stomach, partial
   43640  C                            Vagotomy & pylorus repair
   43641  C                            Vagotomy & pylorus repair
   43800  C                            Reconstruction of pylorus
   43810  C                            Fusion of stomach and bowel
   43820  C                            Fusion of stomach and bowel
   43825  C                            Fusion of stomach and bowel
   43830  C                            Place gastrostomy tube
   43831  C                            Place gastrostomy tube
   43832  C                            Place gastrostomy tube
   43840  C                            Repair of stomach lesion
   43842  C                            Gastroplasty for obesity
   43843  C                            Gastroplasty for obesity
   43846  C                            Gastric bypass for obesity
   43847  C                            Gastric bypass for obesity
   43848  C                            Revision gastroplasty
   43850  C                            Revise stomach-bowel fusion
   43855  C                            Revise stomach-bowel fusion
   43860  C                            Revise stomach-bowel fusion
   43865  C                            Revise stomach-bowel fusion
   43880  C                            Repair stomach-bowel fistula
   44005  C                            Freeing of bowel adhesion
   44010  C                            Incision of small bowel
   44015  C                            Insert needle catheter, bowel
   44020  C                            Exploration of small bowel
   44021  C                            Decompress small bowel
   44025  C                            Incision of large bowel
   44050  C                            Reduce bowel obstruction
   44055  C                            Correct malrotation of bowel
   44110  C                            Excision of bowel lesion(s)
   44111  C                            Excision of bowel lesion(s)
   44120  C                            Removal of small intestine
   44121  C                            Removal of small intestine
   44125  C                            Removal of small intestine
   44130  C                            Bowel to bowel fusion
   44139  C                            Mobilization of colon
   44140  C                            Partial removal of colon
   44141  C                            Partial removal of colon
   44143  C                            Partial removal of colon
   44144  C                            Partial removal of colon
   44145  C                            Partial removal of colon
   44146  C                            Partial removal of colon
   44147  C                            Partial removal of colon
   44150  C                            Removal of colon
   44151  C                            Removal of colon/ileostomy
   44152  C                            Removal of colon/ileostomy
   44153  C                            Removal of colon/ileostomy
   44155  C                            Removal of colon
   44156  C                            Removal of colon/ileostomy
   44160  C                            Removal of colon
   44300  C                            Open bowel to skin
   44310  C                            Ileostomy/jejunostomy
   44314  C                            Revision of ileostomy
   44316  C                            Devise bowel pouch
   44320  C                            Colostomy
   44322  C                            Colostomy with biopsies
   44345  C                            Revision of colostomy
   44346  C                            Revision of colostomy
   44500  C                            Intro, gastrointestinal tube
   44602  C                            Suture, small intestine
   44603  C                            Suture, small intestine
   44604  C                            Suture, large intestine
   44605  C                            Repair of bowel lesion
   44615  C                            Intestinal stricturoplasty
   44620  C                            Repair bowel opening
   44625  C                            Repair bowel opening
   44626  C                            Repair bowel opening
   44640  C                            Repair bowel-skin fistula
   44650  C                            Repair bowel fistula
   44660  C                            Repair bowel-bladder fistula
   44661  C                            Repair bowel-bladder fistula
   44680  C                            Surgical revision, intestine
   44700  C                            Suspend bowel w/prosthesis
   44800  C                            Excision of bowel pouch
   44820  C                            Excision of mesentery lesion
   44850  C                            Repair of mesentery
   44899  C                            Bowel surgery procedure
   44900  C                            Drain, app abscess, open
   44901  C                            Drain, app abscess, perc
   44950  C                            Appendectomy
   44955  C                            Appendectomy add-on
   44960  C                            Appendectomy
   45110  C                            Removal of rectum
   45111  C                            Partial removal of rectum
   45112  C                            Removal of rectum
   45113  C                            Partial proctectomy
   45114  C                            Partial removal of rectum
   45116  C                            Partial removal of rectum
   45119  C                            Remove, rectum w/reservoir
   45120  C                            Removal of rectum
   45121  C                            Removal of rectum and colon
   45123  C                            Partial proctectomy
   45130  C                            Excision of rectal prolapse
   45135  C                            Excision of rectal prolapse
   45540  C                            Correct rectal prolapse
   45541  C                            Correct rectal prolapse
   45550  C                            Repair rectum;remove sigmoid
   45562  C                            Exploration/repair of rectum
   45563  C                            Exploration/repair of rectum
   45800  C                            Repair rectumbladder fistula
   45805  C                            Repair fistula; colostomy
   45820  C                            Repair rectourethral fistula
   45825  C                            Repair fistula; colostomy
   46705  C                            Repair of anal stricture
   46715  C                            Repair of anovaginal fistula
   46716  C                            Repair of anovaginal fistula
   46730  C                            Construction of absent anus
   46735  C                            Construction of absent anus
   46740  C                            Construction of absent anus
   46742  C                            Repair, imperforated anus
   46744  C                            Repair, cloacal anomaly
   46746  C                            Repair, cloacal anomaly
   46748  C                            Repair, cloacal anomaly
   46751  C                            Repair of anal sphincter
   47001  C                            Needle biopsy, liver add-on
   47010  C                            Open drainage, liver lesion
   47011  C                            Percut drain, liver lesion
   47015  C                            Inject/aspirate liver cyst
   47100  C                            Wedge biopsy of liver
   47120  C                            Partial removal of liver
   47122  C                            Extensive removal of liver
   47125  C                            Partial removal of liver
   47130  C                            Partial removal of liver
   47133  C                            Removal of donor liver
   47134  C                            Partial removal, donor liver
   47135  C                            Transplantation of liver
   47136  C                            Transplantation of liver
   47300  C                            Surgery for liver lesion
   47350  C                            Repair liver wound
   47360  C                            Repair liver wound
   47361  C                            Repair liver wound
   47362  C                            Repair liver wound
   47400  C                            Incision of liver duct
   47420  C                            Incision of bile duct
   47425  C                            Incision of bile duct
   47460  C                            Incise bile duct sphincter
   47480  C                            Incision of gallbladder
   47490  C                            Incision of gallbladder
   47550  C                            Bile duct endoscopy add-on
   47600  C                            Removal of gallbladder
   47605  C                            Removal of gallbladder
   47610  C                            Removal of gallbladder
   47612  C                            Removal of gallbladder
   47620  C                            Removal of gallbladder
   47700  C                            Exploration of bile ducts

[[Page 35480]]

 
   47701  C                            Bile duct revision
   47711  C                            Excision of bile duct tumor
   47712  C                            Excision of bile duct tumor
   47715  C                            Excision of bile duct cyst
   47716  C                            Fusion of bile duct cyst
   47720  C                            Fuse gallbladder & bowel
   47721  C                            Fuse upper gi structures
   47740  C                            Fuse gallbladder & bowel
   47741  C                            Fuse gallbladder & bowel
   47760  C                            Fuse bile ducts and bowel
   47765  C                            Fuse liver ducts & bowel
   47780  C                            Fuse bile ducts and bowel
   47785  C                            Fuse bile ducts and bowel
   47800  C                            Reconstruction of bile ducts
   47801  C                            Placement, bile duct support
   47802  C                            Fuse liver duct & intestine
   47900  C                            Suture bile duct injury
   48000  C                            Drainage of abdomen
   48001  C                            Placement of drain, pancreas
   48005  C                            Resect/debride pancreas
   48020  C                            Removal of pancreatic stone
   48100  C                            Biopsy of pancreas
   48120  C                            Removal of pancreas lesion
   48140  C                            Partial removal of pancreas
   48145  C                            Partial removal of pancreas
   48146  C                            Pancreatectomy
   48148  C                            Removal of pancreatic duct
   48150  C                            Partial removal of pancreas
   48152  C                            Pancreatectomy
   48153  C                            Pancreatectomy
   48154  C                            Pancreatectomy
   48155  C                            Removal of pancreas
   48180  C                            Fuse pancreas and bowel
   48400  C                            Injection, intraop add-on
   48500  C                            Surgery of pancreas cyst
   48510  C                            Drain pancreatic pseudocyst
   48511  C                            Drain pancreatic pseudocyst
   48520  C                            Fuse pancreas cyst and bowel
   48540  C                            Fuse pancreas cyst and bowel
   48545  C                            Pancreatorrhaphy
   48547  C                            Duodenal exclusion
   48556  C                            Removal, allograft pancreas
   49000  C                            Exploration of abdomen
   49002  C                            Reopening of abdomen
   49010  C                            Exploration behind abdomen
   49020  C                            Drain abdominal abscess
   49021  C                            Drain abdominal abscess
   49040  C                            Open drainage abdom abscess
   49041  C                            Percut drain abdom abscess
   49060  C                            Open drain retroper abscess
   49061  C                            Percutdrain retroper abscess
   49062  C                            Drain to peritoneal cavity
   49200  C                            Removal of abdominal lesion
   49201  C                            Removal of abdominal lesion
   49215  C                            Excise sacral spine tumor
   49220  C                            Multiple surgery, abdomen
   49255  C                            Removal of omentum
   49425  C                            Insert abdomen-venous drain
   49428  C                            Ligation of shunt
   49605  C                            Repair umbilical lesion
   49606  C                            Repair umbilical lesion
   49610  C                            Repair umbilical lesion
   49611  C                            Repair umbilical lesion
   49900  C                            Repair of abdominal wall
   49905  C                            Omental flap
   49906  C                            Free omental flap, microvasc
   50010  C                            Exploration of kidney
   50020  C                            Open drain renal abscess
   50021  C                            Percut drain renal abscess
   50040  C                            Drainage of kidney
   50045  C                            Exploration of kidney
   50060  C                            Removal of kidney stone
   50065  C                            Incision of kidney
   50070  C                            Incision of kidney
   50075  C                            Removal of kidney stone
   50080  C                            Removal of kidney stone
   50081  C                            Removal of kidney stone
   50100  C                            Revise kidney blood vessels
   50120  C                            Exploration of kidney
   50125  C                            Explore and drain kidney
   50130  C                            Removal of kidney stone
   50135  C                            Exploration of kidney
   50205  C                            Biopsy of kidney
   50220  C                            Removal of kidney
   50225  C                            Removal of kidney
   50230  C                            Removal of kidney
   50234  C                            Removal of kidney & ureter
   50236  C                            Removal of kidney & ureter
   50240  C                            Partial removal of kidney
   50280  C                            Removal of kidney lesion
   50290  C                            Removal of kidney lesion
   50300  C                            Removal of donor kidney
   50320  C                            Removal of donor kidney
   50340  C                            Removal of kidney
   50360  C                            Transplantation of kidney
   50365  C                            Transplantation of kidney
   50370  C                            Remove transplanted kidney
   50380  C                            Reimplantation of kidney
   50400  C                            Revision of kidney/ureter
   50405  C                            Revision of kidney/ureter
   50500  C                            Repair of kidney wound
   50520  C                            Close kidney-skin fistula
   50525  C                            Repair renal-abdomen fistula
   50526  C                            Repair renal-abdomen fistula
   50540  C                            Revision of horseshoe kidney
   50570  C                            Kidney endoscopy
   50572  C                            Kidney endoscopy
   50574  C                            Kidney endoscopy & biopsy
   50575  C                            Kidney endoscopy
   50576  C                            Kidney endoscopy & treatment
   50578  C                            Renal endoscopy; radiotracer
   50580  C                            Kidney endoscopy & treatment
   50600  C                            Exploration of ureter
   50605  C                            Insert ureteral support
   50610  C                            Removal of ureter stone
   50620  C                            Removal of ureter stone
   50630  C                            Removal of ureter stone
   50650  C                            Removal of ureter
   50660  C                            Removal of ureter
   50700  C                            Revision of ureter
   50715  C                            Release of ureter
   50722  C                            Release of ureter
   50725  C                            Release/revise ureter
   50727  C                            Revise ureter
   50728  C                            Revise ureter
   50740  C                            Fusion of ureter & kidney
   50750  C                            Fusion of ureter & kidney
   50760  C                            Fusion of ureters
   50770  C                            Splicing of ureters
   50780  C                            Reimplant ureter in bladder
   50782  C                            Reimplant ureter in bladder
   50783  C                            Reimplant ureter in bladder
   50785  C                            Reimplant ureter in bladder
   50800  C                            Implant ureter in bowel
   50810  C                            Fusion of ureter & bowel
   50815  C                            Urine shunt to bowel
   50820  C                            Construct bowel bladder
   50825  C                            Construct bowel bladder
   50830  C                            Revise urine flow
   50840  C                            Replace ureter by bowel
   50845  C                            Appendico-vesicostomy
   50860  C                            Transplant ureter to skin
   50900  C                            Repair of ureter
   50920  C                            Closure ureter/skin fistula
   50930  C                            Closure ureter/bowel fistula
   50940  C                            Release of ureter
   50970  C                            Ureter endoscopy
   50972  C                            Ureter endoscopy & catheter
   50974  C                            Ureter endoscopy & biopsy
   50976  C                            Ureter endoscopy & treatment
   50978  C                            Ureter endoscopy & tracer
   50980  C                            Ureter endoscopy & treatment
   51060  C                            Removal of ureter stone
   51525  C                            Removal of bladder lesion
   51530  C                            Removal of bladder lesion
   51535  C                            Repair of ureter lesion
   51550  C                            Partial removal of bladder
   51555  C                            Partial removal of bladder
   51565  C                            Revise bladder & ureter(s)
   51570  C                            Removal of bladder
   51575  C                            Removal of bladder & nodes
   51580  C                            Remove bladder; revise tract
   51585  C                            Removal of bladder & nodes
   51590  C                            Remove bladder; revise tract
   51595  C                            Remove bladder; revise tract
   51596  C                            Remove bladder, create pouch
   51597  C                            Removal of pelvic structures
   51800  C                            Revision of bladder/urethra
   51820  C                            Revision of urinary tract
   51840  C                            Attach bladder/urethra
   51841  C                            Attach bladder/urethra
   51845  C                            Repair bladder neck
   51860  C                            Repair of bladder wound
   51865  C                            Repair of bladder wound
   51900  C                            Repair bladder/vagina lesion
   51920  C                            Close bladder-uterus fistula
   51925  C                            Hysterectomy/bladder repair
   51940  C                            Correction of bladder defect
   51960  C                            Revision of bladder & bowel
   51980  C                            Construct bladder opening
   53085  C                            Drainage of urinary leakage
   53415  C                            Reconstruction of urethra
   53443  C                            Reconstruction of urethra
   54125  C                            Removal of penis
   54130  C                            Remove penis & nodes
   54135  C                            Remove penis & nodes
   54332  C                            Revise penis, urethra
   54336  C                            Revise penis, urethra
   54390  C                            Repair penis and bladder
   54430  C                            Revision of penis
   54535  C                            Extensive testis surgery
   54560  C                            Exploration for testis
   54650  C                            Orchiopexy (Fowler-Stephens)
   55600  C                            Incise sperm duct pouch
   55605  C                            Incise sperm duct pouch
   55650  C                            Remove sperm duct pouch
   55801  C                            Removal of prostate
   55810  C                            Extensive prostate surgery
   55812  C                            Extensive prostate surgery
   55815  C                            Extensive prostate surgery
   55821  C                            Removal of prostate
   55831  C                            Removal of prostate
   55840  C                            Extensive prostate surgery
   55842  C                            Extensive prostate surgery
   55845  C                            Extensive prostate surgery
   55860  C                            Surgical exposure, prostate
   55862  C                            Extensive prostate surgery
   55865  C                            Extensive prostate surgery
   56308  C                            Laparoscopy; hysterectomy
   56310  C                            Laparoscopic enterolysis
   56314  C                            Lapar; drain lymphocele
   56315  C                            Laparoscopic appendectomy
   56322  C                            Laparoscopy, vagus nerves
   56323  C                            Laparoscopy, vagus nerves
   56324  C                            Laparoscopy, cholecystoenter
   56340  C                            Laparoscopic cholecystectomy
   56341  C                            Laparoscopic cholecystectomy

[[Page 35481]]

 
   56342  C                            Laparoscopic cholecystectomy
   56345  C                            Laparoscopic splenectomy
   56347  C                            Laparoscopic jejunostomy
   56348  C                            Laparo; resect intestine
   56349  C                            Laparoscopy; fundoplasty
   56630  C                            Extensive vulva surgery
   56631  C                            Extensive vulva surgery
   56632  C                            Extensive vulva surgery
   56633  C                            Extensive vulva surgery
   56634  C                            Extensive vulva surgery
   56637  C                            Extensive vulva surgery
   56640  C                            Extensive vulva surgery
   56805  C                            Repair clitoris
   57108  C                            Partial removal of vagina
   57110  C                            Remove vagina wall, complete
   57120  C                            Closure of vagina
   57270  C                            Repair of bowel pouch
   57280  C                            Suspension of vagina
   57282  C                            Repair of vaginal prolapse
   57292  C                            Construct vagina with graft
   57305  C                            Repair rectum-vagina fistula
   57307  C                            Fistula repair & colostomy
   57308  C                            Fistula repair, transperine
   57310  C                            Repair urethrovaginal lesion
   57311  C                            Repair urethrovaginal lesion
   57320  C                            Repair bladder-vagina lesion
   57330  C                            Repair bladder-vagina lesion
   57335  C                            Repair vagina
   57531  C                            Removal of cervix, radical
   57540  C                            Removal of residual cervix
   57545  C                            Remove cervix, repair pelvis
   58140  C                            Removal of uterus lesion
   58150  C                            Total hysterectomy
   58152  C                            Total hysterectomy
   58180  C                            Partial hysterectomy
   58200  C                            Extensive hysterectomy
   58210  C                            Extensive hysterectomy
   58240  C                            Removal of pelvis contents
   58260  C                            Vaginal hysterectomy
   58262  C                            Vaginal hysterectomy
   58263  C                            Vaginal hysterectomy
   58267  C                            Hysterectomy & vagina repair
   58270  C                            Hysterectomy & vagina repair
   58275  C                            Hysterectomy, revise vagina
   58280  C                            Hysterectomy, revise vagina
   58285  C                            Extensive hysterectomy
   58400  C                            Suspension of uterus
   58410  C                            Suspension of uterus
   58520  C                            Repair of ruptured uterus
   58540  C                            Revision of uterus
   58600  C                            Division of fallopian tube
   58605  C                            Division of fallopian tube
   58611  C                            Ligate oviduct(s) add-on
   58615  C                            Occlude fallopian tube(s)
   58700  C                            Removal of fallopian tube
   58720  C                            Removal of ovary/tube(s)
   58740  C                            Revise fallopian tube(s)
   58750  C                            Repair oviduct
   58752  C                            Revise ovarian tube(s)
   58760  C                            Remove tubal obstruction
   58770  C                            Create new tubal opening
   58805  C                            Drainage of ovarian cyst(s)
   58822  C                            Percut drain ovary abscess
   58823  C                            Percut drain pelvic abscess
   58825  C                            Transposition, ovary(s)
   58900  C                            Biopsy of ovary(s)
   58920  C                            Partial removal of ovary(s)
   58925  C                            Removal of ovarian cyst(s)
   58940  C                            Removal of ovary(s)
   58943  C                            Removal of ovary(s)
   58950  C                            Resect ovarian malignancy
   58951  C                            Resect ovarian malignancy
   58952  C                            Resect ovarian malignancy
   58960  C                            Exploration of abdomen
   59100  C                            Remove uterus lesion
   59120  C                            Treat ectopic pregnancy
   59121  C                            Treat ectopic pregnancy
   59130  C                            Treat ectopic pregnancy
   59135  C                            Treat ectopic pregnancy
   59136  C                            Treat ectopic pregnancy
   59140  C                            Treat ectopic pregnancy
   59150  C                            Treat ectopic pregnancy
   59151  C                            Treat ectopic pregnancy
   59325  C                            Revision of cervix
   59350  C                            Repair of uterus
   59514  C                            Cesarean delivery only
   59525  C                            Remove uterus after cesarean
   59620  C                            Attempted vbac delivery only
   59830  C                            Treat uterus infection
   59850  C                            Abortion
   59851  C                            Abortion
   59852  C                            Abortion
   59855  C                            Abortion
   59856  C                            Abortion
   59857  C                            Abortion
   59866  C                            Abortion
   60212  C                            Parital thyroid excision
   60252  C                            Removal of thyroid
   60254  C                            Extensive thyroid surgery
   60260  C                            Repeat thyroid surgery
   60270  C                            Removal of thyroid
   60271  C                            Removal of thyroid
   60500  C                            Explore parathyroid glands
   60502  C                            Re-explore parathyroids
   60505  C                            Explore parathyroid glands
   60512  C                            Autotransplant, parathyroid
   60520  C                            Removal of thymus gland
   60521  C                            Removal thymus gland
   60522  C                            Removal of thymus gland
   60540  C                            Explore adrenal gland
   60545  C                            Explore adrenal gland
   60600  C                            Remove carotid body lesion
   60605  C                            Remove carotid body lesion
   61105  C                            Twist drill hole
   61106  C                            Drill skull for exam/surgery
   61107  C                            Drill skull for implantation
   61108  C                            Drill skull for drainage
   61120  C                            Burr hole for puncture
   61130  C                            Pierce skull, exam/surgery
   61140  C                            Pierce skull for biopsy
   61150  C                            Pierce skull for drainage
   61151  C                            Pierce skull for drainage
   61154  C                            Pierce skull, remove clot
   61156  C                            Pierce skull for drainage
   61210  C                            Pierce skull; implant device
   61250  C                            Pierce skull & explore
   61253  C                            Pierce skull & explore
   61304  C                            Open skull for exploration
   61305  C                            Open skull for exploration
   61312  C                            Open skull for drainage
   61313  C                            Open skull for drainage
   61314  C                            Open skull for drainage
   61315  C                            Open skull for drainage
   61320  C                            Open skull for drainage
   61321  C                            Open skull for drainage
   61330  C                            Decompress eye socket
   61332  C                            Explore/biopsy eye socket
   61333  C                            Explore orbit; remove lesion
   61334  C                            Explore orbit; remove object
   61340  C                            Relieve cranial pressure
   61343  C                            Incise skull, pressure relief
   61345  C                            Relieve cranial pressure
   61440  C                            Incise skull for surgery
   61450  C                            Incise skull for surgery
   61458  C                            Incise skull for brain wound
   61460  C                            Incise skull for surgery
   61470  C                            Incise skull for surgery
   61480  C                            Incise skull for surgery
   61490  C                            Incise skull for surgery
   61500  C                            Removal of skull lesion
   61501  C                            Remove infected skull bone
   61510  C                            Removal of brain lesion
   61512  C                            Remove brain lining lesion
   61514  C                            Removal of brain abscess
   61516  C                            Removal of brain lesion
   61518  C                            Removal of brain lesion
   61519  C                            Remove brain lining lesion
   61520  C                            Removal of brain lesion
   61521  C                            Removal of brain lesion
   61522  C                            Removal of brain abscess
   61524  C                            Removal of brain lesion
   61526  C                            Removal of brain lesion
   61530  C                            Removal of brain lesion
   61531  C                            Implant brain electrodes
   61533  C                            Implant brain electrodes
   61534  C                            Removal of brain lesion
   61535  C                            Remove brain electrodes
   61536  C                            Removal of brain lesion
   61538  C                            Removal of brain tissue
   61539  C                            Removal of brain tissue
   61541  C                            Incision of brain tissue
   61542  C                            Removal of brain tissue
   61543  C                            Removal of brain tissue
   61544  C                            Remove & treat brain lesion
   61545  C                            Excision of brain tumor
   61546  C                            Removal of pituitary gland
   61548  C                            Removal of pituitary gland
   61550  C                            Release of skull seams
   61552  C                            Release of skull seams
   61556  C                            Incise skull/sutures
   61557  C                            Incise skull/sutures
   61558  C                            Excision of skull/sutures
   61559  C                            Excision of skull/sutures
   61563  C                            Excision of skull tumor
   61564  C                            Excision of skull tumor
   61570  C                            Remove brain foreign body
   61571  C                            Incise skull for brain wound
   61575  C                            Skull base/brainstem surgery
   61576  C                            Skull base/brainstem surgery
   61580  C                            Craniofacial approach, skull
   61581  C                            Craniofacial approach, skull
   61582  C                            Craniofacial approach, skull
   61583  C                            Craniofacial approach, skull
   61584  C                            Orbitocranial approach/skull
   61585  C                            Orbitocranial approach/skull
   61586  C                            Resect nasopharynx, skull
   61590  C                            Infratemporal approach/skull
   61591  C                            Infratemporal approach/skull
   61592  C                            Orbitocranial approach/skull
   61595  C                            Transtemporal approach/skull
   61596  C                            Transcochlear approach/skull
   61597  C                            Transcondylar approach/skull
   61598  C                            Transpetrosal approach/skull
   61600  C                            Resect/excise cranial lesion
   61601  C                            Resect/excise cranial lesion
   61605  C                            Resect/excise cranial lesion
   61606  C                            Resect/excise cranial lesion
   61607  C                            Resect/excise cranial lesion
   61608  C                            Resect/excise cranial lesion
   61609  C                            Transect, artery, sinus
   61610  C                            Transect, artery, sinus
   61611  C                            Transect, artery, sinus
   61612  C                            Transect, artery, sinus
   61613  C                            Remove aneurysm, sinus
   61615  C                            Resect/excise lesion, skull
   61616  C                            Resect/excise lesion, skull
   61618  C                            Repair dura
   61619  C                            Repair dura
   61624  C                            Occlusion/embolization cath

[[Page 35482]]

 
   61626  C                            Occlusion/embolization cath
   61680  C                            Intracranial vessel surgery
   61682  C                            Intracranial vessel surgery
   61684  C                            Intracranial vessel surgery
   61686  C                            Intracranial vessel surgery
   61690  C                            Intracranial vessel surgery
   61692  C                            Intracranial vessel surgery
   61700  C                            Inner skull vessel surgery
   61702  C                            Inner skull vessel surgery
   61703  C                            Clamp neck artery
   61705  C                            Revise circulation to head
   61708  C                            Revise circulation to head
   61710  C                            Revise circulation to head
   61711  C                            Fusion of skull arteries
   61712  C                            Skull or spine microsurgery
   61720  C                            Incise skull/brain surgery
   61735  C                            Incise skull/brain surgery
   61750  C                            Incise skull; brain biopsy
   61751  C                            Brain biopsy with cat scan
   61760  C                            Implant brain electrodes
   61770  C                            Incise skull for treatment
   61791  C                            Treat trigeminal tract
   61795  C                            Brain surgery using computer
   61850  C                            Implant neuroelectrodes
   61855  C                            Implant neuroelectrodes
   61860  C                            Implant neuroelectrodes
   61865  C                            Implant neuroelectrodes
   61870  C                            Implant neuroelectrodes
   61875  C                            Implant neuroelectrodes
   61880  C                            Revise/remove neuroelectrode
   61888  C                            Revise/remove neuroreceiver
   62000  C                            Repair of skull fracture
   62005  C                            Repair of skull fracture
   62010  C                            Treatment of head injury
   62100  C                            Repair brain fluid leakage
   62115  C                            Reduction of skull defect
   62116  C                            Reduction of skull defect
   62117  C                            Reduction of skull defect
   62120  C                            Repair skull cavity lesion
   62121  C                            Incise skull repair
   62140  C                            Repair of skull defect
   62141  C                            Repair of skull defect
   62142  C                            Remove skull plate/flap
   62143  C                            Replace skull plate/flap
   62145  C                            Repair of skull & brain
   62146  C                            Repair of skull with graft
   62147  C                            Repair of skull with graft
   62180  C                            Establish brain cavity shunt
   62190  C                            Establish brain cavity shunt
   62192  C                            Establish brain cavity shunt
   62200  C                            Establish brain cavity shunt
   62201  C                            Establish brain cavity shunt
   62220  C                            Establish brain cavity shunt
   62223  C                            Establish brain cavity shunt
   62256  C                            Remove brain cavity shunt
   62258  C                            Replace brain cavity shunt
   62351  C                            Implant spinal catheter
   63001  C                            Removal of spinal lamina
   63003  C                            Removal of spinal lamina
   63005  C                            Removal of spinal lamina
   63011  C                            Removal of spinal lamina
   63012  C                            Removal of spinal lamina
   63015  C                            Removal of spinal lamina
   63016  C                            Removal of spinal lamina
   63017  C                            Removal of spinal lamina
   63020  C                            Neck spine disk surgery
   63030  C                            Low back disk surgery
   63035  C                            Spinal disk surgery add-on
   63040  C                            Neck spine disk surgery
   63042  C                            Low back disk surgery
   63045  C                            Removal of spinal lamina
   63046  C                            Removal of spinal lamina
   63047  C                            Removal of spinal lamina
   63048  C                            Remove spinal lamina add-on
   63055  C                            Decompress spinal cord
   63056  C                            Decompress spinal cord
   63057  C                            Decompress spine cord add-on
   63064  C                            Decompress spinal cord
   63066  C                            Decompress spine cord add-on
   63075  C                            Neck spine disk surgery
   63076  C                            Neck spine disk surgery
   63077  C                            Spine disk surgery, thorax
   63078  C                            Spine disk surgery, thorax
   63081  C                            Removal of vertebral body
   63082  C                            Remove vertebral body add-on
   63085  C                            Removal of vertebral body
   63086  C                            Remove vertebral body add-on
   63087  C                            Removal of vertebral body
   63088  C                            Remove vertebral body add-on
   63090  C                            Removal of vertebral body
   63091  C                            Remove vertebral body add-on
   63170  C                            Incise spinal cord tract(s)
   63172  C                            Drainage of spinal cyst
   63173  C                            Drainage of spinal cyst
   63180  C                            Revise spinal cord ligaments
   63182  C                            Revise spinal cord ligaments
   63185  C                            Incise spinal column/nerves
   63190  C                            Incise spinal column/nerves
   63191  C                            Incise spinal column/nerves
   63194  C                            Incise spinal column & cord
   63195  C                            Incise spinal column & cord
   63196  C                            Incise spinal column & cord
   63197  C                            Incise spinal column & cord
   63198  C                            Incise spinal column & cord
   63199  C                            Incise spinal column & cord
   63200  C                            Release of spinal cord
   63250  C                            Revise spinal cord vessels
   63251  C                            Revise spinal cord vessels
   63252  C                            Revise spinal cord vessels
   63265  C                            Excise intraspinal lesion
   63266  C                            Excise intraspinal lesion
   63267  C                            Excise intraspinal lesion
   63268  C                            Excise intraspinal lesion
   63270  C                            Excise intraspinal lesion
   63271  C                            Excise intraspinal lesion
   63272  C                            Excise intraspinal lesion
   63273  C                            Excise intraspinal lesion
   63275  C                            Biopsy/excise spinal tumor
   63276  C                            Biopsy/excise spinal tumor
   63277  C                            Biopsy/excise spinal tumor
   63278  C                            Biopsy/excise spinal tumor
   63280  C                            Biopsy/excise spinal tumor
   63281  C                            Biopsy/excise spinal tumor
   63282  C                            Biopsy/excise spinal tumor
   63283  C                            Biopsy/excise spinal tumor
   63285  C                            Biopsy/excise spinal tumor
   63286  C                            Biopsy/excise spinal tumor
   63287  C                            Biopsy/excise spinal tumor
   63290  C                            Biopsy/excise spinal tumor
   63300  C                            Removal of vertebral body
   63301  C                            Removal of vertebral body
   63302  C                            Removal of vertebral body
   63303  C                            Removal of vertebral body
   63304  C                            Removal of vertebral body
   63305  C                            Removal of vertebral body
   63306  C                            Removal of vertebral body
   63307  C                            Removal of vertebral body
   63308  C                            Remove vertebral body add-on
   63655  C                            Implant neuroelectrodes
   63700  C                            Repair of spinal herniation
   63702  C                            Repair of spinal herniation
   63704  C                            Repair of spinal herniation
   63706  C                            Repair of spinal herniation
   63707  C                            Repair spinal fluid leakage
   63709  C                            Repair spinal fluid leakage
   63710  C                            Graft repair of spine defect
   63740  C                            Install spinal shunt
   63741  C                            Install spinal shunt
   64752  C                            Incision of vagus nerve
   64755  C                            Incision of stomach nerves
   64760  C                            Incision of vagus nerve
   64763  C                            Incise hip/thigh nerve
   64766  C                            Incise hip/thigh nerve
   64802  C                            Remove sympathetic nerves
   64804  C                            Remove sympathetic nerves
   64809  C                            Remove sympathetic nerves
   64818  C                            Remove sympathetic nerves
   64820  C                            Remove sympathetic nerves
   64866  C                            Fusion of facial/other nerve
   64868  C                            Fusion of facial/other nerve
   65110  C                            Removal of eye
   65112  C                            Remove eye, revise socket
   65114  C                            Remove eye, revise socket
   65273  C                            Repair of eye wound
   67414  C                            Explore/decompress eye socke
   67445  C                            Explore/decompress eye socke
   67570  C                            Decompress optic nerve
   69155  C                            Extensive ear/neck surgery
   69535  C                            Remove part of temporal bone
   69554  C                            Remove ear lesion
   69950  C                            Incise inner ear nerve
   69955  C                            Release facial nerve
   69960  C                            Release inner ear canal
   69970  C                            Remove inner ear lesion
   69979  C                            Temporal bone surgery
   74300  C                            X-ray bile ducts, pancreas
   74301  C                            X-rays at surgery add-on
   75894  C                            X-rays, transcatheter therapy
   75896  C                            X-rays, transcatheter therapy
   75900  C                            Arterial catheter exchange
   75940  C                            X-ray placement, vein filter
   75945  C                            Intravascular us
   75946  C                            Intravascular us add-on
   75960  C                            Transcatheter intro, stent
   75961  C                            Retrieval, broken catheter
   75962  C                            Repair arterial blockage
   75964  C                            Repair artery blockage, each
   75966  C                            Repair arterial blockage
   75968  C                            Repair artery blockage, each
   75970  C                            Vascular biopsy
   75978  C                            Repair venous blockage
   75992  C                            Atherectomy, x-ray exam
   75993  C                            Atherectomy, x-ray exam
   75994  C                            Atherectomy, x-ray exam
   75995  C                            Atherectomy, x-ray exam
   75996  C                            Atherectomy, x-ray exam
   92970  C                            Cardioassist, internal
   92971  C                            Cardioassist, external
   92975  C                            Dissolve clot, heart vessel
   92977  C                            Dissolve clot, heart vessel
   92978  C                            Intravas us, heart add-on
   92979  C                            Intravas us, heart (add-on)
   92980  C                            Insert intracoronary stent
   92981  C                            Insert intracoronary stent
   92982  C                            Coronary artery dilation
   92984  C                            Coronary artery dilation
   92986  C                            Revision of aortic valve
   92987  C                            Revision of mitral valve
   92990  C                            Revision of pulmonary valve
   92992  C                            Revision of heart chamber

[[Page 35483]]

 
   92993  C                            Revision of heart chamber
   92995  C                            Coronary atherectomy
   92996  C                            Coronary atherectomy add-on
   92997  C                            Pul art balloon repair, perc
   92998  C                            Pul art balloon repair, perc
   94652  C                            Pressure breathing (IPPB)
   94656  C                            Initial ventilator mgmt
   95920  C                            Intraop nerve test add-on
   95961  C                            Electrode stimulation, brain
   95962  C                            Electrode stimulation, brain
   99190  C                            Special pump services
   99191  C                            Special pump services
   99192  C                            Special pump services
   99234  C                            Observ/hosp same date
   99235  C                            Observ/hosp same date
   99236  C                            Observ/hosp same date
   99251  C                            Initial inpatient consult
   99252  C                            Initial inpatient consult
   99253  C                            Initial inpatient consult
   99254  C                            Initial inpatient consult
   99255  C                            Initial inpatient consult
   99261  C                            Follow-up inpatient consult
   99262  C                            Follow-up inpatient consult
   99263  C                            Follow-up inpatient consult
   99295  C                            Neonatal critical care
   99296  C                            Neonatal critical care
   99297  C                            Neonatal critical care
   99356  C                            Prolonged service, inpatient
   99357  C                            Prolonged service, inpatient
   99433  C                            Normal newborn care,hospital
------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 1997 American Medical
  Association. All rights reserved. Applicable FARS/DFARS apply.
\2\ Copyright 1994 American Dental Association. All rights reserved.

    51. On pages 48005 through 48030, Addendum I is corrected to read 
as follows:

  
[[Page 35483]]


              Addendum I.--Service Mix Indices by Hospital
------------------------------------------------------------------------
                            Hospital                               SMI
------------------------------------------------------------------------
10001..........................................................     2.87
10004..........................................................     1.70
10005..........................................................     2.04
10006..........................................................     2.81
10007..........................................................     1.56
10008..........................................................     1.77
10009..........................................................     1.47
10010..........................................................     2.30
10011..........................................................     2.42
10012..........................................................     2.01
10015..........................................................     2.11
10016..........................................................     2.49
10018..........................................................     6.17
10019..........................................................     2.24
10021..........................................................     1.64
10022..........................................................     1.86
10023..........................................................     2.47
10024..........................................................     2.75
10025..........................................................     2.02
10027..........................................................     1.00
10029..........................................................     2.98
10031..........................................................     1.85
10032..........................................................     1.27
10033..........................................................     1.47
10034..........................................................     2.41
10035..........................................................     2.82
10036..........................................................     2.42
10038..........................................................     4.13
10039..........................................................     2.05
10040..........................................................     2.42
10043..........................................................     2.17
10044..........................................................     2.03
10045..........................................................     1.82
10046..........................................................     2.00
10047..........................................................     1.55
10049..........................................................     2.86
10050..........................................................     1.79
10051..........................................................     1.49
10052..........................................................     1.48
10053..........................................................     1.88
10054..........................................................     1.79
10055..........................................................     2.63
10056..........................................................     2.61
10058..........................................................     1.16
10059..........................................................     1.76
10061..........................................................     2.48
10062..........................................................     1.64
10064..........................................................     3.07
10065..........................................................     2.25
10066..........................................................     1.32
10068..........................................................     1.35
10069..........................................................     2.15
10072..........................................................     2.44
10073..........................................................     2.43
10078..........................................................     2.31
10079..........................................................     2.33
10080..........................................................     1.05
10081..........................................................     2.33
10083..........................................................     2.10
10084..........................................................     3.82
10087..........................................................     2.56
10089..........................................................     2.42
10090..........................................................     2.33
10091..........................................................     1.55
10092..........................................................     2.36
10094..........................................................     2.36
10095..........................................................     1.36
10097..........................................................     1.92
10098..........................................................     1.68
10099..........................................................     1.89
10100..........................................................     2.58
10101..........................................................     2.26
10102..........................................................     1.23
10103..........................................................     2.19
10104..........................................................     2.47
10108..........................................................     1.82
10109..........................................................     2.17
10110..........................................................     1.14
10112..........................................................     1.73
10113..........................................................     2.55
10114..........................................................     2.24
10115..........................................................     1.40
10117..........................................................     1.19
10118..........................................................     2.43
10119..........................................................     2.05
10120..........................................................     1.91
10123..........................................................     2.90
10124..........................................................     3.20
10125..........................................................     1.38
10126..........................................................     2.00
10127..........................................................     3.04
10128..........................................................     1.28
10129..........................................................     1.76
10130..........................................................     1.59
10131..........................................................     2.58
10134..........................................................     1.44
10137..........................................................     1.41
10138..........................................................     1.21
10139..........................................................     2.54
10143..........................................................     1.80
10144..........................................................     2.52
10145..........................................................     1.51
10146..........................................................     2.79
10148..........................................................     1.83
10149..........................................................     2.67
10150..........................................................     1.99
10152..........................................................     2.08
10155..........................................................     1.50
13025..........................................................     1.76
13027..........................................................     1.08
13028..........................................................     0.89
13300..........................................................     1.38
14000..........................................................     1.26
14002..........................................................     1.20
20001..........................................................     2.64
20002..........................................................     1.99
20004..........................................................     1.80
20005..........................................................     1.03
20006..........................................................     1.87
20007..........................................................     0.84
20008..........................................................     2.08
20009..........................................................     1.03
20010..........................................................     0.53
20011..........................................................     0.98
20012..........................................................     3.12
20013..........................................................     1.76
20014..........................................................     1.70
20017..........................................................     3.05
20024..........................................................     1.78
20025..........................................................     1.00
24001..........................................................     1.40
30001..........................................................     2.48
30002..........................................................     2.35
30003..........................................................     1.98
30004..........................................................     0.83
30006..........................................................     2.66
30007..........................................................     2.48
30009..........................................................     1.32
30010..........................................................     2.44
30011..........................................................     3.35
30012..........................................................     1.86
30014..........................................................     2.89
30016..........................................................     1.75
30017..........................................................     2.70
30018..........................................................     2.90
30019..........................................................     2.27
30022..........................................................     1.64
30023..........................................................     2.67
30024..........................................................     3.42
30025..........................................................     1.66
30027..........................................................     1.62
30030..........................................................     2.79
30033..........................................................     2.36
30034..........................................................     1.24
30035..........................................................     2.92
30036..........................................................     2.27

[[Page 35484]]

 
30037..........................................................     3.90
30038..........................................................     3.06
30040..........................................................     1.83
30041..........................................................     1.23
30043..........................................................     2.41
30044..........................................................     1.97
30047..........................................................     1.57
30049..........................................................     0.75
30054..........................................................     0.84
30055..........................................................     2.33
30059..........................................................     2.44
30060..........................................................     2.14
30061..........................................................     1.90
30062..........................................................     2.33
30064..........................................................     2.43
30065..........................................................     2.75
30067..........................................................     1.56
30068..........................................................     2.35
30069..........................................................     2.80
30080..........................................................     2.53
30083..........................................................     2.40
30085..........................................................     2.32
30086..........................................................     2.18
30087..........................................................     3.31
30088..........................................................     2.05
30089..........................................................     2.52
30092..........................................................     2.52
30093..........................................................     1.60
30094..........................................................     1.96
30095..........................................................     2.95
33025..........................................................     1.61
33026..........................................................     1.81
33028..........................................................     1.49
34004..........................................................     1.34
34008..........................................................     1.57
34009..........................................................     1.31
34010..........................................................     1.31
34013..........................................................     1.33
34015..........................................................     1.31
34019..........................................................     1.28
40001..........................................................     2.26
40002..........................................................     2.09
40003..........................................................     1.80
40004..........................................................     3.63
40005..........................................................     1.89
40007..........................................................     3.84
40008..........................................................     1.26
40010..........................................................     2.98
40011..........................................................     1.94
40014..........................................................     2.54
40015..........................................................     1.65
40016..........................................................     1.93
40017..........................................................     2.35
40018..........................................................     2.70
40019..........................................................     2.29
40020..........................................................     2.73
40021..........................................................     2.97
40022..........................................................     2.23
40024..........................................................     1.68
40025..........................................................     1.72
40026..........................................................     2.41
40027..........................................................     2.93
40028..........................................................     2.00
40029..........................................................     3.25
40030..........................................................     1.26
40032..........................................................     0.91
40035..........................................................     1.12
40036..........................................................     2.94
40037..........................................................     1.85
40039..........................................................     2.44
40040..........................................................     1.27
40041..........................................................     3.11
40042..........................................................     2.04
40044..........................................................     1.28
40045..........................................................     1.60
40047..........................................................     1.71
40048..........................................................     2.33
40050..........................................................     2.67
40051..........................................................     2.02
40053..........................................................     1.59
40054..........................................................     2.96
40055..........................................................     2.47
40058..........................................................     2.12
40060..........................................................     1.33
40062..........................................................     2.30
40064..........................................................     1.40
40066..........................................................     3.24
40067..........................................................     1.18
40069..........................................................     2.76
40070..........................................................     1.70
40071..........................................................     2.52
40072..........................................................     2.19
40074..........................................................     2.70
40075..........................................................     1.63
40076..........................................................     1.70
40077..........................................................     1.63
40078..........................................................     2.58
40080..........................................................     1.69
40081..........................................................     0.93
40082..........................................................     1.71
40084..........................................................     2.89
40085..........................................................     1.83
40088..........................................................     2.99
40090..........................................................     1.25
40091..........................................................     1.63
40093..........................................................     1.19
40100..........................................................     2.21
40105..........................................................     1.22
40106..........................................................     1.95
40107..........................................................     1.50
40109..........................................................     1.91
40114..........................................................     4.32
40116..........................................................     2.81
40118..........................................................     2.62
40119..........................................................     2.76
40124..........................................................     2.31
40126..........................................................     1.82
40132..........................................................     0.96
43026..........................................................     1.42
43027..........................................................     0.87
43028..........................................................     1.19
43029..........................................................     1.76
43031..........................................................     0.82
43032..........................................................     2.80
43300..........................................................     1.51
44004..........................................................     1.29
44005..........................................................     1.32
44006..........................................................     1.38
44010..........................................................     1.52
44011..........................................................     1.69
44012..........................................................     1.32
50002..........................................................     1.89
50006..........................................................     2.28
50007..........................................................     2.11
50009..........................................................     2.75
50013..........................................................     2.93
50014..........................................................     2.65
50015..........................................................     2.21
50016..........................................................     2.00
50017..........................................................     4.45
50018..........................................................     2.36
50021..........................................................     2.13
50022..........................................................     2.57
50024..........................................................     2.06
50025..........................................................     2.08
50026..........................................................     2.05
50028..........................................................     2.32
50029..........................................................     2.13
50030..........................................................     1.75
50032..........................................................     2.91
50033..........................................................     2.05
50036..........................................................     2.58
50038..........................................................     1.39
50039..........................................................     2.62
50042..........................................................     3.00
50043..........................................................     2.66
50045..........................................................     3.04
50046..........................................................     2.17
50047..........................................................     2.86
50051..........................................................     1.45
50054..........................................................     1.57
50055..........................................................     1.71
50056..........................................................     3.32
50057..........................................................     3.01
50058..........................................................     2.70
50060..........................................................     1.93
50061..........................................................     4.86
50063..........................................................     2.56
50065..........................................................     2.34
50066..........................................................     2.25
50067..........................................................     1.80
50068..........................................................     2.45
50069..........................................................     2.55
50077..........................................................     2.72
50078..........................................................     2.45
50079..........................................................     2.02
50080..........................................................     1.68
50081..........................................................     1.10
50082..........................................................     2.59
50084..........................................................     2.23
50088..........................................................     1.30
50089..........................................................     1.99
50090..........................................................     2.38
50091..........................................................     2.33
50092..........................................................     1.71
50093..........................................................     3.45
50095..........................................................     3.59
50096..........................................................     2.44
50097..........................................................     3.49
50099..........................................................     2.11
50100..........................................................     2.37
50101..........................................................     2.56
50102..........................................................     1.86
50103..........................................................     2.79
50104..........................................................     2.16
50107..........................................................     2.48
50108..........................................................     2.48
50109..........................................................     2.25
50110..........................................................     3.14
50111..........................................................     4.66
50112..........................................................     2.51
50113..........................................................     1.26
50114..........................................................     2.19
50115..........................................................     1.87
50116..........................................................     2.62
50117..........................................................     2.82
50118..........................................................     2.37
50121..........................................................     2.97
50122..........................................................     2.74
50124..........................................................     2.34
50125..........................................................     2.92
50126..........................................................     2.67
50127..........................................................     1.96
50128..........................................................     2.19
50129..........................................................     2.61
50131..........................................................     2.34
50132..........................................................     2.44
50133..........................................................     1.99
50135..........................................................     1.34
50136..........................................................     2.46
50144..........................................................     2.21
50145..........................................................     2.53
50146..........................................................     1.30
50148..........................................................     2.21
50149..........................................................     2.20
50150..........................................................     2.29
50152..........................................................     2.15
50153..........................................................     2.32

[[Page 35485]]

 
50155..........................................................     2.05
50158..........................................................     3.24
50159..........................................................     1.34
50167..........................................................     1.30
50168..........................................................     3.18
50169..........................................................     2.48
50170..........................................................     2.63
50172..........................................................     1.71
50173..........................................................     2.59
50174..........................................................     3.12
50175..........................................................     3.10
50177..........................................................     1.80
50179..........................................................     2.45
50180..........................................................     2.09
50183..........................................................     1.22
50186..........................................................     1.67
50188..........................................................     3.47
50189..........................................................     2.28
50191..........................................................     2.39
50192..........................................................     1.45
50193..........................................................     1.68
50194..........................................................     2.48
50195..........................................................     2.14
50196..........................................................     2.11
50197..........................................................     2.49
50204..........................................................     3.00
50205..........................................................     2.12
50207..........................................................     3.11
50208..........................................................     2.02
50211..........................................................     2.50
50213..........................................................     1.26
50214..........................................................     2.16
50215..........................................................     2.83
50217..........................................................     2.07
50219..........................................................     1.77
50222..........................................................     2.39
50224..........................................................     2.49
50225..........................................................     2.08
50226..........................................................     2.63
50228..........................................................     1.13
50230..........................................................     2.69
50231..........................................................     3.45
50232..........................................................     2.78
50233..........................................................     2.70
50234..........................................................     1.56
50235..........................................................     2.48
50236..........................................................     2.04
50238..........................................................     2.03
50239..........................................................     2.50
50240..........................................................     2.55
50241..........................................................     2.21
50242..........................................................     2.13
50243..........................................................     1.94
50245..........................................................     1.15
50248..........................................................     1.39
50251..........................................................     2.10
50253..........................................................     1.33
50254..........................................................     2.98
50256..........................................................     1.36
50257..........................................................     1.66
50260..........................................................     1.32
50261..........................................................     1.98
50262..........................................................     2.09
50264..........................................................     2.13
50267..........................................................     2.56
50270..........................................................     2.48
50272..........................................................     1.77
50274..........................................................     1.44
50276..........................................................     1.18
50277..........................................................     2.32
50278..........................................................     2.44
50279..........................................................     1.81
50280..........................................................     2.50
50281..........................................................     3.59
50282..........................................................     2.19
50283..........................................................     1.12
50286..........................................................     0.95
50289..........................................................     2.46
50290..........................................................     2.28
50291..........................................................     1.60
50292..........................................................     1.37
50293..........................................................     1.30
50295..........................................................     2.45
50296..........................................................     2.25
50298..........................................................     2.00
50299..........................................................     2.87
50300..........................................................     2.80
50301..........................................................     2.81
50302..........................................................     2.65
50305..........................................................     1.97
50307..........................................................     3.51
50308..........................................................     2.19
50309..........................................................     2.76
50310..........................................................     2.76
50312..........................................................     2.34
50313..........................................................     2.89
50315..........................................................     1.13
50317..........................................................     1.79
50320..........................................................     1.18
50324..........................................................     2.91
50325..........................................................     1.66
50327..........................................................     2.26
50328..........................................................     2.48
50329..........................................................     1.65
50331..........................................................     1.93
50333..........................................................     1.02
50334..........................................................     3.18
50335..........................................................     1.25
50336..........................................................     2.31
50337..........................................................     1.66
50342..........................................................     2.71
50343..........................................................     3.02
50348..........................................................     1.58
50349..........................................................     1.14
50350..........................................................     2.08
50351..........................................................     3.05
50352..........................................................     1.73
50353..........................................................     2.37
50355..........................................................     1.01
50357..........................................................     2.29
50359..........................................................     3.22
50360..........................................................     3.01
50366..........................................................     1.90
50367..........................................................     1.81
50369..........................................................     2.21
50377..........................................................     0.87
50378..........................................................     2.01
50379..........................................................     1.42
50380..........................................................     3.09
50382..........................................................     2.50
50385..........................................................     2.10
50388..........................................................     0.92
50390..........................................................     2.47
50391..........................................................     1.88
50392..........................................................     1.28
50393..........................................................     2.75
50394..........................................................     3.09
50396..........................................................     3.93
50397..........................................................     1.31
50401..........................................................     2.18
50404..........................................................     1.43
50406..........................................................     1.38
50407..........................................................     2.72
50410..........................................................     0.95
50414..........................................................     2.49
50417..........................................................     2.79
50418..........................................................     1.26
50419..........................................................     2.46
50420..........................................................     1.85
50421..........................................................     2.33
50423..........................................................     2.09
50424..........................................................     2.77
50426..........................................................     2.46
50427..........................................................     0.76
50430..........................................................     1.39
50431..........................................................     3.59
50432..........................................................     2.32
50433..........................................................     1.44
50434..........................................................     1.36
50435..........................................................     2.34
50436..........................................................     1.48
50438..........................................................     2.38
50440..........................................................     1.46
50441..........................................................     2.01
50443..........................................................     1.47
50444..........................................................     2.14
50446..........................................................     1.32
50447..........................................................     1.58
50448..........................................................     2.94
50449..........................................................     3.19
50454..........................................................     1.62
50455..........................................................     3.08
50456..........................................................     4.96
50457..........................................................     2.05
50459..........................................................     2.34
50464..........................................................     2.94
50468..........................................................     1.50
50469..........................................................     1.60
50470..........................................................     2.00
50471..........................................................     2.87
50476..........................................................     2.46
50477..........................................................     4.20
50478..........................................................     1.52
50481..........................................................     2.61
50482..........................................................     1.02
50483..........................................................     3.02
50485..........................................................     2.90
50486..........................................................     2.29
50488..........................................................     2.09
50491..........................................................     2.30
50492..........................................................     2.24
50494..........................................................     3.06
50496..........................................................     2.35
50497..........................................................     0.98
50498..........................................................     2.38
50502..........................................................     3.39
50503..........................................................     3.27
50506..........................................................     2.28
50516..........................................................     3.02
50517..........................................................     2.24
50522..........................................................     2.30
50523..........................................................     2.05
50526..........................................................     2.36
50528..........................................................     2.01
50531..........................................................     3.13
50534..........................................................     2.28
50535..........................................................     2.67
50537..........................................................     2.62
50539..........................................................     2.08
50542..........................................................     1.93
50543..........................................................     2.53
50545..........................................................     0.96
50546..........................................................     0.93
50547..........................................................     1.07
50548..........................................................     0.78
50549..........................................................     2.47
50550..........................................................     2.23
50551..........................................................     2.38
50552..........................................................     1.24
50557..........................................................     2.14
50559..........................................................     2.43
50560..........................................................     1.94
50564..........................................................     2.41
50565..........................................................     1.80
50566..........................................................     1.51
50567..........................................................     2.22
50568..........................................................     2.50
50569..........................................................     2.37

[[Page 35486]]

 
50570..........................................................     3.06
50571..........................................................     3.05
50573..........................................................     2.27
50577..........................................................     4.04
50579..........................................................     2.31
50580..........................................................     2.21
50581..........................................................     2.22
50583..........................................................     2.97
50584..........................................................     1.93
50585..........................................................     2.47
50586..........................................................     2.74
50588..........................................................     2.48
50589..........................................................     2.89
50590..........................................................     3.11
50591..........................................................     2.47
50592..........................................................     2.82
50593..........................................................     2.00
50594..........................................................     2.75
50597..........................................................     2.74
50598..........................................................     2.46
50599..........................................................     1.45
50601..........................................................     2.48
50603..........................................................     1.64
50607..........................................................     1.59
50608..........................................................     1.68
50613..........................................................     0.69
50615..........................................................     2.53
50616..........................................................     2.40
50618..........................................................     1.29
50624..........................................................     2.73
50625..........................................................     2.47
50633..........................................................     2.48
50636..........................................................     2.91
50638..........................................................     1.48
50641..........................................................     2.02
50644..........................................................     2.56
50660..........................................................     1.41
50661..........................................................     1.30
50662..........................................................     1.02
50663..........................................................     2.15
50666..........................................................     1.06
50667..........................................................     1.07
50668..........................................................     1.03
50676..........................................................     0.87
50678..........................................................     2.02
50680..........................................................     1.50
50682..........................................................     1.18
50684..........................................................     2.01
50685..........................................................     2.37
50688..........................................................     1.62
50689..........................................................     2.32
50693..........................................................     2.05
50694..........................................................     2.01
50695..........................................................     1.64
50696..........................................................     3.01
50697..........................................................     4.28
50699..........................................................     2.19
50700..........................................................     2.33
50701..........................................................     1.92
50702..........................................................     0.89
50704..........................................................     1.87
50709..........................................................     2.69
52031..........................................................     1.05
53026..........................................................     1.72
53027..........................................................     1.00
53028..........................................................     1.05
53029..........................................................     1.33
53030..........................................................     1.05
53031..........................................................     1.08
53032..........................................................     0.98
53033..........................................................     1.30
53034..........................................................     1.63
53035..........................................................     1.40
53036..........................................................     1.24
53037..........................................................     1.25
53300..........................................................     1.41
53301..........................................................     1.98
53302..........................................................     1.59
53304..........................................................     1.24
53305..........................................................     0.98
54001..........................................................     1.31
54003..........................................................     1.76
54012..........................................................     1.35
54032..........................................................     1.31
54053..........................................................     1.43
54055..........................................................     1.09
54060..........................................................     1.31
54064..........................................................     1.09
54065..........................................................     1.31
54069..........................................................     1.31
54074..........................................................     1.31
54075..........................................................     1.31
54078..........................................................     1.65
54087..........................................................     1.30
54091..........................................................     1.57
54093..........................................................     1.51
54095..........................................................     1.31
54096..........................................................     1.33
54097..........................................................     1.34
54098..........................................................     1.31
54099..........................................................     1.32
54104..........................................................     1.50
54105..........................................................     1.31
54106..........................................................     1.32
54108..........................................................     1.22
54110..........................................................     1.31
54111..........................................................     1.31
54113..........................................................     1.31
54116..........................................................     1.33
54119..........................................................     1.31
54122..........................................................     1.16
54123..........................................................     1.34
54125..........................................................     1.60
54130..........................................................     1.31
54131..........................................................     1.63
54133..........................................................     0.88
54139..........................................................     1.20
60001..........................................................     2.91
60003..........................................................     2.83
60004..........................................................     1.55
60006..........................................................     2.08
60007..........................................................     1.50
60008..........................................................     2.08
60009..........................................................     2.23
60010..........................................................     2.35
60011..........................................................     1.26
60012..........................................................     1.83
60013..........................................................     1.79
60014..........................................................     2.41
60015..........................................................     1.70
60016..........................................................     2.01
60018..........................................................     2.17
60020..........................................................     1.96
60022..........................................................     1.73
60023..........................................................     2.50
60024..........................................................     1.52
60027..........................................................     2.15
60028..........................................................     2.48
60029..........................................................     1.17
60030..........................................................     2.74
60031..........................................................     2.20
60032..........................................................     2.73
60033..........................................................     1.65
60034..........................................................     1.97
60036..........................................................     1.85
60037..........................................................     1.43
60038..........................................................     1.39
60041..........................................................     1.00
60042..........................................................     1.58
60043..........................................................     1.34
60044..........................................................     2.09
60046..........................................................     2.82
60047..........................................................     0.89
60049..........................................................     2.70
60050..........................................................     1.95
60052..........................................................     1.66
60053..........................................................     1.68
60054..........................................................     2.42
60056..........................................................     1.27
60057..........................................................     2.07
60058..........................................................     1.27
60060..........................................................     1.31
60062..........................................................     1.48
60063..........................................................     0.77
60064..........................................................     3.00
60065..........................................................     2.24
60068..........................................................     1.24
60070..........................................................     1.33
60071..........................................................     2.09
60073..........................................................     1.27
60075..........................................................     2.56
60076..........................................................     1.84
60085..........................................................     1.11
60088..........................................................     1.55
60090..........................................................     1.55
60096..........................................................     2.20
60100..........................................................     2.02
60103..........................................................     4.08
60104..........................................................     2.29
62009..........................................................     0.81
62011..........................................................     2.20
63027..........................................................     1.45
63030..........................................................     1.82
63301..........................................................     1.57
64007..........................................................     1.31
64009..........................................................     1.09
64012..........................................................     1.26
64016..........................................................     1.41
70001..........................................................     2.72
70002..........................................................     2.47
70003..........................................................     2.00
70004..........................................................     2.24
70005..........................................................     1.71
70006..........................................................     2.31
70007..........................................................     2.73
70008..........................................................     1.95
70009..........................................................     2.65
70010..........................................................     2.41
70011..........................................................     2.06
70012..........................................................     2.13
70015..........................................................     2.17
70016..........................................................     2.03
70017..........................................................     2.24
70018..........................................................     2.16
70019..........................................................     2.80
70020..........................................................     2.10
70021..........................................................     2.56
70022..........................................................     2.37
70024..........................................................     2.24
70025..........................................................     2.75
70026..........................................................     2.05
70027..........................................................     2.14
70028..........................................................     2.17
70029..........................................................     2.29
70030..........................................................     2.44
70031..........................................................     2.07
70033..........................................................     1.93
70035..........................................................     2.35
70036..........................................................     1.96
70039..........................................................     1.06
72003..........................................................     1.04
72004..........................................................     0.79
74000..........................................................     1.25
74007..........................................................     1.31
74008..........................................................     1.53
80001..........................................................     2.94
80002..........................................................     2.15
80003..........................................................     2.63

[[Page 35487]]

 
80004..........................................................     2.42
80005..........................................................     2.70
80006..........................................................     2.31
80007..........................................................     2.07
83300..........................................................     3.40
84002..........................................................     1.43
90001..........................................................     3.34
90002..........................................................     1.80
90003..........................................................     1.70
90004..........................................................     2.38
90006..........................................................     2.41
90007..........................................................     1.18
90008..........................................................     2.36
90010..........................................................     1.96
90011..........................................................     2.42
90015..........................................................     0.65
93025..........................................................     1.03
93300..........................................................     1.98
94004..........................................................     1.10
100001.........................................................     1.48
100002.........................................................     2.47
100004.........................................................     1.78
100006.........................................................     2.29
100007.........................................................     2.82
100008.........................................................     3.02
100009.........................................................     2.29
100010.........................................................     2.56
100012.........................................................     2.75
100014.........................................................     2.53
100015.........................................................     2.49
100017.........................................................     2.55
100018.........................................................     1.83
100019.........................................................     3.21
100020.........................................................     2.87
100022.........................................................     1.37
100023.........................................................     2.44
100024.........................................................     2.88
100025.........................................................     2.21
100026.........................................................     2.63
100027.........................................................     1.37
100028.........................................................     2.73
100029.........................................................     2.42
100030.........................................................     2.91
100032.........................................................     1.98
100034.........................................................     2.35
100035.........................................................     2.31
100038.........................................................     2.22
100039.........................................................     2.68
100040.........................................................     2.85
100043.........................................................     2.28
100044.........................................................     2.35
100045.........................................................     2.20
100046.........................................................     2.21
100047.........................................................     1.91
100048.........................................................     1.58
100049.........................................................     2.46
100050.........................................................     2.15
100051.........................................................     2.51
100052.........................................................     3.58
100053.........................................................     2.46
100054.........................................................     2.02
100055.........................................................     2.20
100056.........................................................     3.26
100057.........................................................     2.88
100060.........................................................     2.36
100061.........................................................     2.52
100062.........................................................     2.43
100063.........................................................     2.19
100067.........................................................     2.29
100068.........................................................     2.00
100069.........................................................     2.45
100070.........................................................     2.40
100071.........................................................     2.15
100072.........................................................     2.29
100073.........................................................     1.88
100075.........................................................     2.01
100076.........................................................     2.37
100077.........................................................     3.09
100078.........................................................     1.05
100079.........................................................     1.68
100080.........................................................     2.30
100081.........................................................     1.76
100082.........................................................     2.14
100084.........................................................     1.98
100085.........................................................     2.15
100086.........................................................     2.33
100087.........................................................     3.40
100088.........................................................     3.10
100090.........................................................     2.72
100098.........................................................     1.47
100099.........................................................     2.72
100102.........................................................     2.00
100103.........................................................     1.20
100105.........................................................     2.58
100106.........................................................     2.64
100107.........................................................     2.48
100108.........................................................     2.05
100109.........................................................     2.66
100110.........................................................     2.13
100112.........................................................     0.99
100113.........................................................     2.67
100114.........................................................     2.37
100117.........................................................     2.94
100118.........................................................     1.88
100121.........................................................     2.58
100122.........................................................     2.60
100124.........................................................     1.82
100125.........................................................     2.35
100126.........................................................     2.07
100127.........................................................     2.70
100128.........................................................     2.41
100129.........................................................     3.11
100130.........................................................     2.11
100131.........................................................     2.89
100132.........................................................     2.24
100134.........................................................     1.52
100135.........................................................     3.73
100137.........................................................     2.25
100138.........................................................     1.19
100139.........................................................     1.41
100140.........................................................     2.43
100142.........................................................     1.88
100144.........................................................     2.72
100145.........................................................     2.11
100146.........................................................     1.91
100147.........................................................     1.77
100150.........................................................     2.52
100151.........................................................     3.45
100154.........................................................     3.18
100156.........................................................     2.31
100157.........................................................     3.23
100159.........................................................     1.44
100160.........................................................     1.89
100161.........................................................     2.14
100162.........................................................     2.11
100165.........................................................     2.07
100166.........................................................     2.27
100167.........................................................     3.78
100168.........................................................     2.45
100169.........................................................     2.54
100170.........................................................     2.65
100172.........................................................     2.26
100173.........................................................     2.85
100174.........................................................     2.00
100175.........................................................     1.89
100176.........................................................     1.87
100177.........................................................     2.79
100179.........................................................     3.41
100181.........................................................     4.01
100183.........................................................     2.58
100187.........................................................     2.35
100189.........................................................     2.51
100191.........................................................     2.40
100199.........................................................     2.93
100200.........................................................     3.81
100203.........................................................     2.11
100204.........................................................     2.40
100206.........................................................     2.36
100208.........................................................     2.03
100209.........................................................     2.53
100210.........................................................     2.25
100211.........................................................     1.90
100212.........................................................     2.25
100213.........................................................     1.83
100217.........................................................     3.37
100220.........................................................     2.88
100221.........................................................     2.29
100222.........................................................     1.41
100223.........................................................     2.22
100224.........................................................     2.20
100225.........................................................     2.50
100226.........................................................     1.62
100228.........................................................     2.06
100229.........................................................     1.80
100230.........................................................     1.78
100231.........................................................     2.12
100232.........................................................     2.49
100234.........................................................     1.92
100235.........................................................     2.09
100236.........................................................     2.00
100237.........................................................     2.69
100238.........................................................     2.97
100239.........................................................     2.43
100240.........................................................     4.60
100241.........................................................     2.37
100242.........................................................     2.68
100243.........................................................     1.87
100244.........................................................     2.34
100246.........................................................     2.81
100248.........................................................     1.80
100249.........................................................     2.23
100252.........................................................     2.30
100253.........................................................     2.46
100254.........................................................     2.05
100255.........................................................     2.16
100256.........................................................     2.07
100258.........................................................     2.31
100259.........................................................     2.62
100260.........................................................     3.34
100262.........................................................     3.13
100263.........................................................     2.32
100264.........................................................     1.95
100265.........................................................     2.18
100266.........................................................     2.60
100267.........................................................     2.57
100268.........................................................     2.27
100269.........................................................     2.58
100270.........................................................     1.01
100271.........................................................     1.78
100275.........................................................     2.20
100276.........................................................     2.85
100277.........................................................     0.95
100279.........................................................     1.98
100280.........................................................     1.80
100281.........................................................     2.14
100282.........................................................     1.60
102006.........................................................     0.97
102008.........................................................     1.00
102009.........................................................     0.91
102013.........................................................     3.31
103026.........................................................     1.43
103027.........................................................     1.40
103028.........................................................     1.43
103030.........................................................     0.91
103031.........................................................     1.29
103032.........................................................     1.78
103034.........................................................     1.17
103300.........................................................     8.70

[[Page 35488]]

 
103301.........................................................     2.40
104002.........................................................     0.57
104008.........................................................     1.36
104015.........................................................     1.31
104017.........................................................     1.31
104018.........................................................     1.32
104024.........................................................     1.52
104029.........................................................     1.31
104034.........................................................     1.31
104036.........................................................     1.33
104037.........................................................     1.31
104038.........................................................     1.43
104040.........................................................     1.28
104045.........................................................     1.43
104046.........................................................     1.32
104054.........................................................     1.34
104057.........................................................     1.30
104060.........................................................     1.33
110001.........................................................     2.49
110002.........................................................     1.69
110003.........................................................     2.51
110004.........................................................     2.40
110005.........................................................     2.24
110006.........................................................     3.00
110007.........................................................     2.42
110008.........................................................     2.22
110009.........................................................     1.12
110010.........................................................     2.73
110011.........................................................     2.22
110013.........................................................     1.39
110014.........................................................     1.57
110015.........................................................     1.62
110016.........................................................     2.92
110017.........................................................     1.24
110018.........................................................     2.17
110020.........................................................     2.99
110023.........................................................     2.32
110024.........................................................     3.45
110025.........................................................     2.66
110026.........................................................     1.66
110027.........................................................     1.50
110028.........................................................     2.54
110029.........................................................     1.98
110030.........................................................     2.84
110031.........................................................     2.38
110032.........................................................     2.54
110033.........................................................     2.76
110034.........................................................     1.35
110035.........................................................     2.61
110037.........................................................     1.54
110038.........................................................     2.10
110039.........................................................     2.72
110040.........................................................     1.90
110041.........................................................     2.00
110042.........................................................     2.27
110043.........................................................     3.05
110044.........................................................     2.46
110045.........................................................     2.26
110046.........................................................     2.07
110048.........................................................     1.44
110049.........................................................     1.26
110050.........................................................     1.62
110051.........................................................     1.80
110052.........................................................     1.00
110054.........................................................     2.03
110056.........................................................     1.25
110059.........................................................     2.26
110061.........................................................     1.19
110062.........................................................     0.89
110063.........................................................     1.62
110064.........................................................     1.87
110065.........................................................     1.08
110066.........................................................     2.35
110069.........................................................     2.46
110070.........................................................     1.69
110071.........................................................     1.22
110072.........................................................     1.44
110073.........................................................     2.05
110074.........................................................     2.58
110075.........................................................     2.22
110076.........................................................     2.61
110078.........................................................     2.61
110079.........................................................     1.15
110080.........................................................     1.91
110082.........................................................     3.13
110083.........................................................     2.93
110086.........................................................     1.89
110087.........................................................     2.56
110088.........................................................     0.89
110089.........................................................     2.16
110091.........................................................     2.89
110092.........................................................     1.60
110093.........................................................     1.40
110094.........................................................     0.94
110095.........................................................     2.83
110096.........................................................     1.35
110097.........................................................     1.24
110098.........................................................     1.64
110100.........................................................     1.23
110101.........................................................     1.49
110103.........................................................     1.22
110104.........................................................     2.04
110105.........................................................     2.37
110107.........................................................     1.94
110108.........................................................     0.79
110109.........................................................     1.48
110111.........................................................     1.70
110112.........................................................     1.38
110113.........................................................     1.35
110114.........................................................     1.60
110115.........................................................     2.37
110118.........................................................     0.74
110120.........................................................     1.08
110121.........................................................     4.41
110122.........................................................     2.62
110124.........................................................     2.05
110125.........................................................     3.01
110127.........................................................     1.48
110128.........................................................     2.26
110129.........................................................     2.64
110130.........................................................     1.69
110132.........................................................     1.92
110134.........................................................     1.16
110135.........................................................     4.19
110140.........................................................     2.22
110141.........................................................     1.13
110142.........................................................     1.42
110143.........................................................     2.84
110144.........................................................     1.82
110146.........................................................     1.73
110149.........................................................     1.52
110150.........................................................     2.35
110152.........................................................     1.73
110153.........................................................     1.88
110155.........................................................     1.29
110156.........................................................     1.45
110161.........................................................     3.12
110163.........................................................     3.02
110164.........................................................     2.27
110165.........................................................     2.58
110166.........................................................     2.36
110168.........................................................     2.64
110169.........................................................     6.44
110171.........................................................     2.04
110172.........................................................     3.19
110174.........................................................     1.74
110176.........................................................     2.56
110177.........................................................     2.52
110178.........................................................     7.50
110179.........................................................     2.12
110181.........................................................     1.11
110183.........................................................     2.23
110184.........................................................     2.04
110185.........................................................     1.36
110186.........................................................     3.11
110187.........................................................     2.20
110188.........................................................     2.72
110189.........................................................     1.74
110190.........................................................     1.62
110191.........................................................     3.24
110192.........................................................     2.27
110193.........................................................     2.89
110194.........................................................     1.37
110195.........................................................     1.06
110198.........................................................     2.85
110200.........................................................     4.09
110201.........................................................     2.16
110203.........................................................     1.30
110205.........................................................     1.62
110207.........................................................     1.20
110208.........................................................     1.51
110209.........................................................     1.32
112000.........................................................     1.03
112003.........................................................     1.55
112004.........................................................     0.80
113026.........................................................     1.20
113027.........................................................     1.41
113300.........................................................     2.09
114000.........................................................     1.31
114003.........................................................     1.31
114008.........................................................     1.31
114010.........................................................     1.60
114015.........................................................     1.31
114016.........................................................     1.31
114017.........................................................     1.33
114020.........................................................     1.31
114022.........................................................     1.31
114023.........................................................     1.42
114024.........................................................     1.34
114025.........................................................     1.35
114030.........................................................     1.44
114031.........................................................     1.31
114032.........................................................     1.32
114033.........................................................     1.30
114034.........................................................     1.30
120001.........................................................     2.73
120002.........................................................     2.74
120003.........................................................     1.92
120004.........................................................     2.04
120005.........................................................     3.07
120006.........................................................     2.08
120007.........................................................     3.04
120009.........................................................     1.13
120010.........................................................     2.52
120012.........................................................     1.30
120014.........................................................     2.80
120018.........................................................     0.71
120019.........................................................     2.43
120022.........................................................     1.25
120024.........................................................     0.80
120025.........................................................     0.78
120026.........................................................     2.86
120027.........................................................     1.83
123025.........................................................     1.46
123300.........................................................     1.55
124001.........................................................     1.31
130001.........................................................     1.53
130002.........................................................     2.87
130003.........................................................     2.91
130005.........................................................     3.26
130006.........................................................     1.88
130007.........................................................     3.34
130008.........................................................     1.84
130009.........................................................     2.31
130010.........................................................     0.87
130011.........................................................     2.35
130012.........................................................     1.55
130013.........................................................     2.53

[[Page 35489]]

 
130014.........................................................     3.08
130015.........................................................     1.13
130016.........................................................     1.96
130017.........................................................     1.83
130018.........................................................     2.96
130019.........................................................     1.76
130021.........................................................     1.04
130022.........................................................     2.25
130024.........................................................     2.67
130025.........................................................     1.81
130026.........................................................     3.37
130027.........................................................     1.54
130028.........................................................     2.15
130029.........................................................     1.95
130030.........................................................     0.84
130031.........................................................     2.21
130034.........................................................     1.50
130035.........................................................     1.89
130036.........................................................     3.68
130037.........................................................     1.67
130043.........................................................     1.57
130044.........................................................     1.53
130045.........................................................     1.51
130048.........................................................     1.22
130049.........................................................     2.37
130054.........................................................     0.60
130056.........................................................     0.73
130060.........................................................     2.53
130061.........................................................     1.44
133025.........................................................     1.42
134002.........................................................     1.31
134009.........................................................     1.36
140001.........................................................     2.07
140002.........................................................     2.23
140003.........................................................     1.57
140005.........................................................     1.34
140007.........................................................     2.46
140008.........................................................     2.40
140010.........................................................     2.28
140011.........................................................     1.68
140012.........................................................     2.14
140013.........................................................     2.56
140014.........................................................     2.22
140015.........................................................     2.68
140016.........................................................     1.86
140018.........................................................     1.75
140019.........................................................     1.56
140024.........................................................     1.72
140025.........................................................     1.42
140026.........................................................     2.32
140027.........................................................     1.85
140029.........................................................     1.98
140030.........................................................     2.68
140031.........................................................     1.58
140032.........................................................     2.80
140033.........................................................     2.48
140034.........................................................     2.22
140035.........................................................     1.61
140036.........................................................     2.46
140037.........................................................     1.51
140038.........................................................     1.53
140040.........................................................     2.19
140041.........................................................     1.99
140042.........................................................     1.54
140043.........................................................     2.63
140045.........................................................     1.53
140046.........................................................     2.29
140047.........................................................     1.34
140048.........................................................     2.09
140049.........................................................     1.91
140051.........................................................     2.45
140052.........................................................     2.55
140053.........................................................     2.92
140054.........................................................     2.35
140055.........................................................     1.52
140058.........................................................     2.12
140059.........................................................     2.32
140061.........................................................     1.59
140062.........................................................     2.05
140063.........................................................     2.09
140064.........................................................     3.62
140065.........................................................     2.29
140066.........................................................     2.02
140067.........................................................     2.43
140068.........................................................     1.68
140069.........................................................     1.76
140070.........................................................     1.87
140074.........................................................     1.20
140075.........................................................     2.27
140077.........................................................     1.56
140079.........................................................     2.30
140080.........................................................     2.01
140081.........................................................     1.61
140082.........................................................     1.82
140083.........................................................     1.36
140084.........................................................     2.86
140086.........................................................     1.95
140087.........................................................     2.22
140088.........................................................     1.53
140089.........................................................     2.66
140090.........................................................     2.45
140091.........................................................     4.81
140093.........................................................     2.54
140094.........................................................     2.15
140095.........................................................     1.75
140097.........................................................     1.31
140100.........................................................     2.67
140101.........................................................     1.88
140102.........................................................     1.91
140103.........................................................     1.54
140105.........................................................     2.53
140107.........................................................     1.64
140108.........................................................     2.71
140109.........................................................     1.61
140110.........................................................     2.14
140112.........................................................     1.78
140113.........................................................     2.28
140114.........................................................     2.31
140115.........................................................     1.78
140116.........................................................     2.45
140117.........................................................     2.57
140118.........................................................     2.62
140119.........................................................     2.46
140120.........................................................     2.27
140121.........................................................     2.34
140122.........................................................     2.29
140125.........................................................     2.03
140127.........................................................     4.03
140128.........................................................     1.69
140129.........................................................     1.93
140130.........................................................     2.34
140132.........................................................     2.79
140133.........................................................     2.04
140135.........................................................     2.48
140137.........................................................     1.68
140138.........................................................     1.91
140139.........................................................     1.66
140140.........................................................     1.68
140141.........................................................     2.11
140143.........................................................     2.27
140144.........................................................     1.53
140145.........................................................     1.91
140146.........................................................     1.89
140147.........................................................     2.23
140148.........................................................     2.69
140150.........................................................     1.51
140151.........................................................     1.28
140152.........................................................     1.66
140155.........................................................     2.27
140158.........................................................     1.63
140160.........................................................     3.01
140161.........................................................     2.34
140162.........................................................     2.26
140164.........................................................     2.67
140165.........................................................     2.12
140166.........................................................     1.79
140167.........................................................     2.44
140168.........................................................     1.86
140170.........................................................     1.49
140171.........................................................     1.29
140172.........................................................     1.48
140173.........................................................     1.21
140174.........................................................     2.00
140176.........................................................     2.53
140177.........................................................     1.95
140179.........................................................     2.43
140180.........................................................     1.88
140181.........................................................     1.81
140182.........................................................     1.74
140184.........................................................     1.80
140185.........................................................     2.35
140186.........................................................     2.04
140187.........................................................     2.01
140188.........................................................     1.25
140189.........................................................     2.04
140190.........................................................     1.71
140191.........................................................     1.93
140193.........................................................     2.35
140197.........................................................     1.79
140199.........................................................     1.71
140200.........................................................     1.91
140202.........................................................     2.35
140203.........................................................     2.36
140205.........................................................     3.84
140206.........................................................     2.06
140207.........................................................     2.69
140208.........................................................     2.26
140209.........................................................     2.56
140210.........................................................     2.02
140211.........................................................     2.32
140212.........................................................     1.18
140213.........................................................     2.38
140215.........................................................     1.27
140217.........................................................     2.16
140218.........................................................     1.82
140220.........................................................     1.84
140223.........................................................     2.62
140224.........................................................     2.14
140228.........................................................     2.13
140230.........................................................     1.09
140231.........................................................     2.27
140233.........................................................     2.45
140234.........................................................     2.29
140236.........................................................     1.27
140239.........................................................     2.53
140240.........................................................     1.97
140242.........................................................     2.56
140245.........................................................     1.73
140246.........................................................     1.65
140250.........................................................     1.90
140251.........................................................     2.78
140252.........................................................     1.97
140253.........................................................     3.18
140258.........................................................     2.20
140271.........................................................     1.96
140275.........................................................     2.32
140276.........................................................     2.23
140280.........................................................     2.36
140281.........................................................     2.44
140285.........................................................     2.00
140286.........................................................     2.05
140288.........................................................     1.95
140289.........................................................     2.20
140290.........................................................     3.07
140291.........................................................     2.46
140292.........................................................     2.27
140294.........................................................     2.59
140297.........................................................     1.53

[[Page 35490]]

 
140300.........................................................     1.19
142006.........................................................     0.92
142009.........................................................     4.17
143025.........................................................     1.17
143026.........................................................     1.24
143027.........................................................     1.30
144005.........................................................     1.38
144019.........................................................     0.89
144026.........................................................     1.31
144029.........................................................     1.09
144030.........................................................     1.37
144031.........................................................     1.21
144035.........................................................     1.31
144036.........................................................     1.31
150001.........................................................     1.96
150002.........................................................     2.05
150003.........................................................     2.20
150004.........................................................     2.00
150005.........................................................     2.22
150006.........................................................     2.64
150007.........................................................     2.24
150008.........................................................     2.28
150009.........................................................     2.61
150011.........................................................     1.81
150012.........................................................     2.54
150013.........................................................     1.99
150014.........................................................     2.02
150015.........................................................     2.54
150018.........................................................     2.76
150019.........................................................     2.03
150020.........................................................     2.50
150022.........................................................     2.46
150023.........................................................     2.43
150024.........................................................     1.25
150026.........................................................     2.55
150027.........................................................     1.64
150029.........................................................     3.50
150030.........................................................     2.38
150031.........................................................     1.59
150033.........................................................     2.22
150034.........................................................     2.56
150036.........................................................     1.82
150037.........................................................     2.45
150038.........................................................     1.62
150039.........................................................     1.99
150042.........................................................     2.61
150043.........................................................     1.77
150044.........................................................     2.22
150045.........................................................     1.61
150046.........................................................     2.49
150047.........................................................     1.78
150049.........................................................     1.43
150050.........................................................     1.64
150051.........................................................     2.00
150052.........................................................     2.23
150053.........................................................     1.90
150054.........................................................     1.55
150057.........................................................     2.05
150058.........................................................     2.74
150059.........................................................     2.27
150060.........................................................     1.58
150061.........................................................     1.85
150062.........................................................     2.07
150063.........................................................     1.43
150064.........................................................     1.90
150065.........................................................     2.26
150066.........................................................     1.37
150067.........................................................     2.01
150069.........................................................     2.47
150070.........................................................     1.79
150071.........................................................     1.48
150072.........................................................     1.97
150073.........................................................     1.83
150074.........................................................     2.23
150075.........................................................     1.94
150076.........................................................     1.96
150078.........................................................     1.76
150079.........................................................     1.62
150084.........................................................     3.13
150089.........................................................     2.37
150090.........................................................     1.74
150091.........................................................     1.80
150092.........................................................     1.46
150094.........................................................     2.06
150095.........................................................     2.20
150096.........................................................     2.05
150097.........................................................     2.00
150098.........................................................     1.65
150099.........................................................     2.33
150101.........................................................     1.89
150102.........................................................     1.61
150103.........................................................     1.25
150104.........................................................     1.91
150105.........................................................     1.89
150106.........................................................     1.78
150109.........................................................     3.04
150110.........................................................     1.51
150111.........................................................     1.58
150112.........................................................     2.38
150114.........................................................     1.54
150115.........................................................     2.66
150122.........................................................     1.98
150123.........................................................     1.16
150124.........................................................     1.65
150125.........................................................     2.13
150126.........................................................     2.50
150127.........................................................     1.15
150128.........................................................     2.44
150129.........................................................     1.93
150130.........................................................     1.33
150132.........................................................     2.49
150133.........................................................     2.13
150134.........................................................     1.68
150136.........................................................     2.41
152007.........................................................     0.58
152009.........................................................     0.50
153025.........................................................     1.67
153027.........................................................     2.54
153029.........................................................     1.25
153030.........................................................     1.65
154009.........................................................     1.49
154011.........................................................     1.63
154013.........................................................     1.41
154014.........................................................     1.30
154026.........................................................     1.41
154028.........................................................     1.21
154031.........................................................     1.38
154032.........................................................     1.56
154035.........................................................     1.35
154036.........................................................     1.32
154037.........................................................     1.43
154038.........................................................     1.47
154042.........................................................     1.44
160001.........................................................     3.07
160002.........................................................     2.01
160003.........................................................     1.86
160005.........................................................     2.09
160007.........................................................     1.11
160008.........................................................     2.11
160009.........................................................     1.94
160012.........................................................     1.52
160013.........................................................     2.88
160014.........................................................     1.68
160016.........................................................     2.75
160018.........................................................     1.50
160020.........................................................     1.59
160021.........................................................     2.33
160023.........................................................     1.66
160024.........................................................     2.57
160026.........................................................     1.81
160027.........................................................     1.84
160028.........................................................     2.31
160029.........................................................     3.20
160030.........................................................     3.22
160031.........................................................     1.61
160032.........................................................     2.21
160033.........................................................     2.76
160034.........................................................     2.04
160035.........................................................     0.99
160036.........................................................     1.97
160037.........................................................     1.95
160039.........................................................     1.57
160040.........................................................     3.33
160041.........................................................     1.46
160043.........................................................     1.59
160044.........................................................     2.22
160045.........................................................     2.62
160046.........................................................     2.10
160047.........................................................     2.24
160048.........................................................     1.62
160049.........................................................     1.03
160050.........................................................     2.38
160051.........................................................     1.73
160052.........................................................     1.77
160054.........................................................     1.83
160055.........................................................     2.01
160056.........................................................     1.61
160057.........................................................     2.60
160058.........................................................     1.56
160060.........................................................     1.79
160061.........................................................     2.05
160062.........................................................     1.56
160063.........................................................     1.78
160064.........................................................     2.89
160065.........................................................     1.92
160066.........................................................     2.25
160067.........................................................     2.30
160069.........................................................     3.06
160070.........................................................     1.57
160072.........................................................     2.16
160073.........................................................     1.27
160074.........................................................     1.49
160075.........................................................     1.74
160076.........................................................     2.40
160077.........................................................     1.75
160079.........................................................     3.18
160080.........................................................     2.54
160081.........................................................     1.81
160082.........................................................     3.05
160083.........................................................     2.70
160085.........................................................     1.47
160086.........................................................     1.29
160088.........................................................     1.55
160089.........................................................     2.63
160090.........................................................     1.56
160091.........................................................     1.64
160092.........................................................     1.79
160093.........................................................     1.35
160094.........................................................     2.74
160095.........................................................     1.10
160097.........................................................     2.05
160098.........................................................     1.49
160099.........................................................     1.74
160101.........................................................     1.12
160102.........................................................     2.60
160103.........................................................     1.26
160104.........................................................     1.96
160106.........................................................     2.86
160107.........................................................     1.46
160108.........................................................     2.22
160109.........................................................     1.59
160110.........................................................     2.09
160111.........................................................     1.60
160112.........................................................     3.03
160113.........................................................     1.29
160114.........................................................     2.53
160115.........................................................     2.31
160116.........................................................     1.94

[[Page 35491]]

 
160117.........................................................     2.69
160118.........................................................     1.74
160120.........................................................     0.91
160122.........................................................     2.22
160124.........................................................     2.12
160126.........................................................     1.72
160129.........................................................     2.78
160130.........................................................     1.44
160131.........................................................     1.59
160134.........................................................     1.11
160135.........................................................     1.71
160138.........................................................     1.29
160140.........................................................     1.62
160142.........................................................     1.33
160143.........................................................     1.84
160145.........................................................     1.63
160146.........................................................     2.66
160147.........................................................     1.64
160151.........................................................     1.37
160152.........................................................     1.42
160153.........................................................     2.57
164002.........................................................     2.09
170001.........................................................     3.10
170004.........................................................     1.53
170006.........................................................     1.97
170008.........................................................     2.10
170009.........................................................     2.13
170010.........................................................     2.63
170012.........................................................     2.93
170013.........................................................     3.30
170014.........................................................     1.84
170015.........................................................     2.32
170016.........................................................     2.49
170017.........................................................     2.45
170018.........................................................     1.60
170019.........................................................     3.08
170020.........................................................     3.38
170022.........................................................     2.37
170023.........................................................     5.05
170024.........................................................     2.18
170025.........................................................     1.96
170026.........................................................     2.92
170027.........................................................     3.06
170030.........................................................     1.50
170031.........................................................     1.88
170032.........................................................     1.53
170033.........................................................     2.49
170034.........................................................     1.77
170035.........................................................     1.44
170036.........................................................     0.97
170037.........................................................     2.84
170038.........................................................     0.99
170039.........................................................     1.58
170040.........................................................     2.29
170041.........................................................     1.34
170043.........................................................     1.11
170044.........................................................     1.52
170045.........................................................     1.67
170049.........................................................     2.82
170051.........................................................     0.97
170052.........................................................     1.48
170053.........................................................     0.98
170054.........................................................     1.59
170055.........................................................     1.66
170056.........................................................     0.98
170057.........................................................     1.53
170058.........................................................     4.02
170060.........................................................     2.32
170061.........................................................     2.01
170063.........................................................     1.24
170064.........................................................     1.47
170066.........................................................     1.12
170067.........................................................     2.05
170068.........................................................     3.20
170070.........................................................     2.12
170072.........................................................     1.23
170073.........................................................     1.28
170074.........................................................     2.04
170075.........................................................     1.02
170076.........................................................     1.87
170077.........................................................     1.94
170079.........................................................     1.38
170080.........................................................     1.48
170081.........................................................     1.30
170082.........................................................     1.90
170084.........................................................     1.68
170085.........................................................     1.61
170086.........................................................     3.15
170088.........................................................     1.42
170089.........................................................     1.21
170090.........................................................     1.24
170092.........................................................     1.28
170093.........................................................     1.47
170094.........................................................     1.87
170095.........................................................     2.66
170097.........................................................     1.78
170098.........................................................     2.43
170099.........................................................     2.05
170100.........................................................     0.74
170101.........................................................     1.38
170102.........................................................     1.65
170103.........................................................     4.11
170104.........................................................     3.30
170105.........................................................     1.98
170106.........................................................     1.13
170109.........................................................     1.90
170110.........................................................     1.61
170112.........................................................     1.38
170113.........................................................     2.22
170114.........................................................     2.28
170115.........................................................     1.73
170116.........................................................     2.67
170117.........................................................     0.88
170119.........................................................     1.35
170120.........................................................     3.00
170122.........................................................     2.51
170123.........................................................     3.32
170124.........................................................     1.94
170126.........................................................     1.13
170128.........................................................     1.84
170131.........................................................     1.83
170133.........................................................     3.36
170134.........................................................     1.67
170137.........................................................     2.62
170139.........................................................     0.66
170142.........................................................     2.84
170143.........................................................     2.81
170144.........................................................     2.74
170145.........................................................     2.12
170146.........................................................     2.79
170147.........................................................     1.36
170148.........................................................     2.40
170150.........................................................     3.13
170151.........................................................     1.82
170152.........................................................     1.35
170160.........................................................     1.38
170164.........................................................     1.63
170166.........................................................     1.34
170168.........................................................     1.13
170171.........................................................     1.33
170175.........................................................     4.10
170176.........................................................     2.39
170182.........................................................     3.25
172004.........................................................     0.74
173025.........................................................     1.24
173026.........................................................     1.14
173027.........................................................     1.93
173028.........................................................     1.30
174003.........................................................     1.39
174006.........................................................     0.83
174012.........................................................     1.31
174014.........................................................     1.63
174016.........................................................     1.42
174018.........................................................     1.32
180001.........................................................     2.14
180004.........................................................     1.75
180005.........................................................     2.13
180006.........................................................     1.14
180007.........................................................     2.57
180009.........................................................     2.62
180010.........................................................     2.50
180011.........................................................     2.15
180012.........................................................     2.43
180013.........................................................     2.50
180014.........................................................     2.91
180015.........................................................     1.71
180016.........................................................     2.19
180017.........................................................     2.33
180018.........................................................     2.49
180019.........................................................     2.80
180021.........................................................     1.77
180023.........................................................     1.79
180024.........................................................     1.97
180025.........................................................     2.16
180026.........................................................     1.90
180027.........................................................     2.73
180030.........................................................     1.32
180031.........................................................     1.47
180032.........................................................     1.24
180033.........................................................     1.72
180034.........................................................     1.83
180035.........................................................     2.38
180036.........................................................     2.52
180037.........................................................     2.40
180038.........................................................     2.07
180040.........................................................     3.16
180041.........................................................     2.19
180042.........................................................     1.81
180043.........................................................     1.33
180044.........................................................     2.31
180045.........................................................     2.37
180046.........................................................     2.15
180047.........................................................     1.57
180048.........................................................     2.13
180049.........................................................     2.97
180051.........................................................     2.73
180054.........................................................     2.10
180055.........................................................     1.84
180056.........................................................     2.22
180058.........................................................     1.35
180059.........................................................     1.43
180060.........................................................     0.79
180063.........................................................     1.36
180064.........................................................     2.15
180065.........................................................     1.29
180066.........................................................     2.34
180067.........................................................     2.38
180070.........................................................     1.70
180072.........................................................     1.61
180075.........................................................     1.70
180078.........................................................     2.06
180079.........................................................     1.62
180080.........................................................     3.07
180087.........................................................     2.76
180088.........................................................     3.19
180092.........................................................     2.05
180093.........................................................     2.56
180094.........................................................     1.48
180095.........................................................     1.79
180099.........................................................     1.62
180101.........................................................     1.63
180102.........................................................     2.50
180103.........................................................     2.74
180104.........................................................     2.27
180105.........................................................     1.53
180106.........................................................     1.44
180108.........................................................     1.39
180115.........................................................     1.53

[[Page 35492]]

 
180116.........................................................     2.27
180117.........................................................     2.17
180118.........................................................     1.48
180120.........................................................     1.47
180121.........................................................     2.30
180122.........................................................     1.58
180123.........................................................     2.48
180124.........................................................     2.94
180126.........................................................     1.39
180127.........................................................     2.61
180128.........................................................     1.87
180129.........................................................     1.29
180130.........................................................     2.61
180132.........................................................     2.46
180133.........................................................     2.23
180134.........................................................     1.80
180136.........................................................     4.00
180137.........................................................     1.72
180138.........................................................     1.98
180139.........................................................     1.43
180140.........................................................     1.17
183026.........................................................     0.99
183027.........................................................     1.09
183028.........................................................     1.28
184000.........................................................     1.58
184002.........................................................     0.78
184007.........................................................     1.31
184008.........................................................     2.67
184009.........................................................     1.35
184015.........................................................     0.84
190003.........................................................     1.93
190004.........................................................     2.30
190007.........................................................     1.77
190013.........................................................     1.76
190014.........................................................     2.37
190015.........................................................     2.21
190017.........................................................     2.01
190018.........................................................     2.04
190019.........................................................     2.01
190020.........................................................     2.33
190025.........................................................     1.90
190026.........................................................     2.13
190027.........................................................     1.96
190029.........................................................     1.89
190033.........................................................     1.10
190034.........................................................     1.95
190035.........................................................     3.11
190036.........................................................     2.52
190037.........................................................     0.98
190039.........................................................     1.93
190040.........................................................     2.27
190041.........................................................     2.45
190043.........................................................     1.08
190044.........................................................     1.95
190045.........................................................     2.08
190046.........................................................     1.76
190048.........................................................     1.93
190049.........................................................     2.50
190050.........................................................     1.87
190053.........................................................     1.45
190054.........................................................     2.16
190059.........................................................     1.65
190060.........................................................     2.74
190064.........................................................     3.53
190065.........................................................     2.15
190071.........................................................     1.38
190077.........................................................     0.83
190078.........................................................     2.94
190079.........................................................     2.02
190081.........................................................     1.06
190083.........................................................     1.40
190086.........................................................     2.59
190088.........................................................     2.25
190089.........................................................     1.67
190090.........................................................     1.64
190092.........................................................     1.81
190095.........................................................     1.86
190098.........................................................     1.45
190099.........................................................     1.34
190102.........................................................     2.88
190103.........................................................     0.93
190106.........................................................     1.61
190109.........................................................     1.89
190110.........................................................     1.41
190111.........................................................     3.17
190112.........................................................     2.61
190113.........................................................     2.92
190114.........................................................     1.72
190115.........................................................     4.31
190116.........................................................     2.10
190118.........................................................     1.69
190120.........................................................     1.45
190124.........................................................     2.27
190125.........................................................     2.02
190128.........................................................     1.98
190130.........................................................     1.69
190131.........................................................     1.33
190133.........................................................     1.48
190134.........................................................     1.13
190135.........................................................     2.31
190136.........................................................     0.99
190138.........................................................     6.32
190140.........................................................     1.71
190142.........................................................     1.01
190144.........................................................     2.45
190145.........................................................     1.46
190146.........................................................     1.83
190147.........................................................     1.72
190148.........................................................     1.12
190149.........................................................     1.62
190151.........................................................     1.77
190155.........................................................     1.37
190156.........................................................     0.93
190158.........................................................     2.29
190160.........................................................     2.59
190162.........................................................     1.60
190164.........................................................     2.97
190167.........................................................     1.86
190170.........................................................     0.92
190173.........................................................     1.95
190175.........................................................     2.30
190176.........................................................     1.55
190177.........................................................     2.38
190178.........................................................     1.19
190182.........................................................     2.06
190184.........................................................     1.21
190185.........................................................     2.55
190186.........................................................     1.13
190189.........................................................     0.88
190190.........................................................     1.37
190191.........................................................     2.04
190196.........................................................     2.35
190197.........................................................     2.41
190200.........................................................     2.51
190201.........................................................     2.07
190202.........................................................     1.79
190203.........................................................     2.56
190204.........................................................     2.25
190205.........................................................     2.38
190206.........................................................     1.85
190207.........................................................     2.90
190208.........................................................     1.03
190218.........................................................     2.28
190231.........................................................     4.22
192004.........................................................     1.24
192005.........................................................     1.34
192006.........................................................     1.68
192008.........................................................     1.32
192016.........................................................     3.42
193027.........................................................     1.59
193028.........................................................     1.51
193034.........................................................     1.19
193038.........................................................     1.34
193041.........................................................     0.77
193044.........................................................     2.33
193300.........................................................     1.34
194014.........................................................     1.31
194019.........................................................     1.32
194022.........................................................     1.09
194023.........................................................     1.26
194024.........................................................     1.39
194031.........................................................     1.39
194044.........................................................     1.30
194058.........................................................     1.31
200001.........................................................     2.58
200002.........................................................     2.11
200003.........................................................     1.73
200006.........................................................     1.31
200007.........................................................     1.58
200008.........................................................     1.99
200009.........................................................     2.10
200012.........................................................     1.59
200013.........................................................     1.91
200015.........................................................     2.04
200016.........................................................     1.77
200017.........................................................     2.54
200018.........................................................     1.96
200019.........................................................     2.07
200020.........................................................     2.09
200021.........................................................     2.31
200023.........................................................     0.98
200024.........................................................     2.28
200025.........................................................     2.33
200026.........................................................     1.72
200027.........................................................     1.64
200028.........................................................     1.76
200031.........................................................     1.76
200032.........................................................     1.84
200033.........................................................     2.02
200034.........................................................     2.48
200037.........................................................     1.82
200038.........................................................     2.22
200039.........................................................     2.30
200040.........................................................     2.69
200041.........................................................     2.24
200043.........................................................     1.20
200050.........................................................     2.60
200051.........................................................     2.45
200052.........................................................     1.70
200055.........................................................     1.38
200062.........................................................     1.35
200063.........................................................     2.32
200066.........................................................     1.94
204005.........................................................     1.45
204006.........................................................     1.30
204007.........................................................     0.66
213027.........................................................      .41
213028.........................................................     3.88
214000.........................................................     1.30
214003.........................................................     1.30
214015.........................................................     1.09
214017.........................................................     1.35
220001.........................................................     2.08
220003.........................................................     2.07
220004.........................................................     2.17
220006.........................................................     2.14
220008.........................................................     2.00
220010.........................................................     2.51
220011.........................................................     1.51
220015.........................................................     2.08
220016.........................................................     2.06
220017.........................................................     1.98
220019.........................................................     2.21
220020.........................................................     1.72
220021.........................................................     2.02
220023.........................................................     1.93
220024.........................................................     2.16
220025.........................................................     1.66

[[Page 35493]]

 
220028.........................................................     1.90
220029.........................................................     2.03
220030.........................................................     1.43
220031.........................................................     1.69
220033.........................................................     2.00
220035.........................................................     2.24
220038.........................................................     2.00
220041.........................................................     2.17
220042.........................................................     2.00
220046.........................................................     2.55
220049.........................................................     2.27
220050.........................................................     2.08
220051.........................................................     2.36
220052.........................................................     1.99
220053.........................................................     1.93
220055.........................................................     2.41
220057.........................................................     2.17
220058.........................................................     1.95
220060.........................................................     2.24
220062.........................................................     1.56
220063.........................................................     2.06
220064.........................................................     1.81
220065.........................................................     1.84
220066.........................................................     2.41
220067.........................................................     2.26
220068.........................................................     1.19
220070.........................................................     1.90
220071.........................................................     1.75
220073.........................................................     1.91
220074.........................................................     1.97
220075.........................................................     2.55
220076.........................................................     1.89
220077.........................................................     1.97
220079.........................................................     1.86
220080.........................................................     1.99
220081.........................................................     1.87
220082.........................................................     2.17
220083.........................................................     1.84
220084.........................................................     2.44
220086.........................................................     1.81
220088.........................................................     1.99
220089.........................................................     2.00
220090.........................................................     1.93
220092.........................................................     2.05
220094.........................................................     1.85
220095.........................................................     1.81
220098.........................................................     2.14
220100.........................................................     1.87
220101.........................................................     2.12
220104.........................................................     1.34
220105.........................................................     2.03
220106.........................................................     2.07
220107.........................................................     2.22
220108.........................................................     2.01
220111.........................................................     2.23
220116.........................................................     1.65
220119.........................................................     1.83
220123.........................................................     1.80
220126.........................................................     2.22
220128.........................................................     1.87
220135.........................................................     2.09
220162.........................................................     1.54
220163.........................................................     1.49
220171.........................................................     1.51
222000.........................................................     1.46
222002.........................................................     0.96
222006.........................................................     1.18
222008.........................................................     0.91
222024.........................................................     2.77
222026.........................................................     0.89
222027.........................................................     0.98
222029.........................................................     1.19
222035.........................................................     1.15
222043.........................................................     0.89
222044.........................................................     1.63
222045.........................................................     4.98
223026.........................................................     1.28
223027.........................................................     1.35
223028.........................................................     1.60
223029.........................................................     1.09
223030.........................................................     1.67
223302.........................................................     1.88
224007.........................................................     1.45
224013.........................................................     1.55
224018.........................................................     1.40
224021.........................................................     1.29
224022.........................................................     2.16
224023.........................................................     2.45
224029.........................................................     1.30
224034.........................................................     1.41
224035.........................................................     1.37
230001.........................................................     1.86
230002.........................................................     2.82
230003.........................................................     1.83
230004.........................................................     2.55
230005.........................................................     2.21
230006.........................................................     2.01
230007.........................................................     2.65
230012.........................................................     1.06
230013.........................................................     2.04
230015.........................................................     2.08
230017.........................................................     2.61
230019.........................................................     2.88
230020.........................................................     3.03
230021.........................................................     2.71
230022.........................................................     2.48
230024.........................................................     2.64
230027.........................................................     1.89
230029.........................................................     2.40
230030.........................................................     2.65
230031.........................................................     2.42
230032.........................................................     3.13
230034.........................................................     2.04
230035.........................................................     2.09
230036.........................................................     2.40
230037.........................................................     2.23
230038.........................................................     2.72
230040.........................................................     2.46
230041.........................................................     2.39
230042.........................................................     1.93
230046.........................................................     1.88
230047.........................................................     2.86
230053.........................................................     1.35
230054.........................................................     2.40
230055.........................................................     1.96
230056.........................................................     1.74
230058.........................................................     2.52
230059.........................................................     2.92
230060.........................................................     2.26
230062.........................................................     1.67
230063.........................................................     2.10
230065.........................................................     2.52
230066.........................................................     2.45
230068.........................................................     2.61
230069.........................................................     1.91
230070.........................................................     3.08
230071.........................................................     1.75
230072.........................................................     2.17
230075.........................................................     2.53
230076.........................................................     4.12
230077.........................................................     3.10
230078.........................................................     2.03
230080.........................................................     3.05
230081.........................................................     2.32
230082.........................................................     1.93
230085.........................................................     3.46
230086.........................................................     1.74
230087.........................................................     2.10
230089.........................................................     2.32
230092.........................................................     2.54
230093.........................................................     2.75
230095.........................................................     2.54
230096.........................................................     2.19
230097.........................................................     2.92
230099.........................................................     2.08
230100.........................................................     1.63
230101.........................................................     2.07
230103.........................................................     2.02
230104.........................................................     2.33
230105.........................................................     3.26
230106.........................................................     1.92
230107.........................................................     1.32
230108.........................................................     2.20
230110.........................................................     2.43
230111.........................................................     1.65
230113.........................................................     1.30
230114.........................................................     6.78
230115.........................................................     1.73
230116.........................................................     1.53
230117.........................................................     2.37
230118.........................................................     2.01
230119.........................................................     2.04
230120.........................................................     2.55
230121.........................................................     2.38
230122.........................................................     3.08
230124.........................................................     2.14
230125.........................................................     1.74
230128.........................................................     3.16
230129.........................................................     2.41
230130.........................................................     2.71
230132.........................................................     2.19
230133.........................................................     2.34
230134.........................................................     2.25
230135.........................................................     2.53
230137.........................................................     2.29
230141.........................................................     2.25
230142.........................................................     2.32
230143.........................................................     2.41
230144.........................................................     2.34
230145.........................................................     2.29
230146.........................................................     1.96
230147.........................................................     1.81
230149.........................................................     1.53
230151.........................................................     1.96
230153.........................................................     2.02
230154.........................................................     1.40
230155.........................................................     1.56
230156.........................................................     2.14
230157.........................................................     2.56
230159.........................................................     2.60
230162.........................................................     1.02
230165.........................................................     2.96
230167.........................................................     2.68
230169.........................................................     2.53
230171.........................................................     1.46
230172.........................................................     1.73
230174.........................................................     2.08
230175.........................................................     1.29
230176.........................................................     2.75
230178.........................................................     1.77
230180.........................................................     1.93
230184.........................................................     4.93
230186.........................................................     1.78
230188.........................................................     2.23
230189.........................................................     1.32
230190.........................................................     1.19
230191.........................................................     1.96
230193.........................................................     2.13
230194.........................................................     1.12
230195.........................................................     2.63
230197.........................................................     3.23
230199.........................................................     2.08
230201.........................................................     2.40
230204.........................................................     2.62
230205.........................................................     2.36
230207.........................................................     2.08
230208.........................................................     2.25
230211.........................................................     0.92

[[Page 35494]]

 
230212.........................................................     1.94
230213.........................................................     1.32
230216.........................................................     1.91
230217.........................................................     2.45
230219.........................................................     2.39
230221.........................................................     2.12
230222.........................................................     2.46
230223.........................................................     2.71
230227.........................................................     2.45
230230.........................................................     2.74
230232.........................................................     1.07
230235.........................................................     2.06
230236.........................................................     2.56
230239.........................................................     2.22
230241.........................................................     2.32
230244.........................................................     2.38
230253.........................................................     2.24
230254.........................................................     2.45
230257.........................................................     4.97
230259.........................................................     2.62
230264.........................................................     2.86
230269.........................................................     2.63
230270.........................................................     3.10
230273.........................................................     1.84
230275.........................................................     2.24
230276.........................................................     1.21
230278.........................................................     1.76
230279.........................................................     1.35
230280.........................................................     2.02
233025.........................................................     1.25
233026.........................................................     1.06
233027.........................................................     1.20
233300.........................................................     3.11
234006.........................................................     1.37
234011.........................................................     1.34
234021.........................................................     1.09
234030.........................................................     2.61
240001.........................................................     3.00
240002.........................................................     2.77
240004.........................................................     1.26
240005.........................................................     1.28
240006.........................................................     2.65
240007.........................................................     2.69
240008.........................................................     2.77
240009.........................................................     1.46
240010.........................................................     3.32
240011.........................................................     2.39
240013.........................................................     2.37
240014.........................................................     2.42
240016.........................................................     2.88
240017.........................................................     3.49
240018.........................................................     3.00
240019.........................................................     2.66
240020.........................................................     2.02
240021.........................................................     1.89
240022.........................................................     2.19
240023.........................................................     2.28
240025.........................................................     1.95
240027.........................................................     2.58
240028.........................................................     2.10
240029.........................................................     2.69
240030.........................................................     2.93
240031.........................................................     2.12
240036.........................................................     2.25
240037.........................................................     1.80
240038.........................................................     2.90
240040.........................................................     2.37
240041.........................................................     2.44
240043.........................................................     3.09
240044.........................................................     2.40
240045.........................................................     1.84
240047.........................................................     2.92
240048.........................................................     3.42
240049.........................................................     1.82
240050.........................................................     2.90
240051.........................................................     1.90
240052.........................................................     2.04
240053.........................................................     2.93
240056.........................................................     2.93
240057.........................................................     2.22
240058.........................................................     1.40
240059.........................................................     3.22
240061.........................................................     4.29
240063.........................................................     2.50
240064.........................................................     2.83
240065.........................................................     1.64
240066.........................................................     3.84
240069.........................................................     3.35
240071.........................................................     2.27
240072.........................................................     2.60
240073.........................................................     1.57
240075.........................................................     2.27
240076.........................................................     2.59
240077.........................................................     2.36
240078.........................................................     3.37
240079.........................................................     1.84
240080.........................................................     1.91
240082.........................................................     1.77
240083.........................................................     2.22
240084.........................................................     2.68
240085.........................................................     1.45
240086.........................................................     2.13
240087.........................................................     2.13
240088.........................................................     1.83
240089.........................................................     1.22
240090.........................................................     3.11
240093.........................................................     2.50
240094.........................................................     1.51
240096.........................................................     1.45
240097.........................................................     5.89
240098.........................................................     2.02
240099.........................................................     1.71
240100.........................................................     2.66
240101.........................................................     2.00
240102.........................................................     1.58
240103.........................................................     1.80
240104.........................................................     2.59
240105.........................................................     1.27
240106.........................................................     1.37
240107.........................................................     1.65
240108.........................................................     2.35
240109.........................................................     1.83
240110.........................................................     2.25
240111.........................................................     2.24
240112.........................................................     1.89
240114.........................................................     1.77
240115.........................................................     2.91
240116.........................................................     1.60
240117.........................................................     1.21
240119.........................................................     1.18
240121.........................................................     2.15
240122.........................................................     1.34
240123.........................................................     2.15
240124.........................................................     2.17
240125.........................................................     1.73
240127.........................................................     1.60
240128.........................................................     2.46
240129.........................................................     2.03
240130.........................................................     2.83
240132.........................................................     2.62
240133.........................................................     3.09
240135.........................................................     0.79
240137.........................................................     3.34
240138.........................................................     1.34
240139.........................................................     2.00
240141.........................................................     2.37
240142.........................................................     1.76
240143.........................................................     1.48
240144.........................................................     2.59
240145.........................................................     1.51
240146.........................................................     2.00
240148.........................................................     1.75
240150.........................................................     1.14
240152.........................................................     2.44
240153.........................................................     1.78
240154.........................................................     1.43
240155.........................................................     2.44
240157.........................................................     2.23
240160.........................................................     2.45
240161.........................................................     1.78
240162.........................................................     2.04
240163.........................................................     1.81
240166.........................................................     3.39
240169.........................................................     2.32
240170.........................................................     1.78
240171.........................................................     2.78
240172.........................................................     1.84
240173.........................................................     2.46
240179.........................................................     1.69
240184.........................................................     1.73
240187.........................................................     3.17
240193.........................................................     2.03
240200.........................................................     0.89
240207.........................................................     2.57
240210.........................................................     2.57
240211.........................................................     0.95
242004.........................................................     1.50
243300.........................................................     1.31
243302.........................................................     5.75
250001.........................................................     2.19
250002.........................................................     1.48
250003.........................................................     1.01
250004.........................................................     2.14
250005.........................................................     0.90
250006.........................................................     2.02
250007.........................................................     1.83
250008.........................................................     1.07
250009.........................................................     2.75
250010.........................................................     1.53
250012.........................................................     1.37
250015.........................................................     2.17
250017.........................................................     1.30
250018.........................................................     0.62
250019.........................................................     2.13
250020.........................................................     1.32
250021.........................................................     0.78
250023.........................................................     0.67
250024.........................................................     0.90
250025.........................................................     1.89
250027.........................................................     1.65
250029.........................................................     1.56
250030.........................................................     1.04
250031.........................................................     2.41
250032.........................................................     1.96
250033.........................................................     1.61
250034.........................................................     3.37
250035.........................................................     1.68
250036.........................................................     1.76
250037.........................................................     1.43
250038.........................................................     1.30
250039.........................................................     1.02
250040.........................................................     2.33
250042.........................................................     2.15
250043.........................................................     1.74
250044.........................................................     1.82
250045.........................................................     1.71
250048.........................................................     2.91
250049.........................................................     1.35
250050.........................................................     2.03
250051.........................................................     1.16
250057.........................................................     2.24
250058.........................................................     2.47
250059.........................................................     1.78
250060.........................................................     0.97
250061.........................................................     1.52
250063.........................................................     1.31
250065.........................................................     1.35
250066.........................................................     1.07

[[Page 35495]]

 
250067.........................................................     1.34
250068.........................................................     1.43
250069.........................................................     3.24
250071.........................................................     1.12
250072.........................................................     2.22
250076.........................................................     0.66
250077.........................................................     1.33
250078.........................................................     2.40
250079.........................................................     1.17
250081.........................................................     3.07
250082.........................................................     2.61
250083.........................................................     1.25
250084.........................................................     2.71
250085.........................................................     1.31
250088.........................................................     1.89
250089.........................................................     1.57
250093.........................................................     1.81
250094.........................................................     3.47
250095.........................................................     1.95
250096.........................................................     1.82
250097.........................................................     1.96
250098.........................................................     1.24
250099.........................................................     2.80
250100.........................................................     2.62
250101.........................................................     1.06
250102.........................................................     2.62
250104.........................................................     3.07
250105.........................................................     1.30
250107.........................................................     1.15
250109.........................................................     1.19
250112.........................................................     1.19
250117.........................................................     1.37
250119.........................................................     1.59
250120.........................................................     2.08
250122.........................................................     2.53
250123.........................................................     2.87
250124.........................................................     1.28
250125.........................................................     2.08
250126.........................................................     1.19
250128.........................................................     1.63
250131.........................................................     1.57
250134.........................................................     0.91
250136.........................................................     2.70
250138.........................................................     3.12
250141.........................................................     2.85
250145.........................................................     1.26
250146.........................................................     1.23
250148.........................................................     2.11
250149.........................................................     1.22
253025.........................................................     1.78
254001.........................................................     1.32
260001.........................................................     2.22
260002.........................................................     2.23
260003.........................................................     1.52
260004.........................................................     1.43
260005.........................................................     2.38
260006.........................................................     2.06
260007.........................................................     2.52
260008.........................................................     1.08
260009.........................................................     2.43
260011.........................................................     2.21
260012.........................................................     1.45
260013.........................................................     1.95
260014.........................................................     2.34
260015.........................................................     2.15
260017.........................................................     2.67
260018.........................................................     1.11
260019.........................................................     1.63
260020.........................................................     2.17
260021.........................................................     2.00
260022.........................................................     2.25
260023.........................................................     2.29
260024.........................................................     1.52
260025.........................................................     3.21
260027.........................................................     2.35
260029.........................................................     2.02
260030.........................................................     1.21
260031.........................................................     2.38
260032.........................................................     2.31
260034.........................................................     1.31
260035.........................................................     1.46
260036.........................................................     1.79
260039.........................................................     1.52
260040.........................................................     2.36
260042.........................................................     2.08
260044.........................................................     1.84
260047.........................................................     2.09
260048.........................................................     1.87
260050.........................................................     2.38
260052.........................................................     2.07
260053.........................................................     1.65
260054.........................................................     2.14
260055.........................................................     1.65
260057.........................................................     1.64
260059.........................................................     2.22
260061.........................................................     2.44
260062.........................................................     2.33
260063.........................................................     2.01
260064.........................................................     2.31
260065.........................................................     2.34
260066.........................................................     1.93
260067.........................................................     1.18
260068.........................................................     2.74
260070.........................................................     1.36
260073.........................................................     1.72
260074.........................................................     1.67
260077.........................................................     2.44
260078.........................................................     2.50
260079.........................................................     1.54
260080.........................................................     1.95
260081.........................................................     2.05
260082.........................................................     1.49
260085.........................................................     2.58
260086.........................................................     1.73
260091.........................................................     2.81
260094.........................................................     2.31
260095.........................................................     2.09
260096.........................................................     2.94
260097.........................................................     2.94
260100.........................................................     1.81
260102.........................................................     1.05
260103.........................................................     1.83
260104.........................................................     2.19
260105.........................................................     2.45
260107.........................................................     3.26
260108.........................................................     2.24
260109.........................................................     1.90
260110.........................................................     2.14
260113.........................................................     2.22
260115.........................................................     1.63
260116.........................................................     2.21
260119.........................................................     2.50
260120.........................................................     2.07
260122.........................................................     1.92
260123.........................................................     1.29
260127.........................................................     1.79
260128.........................................................     1.31
260129.........................................................     2.04
260131.........................................................     1.92
260134.........................................................     2.23
260137.........................................................     2.83
260138.........................................................     2.22
260141.........................................................     1.89
260142.........................................................     2.46
260143.........................................................     1.27
260147.........................................................     1.70
260148.........................................................     1.26
260158.........................................................     1.63
260159.........................................................     2.15
260160.........................................................     1.64
260162.........................................................     2.65
260163.........................................................     1.78
260164.........................................................     1.66
260166.........................................................     2.19
260172.........................................................     1.86
260173.........................................................     1.23
260175.........................................................     2.64
260176.........................................................     2.50
260177.........................................................     3.17
260178.........................................................     3.40
260179.........................................................     2.25
260180.........................................................     2.10
260183.........................................................     2.52
260186.........................................................     2.55
260188.........................................................     2.19
260189.........................................................     0.89
260190.........................................................     2.45
260191.........................................................     2.55
260193.........................................................     2.25
260195.........................................................     2.05
260197.........................................................     2.16
260198.........................................................     2.48
260200.........................................................     1.87
262001.........................................................     1.06
262011.........................................................     0.81
263025.........................................................     1.40
263026.........................................................     2.48
263300.........................................................     2.06
263301.........................................................     1.47
263302.........................................................     1.74
264005.........................................................     1.09
264007.........................................................     1.07
264008.........................................................     1.09
264010.........................................................     0.89
264013.........................................................     1.32
264016.........................................................     2.84
264017.........................................................     1.50
264021.........................................................     1.31
264024.........................................................     1.31
264025.........................................................     1.03
264026.........................................................     1.33
270002.........................................................     2.30
270003.........................................................     2.42
270004.........................................................     2.99
270006.........................................................     0.57
270007.........................................................     1.05
270009.........................................................     1.55
270011.........................................................     2.44
270012.........................................................     3.15
270013.........................................................     2.49
270014.........................................................     2.85
270016.........................................................     1.06
270017.........................................................     1.94
270019.........................................................     1.17
270021.........................................................     1.95
270023.........................................................     2.70
270024.........................................................     1.00
270026.........................................................     1.72
270027.........................................................     1.31
270028.........................................................     2.26
270029.........................................................     1.80
270032.........................................................     2.54
270033.........................................................     0.94
270035.........................................................     1.59
270036.........................................................     1.21
270039.........................................................     1.81
270040.........................................................     1.80
270041.........................................................     1.49
270044.........................................................     2.51
270046.........................................................     1.19
270048.........................................................     1.93
270049.........................................................     1.78
270050.........................................................     1.92
270051.........................................................     2.52
270052.........................................................     1.09
270053.........................................................     0.99
270057.........................................................     2.21
270058.........................................................     1.58

[[Page 35496]]

 
270059.........................................................     0.64
270060.........................................................     0.97
270063.........................................................     1.11
270068.........................................................     2.08
270072.........................................................     0.62
270073.........................................................     1.13
270079.........................................................     1.45
270080.........................................................     1.92
270081.........................................................     1.03
270082.........................................................     0.96
270083.........................................................     1.27
270084.........................................................     1.53
280001.........................................................     1.87
280005.........................................................     2.46
280009.........................................................     3.31
280010.........................................................     1.00
280011.........................................................     1.45
280012.........................................................     1.98
280013.........................................................     1.90
280014.........................................................     1.72
280015.........................................................     1.98
280017.........................................................     1.89
280018.........................................................     1.69
280020.........................................................     2.20
280021.........................................................     2.58
280022.........................................................     1.17
280023.........................................................     2.68
280024.........................................................     1.49
280025.........................................................     1.11
280026.........................................................     1.45
280028.........................................................     2.22
280029.........................................................     1.36
280030.........................................................     2.09
280031.........................................................     1.38
280032.........................................................     2.87
280033.........................................................     1.58
280034.........................................................     2.38
280035.........................................................     1.60
280037.........................................................     1.27
280038.........................................................     2.06
280039.........................................................     2.08
280040.........................................................     2.88
280041.........................................................     1.31
280042.........................................................     1.18
280043.........................................................     1.85
280045.........................................................     1.83
280046.........................................................     1.52
280047.........................................................     2.11
280048.........................................................     1.56
280049.........................................................     1.40
280050.........................................................     2.04
280051.........................................................     2.51
280052.........................................................     2.47
280054.........................................................     1.88
280055.........................................................     1.71
280056.........................................................     1.41
280057.........................................................     2.35
280058.........................................................     1.81
280060.........................................................     2.10
280061.........................................................     3.34
280062.........................................................     1.89
280064.........................................................     2.35
280065.........................................................     2.32
280066.........................................................     1.63
280068.........................................................     1.39
280070.........................................................     1.93
280073.........................................................     1.72
280074.........................................................     1.51
280075.........................................................     2.66
280076.........................................................     1.76
280077.........................................................     2.47
280079.........................................................     1.13
280080.........................................................     1.48
280081.........................................................     2.37
280082.........................................................     1.49
280083.........................................................     1.73
280084.........................................................     1.67
280085.........................................................     2.28
280088.........................................................     2.91
280089.........................................................     1.83
280090.........................................................     1.18
280091.........................................................     2.26
280092.........................................................     1.58
280094.........................................................     1.76
280097.........................................................     1.48
280098.........................................................     1.04
280101.........................................................     1.06
280102.........................................................     1.49
280104.........................................................     1.86
280105.........................................................     2.44
280106.........................................................     2.10
280107.........................................................     1.98
280108.........................................................     3.67
280109.........................................................     1.21
280110.........................................................     2.48
280111.........................................................     1.90
280114.........................................................     1.42
280115.........................................................     2.11
280117.........................................................     2.21
280118.........................................................     1.72
283301.........................................................     1.81
284007.........................................................     2.57
290001.........................................................     2.08
290002.........................................................     0.73
290003.........................................................     2.66
290005.........................................................     2.98
290006.........................................................     1.79
290007.........................................................     1.41
290008.........................................................     2.63
290009.........................................................     2.00
290010.........................................................     2.06
290011.........................................................     1.05
290012.........................................................     2.32
290013.........................................................     0.98
290014.........................................................     1.98
290015.........................................................     1.35
290016.........................................................     2.02
290019.........................................................     2.27
290020.........................................................     0.90
290021.........................................................     2.21
290022.........................................................     2.62
290027.........................................................     1.16
290032.........................................................     2.00
290038.........................................................     1.59
292002.........................................................     0.95
293027.........................................................     1.20
294003.........................................................     1.33
294004.........................................................     1.32
294005.........................................................     1.48
300001.........................................................     2.49
300003.........................................................     1.71
300005.........................................................     2.35
300006.........................................................     1.52
300007.........................................................     2.44
300008.........................................................     2.45
300009.........................................................     1.98
300010.........................................................     1.69
300011.........................................................     2.13
300013.........................................................     1.55
300014.........................................................     2.25
300015.........................................................     2.41
300016.........................................................     1.86
300017.........................................................     1.86
300018.........................................................     2.31
300019.........................................................     2.10
300021.........................................................     1.85
300022.........................................................     2.17
300023.........................................................     2.01
300024.........................................................     2.07
300028.........................................................     1.60
300029.........................................................     2.69
300033.........................................................     1.51
303026.........................................................     1.74
303027.........................................................     1.41
304000.........................................................     0.79
304001.........................................................     0.15
304003.........................................................     1.31
310001.........................................................     2.12
310002.........................................................     1.95
310005.........................................................     2.21
310006.........................................................     2.54
310008.........................................................     2.74
310009.........................................................     2.32
310010.........................................................     1.94
310011.........................................................     2.77
310013.........................................................     2.10
310015.........................................................     2.12
310016.........................................................     2.26
310017.........................................................     2.52
310018.........................................................     2.00
310019.........................................................     2.37
310020.........................................................     2.19
310021.........................................................     2.07
310022.........................................................     2.26
310024.........................................................     2.26
310025.........................................................     2.20
310026.........................................................     1.99
310027.........................................................     2.07
310028.........................................................     1.95
310029.........................................................     3.34
310031.........................................................     2.06
310032.........................................................     2.11
310034.........................................................     2.51
310036.........................................................     1.71
310037.........................................................     2.22
310039.........................................................     2.60
310041.........................................................     2.21
310042.........................................................     2.41
310043.........................................................     2.06
310044.........................................................     2.07
310045.........................................................     2.46
310047.........................................................     2.44
310048.........................................................     2.36
310050.........................................................     1.75
310051.........................................................     2.59
310052.........................................................     1.99
310054.........................................................     2.18
310056.........................................................     1.80
310057.........................................................     2.31
310058.........................................................     1.19
310060.........................................................     2.81
310061.........................................................     2.27
310063.........................................................     2.25
310064.........................................................     2.23
310067.........................................................     2.45
310069.........................................................     2.50
310070.........................................................     2.28
310072.........................................................     2.60
310073.........................................................     1.84
310074.........................................................     1.39
310076.........................................................     2.17
310077.........................................................     2.45
310078.........................................................     1.89
310081.........................................................     2.28
310083.........................................................     1.46
310084.........................................................     2.00
310086.........................................................     2.18
310088.........................................................     1.73
310090.........................................................     2.19
310091.........................................................     2.53
310092.........................................................     2.22
310093.........................................................     1.92
310096.........................................................     2.50
310105.........................................................     1.36
310111.........................................................     1.95
310112.........................................................     2.22
310113.........................................................     2.25
310115.........................................................     1.86

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310116.........................................................     2.33
310118.........................................................     2.24
310120.........................................................     1.58
312014.........................................................     0.98
313025.........................................................     1.34
313027.........................................................     1.42
313029.........................................................     1.53
313030.........................................................     1.15
314010.........................................................     1.42
314011.........................................................     1.32
314012.........................................................     1.70
314021.........................................................     1.45
314022.........................................................     1.30
320001.........................................................     1.41
320002.........................................................     1.71
320003.........................................................     2.33
320004.........................................................     2.32
320005.........................................................     2.82
320006.........................................................     2.64
320009.........................................................     2.35
320011.........................................................     1.66
320012.........................................................     2.37
320013.........................................................     2.07
320014.........................................................     1.76
320016.........................................................     2.76
320017.........................................................     1.93
320018.........................................................     2.60
320019.........................................................     1.14
320021.........................................................     1.66
320022.........................................................     2.97
320023.........................................................     1.26
320030.........................................................     1.81
320031.........................................................     1.20
320032.........................................................     1.34
320033.........................................................     2.12
320035.........................................................     1.12
320037.........................................................     2.03
320038.........................................................     2.52
320046.........................................................     2.05
320048.........................................................     1.44
320063.........................................................     2.18
320065.........................................................     2.14
320067.........................................................     1.20
320068.........................................................     2.13
320069.........................................................     1.80
320074.........................................................     2.06
320079.........................................................     2.13
322002.........................................................     2.00
322003.........................................................     0.74
323027.........................................................     1.44
323028.........................................................     1.66
323029.........................................................     1.20
324003.........................................................     1.32
324004.........................................................     1.31
324007.........................................................     1.46
324008.........................................................     1.46
330001.........................................................     2.00
330002.........................................................     2.17
330003.........................................................     2.16
330004.........................................................     2.21
330005.........................................................     2.18
330006.........................................................     2.13
330007.........................................................     2.13
330008.........................................................     2.17
330010.........................................................     2.00
330011.........................................................     1.61
330012.........................................................     2.04
330013.........................................................     2.44
330014.........................................................     1.85
330016.........................................................     1.78
330023.........................................................     2.34
330024.........................................................     2.20
330025.........................................................     1.76
330027.........................................................     0.83
330028.........................................................     1.77
330029.........................................................     1.46
330030.........................................................     2.34
330033.........................................................     1.55
330034.........................................................     1.02
330036.........................................................     2.14
330037.........................................................     2.37
330038.........................................................     1.73
330039.........................................................     1.11
330041.........................................................     2.91
330043.........................................................     1.81
330044.........................................................     2.16
330045.........................................................     2.61
330046.........................................................     1.89
330047.........................................................     2.17
330048.........................................................     2.66
330049.........................................................     2.29
330053.........................................................     1.74
330055.........................................................     2.33
330056.........................................................     1.81
330057.........................................................     2.21
330058.........................................................     1.99
330059.........................................................     2.00
330061.........................................................     2.62
330062.........................................................     1.41
330064.........................................................     2.24
330065.........................................................     2.30
330066.........................................................     1.93
330067.........................................................     2.38
330072.........................................................     1.82
330073.........................................................     1.85
330074.........................................................     2.73
330075.........................................................     1.93
330078.........................................................     2.18
330079.........................................................     1.95
330084.........................................................     2.11
330085.........................................................     1.69
330086.........................................................     1.82
330088.........................................................     1.57
330090.........................................................     2.19
330091.........................................................     2.13
330092.........................................................     1.18
330094.........................................................     1.99
330095.........................................................     2.31
330096.........................................................     2.18
330097.........................................................     1.68
330100.........................................................     4.58
330101.........................................................     2.26
330102.........................................................     2.67
330103.........................................................     2.51
330104.........................................................     1.94
330106.........................................................     2.48
330107.........................................................     2.31
330108.........................................................     2.12
330111.........................................................     1.83
330114.........................................................     0.86
330115.........................................................     2.27
330116.........................................................     1.85
330118.........................................................     2.36
330119.........................................................     2.54
330121.........................................................     1.27
330122.........................................................     2.60
330125.........................................................     1.75
330126.........................................................     2.15
330132.........................................................     1.38
330133.........................................................     2.64
330135.........................................................     2.26
330136.........................................................     1.16
330140.........................................................     2.29
330141.........................................................     2.22
330144.........................................................     2.28
330148.........................................................     1.67
330151.........................................................     1.94
330152.........................................................     2.34
330153.........................................................     2.07
330154.........................................................     2.03
330157.........................................................     1.84
330158.........................................................     2.38
330159.........................................................     2.19
330160.........................................................     1.92
330161.........................................................     1.25
330162.........................................................     3.67
330163.........................................................     2.40
330164.........................................................     1.79
330166.........................................................     1.95
330167.........................................................     3.04
330171.........................................................     2.39
330175.........................................................     1.90
330177.........................................................     1.82
330179.........................................................     1.18
330180.........................................................     1.79
330181.........................................................     2.08
330182.........................................................     3.55
330183.........................................................     1.79
330184.........................................................     2.21
330185.........................................................     1.65
330186.........................................................     0.39
330188.........................................................     2.38
330189.........................................................     6.34
330191.........................................................     2.03
330193.........................................................     2.41
330194.........................................................     1.88
330197.........................................................     1.95
330198.........................................................     2.21
330203.........................................................     3.62
330205.........................................................     1.98
330208.........................................................     2.27
330209.........................................................     2.09
330211.........................................................     1.91
330212.........................................................     2.23
330213.........................................................     1.64
330214.........................................................     2.26
330215.........................................................     2.38
330218.........................................................     1.68
330219.........................................................     1.74
330221.........................................................     1.98
330222.........................................................     2.46
330223.........................................................     1.85
330224.........................................................     2.43
330225.........................................................     2.13
330226.........................................................     2.16
330229.........................................................     1.99
330230.........................................................     2.20
330232.........................................................     1.94
330235.........................................................     2.65
330236.........................................................     1.88
330238.........................................................     2.18
330239.........................................................     2.06
330241.........................................................     2.01
330242.........................................................     2.15
330245.........................................................     2.11
330246.........................................................     2.37
330249.........................................................     1.92
330250.........................................................     2.16
330252.........................................................     1.09
330254.........................................................     2.00
330258.........................................................     1.41
330259.........................................................     2.14
330261.........................................................     2.09
330263.........................................................     2.52
330264.........................................................     2.19
330265.........................................................     1.58
330267.........................................................     2.03
330268.........................................................     1.43
330270.........................................................     1.79
330273.........................................................     2.36
330275.........................................................     1.82
330276.........................................................     1.74
330277.........................................................     2.17
330279.........................................................     2.54
330285.........................................................     1.92
330286.........................................................     2.18
330288.........................................................     0.97
330290.........................................................     1.82

[[Page 35498]]

 
330293.........................................................     1.54
330304.........................................................     2.53
330306.........................................................     1.70
330307.........................................................     2.33
330308.........................................................     2.67
330314.........................................................     2.43
330316.........................................................     2.96
330327.........................................................     1.61
330331.........................................................     2.10
330332.........................................................     3.12
330333.........................................................     2.90
330336.........................................................     1.88
330338.........................................................     2.46
330339.........................................................     1.90
330340.........................................................     2.38
330350.........................................................     2.04
330353.........................................................     2.62
330354.........................................................     1.65
330357.........................................................     1.88
330359.........................................................     0.93
330372.........................................................     2.66
330381.........................................................     1.89
330386.........................................................     1.90
330389.........................................................     1.66
330390.........................................................     1.31
330393.........................................................     2.43
330394.........................................................     2.31
330395.........................................................     2.16
330397.........................................................     1.38
330398.........................................................     2.74
330399.........................................................     1.25
332012.........................................................     1.27
332022.........................................................     1.06
333025.........................................................     1.16
333027.........................................................     1.18
333028.........................................................     0.83
333300.........................................................     1.97
334002.........................................................     1.31
334023.........................................................     1.63
334027.........................................................     1.35
334048.........................................................     1.90
334049.........................................................     1.27
334055.........................................................     1.34
340001.........................................................     1.74
340002.........................................................     3.11
340003.........................................................     2.06
340004.........................................................     2.45
340005.........................................................     2.06
340006.........................................................     1.74
340007.........................................................     1.78
340008.........................................................     2.04
340010.........................................................     2.74
340011.........................................................     1.74
340012.........................................................     2.11
340013.........................................................     1.76
340014.........................................................     1.42
340015.........................................................     2.74
340016.........................................................     2.80
340017.........................................................     2.49
340018.........................................................     2.19
340019.........................................................     1.62
340020.........................................................     1.91
340021.........................................................     2.46
340022.........................................................     1.83
340023.........................................................     1.80
340024.........................................................     2.03
340025.........................................................     2.51
340027.........................................................     2.77
340028.........................................................     2.20
340030.........................................................     2.05
340031.........................................................     1.83
340032.........................................................     2.25
340035.........................................................     2.11
340036.........................................................     1.62
340037.........................................................     1.65
340038.........................................................     2.85
340039.........................................................     2.43
340040.........................................................     2.67
340041.........................................................     1.79
340042.........................................................     1.96
340044.........................................................     1.63
340045.........................................................     1.18
340047.........................................................     2.12
340049.........................................................     6.30
340050.........................................................     2.19
340051.........................................................     2.47
340052.........................................................     1.73
340053.........................................................     2.81
340054.........................................................     2.34
340055.........................................................     1.87
340060.........................................................     2.11
340061.........................................................     1.79
340063.........................................................     1.37
340064.........................................................     2.00
340065.........................................................     1.85
340067.........................................................     2.31
340068.........................................................     2.28
340069.........................................................     2.13
340070.........................................................     2.45
340071.........................................................     1.89
340072.........................................................     2.14
340073.........................................................     2.93
340075.........................................................     2.03
340080.........................................................     1.60
340084.........................................................     1.63
340085.........................................................     2.13
340087.........................................................     1.89
340088.........................................................     2.90
340089.........................................................     1.50
340090.........................................................     1.88
340091.........................................................     2.67
340093.........................................................     1.77
340094.........................................................     3.18
340096.........................................................     2.26
340097.........................................................     2.48
340098.........................................................     2.29
340099.........................................................     1.96
340101.........................................................     2.33
340104.........................................................     1.55
340105.........................................................     3.43
340106.........................................................     1.67
340107.........................................................     2.68
340109.........................................................     3.18
340111.........................................................     2.00
340112.........................................................     1.70
340113.........................................................     2.24
340114.........................................................     1.84
340115.........................................................     2.33
340116.........................................................     2.54
340119.........................................................     2.20
340120.........................................................     1.81
340121.........................................................     2.07
340123.........................................................     2.04
340124.........................................................     1.85
340125.........................................................     3.31
340126.........................................................     2.36
340127.........................................................     1.80
340129.........................................................     2.35
340130.........................................................     2.31
340131.........................................................     2.43
340132.........................................................     1.87
340133.........................................................     1.45
340141.........................................................     2.50
340142.........................................................     1.97
340143.........................................................     2.56
340144.........................................................     2.69
340145.........................................................     2.30
340146.........................................................     1.82
340147.........................................................     2.77
340148.........................................................     3.86
340151.........................................................     2.31
340153.........................................................     3.73
340155.........................................................     2.22
340158.........................................................     2.63
340159.........................................................     1.46
340160.........................................................     2.30
340162.........................................................     1.70
340164.........................................................     1.88
340166.........................................................     2.00
340171.........................................................     2.59
342012.........................................................     0.80
343025.........................................................     1.53
344005.........................................................     1.31
344006.........................................................     1.31
344010.........................................................     1.47
344011.........................................................     1.43
344014.........................................................     0.71
344015.........................................................     1.31
344016.........................................................     1.09
344019.........................................................     1.31
350001.........................................................     1.12
350002.........................................................     3.45
350003.........................................................     2.22
350004.........................................................     3.44
350005.........................................................     1.99
350006.........................................................     1.93
350007.........................................................     2.58
350008.........................................................     1.70
350009.........................................................     2.96
350010.........................................................     2.90
350011.........................................................     2.89
350012.........................................................     2.14
350013.........................................................     1.84
350014.........................................................     1.86
350015.........................................................     3.03
350016.........................................................     1.06
350017.........................................................     2.50
350018.........................................................     2.51
350019.........................................................     3.11
350020.........................................................     1.39
350021.........................................................     2.41
350023.........................................................     1.92
350024.........................................................     1.91
350025.........................................................     1.12
350027.........................................................     1.38
350029.........................................................     1.36
350030.........................................................     2.63
350033.........................................................     1.95
350034.........................................................     1.96
350035.........................................................     0.81
350038.........................................................     2.94
350039.........................................................     1.96
350041.........................................................     1.45
350042.........................................................     3.18
350043.........................................................     2.85
350044.........................................................     1.65
350047.........................................................     1.92
350049.........................................................     2.09
350050.........................................................     1.45
350051.........................................................     1.67
350053.........................................................     1.27
350055.........................................................     1.18
350056.........................................................     1.89
350058.........................................................     1.67
350060.........................................................     0.77
350061.........................................................     2.48
360001.........................................................     2.64
360002.........................................................     2.29
360003.........................................................     1.85
360006.........................................................     2.89
360007.........................................................     1.80
360008.........................................................     2.13
360009.........................................................     2.29
360010.........................................................     2.65
360011.........................................................     1.92
360012.........................................................     2.66
360013.........................................................     2.14
360014.........................................................     2.53

[[Page 35499]]

 
360016.........................................................     1.81
360017.........................................................     3.33
360018.........................................................     2.33
360019.........................................................     1.98
360020.........................................................     2.08
360021.........................................................     5.43
360024.........................................................     2.14
360025.........................................................     1.91
360026.........................................................     1.75
360027.........................................................     2.33
360028.........................................................     3.86
360029.........................................................     2.40
360030.........................................................     2.23
360031.........................................................     1.96
360032.........................................................     2.43
360034.........................................................     1.83
360035.........................................................     1.99
360036.........................................................     2.27
360037.........................................................     2.14
360039.........................................................     2.10
360040.........................................................     2.00
360041.........................................................     2.04
360042.........................................................     2.06
360044.........................................................     2.15
360045.........................................................     1.77
360046.........................................................     2.26
360047.........................................................     1.50
360048.........................................................     2.09
360049.........................................................     2.55
360050.........................................................     1.48
360051.........................................................     2.75
360052.........................................................     2.24
360054.........................................................     2.54
360055.........................................................     2.36
360056.........................................................     2.33
360057.........................................................     1.64
360058.........................................................     2.00
360059.........................................................     1.56
360062.........................................................     2.57
360063.........................................................     1.65
360064.........................................................     2.42
360065.........................................................     2.08
360066.........................................................     2.38
360067.........................................................     1.63
360068.........................................................     2.26
360069.........................................................     1.71
360070.........................................................     1.90
360071.........................................................     2.19
360072.........................................................     2.20
360074.........................................................     2.05
360075.........................................................     2.04
360076.........................................................     2.47
360077.........................................................     2.20
360078.........................................................     2.40
360079.........................................................     2.59
360080.........................................................     2.08
360081.........................................................     2.19
360082.........................................................     2.65
360083.........................................................     2.23
360084.........................................................     2.31
360085.........................................................     2.57
360086.........................................................     2.40
360087.........................................................     2.16
360088.........................................................     1.91
360089.........................................................     2.00
360090.........................................................     3.18
360091.........................................................     2.21
360092.........................................................     1.73
360093.........................................................     2.81
360094.........................................................     1.82
360095.........................................................     2.56
360096.........................................................     2.20
360098.........................................................     2.80
360099.........................................................     2.12
360100.........................................................     2.42
360101.........................................................     2.92
360102.........................................................     2.51
360103.........................................................     1.96
360106.........................................................     1.58
360107.........................................................     2.01
360108.........................................................     1.64
360109.........................................................     2.24
360112.........................................................     2.44
360113.........................................................     2.40
360114.........................................................     1.97
360115.........................................................     1.97
360116.........................................................     1.68
360118.........................................................     2.05
360121.........................................................     2.65
360123.........................................................     2.13
360125.........................................................     1.64
360126.........................................................     1.77
360127.........................................................     2.13
360128.........................................................     1.63
360129.........................................................     1.65
360130.........................................................     1.88
360131.........................................................     2.14
360132.........................................................     2.30
360133.........................................................     2.40
360134.........................................................     2.32
360136.........................................................     1.52
360137.........................................................     2.10
360140.........................................................     1.69
360141.........................................................     2.57
360142.........................................................     1.91
360143.........................................................     2.16
360144.........................................................     2.43
360145.........................................................     2.33
360147.........................................................     2.16
360148.........................................................     1.98
360149.........................................................     2.50
360150.........................................................     2.91
360151.........................................................     2.57
360152.........................................................     2.41
360153.........................................................     1.78
360154.........................................................     1.51
360155.........................................................     2.43
360156.........................................................     2.12
360159.........................................................     2.11
360161.........................................................     2.22
360162.........................................................     2.00
360163.........................................................     2.68
360164.........................................................     1.58
360165.........................................................     1.72
360166.........................................................     1.56
360170.........................................................     1.92
360172.........................................................     2.63
360174.........................................................     2.39
360175.........................................................     2.41
360176.........................................................     1.68
360177.........................................................     1.47
360178.........................................................     2.36
360179.........................................................     2.17
360180.........................................................     2.46
360184.........................................................     1.43
360185.........................................................     1.74
360186.........................................................     1.49
360187.........................................................     2.34
360188.........................................................     1.73
360189.........................................................     2.21
360192.........................................................     2.11
360193.........................................................     2.29
360194.........................................................     2.06
360195.........................................................     2.55
360197.........................................................     1.83
360200.........................................................     1.69
360203.........................................................     2.33
360204.........................................................     1.85
360210.........................................................     2.48
360211.........................................................     2.08
360212.........................................................     2.15
360213.........................................................     1.96
360218.........................................................     2.25
360230.........................................................     2.64
360231.........................................................     1.39
360234.........................................................     1.96
360236.........................................................     2.29
360239.........................................................     2.44
360241.........................................................     1.12
360242.........................................................     1.60
360244.........................................................     1.31
360245.........................................................     1.34
362004.........................................................     2.12
362007.........................................................     0.46
362014.........................................................     6.82
362015.........................................................     1.36
363300.........................................................     1.79
363303.........................................................     2.00
363305.........................................................     1.79
363306.........................................................     1.23
364003.........................................................     1.44
364017.........................................................     1.22
364026.........................................................     1.35
364029.........................................................     1.39
364038.........................................................     1.63
370001.........................................................     2.91
370002.........................................................     2.47
370004.........................................................     2.61
370005.........................................................     1.38
370006.........................................................     2.35
370007.........................................................     1.70
370008.........................................................     2.57
370011.........................................................     1.83
370012.........................................................     1.32
370013.........................................................     2.58
370014.........................................................     2.48
370015.........................................................     1.80
370016.........................................................     2.30
370017.........................................................     1.70
370018.........................................................     2.92
370019.........................................................     2.26
370020.........................................................     2.07
370021.........................................................     1.30
370022.........................................................     2.66
370023.........................................................     2.24
370025.........................................................     2.32
370026.........................................................     2.80
370028.........................................................     2.84
370029.........................................................     2.17
370030.........................................................     1.94
370032.........................................................     3.38
370033.........................................................     2.36
370034.........................................................     2.42
370035.........................................................     1.77
370036.........................................................     0.72
370037.........................................................     3.59
370038.........................................................     1.46
370039.........................................................     1.82
370040.........................................................     2.84
370041.........................................................     1.57
370042.........................................................     1.32
370043.........................................................     1.07
370045.........................................................     1.52
370046.........................................................     1.86
370047.........................................................     2.19
370048.........................................................     1.83
370049.........................................................     2.76
370051.........................................................     1.23
370054.........................................................     2.15
370056.........................................................     2.68
370057.........................................................     1.86
370059.........................................................     0.96
370060.........................................................     2.06
370063.........................................................     1.47
370064.........................................................     1.48
370065.........................................................     2.33
370071.........................................................     1.48
370072.........................................................     1.27

[[Page 35500]]

 
370076.........................................................     2.23
370077.........................................................     1.87
370078.........................................................     3.26
370079.........................................................     1.68
370080.........................................................     1.82
370082.........................................................     1.22
370083.........................................................     2.29
370084.........................................................     1.49
370085.........................................................     1.70
370086.........................................................     2.07
370089.........................................................     2.06
370091.........................................................     2.79
370092.........................................................     2.14
370093.........................................................     3.92
370094.........................................................     2.86
370095.........................................................     1.34
370097.........................................................     1.94
370099.........................................................     1.98
370100.........................................................     1.24
370103.........................................................     1.55
370105.........................................................     2.79
370106.........................................................     3.64
370108.........................................................     1.53
370112.........................................................     1.50
370113.........................................................     1.90
370114.........................................................     2.83
370121.........................................................     2.39
370122.........................................................     0.92
370123.........................................................     2.24
370125.........................................................     1.87
370126.........................................................     1.24
370131.........................................................     1.18
370133.........................................................     1.80
370138.........................................................     2.26
370139.........................................................     1.64
370140.........................................................     1.76
370141.........................................................     1.68
370146.........................................................     1.52
370148.........................................................     2.10
370149.........................................................     2.65
370153.........................................................     2.37
370154.........................................................     2.41
370156.........................................................     2.29
370158.........................................................     1.44
370159.........................................................     2.14
370163.........................................................     1.19
370165.........................................................     1.28
370166.........................................................     1.79
370169.........................................................     1.91
370176.........................................................     1.99
370177.........................................................     1.48
370178.........................................................     2.01
370179.........................................................     1.40
370183.........................................................     1.38
370186.........................................................     2.40
370190.........................................................     2.72
370192.........................................................     2.64
372004.........................................................     0.74
373025.........................................................     1.44
373026.........................................................     1.05
374003.........................................................     1.43
374006.........................................................     1.09
374008.........................................................     1.62
374012.........................................................     1.25
374018.........................................................     1.30
374020.........................................................     1.38
380001.........................................................     2.56
380002.........................................................     3.62
380003.........................................................     3.00
380004.........................................................     3.26
380005.........................................................     4.66
380006.........................................................     2.69
380007.........................................................     2.88
380008.........................................................     1.60
380009.........................................................     2.04
380010.........................................................     1.71
380011.........................................................     2.19
380013.........................................................     1.52
380014.........................................................     2.51
380017.........................................................     3.48
380018.........................................................     2.29
380019.........................................................     1.71
380020.........................................................     3.29
380021.........................................................     2.50
380022.........................................................     2.52
380023.........................................................     2.25
380025.........................................................     2.54
380026.........................................................     2.19
380027.........................................................     1.81
380029.........................................................     2.00
380031.........................................................     1.56
380033.........................................................     2.83
380035.........................................................     2.69
380036.........................................................     2.23
380037.........................................................     2.24
380038.........................................................     2.80
380039.........................................................     1.87
380040.........................................................     2.03
380042.........................................................     1.73
380047.........................................................     3.41
380048.........................................................     2.03
380050.........................................................     2.26
380051.........................................................     2.84
380052.........................................................     2.34
380056.........................................................     1.38
380060.........................................................     2.26
380061.........................................................     2.53
380062.........................................................     0.85
380063.........................................................     1.64
380064.........................................................     1.85
380065.........................................................     1.72
380066.........................................................     2.76
380068.........................................................     1.29
380069.........................................................     1.67
380070.........................................................     1.83
380071.........................................................     3.16
380072.........................................................     1.67
380075.........................................................     2.82
380078.........................................................     1.79
380081.........................................................     0.94
380082.........................................................     2.43
380083.........................................................     2.28
380084.........................................................     1.97
380087.........................................................     2.29
380088.........................................................     1.95
380089.........................................................     2.67
380090.........................................................     2.69
390001.........................................................     2.28
390002.........................................................     2.31
390003.........................................................     1.68
390004.........................................................     2.37
390005.........................................................     2.13
390006.........................................................     1.56
390007.........................................................     3.01
390008.........................................................     1.88
390009.........................................................     2.27
390010.........................................................     2.46
390011.........................................................     2.35
390012.........................................................     2.52
390013.........................................................     2.64
390015.........................................................     1.83
390016.........................................................     2.19
390017.........................................................     2.05
390018.........................................................     2.64
390019.........................................................     2.13
390022.........................................................     2.62
390023.........................................................     1.66
390024.........................................................     2.86
390025.........................................................     1.01
390026.........................................................     1.87
390028.........................................................     2.81
390029.........................................................     2.48
390030.........................................................     2.03
390031.........................................................     2.04
390032.........................................................     2.24
390035.........................................................     2.44
390036.........................................................     2.41
390037.........................................................     2.41
390039.........................................................     2.16
390040.........................................................     1.67
390041.........................................................     2.43
390042.........................................................     2.15
390043.........................................................     2.81
390044.........................................................     2.47
390045.........................................................     2.07
390046.........................................................     1.82
390047.........................................................     2.37
390048.........................................................     2.18
390049.........................................................     2.55
390051.........................................................     2.39
390052.........................................................     2.37
390054.........................................................     1.88
390055.........................................................     2.50
390056.........................................................     1.93
390057.........................................................     2.26
390058.........................................................     2.88
390060.........................................................     1.55
390061.........................................................     2.09
390062.........................................................     2.64
390063.........................................................     3.18
390065.........................................................     2.18
390066.........................................................     1.97
390067.........................................................     2.36
390068.........................................................     1.71
390069.........................................................     2.07
390070.........................................................     2.99
390071.........................................................     2.38
390072.........................................................     2.07
390073.........................................................     2.34
390074.........................................................     2.49
390075.........................................................     2.39
390076.........................................................     2.35
390078.........................................................     2.72
390079.........................................................     2.76
390080.........................................................     2.27
390083.........................................................     1.70
390084.........................................................     1.63
390086.........................................................     2.12
390088.........................................................     1.82
390090.........................................................     2.61
390091.........................................................     2.07
390093.........................................................     1.88
390095.........................................................     2.17
390096.........................................................     2.12
390097.........................................................     2.24
390100.........................................................     2.36
390101.........................................................     1.57
390102.........................................................     2.62
390103.........................................................     1.99
390104.........................................................     1.86
390106.........................................................     1.90
390107.........................................................     2.35
390108.........................................................     2.27
390109.........................................................     1.45
390110.........................................................     2.02
390111.........................................................     1.83
390112.........................................................     2.15
390113.........................................................     2.24
390114.........................................................     2.04
390115.........................................................     2.23
390116.........................................................     2.11
390118.........................................................     2.53
390119.........................................................     2.35
390121.........................................................     2.40
390122.........................................................     2.01
390123.........................................................     2.78
390125.........................................................     2.16
390127.........................................................     2.39

[[Page 35501]]

 
390128.........................................................     2.69
390130.........................................................     2.00
390131.........................................................     2.36
390132.........................................................     1.94
390133.........................................................     2.42
390135.........................................................     2.00
390136.........................................................     3.53
390137.........................................................     2.30
390138.........................................................     2.02
390139.........................................................     2.41
390142.........................................................     1.82
390145.........................................................     2.23
390146.........................................................     2.08
390147.........................................................     2.32
390150.........................................................     1.87
390151.........................................................     2.28
390152.........................................................     2.31
390153.........................................................     1.89
390154.........................................................     2.53
390155.........................................................     1.33
390156.........................................................     2.31
390157.........................................................     2.37
390158.........................................................     2.27
390160.........................................................     2.65
390161.........................................................     2.45
390162.........................................................     2.22
390163.........................................................     2.32
390164.........................................................     2.01
390166.........................................................     1.65
390167.........................................................     2.15
390168.........................................................     2.09
390169.........................................................     2.95
390173.........................................................     1.97
390174.........................................................     2.26
390176.........................................................     2.00
390178.........................................................     2.45
390179.........................................................     2.23
390180.........................................................     2.28
390181.........................................................     2.25
390183.........................................................     2.37
390184.........................................................     1.62
390185.........................................................     2.69
390189.........................................................     2.17
390191.........................................................     2.94
390192.........................................................     1.97
390193.........................................................     2.44
390194.........................................................     2.11
390195.........................................................     2.67
390196.........................................................     2.10
390197.........................................................     2.87
390198.........................................................     1.52
390199.........................................................     1.66
390200.........................................................     1.45
390201.........................................................     2.13
390203.........................................................     2.45
390204.........................................................     2.30
390205.........................................................     2.28
390206.........................................................     1.93
390209.........................................................     1.92
390211.........................................................     2.50
390213.........................................................     1.01
390215.........................................................     2.33
390217.........................................................     2.12
390219.........................................................     1.77
390222.........................................................     2.63
390224.........................................................     1.59
390225.........................................................     2.14
390226.........................................................     2.14
390228.........................................................     2.10
390231.........................................................     2.05
390233.........................................................     1.89
390235.........................................................     1.76
390236.........................................................     2.00
390237.........................................................     2.10
390238.........................................................     2.27
390242.........................................................     2.31
390244.........................................................     0.99
390245.........................................................     1.98
390246.........................................................     2.30
390247.........................................................     1.06
390249.........................................................     1.03
390256.........................................................     1.74
390258.........................................................     2.34
390260.........................................................     3.40
390262.........................................................     2.54
390263.........................................................     2.66
390265.........................................................     1.46
390266.........................................................     2.94
390267.........................................................     2.51
390268.........................................................     2.47
390270.........................................................     2.41
390277.........................................................     1.09
390279.........................................................     2.19
392024.........................................................     1.54
392025.........................................................     1.67
392026.........................................................     1.05
393025.........................................................     1.10
393026.........................................................     1.57
393027.........................................................     1.76
393031.........................................................     1.45
393032.........................................................     1.06
393035.........................................................     0.85
393037.........................................................     1.35
393038.........................................................     1.63
393039.........................................................     1.00
393040.........................................................     3.14
393042.........................................................     1.68
393043.........................................................     0.88
393301.........................................................     1.76
393302.........................................................     1.48
394006.........................................................     1.31
394007.........................................................     1.38
394008.........................................................     2.75
394020.........................................................     1.14
394023.........................................................     1.34
394034.........................................................     1.22
394041.........................................................     1.09
400001.........................................................     1.56
400002.........................................................     3.46
400003.........................................................     1.44
400004.........................................................     1.88
400005.........................................................     1.64
400006.........................................................     2.37
400007.........................................................     1.13
400009.........................................................     1.77
400011.........................................................     2.23
400012.........................................................     1.03
400013.........................................................     1.35
400014.........................................................     4.33
400016.........................................................     2.08
400017.........................................................     1.95
400018.........................................................     1.33
400019.........................................................     3.06
400021.........................................................     1.89
400022.........................................................     1.78
400027.........................................................     0.85
400028.........................................................     1.51
400029.........................................................     1.06
400032.........................................................     1.10
400094.........................................................     1.07
400098.........................................................     1.33
400102.........................................................     1.90
400106.........................................................     1.48
400109.........................................................     1.91
400111.........................................................     1.29
400113.........................................................     1.98
400114.........................................................     1.37
400115.........................................................     1.11
400117.........................................................     2.09
400118.........................................................     1.61
400120.........................................................     2.23
400122.........................................................     0.93
400123.........................................................     3.45
400124.........................................................     8.61
404002.........................................................     2.33
410001.........................................................     2.10
410004.........................................................     1.90
410005.........................................................     2.63
410006.........................................................     2.14
410007.........................................................     2.36
410008.........................................................     2.45
410009.........................................................     2.76
410010.........................................................     1.74
410011.........................................................     2.21
410012.........................................................     2.51
410013.........................................................     2.44
413025.........................................................     1.43
414000.........................................................     1.92
420002.........................................................     2.45
420004.........................................................     1.85
420005.........................................................     2.31
420006.........................................................     1.21
420007.........................................................     2.47
420009.........................................................     2.69
420010.........................................................     2.32
420011.........................................................     1.69
420014.........................................................     1.38
420015.........................................................     2.30
420016.........................................................     1.68
420018.........................................................     1.86
420019.........................................................     2.11
420020.........................................................     2.41
420023.........................................................     2.81
420026.........................................................     3.52
420027.........................................................     2.14
420030.........................................................     2.06
420031.........................................................     1.34
420033.........................................................     1.82
420036.........................................................     2.49
420037.........................................................     1.69
420038.........................................................     1.69
420039.........................................................     1.85
420042.........................................................     1.78
420043.........................................................     2.04
420048.........................................................     2.19
420049.........................................................     2.64
420051.........................................................     2.34
420053.........................................................     2.21
420054.........................................................     1.65
420055.........................................................     1.77
420056.........................................................     2.63
420057.........................................................     1.70
420059.........................................................     1.53
420061.........................................................     1.79
420062.........................................................     2.16
420064.........................................................     1.55
420065.........................................................     2.64
420066.........................................................     1.91
420067.........................................................     3.06
420068.........................................................     2.80
420069.........................................................     1.57
420070.........................................................     2.37
420071.........................................................     2.47
420072.........................................................     1.30
420073.........................................................     2.50
420074.........................................................     1.11
420075.........................................................     1.79
420078.........................................................     2.50
420079.........................................................     1.75
420080.........................................................     2.41
420081.........................................................     0.87
420082.........................................................     2.27
420083.........................................................     3.31
420085.........................................................     2.03
420086.........................................................     2.36
420087.........................................................     2.53
420088.........................................................     2.47
420089.........................................................     2.60

[[Page 35502]]

 
420091.........................................................     2.75
423025.........................................................     2.50
423026.........................................................     1.63
424006.........................................................     1.31
424007.........................................................     1.20
424009.........................................................     1.29
424010.........................................................     1.40
430004.........................................................     1.89
430005.........................................................     2.74
430007.........................................................     2.48
430008.........................................................     2.62
430010.........................................................     2.27
430011.........................................................     3.02
430012.........................................................     3.46
430013.........................................................     2.95
430014.........................................................     2.66
430015.........................................................     2.99
430016.........................................................     2.57
430018.........................................................     1.57
430022.........................................................     1.16
430023.........................................................     1.43
430024.........................................................     1.04
430026.........................................................     1.20
430027.........................................................     3.75
430028.........................................................     2.35
430029.........................................................     1.91
430031.........................................................     1.67
430033.........................................................     1.68
430034.........................................................     1.40
430036.........................................................     1.94
430037.........................................................     2.47
430038.........................................................     2.48
430040.........................................................     2.01
430041.........................................................     1.67
430043.........................................................     2.11
430044.........................................................     1.45
430047.........................................................     1.89
430048.........................................................     2.07
430049.........................................................     1.31
430051.........................................................     1.01
430054.........................................................     1.79
430056.........................................................     1.30
430057.........................................................     1.62
430060.........................................................     0.98
430062.........................................................     1.70
430064.........................................................     1.93
430065.........................................................     1.32
430066.........................................................     1.16
430073.........................................................     1.57
430076.........................................................     1.02
430077.........................................................     2.99
430079.........................................................     1.01
430087.........................................................     1.14
434004.........................................................     1.52
440001.........................................................     2.05
440002.........................................................     3.46
440003.........................................................     2.67
440006.........................................................     2.96
440007.........................................................     1.14
440008.........................................................     2.07
440009.........................................................     2.91
440010.........................................................     1.65
440011.........................................................     2.26
440012.........................................................     1.81
440014.........................................................     1.62
440015.........................................................     2.82
440016.........................................................     1.92
440017.........................................................     2.44
440018.........................................................     1.54
440019.........................................................     2.38
440020.........................................................     1.95
440022.........................................................     1.48
440023.........................................................     1.54
440024.........................................................     2.81
440025.........................................................     2.13
440026.........................................................     0.99
440029.........................................................     2.89
440030.........................................................     2.65
440031.........................................................     2.25
440032.........................................................     1.48
440033.........................................................     1.82
440034.........................................................     2.53
440035.........................................................     2.40
440039.........................................................     2.02
440040.........................................................     1.54
440041.........................................................     1.67
440046.........................................................     2.35
440047.........................................................     1.66
440048.........................................................     2.88
440049.........................................................     2.45
440050.........................................................     2.22
440051.........................................................     1.56
440052.........................................................     1.54
440053.........................................................     2.74
440054.........................................................     1.97
440056.........................................................     1.73
440057.........................................................     1.88
440058.........................................................     2.80
440059.........................................................     2.36
440060.........................................................     1.53
440061.........................................................     1.87
440063.........................................................     2.54
440064.........................................................     1.66
440065.........................................................     2.27
440067.........................................................     2.61
440068.........................................................     2.32
440070.........................................................     1.68
440071.........................................................     2.37
440072.........................................................     2.63
440073.........................................................     2.55
440078.........................................................     1.59
440081.........................................................     1.92
440082.........................................................     2.63
440083.........................................................     1.62
440084.........................................................     1.41
440090.........................................................     1.47
440091.........................................................     2.83
440100.........................................................     1.70
440102.........................................................     1.92
440103.........................................................     2.37
440104.........................................................     2.39
440105.........................................................     5.91
440109.........................................................     1.94
440110.........................................................     1.93
440111.........................................................     1.26
440114.........................................................     1.86
440115.........................................................     1.85
440120.........................................................     3.10
440125.........................................................     2.59
440130.........................................................     2.76
440131.........................................................     2.59
440132.........................................................     2.11
440133.........................................................     2.76
440135.........................................................     2.10
440137.........................................................     2.03
440141.........................................................     1.08
440142.........................................................     1.41
440143.........................................................     1.54
440144.........................................................     3.51
440145.........................................................     1.31
440147.........................................................     6.45
440148.........................................................     2.30
440149.........................................................     1.44
440150.........................................................     3.11
440151.........................................................     1.85
440152.........................................................     1.54
440153.........................................................     1.95
440156.........................................................     2.88
440157.........................................................     1.64
440159.........................................................     2.22
440161.........................................................     3.36
440162.........................................................     1.30
440166.........................................................     2.53
440168.........................................................     2.06
440173.........................................................     3.78
440174.........................................................     1.91
440175.........................................................     2.45
440176.........................................................     2.77
440178.........................................................     2.12
440180.........................................................     1.62
440181.........................................................     1.87
440182.........................................................     2.10
440183.........................................................     3.04
440184.........................................................     2.78
440185.........................................................     2.30
440186.........................................................     2.08
440187.........................................................     1.86
440189.........................................................     3.14
440192.........................................................     1.68
440193.........................................................     2.95
440194.........................................................     1.92
440197.........................................................     2.70
440200.........................................................     1.92
440203.........................................................     1.79
440205.........................................................     1.34
440206.........................................................     1.91
442007.........................................................     0.98
443025.........................................................     1.66
443026.........................................................     1.44
443029.........................................................     2.87
444003.........................................................     1.07
444004.........................................................     1.32
444006.........................................................     1.27
444010.........................................................     1.20
444017.........................................................     1.31
450002.........................................................     2.26
450004.........................................................     1.66
450005.........................................................     1.97
450007.........................................................     2.83
450008.........................................................     1.73
450010.........................................................     2.35
450011.........................................................     2.73
450014.........................................................     1.64
450015.........................................................     1.21
450016.........................................................     2.92
450018.........................................................     1.48
450020.........................................................     2.07
450021.........................................................     1.73
450023.........................................................     2.65
450024.........................................................     1.46
450025.........................................................     2.71
450028.........................................................     2.11
450029.........................................................     1.95
450031.........................................................     2.08
450032.........................................................     1.52
450033.........................................................     1.92
450034.........................................................     2.15
450035.........................................................     2.37
450037.........................................................     2.25
450039.........................................................     1.07
450040.........................................................     1.90
450042.........................................................     2.14
450044.........................................................     2.21
450046.........................................................     2.65
450047.........................................................     2.20
450050.........................................................     1.26
450051.........................................................     1.77
450052.........................................................     1.46
450053.........................................................     2.23
450054.........................................................     3.01
450055.........................................................     1.70
450056.........................................................     3.09
450058.........................................................     3.08
450059.........................................................     2.53
450063.........................................................     0.92
450064.........................................................     2.79
450065.........................................................     1.59
450068.........................................................     1.97

[[Page 35503]]

 
450072.........................................................     2.22
450073.........................................................     1.42
450076.........................................................     1.67
450078.........................................................     1.11
450079.........................................................     2.56
450080.........................................................     2.84
450081.........................................................     1.87
450082.........................................................     1.57
450083.........................................................     3.18
450085.........................................................     1.71
450087.........................................................     1.84
450090.........................................................     2.26
450092.........................................................     1.78
450094.........................................................     2.42
450096.........................................................     1.75
450097.........................................................     2.99
450098.........................................................     1.12
450099.........................................................     1.97
450101.........................................................     2.43
450102.........................................................     3.08
450104.........................................................     2.70
450107.........................................................     1.99
450108.........................................................     1.31
450109.........................................................     1.54
450111.........................................................     2.41
450112.........................................................     2.57
450113.........................................................     2.56
450118.........................................................     3.04
450119.........................................................     2.38
450121.........................................................     2.47
450123.........................................................     1.71
450124.........................................................     2.02
450126.........................................................     1.69
450128.........................................................     1.91
450130.........................................................     3.22
450131.........................................................     1.77
450132.........................................................     2.15
450133.........................................................     2.21
450135.........................................................     2.15
450137.........................................................     2.08
450140.........................................................     1.34
450142.........................................................     1.99
450143.........................................................     1.70
450144.........................................................     1.63
450145.........................................................     1.26
450146.........................................................     0.98
450147.........................................................     1.84
450148.........................................................     2.15
450149.........................................................     1.90
450150.........................................................     1.58
450151.........................................................     1.52
450152.........................................................     2.19
450153.........................................................     2.25
450154.........................................................     1.66
450155.........................................................     1.57
450157.........................................................     1.30
450160.........................................................     1.78
450162.........................................................     1.98
450163.........................................................     1.61
450164.........................................................     1.25
450165.........................................................     1.71
450166.........................................................     0.89
450169.........................................................     1.16
450170.........................................................     1.46
450176.........................................................     2.20
450177.........................................................     2.12
450178.........................................................     1.40
450181.........................................................     1.33
450184.........................................................     2.79
450185.........................................................     1.43
450187.........................................................     2.03
450188.........................................................     1.72
450190.........................................................     2.71
450191.........................................................     2.51
450192.........................................................     1.65
450193.........................................................     3.61
450194.........................................................     2.17
450196.........................................................     2.52
450200.........................................................     2.33
450201.........................................................     2.06
450203.........................................................     1.84
450209.........................................................     1.76
450210.........................................................     1.63
450211.........................................................     2.19
450214.........................................................     2.43
450217.........................................................     1.05
450219.........................................................     2.22
450221.........................................................     1.20
450222.........................................................     2.22
450224.........................................................     1.90
450229.........................................................     2.52
450231.........................................................     2.65
450234.........................................................     1.39
450235.........................................................     1.93
450236.........................................................     2.48
450237.........................................................     1.78
450239.........................................................     1.35
450241.........................................................     1.31
450243.........................................................     1.41
450246.........................................................     1.43
450249.........................................................     1.22
450250.........................................................     1.22
450253.........................................................     2.38
450258.........................................................     1.08
450259.........................................................     2.05
450264.........................................................     0.91
450269.........................................................     1.24
450270.........................................................     1.46
450271.........................................................     1.30
450272.........................................................     2.76
450276.........................................................     1.36
450278.........................................................     1.34
450280.........................................................     1.76
450283.........................................................     1.29
450286.........................................................     1.18
450288.........................................................     1.59
450289.........................................................     1.04
450292.........................................................     1.74
450293.........................................................     1.60
450296.........................................................     2.13
450299.........................................................     2.26
450303.........................................................     1.03
450306.........................................................     3.30
450307.........................................................     1.00
450309.........................................................     1.49
450315.........................................................     2.47
450320.........................................................     1.79
450321.........................................................     1.16
450322.........................................................     1.06
450324.........................................................     2.35
450327.........................................................     0.95
450330.........................................................     1.67
450334.........................................................     1.07
450337.........................................................     1.39
450340.........................................................     2.47
450341.........................................................     1.87
450346.........................................................     1.98
450347.........................................................     2.27
450348.........................................................     1.14
450351.........................................................     3.89
450352.........................................................     2.17
450353.........................................................     1.66
450355.........................................................     1.15
450358.........................................................     2.48
450362.........................................................     2.40
450369.........................................................     1.44
450370.........................................................     4.40
450371.........................................................     2.02
450372.........................................................     2.61
450373.........................................................     1.32
450374.........................................................     0.99
450376.........................................................     2.22
450378.........................................................     1.66
450379.........................................................     2.29
450381.........................................................     1.67
450388.........................................................     2.66
450389.........................................................     2.00
450393.........................................................     1.84
450395.........................................................     1.50
450399.........................................................     1.00
450400.........................................................     1.73
450403.........................................................     1.71
450411.........................................................     1.61
450417.........................................................     1.75
450418.........................................................     1.83
450419.........................................................     1.49
450423.........................................................     2.32
450424.........................................................     2.41
450429.........................................................     0.88
450431.........................................................     2.86
450438.........................................................     2.68
450446.........................................................     1.32
450447.........................................................     2.77
450451.........................................................     2.08
450457.........................................................     2.85
450460.........................................................     1.72
450462.........................................................     2.03
450464.........................................................     1.46
450465.........................................................     3.04
450467.........................................................     1.47
450469.........................................................     2.64
450473.........................................................     1.17
450475.........................................................     2.22
450484.........................................................     2.18
450488.........................................................     1.84
450489.........................................................     1.13
450497.........................................................     1.79
450498.........................................................     2.12
450508.........................................................     1.87
450514.........................................................     2.09
450517.........................................................     1.31
450518.........................................................     2.10
450523.........................................................     2.59
450530.........................................................     2.37
450534.........................................................     1.17
450535.........................................................     2.21
450537.........................................................     1.87
450538.........................................................     1.64
450539.........................................................     2.33
450544.........................................................     1.93
450545.........................................................     3.48
450547.........................................................     1.52
450550.........................................................     1.97
450551.........................................................     2.22
450558.........................................................     1.97
450559.........................................................     1.22
450561.........................................................     2.18
450563.........................................................     2.44
450565.........................................................     2.10
450570.........................................................     1.46
450571.........................................................     2.45
450573.........................................................     1.52
450574.........................................................     0.84
450575.........................................................     1.17
450578.........................................................     1.02
450580.........................................................     2.14
450583.........................................................     1.10
450584.........................................................     1.71
450586.........................................................     1.56
450587.........................................................     1.86
450591.........................................................     2.51
450596.........................................................     2.29
450597.........................................................     1.60
450603.........................................................     1.05
450604.........................................................     2.39
450605.........................................................     1.92
450609.........................................................     1.06
450610.........................................................     2.47

[[Page 35504]]

 
450614.........................................................     1.50
450615.........................................................     1.98
450617.........................................................     2.12
450620.........................................................     1.38
450623.........................................................     1.81
450626.........................................................     1.13
450628.........................................................     1.17
450630.........................................................     2.17
450631.........................................................     2.20
450632.........................................................     0.78
450633.........................................................     2.27
450634.........................................................     2.37
450638.........................................................     2.97
450639.........................................................     2.27
450641.........................................................     1.70
450643.........................................................     2.16
450644.........................................................     2.47
450646.........................................................     2.32
450647.........................................................     2.94
450648.........................................................     1.75
450649.........................................................     1.37
450651.........................................................     2.04
450652.........................................................     1.21
450653.........................................................     2.35
450654.........................................................     1.19
450656.........................................................     2.51
450658.........................................................     1.93
450659.........................................................     2.36
450661.........................................................     2.98
450662.........................................................     1.63
450665.........................................................     1.61
450666.........................................................     1.81
450668.........................................................     2.66
450669.........................................................     2.18
450670.........................................................     2.34
450672.........................................................     2.64
450673.........................................................     1.22
450674.........................................................     2.94
450675.........................................................     2.10
450677.........................................................     2.23
450678.........................................................     2.58
450683.........................................................     2.18
450684.........................................................     1.93
450686.........................................................     2.16
450688.........................................................     1.96
450690.........................................................     1.50
450691.........................................................     1.76
450694.........................................................     2.35
450696.........................................................     9.87
450697.........................................................     1.90
450698.........................................................     0.94
450700.........................................................     1.36
450702.........................................................     2.25
450703.........................................................     1.20
450704.........................................................     2.16
450705.........................................................     1.61
450706.........................................................     2.12
450709.........................................................     2.77
450711.........................................................     2.40
450712.........................................................     1.34
450713.........................................................     2.35
450715.........................................................     1.59
450716.........................................................     2.51
450717.........................................................     1.98
450718.........................................................     2.23
450723.........................................................     1.80
450724.........................................................     3.48
450725.........................................................     1.70
450727.........................................................     1.85
450728.........................................................     1.09
450730.........................................................     2.03
450733.........................................................     2.29
450735.........................................................     0.59
450742.........................................................     2.15
450743.........................................................     2.75
450746.........................................................     1.34
450747.........................................................     2.56
450749.........................................................     1.11
450750.........................................................     1.40
450751.........................................................     2.18
450754.........................................................     1.69
450755.........................................................     1.71
450757.........................................................     1.08
450758.........................................................     2.03
450760.........................................................     2.45
450761.........................................................     1.18
450763.........................................................     1.70
450766.........................................................     5.27
450769.........................................................     1.08
450770.........................................................     1.35
450774.........................................................     4.58
450775.........................................................     2.11
450776.........................................................     1.34
450777.........................................................     1.52
450779.........................................................     1.89
450780.........................................................     5.46
450788.........................................................     1.72
450795.........................................................     0.93
450797.........................................................     8.56
450801.........................................................     2.42
450802.........................................................     2.75
450803.........................................................     1.22
450804.........................................................     5.75
450809.........................................................     2.15
452013.........................................................     0.93
452019.........................................................     1.81
452022.........................................................     1.41
452033.........................................................     0.93
452036.........................................................     0.74
452038.........................................................     1.26
452039.........................................................     0.96
452043.........................................................     1.02
453025.........................................................     1.17
453028.........................................................     0.84
453029.........................................................     1.13
453031.........................................................     1.57
453033.........................................................     0.88
453034.........................................................     1.09
453035.........................................................     1.98
453036.........................................................     2.77
453037.........................................................     1.31
453038.........................................................     1.26
453040.........................................................     1.19
453041.........................................................     1.14
453042.........................................................     1.06
453044.........................................................     1.79
453047.........................................................     1.21
453048.........................................................     1.06
453052.........................................................     1.51
453053.........................................................     1.38
453054.........................................................     1.51
453056.........................................................     1.47
453057.........................................................     1.33
453059.........................................................     0.80
453065.........................................................     3.10
453300.........................................................     1.21
453302.........................................................     1.60
453304.........................................................     1.53
453305.........................................................     1.02
454012.........................................................     1.31
454018.........................................................     1.31
454026.........................................................     1.47
454028.........................................................     1.31
454029.........................................................     1.95
454030.........................................................     1.31
454032.........................................................     1.18
454037.........................................................     1.32
454038.........................................................     1.31
454042.........................................................     1.30
454043.........................................................     1.31
454045.........................................................     1.34
454050.........................................................     1.31
454056.........................................................     1.63
454057.........................................................     1.36
454063.........................................................     1.20
454064.........................................................     1.32
454065.........................................................     1.36
454066.........................................................     1.32
454069.........................................................     1.70
454072.........................................................     1.31
454073.........................................................     1.57
454089.........................................................     1.35
460001.........................................................     2.75
460003.........................................................     2.99
460004.........................................................     2.40
460005.........................................................     2.35
460006.........................................................     3.47
460007.........................................................     2.73
460008.........................................................     2.45
460009.........................................................     2.52
460010.........................................................     2.34
460011.........................................................     2.11
460013.........................................................     2.58
460014.........................................................     1.33
460015.........................................................     2.71
460016.........................................................     1.42
460017.........................................................     3.03
460018.........................................................     1.58
460019.........................................................     2.12
460020.........................................................     1.83
460021.........................................................     2.11
460022.........................................................     1.27
460023.........................................................     2.88
460024.........................................................     1.09
460025.........................................................     0.83
460026.........................................................     1.91
460027.........................................................     1.49
460029.........................................................     1.75
460030.........................................................     1.87
460032.........................................................     1.72
460033.........................................................     1.59
460035.........................................................     1.17
460036.........................................................     2.03
460037.........................................................     1.91
460039.........................................................     1.53
460041.........................................................     2.64
460042.........................................................     2.59
460044.........................................................     2.05
460046.........................................................     9.51
460047.........................................................     1.74
460049.........................................................     0.11
460050.........................................................     2.03
463025.........................................................     1.64
463301.........................................................     2.17
464003.........................................................     1.31
464010.........................................................     1.25
470001.........................................................     1.93
470003.........................................................     2.50
470004.........................................................     1.49
470005.........................................................     2.09
470006.........................................................     2.45
470008.........................................................     1.83
470010.........................................................     1.87
470011.........................................................     2.21
470012.........................................................     2.75
470015.........................................................     1.83
470018.........................................................     2.05
470020.........................................................     1.15
470023.........................................................     2.39
470024.........................................................     2.06
474001.........................................................     0.86
480001.........................................................     1.58
480002.........................................................     2.11
490001.........................................................     1.56
490002.........................................................     1.62
490004.........................................................     2.19
490005.........................................................     2.42
490006.........................................................     2.01

[[Page 35505]]

 
490007.........................................................     2.39
490009.........................................................     1.81
490011.........................................................     2.62
490012.........................................................     1.52
490013.........................................................     2.55
490014.........................................................     1.79
490015.........................................................     2.92
490017.........................................................     2.63
490018.........................................................     2.78
490019.........................................................     2.15
490020.........................................................     2.57
490022.........................................................     2.29
490023.........................................................     2.27
490024.........................................................     2.28
490027.........................................................     1.89
490030.........................................................     2.58
490031.........................................................     1.86
490032.........................................................     1.67
490033.........................................................     1.73
490035.........................................................     2.10
490037.........................................................     2.37
490038.........................................................     2.27
490040.........................................................     2.89
490041.........................................................     2.95
490042.........................................................     2.46
490043.........................................................     1.96
490044.........................................................     2.22
490045.........................................................     2.14
490046.........................................................     2.85
490047.........................................................     1.45
490048.........................................................     2.34
490050.........................................................     2.65
490052.........................................................     2.31
490053.........................................................     2.76
490054.........................................................     1.45
490057.........................................................     2.40
490059.........................................................     3.04
490060.........................................................     2.36
490063.........................................................     3.55
490066.........................................................     2.47
490067.........................................................     2.62
490069.........................................................     1.40
490071.........................................................     2.92
490073.........................................................     3.67
490074.........................................................     3.72
490075.........................................................     2.54
490077.........................................................     2.50
490079.........................................................     2.06
490084.........................................................     2.18
490085.........................................................     1.89
490088.........................................................     2.53
490089.........................................................     1.56
490090.........................................................     2.33
490091.........................................................     2.37
490092.........................................................     2.19
490093.........................................................     2.28
490094.........................................................     1.60
490095.........................................................     2.11
490097.........................................................     1.97
490098.........................................................     2.04
490099.........................................................     1.12
490100.........................................................     3.24
490101.........................................................     2.39
490107.........................................................     2.90
490110.........................................................     3.18
490111.........................................................     2.23
490112.........................................................     2.39
490113.........................................................     2.42
490114.........................................................     1.63
490115.........................................................     2.12
490116.........................................................     1.97
490117.........................................................     1.31
490118.........................................................     2.42
490119.........................................................     2.43
490120.........................................................     2.37
490122.........................................................     2.68
490123.........................................................     2.23
490124.........................................................     1.89
490126.........................................................     2.27
490127.........................................................     1.57
490130.........................................................     2.03
490131.........................................................     1.68
492001.........................................................     0.79
493025.........................................................     1.24
493026.........................................................     0.92
493027.........................................................     2.34
493028.........................................................     1.39
493301.........................................................     1.94
494001.........................................................     1.31
494011.........................................................     1.09
494018.........................................................     1.34
494020.........................................................     1.31
494022.........................................................     1.30
494023.........................................................     1.28
494025.........................................................     1.17
494026.........................................................     1.32
494028.........................................................     1.31
500001.........................................................     2.51
500002.........................................................     2.10
500003.........................................................     2.36
500005.........................................................     2.14
500007.........................................................     3.03
500008.........................................................     1.60
500011.........................................................     2.13
500012.........................................................     2.76
500014.........................................................     2.57
500015.........................................................     2.03
500019.........................................................     2.49
500021.........................................................     2.22
500023.........................................................     2.13
500024.........................................................     3.90
500025.........................................................     3.10
500026.........................................................     2.20
500027.........................................................     2.86
500029.........................................................     1.05
500030.........................................................     2.59
500031.........................................................     2.08
500033.........................................................     2.66
500036.........................................................     2.56
500037.........................................................     1.71
500039.........................................................     2.90
500041.........................................................     2.29
500042.........................................................     3.14
500043.........................................................     1.85
500044.........................................................     2.56
500045.........................................................     2.36
500048.........................................................     1.65
500049.........................................................     3.17
500050.........................................................     2.47
500051.........................................................     2.62
500053.........................................................     2.42
500054.........................................................     2.27
500055.........................................................     1.86
500057.........................................................     2.65
500058.........................................................     2.50
500059.........................................................     2.45
500060.........................................................     2.25
500061.........................................................     1.15
500062.........................................................     0.99
500064.........................................................     1.29
500065.........................................................     2.66
500068.........................................................     1.09
500069.........................................................     1.25
500071.........................................................     3.04
500072.........................................................     2.25
500073.........................................................     1.39
500074.........................................................     2.39
500077.........................................................     2.29
500079.........................................................     1.61
500080.........................................................     1.14
500084.........................................................     2.32
500085.........................................................     1.66
500086.........................................................     2.05
500088.........................................................     2.78
500089.........................................................     1.93
500090.........................................................     0.71
500092.........................................................     1.77
500094.........................................................     0.83
500096.........................................................     1.79
500097.........................................................     1.33
500098.........................................................     1.45
500101.........................................................     1.17
500102.........................................................     1.74
500104.........................................................     2.07
500106.........................................................     0.71
500107.........................................................     1.77
500108.........................................................     2.64
500110.........................................................     2.79
500118.........................................................     2.52
500119.........................................................     1.78
500122.........................................................     2.31
500123.........................................................     0.86
500124.........................................................     2.21
500125.........................................................     1.40
500129.........................................................     2.04
500132.........................................................     1.48
500138.........................................................     1.08
500139.........................................................     2.56
500141.........................................................     3.07
500146.........................................................     2.18
502002.........................................................     3.69
503300.........................................................     2.70
504002.........................................................     1.43
510001.........................................................     2.11
510002.........................................................     2.26
510004.........................................................     1.10
510005.........................................................     1.47
510006.........................................................     2.66
510007.........................................................     2.10
510008.........................................................     2.40
510012.........................................................     1.99
510013.........................................................     1.57
510015.........................................................     1.15
510016.........................................................     1.15
510018.........................................................     1.65
510020.........................................................     1.23
510022.........................................................     2.33
510023.........................................................     1.92
510024.........................................................     3.05
510026.........................................................     1.48
510027.........................................................     1.61
510028.........................................................     1.46
510029.........................................................     2.51
510030.........................................................     2.23
510031.........................................................     3.05
510033.........................................................     2.05
510038.........................................................     1.64
510039.........................................................     2.31
510043.........................................................     0.96
510046.........................................................     2.03
510047.........................................................     2.56
510048.........................................................     1.45
510050.........................................................     2.19
510053.........................................................     1.54
510055.........................................................     2.17
510058.........................................................     2.37
510059.........................................................     8.02
510060.........................................................     1.66
510063.........................................................     1.20
510065.........................................................     1.24
510066.........................................................     2.03
510067.........................................................     2.36
510068.........................................................     2.25
510070.........................................................     3.03
510071.........................................................     2.10
510072.........................................................     1.56
510077.........................................................     2.09
510081.........................................................     1.31

[[Page 35506]]

 
510082.........................................................     1.70
510084.........................................................     1.44
510085.........................................................     1.78
510086.........................................................     1.15
513026.........................................................     1.19
513027.........................................................     1.33
513028.........................................................     1.63
513030.........................................................     1.49
514001.........................................................     1.44
514007.........................................................     5.99
514008.........................................................     1.86
520002.........................................................     2.56
520003.........................................................     2.35
520004.........................................................     2.57
520006.........................................................     2.22
520007.........................................................     1.57
520008.........................................................     2.29
520009.........................................................     2.07
520010.........................................................     2.33
520011.........................................................     2.95
520013.........................................................     1.97
520014.........................................................     2.25
520015.........................................................     2.51
520016.........................................................     1.83
520017.........................................................     2.02
520018.........................................................     2.11
520019.........................................................     2.23
520021.........................................................     2.57
520024.........................................................     1.96
520025.........................................................     1.95
520026.........................................................     2.28
520028.........................................................     3.23
520029.........................................................     1.34
520030.........................................................     3.15
520031.........................................................     3.82
520032.........................................................     1.84
520033.........................................................     2.11
520034.........................................................     2.43
520035.........................................................     2.87
520037.........................................................     2.62
520038.........................................................     3.13
520039.........................................................     1.77
520040.........................................................     2.01
520041.........................................................     1.95
520042.........................................................     1.95
520044.........................................................     3.00
520045.........................................................     2.24
520047.........................................................     2.03
520048.........................................................     2.34
520049.........................................................     2.90
520053.........................................................     1.70
520054.........................................................     1.58
520057.........................................................     2.90
520058.........................................................     2.71
520059.........................................................     2.73
520060.........................................................     1.66
520062.........................................................     2.38
520063.........................................................     2.99
520064.........................................................     1.79
520066.........................................................     2.95
520068.........................................................     1.68
520069.........................................................     1.98
520070.........................................................     2.35
520071.........................................................     2.40
520074.........................................................     1.57
520075.........................................................     2.44
520076.........................................................     2.50
520077.........................................................     1.14
520078.........................................................     1.91
520082.........................................................     2.79
520083.........................................................     1.70
520087.........................................................     1.22
520088.........................................................     2.40
520089.........................................................     3.23
520090.........................................................     1.99
520091.........................................................     3.56
520092.........................................................     1.99
520094.........................................................     1.92
520095.........................................................     2.55
520096.........................................................     2.31
520097.........................................................     2.23
520098.........................................................     1.46
520100.........................................................     2.48
520101.........................................................     1.53
520102.........................................................     2.46
520103.........................................................     2.51
520107.........................................................     1.83
520109.........................................................     1.99
520110.........................................................     1.71
520111.........................................................     2.05
520112.........................................................     3.22
520113.........................................................     2.58
520114.........................................................     2.06
520115.........................................................     1.98
520116.........................................................     2.48
520117.........................................................     1.79
520118.........................................................     1.11
520120.........................................................     1.08
520121.........................................................     1.72
520122.........................................................     1.44
520123.........................................................     1.81
520124.........................................................     1.88
520130.........................................................     2.49
520131.........................................................     2.06
520132.........................................................     2.46
520134.........................................................     1.58
520135.........................................................     1.84
520136.........................................................     2.30
520138.........................................................     2.32
520139.........................................................     2.50
520140.........................................................     2.42
520141.........................................................     2.11
520142.........................................................     1.24
520144.........................................................     2.14
520145.........................................................     1.48
520146.........................................................     2.23
520148.........................................................     1.82
520149.........................................................     1.13
520151.........................................................     2.45
520152.........................................................     2.03
520153.........................................................     1.50
520154.........................................................     2.23
520156.........................................................     3.09
520157.........................................................     1.54
520160.........................................................     2.62
520161.........................................................     2.22
520170.........................................................     2.85
520171.........................................................     1.82
520173.........................................................     2.67
520177.........................................................     2.29
520178.........................................................     2.28
523025.........................................................     1.44
523300.........................................................     2.56
524000.........................................................     1.41
524003.........................................................     1.23
524017.........................................................     0.45
524034.........................................................     1.27
524035.........................................................     1.26
524038.........................................................     1.57
530002.........................................................     2.18
530003.........................................................     1.37
530004.........................................................     1.80
530005.........................................................     1.67
530006.........................................................     2.14
530008.........................................................     2.36
530009.........................................................     1.94
530010.........................................................     2.28
530011.........................................................     2.08
530012.........................................................     2.20
530014.........................................................     2.54
530015.........................................................     2.19
530016.........................................................     1.93
530017.........................................................     1.93
530018.........................................................     2.15
530019.........................................................     1.56
530022.........................................................     2.04
530023.........................................................     1.51
530025.........................................................     2.00
530026.........................................................     1.48
530027.........................................................     1.60
530029.........................................................     0.99
530031.........................................................     0.96
530032.........................................................     2.14
------------------------------------------------------------------------
Note: The national average service mix discounted for multiple
  procedures is 2.05.

    52. On pages 48030 through 48035, Addendum J is corrected to read 
as follows:

  
[[Page 35506]]


                 Addendum J.--Wage Index for Urban Areas
------------------------------------------------------------------------
                                                                   Wage
          Urban code/Urban area (constituent counties)            index
------------------------------------------------------------------------
0040  Abilene, TX..............................................   0.8287
  Taylor, TX
0060  Aguadilla, PR \2\........................................   0.4188
  Aguada, PR
  Aguadilla, PR
  Moca, PR
0080  Akron, OH................................................   0.9728
  Portage, OH
  Summit, OH
0120  Albany, GA...............................................   0.7914
  Dougherty, GA
  Lee, GA
0160  Albany-Schenectady-Troy, NY..............................   0.8480
  Albany, NY
  Montgomery, NY
  Rensselaer, NY
  Saratoga, NY
  Schenectady, NY
  Schoharie, NY
0200  Albuquerque, NM..........................................   0.9329
  Bernalillo, NM
  Sandoval, NM
  Valencia, NM
0220  Alexandria, LA...........................................   0.8269
  Rapides, LA
0240  Allentown-Bethlehem-Easton, PA...........................   1.0086
  Carbon, PA
  Lehigh, PA
  Northampton, PA
0280  Altoona, PA..............................................   0.9137

[[Page 35507]]

 
  Blair, PA
0320  Amarillo, TX.............................................   0.9425
  Potter, TX
  Randall, TX
0380  Anchorage, AK............................................   1.2998
  Anchorage, AK
0440  Ann Arbor, MI............................................   1.1785
  Lenawee, MI
  Livingston, MI
  Washtenaw, MI
0450  Anniston, AL.............................................   0.8266
  Calhoun, AL
0460  Appleton-Oshkosh-Neenah, WI..............................   0.8996
  Calumet, WI
  Outagamie, WI
  Winnebago, WI
0470  Arecibo, PR \2\..........................................   0.4218
  Arecibo, PR
  Camuy, PR
  Hatillo, PR
0480  Asheville, NC............................................   0.9072
  Buncombe, NC
  Madison, NC
0500  Athens, GA...............................................   0.9087
  Clarke, GA
  Madison, GA
  Oconee, GA
0520  Atlanta, GA \1\..........................................   0.9823
  Barrow, GA
  Bartow, GA
  Carroll, GA
  Cherokee, GA
  Clayton, GA
  Cobb, GA
  Coweta, GA
  DeKalb, GA
  Douglas, GA
  Fayette, GA
  Forsyth, GA
  Fulton, GA
  Gwinnett, GA
  Henry, GA
  Newton, GA
  Paulding, GA
  Pickens, GA
  Rockdale, GA
  Spalding, GA
  Walton, GA
0560  Atlantic-Cape May, NJ....................................   1.0724
  Atlantic, NJ
  Cape May, NJ
0600  Augusta-Aiken, GA-SC.....................................   0.9333
  Columbia, GA
  McDuffie, GA
  Richmond, GA
  Aiken, SC
  Edgefield, SC
0640  Austin-San Marcos, TX \1\................................   0.9133
  Bastrop, TX
  Caldwell, TX
  Hays, TX
  Travis, TX
  Williamson, TX
0680  Bakersfield, CA..........................................   1.0014
  Kern, CA
0720  Baltimore, MD \1\........................................   0.9689
  Anne Arundel, MD
  Baltimore, MD
  BaltimoreCity, MD
  Carroll, MD
  Harford, MD
  Howard, MD
  Queen Anne's, MD
0733  Bangor, ME...............................................   0.9478
  Penobscot, ME
0743  Barnstable-Yarmouth, MA..................................   1.4291
  Barnstable, MA
0760  Baton Rouge, LA..........................................   0.8382
  Ascension, LA
  East Baton Rouge, LA
  Livingston, LA
  West Baton Rouge, LA
0840  Beaumont-Port Arthur, TX.................................   0.8593
  Hardin, TX
  Jefferson, TX
  Orange, TX
0860  Bellingham, WA...........................................   1.1221
  Whatcom, WA
0870  Benton Harbor, MI \2\....................................   0.8923
  Berrien, MI
0875  Bergen-Passaic, NJ \1\...................................   1.1570
  Bergen, NJ
  Passaic, NJ
0880  Billings, MT.............................................   0.9783
  Yellowstone, MT
0920  Biloxi-Gulfport-Pascagoula, MS...........................   0.8415
  Hancock, MS
  Harrison, MS
  Jackson, MS
0960  Binghamton, NY...........................................   0.8914
  Broome, NY
  Tioga, NY
1000  Birmingham, AL...........................................   0.9005
  Blount, AL
  Jefferson, AL
  St. Clair, AL
  Shelby, AL
1010  Bismarck, ND.............................................   0.7859
  Burleigh, ND
  Morton, ND
1020  Bloomington, IN..........................................   0.9128
  Monroe, IN
1040  Bloomington-Normal, IL...................................   0.8733
  McLean, IL
1080  Boise City, ID...........................................   0.8887
  Ada, ID
  Canyon, ID
1123  Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH \1\.....   1.1498
  Bristol, MA
  Essex, MA
  Middlesex, MA
  Norfolk, MA
  Plymouth, MA
  Suffolk, MA
  Worcester, MA
  Hillsborough, NH
  Merrimack, NH
  Rockingham, NH
  Strafford, NH
1125  Boulder-Longmont, CO.....................................   1.0015
  Boulder, CO
1145  Brazoria, TX.............................................   0.9129
  Brazoria, TX
1150  Bremerton, WA............................................   1.0999
  Kitsap, WA
1240  Brownsville-Harlingen-San Benito, TX.....................   0.8740
  Cameron, TX
1260  Bryan-College Station, TX................................   0.8571
  Brazos, TX
1280  Buffalo-Niagara Falls, NY \1\............................   0.9272
  Erie, NY
  Niagara, NY
1303  Burlington, VT...........................................   1.0142
  Chittenden, VT
  Franklin, VT
  GrandIsle, VT
1310  Caguas, PR...............................................   0.4508
  Caguas, PR
  Cayey, PR
  Cidra, PR
  Gurabo, PR
  San Lorenzo, PR
1320  Canton-Massillon, OH.....................................   0.8961
  Carroll, OH
  Stark, OH
1350  Casper, WY...............................................   0.9013
  Natrona, WY
1360  Cedar Rapids, IA.........................................   0.8529
  Linn, IA
1400  Champaign-Urbana, IL.....................................   0.8824
  Champaign, IL
1440  Charleston-North Charleston, SC..........................   0.8807
  Berkeley, SC
  Charleston, SC
  Dorchester, SC
1480  Charleston, WV...........................................   0.9142
  Kanawha, WV
  Putnam, WV
1520  Charlotte-Gastonia-Rock Hill, NC-SC \1\..................   0.9710
  Cabarrus, NC
  Gaston, NC
  Lincoln, NC
  Mecklenburg, NC
  Rowan, NC
  Stanly, NC
  Union, NC
  York, SC
1540  Charlottesville, VA......................................   0.9051
  Albemarle, VA
  Charlottesville City, VA
  Fluvanna, VA
  Greene, VA
1560  Chattanooga, TN-GA.......................................   0.8658
  Catoosa, GA
  Dade, GA
  Walker, GA
  Hamilton, TN
  Marion, TN
1580  Cheyenne, WY \2\.........................................   0.8247
  Laramie, WY
1600  Chicago, IL \1\..........................................   1.0860
  Cook, IL
  DeKalb, IL
  DuPage, IL
  Grundy, IL
  Kane, IL
  Kendall, IL
  Lake, IL
  McHenry, IL
  Will, IL
1620  Chico-Paradise, CA.......................................   1.0429
  Butte, CA
1640  Cincinnati, OH-KY-IN \1\.................................   0.9521
  Dearborn, IN
  Ohio, IN
  Boone, KY
  Campbell, KY
  Gallatin, KY
  Grant, KY
  Kenton, KY
  Pendleton, KY
  Brown, OH
  Clermont, OH
  Hamilton, OH
  Warren, OH
1660  Clarksville-Hopkinsville, TN-KY..........................   0.7852
  Christian, KY
  Montgomery, TN
1680  Cleveland-Lorain-Elyria, OH \1\..........................   0.9804
  Ashtabula, OH
  Cuyahoga, OH
  Geauga, OH

[[Page 35508]]

 
  Lake, OH
  Lorain, OH
  Medina, OH
1720  Colorado Springs, CO.....................................   0.9316
  ElPaso, CO
1740  Columbia, MO.............................................   0.9001
  Boone, MO
1760  Columbia, SC.............................................   0.9192
  Lexington, SC
  Richland, SC
1800  Columbus, GA-AL..........................................   0.8288
  Russell, AL
  Chattahoochee, GA
  Harris, GA
  Muscogee, GA
1840  Columbus, OH \1\.........................................   0.9793
  Delaware, OH
  Fairfield, OH
  Franklin, OH
  Licking, OH
  Madison, OH
  Pickaway, OH
1880  Corpus Christi, TX.......................................   0.8945
  Nueces, TX
  San Patricio, TX
1900  Cumberland, MD-WV........................................   0.8822
  Allegany, MD
  Mineral, WV
1920  Dallas, TX \1\...........................................   0.9674
  Collin, TX
  Dallas, TX
  Denton, TX
  Ellis, TX
  Henderson, TX
  Hunt, TX
  Kaufman, TX
  Rockwall, TX
1950  Danville, VA.............................................   0.8146
  Danville City, VA
  Pittsylvania, VA
1960  Davenport-Moline-Rock Island, IA-IL......................   0.8405
  Scott, IA
  Henry, IL
  Rock Island, IL
2000  Dayton-Springfield, OH...................................   0.9279
  Clark, OH
  Greene, OH
  Miami, OH
  Montgomery, OH
2020  Daytona Beach, FL \2\....................................   0.8838
  Flagler, FL
  Volusia, FL
2030  Decatur, AL..............................................   0.8286
  Lawrence, AL
  Morgan, AL
2040  Decatur, IL..............................................   0.7915
  Macon, IL
2080  Denver, CO \1\...........................................   1.0386
  Adams, CO
  Arapahoe, CO
  Denver, CO
  Douglas, CO
  Jefferson, CO
2120  Des Moines, IA...........................................   0.8837
  Dallas, IA
  Polk, IA
  Warren, IA
2160  Detroit, MI \1\..........................................   1.0840
  Lapeer, MI
  Macomb, MI
  Monroe, MI
  Oakland, MI
  St. Clair, MI
  Wayne, MI
2180  Dothan, AL...............................................   0.8070
  Dale, AL
  Houston, AL
2190  Dover, DE................................................   0.9303
  Kent, DE
2200  Dubuque, IA..............................................   0.8088
  Dubuque, IA
2240  Duluth-Superior, MN-WI...................................   0.9779
  St. Louis, MN
  Douglas, WI
2281  Dutchess County, NY......................................   1.0632
  Dutchess, NY
2290  Eau Claire, WI...........................................   0.8764
  Chippewa, WI
  Eau Claire, WI
2320  El Paso, TX..............................................   1.0123
  El Paso, TX
2330  Elkhart-Goshen, IN.......................................   0.9081
  Elkhart, IN
2335  Elmira, NY \2\...........................................   0.8401
  Chemung, NY
2340  Enid, OK.................................................   0.7962
  Garfield, OK
2360  Erie, PA.................................................   0.8862
  Erie, PA
2400  Eugene-Springfield, OR...................................   1.1659
  Lane, OR
2440  Evansville-Henderson, IN-KY..............................   0.8641
  Posey, IN
  Vanderburgh, IN
  Warrick, IN
  Henderson, KY
2520  Fargo-Moorhead, ND-MN....................................   0.8837
  Clay, MN
  Cass, ND
2560  Fayetteville, NC.........................................   0.8734
  Cumberland, NC
2580  Fayetteville-Springdale-Rogers, AR.......................   0.7461
  Benton, AR
  Washington, AR
2620  Flagstaff, AZ-UT.........................................   0.9115
  Coconino, AZ
  Kane, UT
2640  Flint, MI................................................   1.1171
  Genesee, MI
2650  Florence, AL.............................................   0.7716
  Colbert, AL
  Lauderdale, AL
2655  Florence, SC.............................................   0.8711
  Florence, SC
2670  Fort Collins-Loveland, CO................................   1.0248
  Larimer, CO
2680  Ft. Lauderdale, FL \1\...................................   1.0487
  Broward, FL
2700  Fort Myers-Cape Coral, FL \2\............................   0.8838
  Lee, FL
2710  Fort Pierce-Port St. Lucie, FL...........................   1.0257
  Martin, FL
  St. Lucie, FL
2720  Fort Smith, AR-OK........................................   0.7769
  Crawford, AR
  Sebastian, AR
  Sequoyah, OK
2750  Fort Walton Beach, FL \2\................................   0.8838
  Okaloosa, FL
2760  Fort Wayne, IN...........................................   0.8901
  Adams, IN
  Allen, IN
  DeKalb, IN
  Huntington, IN
  Wells, IN
  Whitley, IN
2800  Forth Worth-Arlington, TX \1\............................   0.9997
  Hood, TX
  Johnson, TX
  Parker, TX
  Tarrant, TX
2840  Fresno, CA...............................................   1.0607
  Fresno, CA
  Madera, CA
2880  Gadsden, AL..............................................   0.8815
  Etowah, AL
2900  Gainesville, FL..........................................   0.9616
  Alachua, FL
2920  Galveston-Texas City, TX.................................   1.0564
  Galveston, TX
2960  Gary, IN.................................................   0.9270
  Lake, IN
  Porter, IN
2975  Glens Falls, NY \2\......................................   0.8401
  Warren, NY
  Washington, NY
2980  Goldsboro, NC............................................   0.8443
  Wayne, NC
2985  Grand Forks, ND-MN.......................................   0.8815
  Polk, MN
  Grand Forks, ND
2995  Grand Junction, CO.......................................   0.9491
  Mesa, CO
3000  Grand Rapids-Muskegon-Holland, MI \1\....................   1.0147
  Allegan, MI
  Kent, MI
  Muskegon, MI
  Ottawa, MI
3040  Great Falls, MT..........................................   0.9306
  Cascade, MT
3060  Greeley, CO..............................................   1.0097
  Weld, CO
3080  Green Bay, WI............................................   0.9585
  Brown, WI
3120  Greensboro-Winston-Salem-High Point, NC \1\..............   0.9351
  Alamance, NC
  Davidson, NC
  Davie, NC
  Forsyth, NC
  Guilford, NC
  Randolph, NC
  Stokes, NC
  Yadkin, NC
3150  Greenville, NC...........................................   0.9064
  Pitt, NC
3160  Greenville-Spartanburg-Anderson, SC......................   0.9059
  Anderson, SC
  Cherokee, SC
  Greenville, SC
  Pickens, SC
  Spartanburg, SC
3180  Hagerstown, MD...........................................   0.9681
  Washington, MD
3200  Hamilton-Middletown, OH..................................   0.8767
  Butler, OH
3240  Harrisburg-Lebanon-Carlisle, PA..........................   1.0187
  Cumberland, PA
  Dauphin, PA
  Lebanon, PA
  Perry, PA
3283  Hartford, CT \1\  \2\....................................   1.2617
  Hartford, CT
  Litchfield, CT
  Middlesex, CT
  Tolland, CT
3285  Hattiesburg, MS..........................................   0.7192
  Forrest, MS
  Lamar, MS
3290  Hickory-Morganton-Lenoir, NC.............................   0.8285
  Alexander, NC

[[Page 35509]]

 
  Burke, NC
  Caldwell, NC
  Catawba, NC
3320  Honolulu, HI.............................................   1.1817
  Honolulu, HI
3350  Houma, LA................................................   0.7854
  Lafourche, LA
  Terrebonne, LA
3360  Houston, TX \1\..........................................   0.9855
  Chambers, TX
  FortBend, TX
  Harris, TX
  Liberty, TX
  Montgomery, TX
  Waller, TX
3400  Huntington-Ashland, WV-KY-OH.............................   0.9160
  Boyd, KY
  Carter, KY
  Greenup, KY
  Lawrence, OH
  Cabell, WV
  Wayne, WV
3440  Huntsville, AL...........................................   0.8485
  Limestone, AL
  Madison, AL
3480  Indianapolis, IN \1\.....................................   0.9848
  Boone, IN
  Hamilton, IN
  Hancock, IN
  Hendricks, IN
  Johnson, IN
  Madison, IN
  Marion, IN
  Morgan, IN
  Shelby, IN
3500  Iowa City, IA............................................   0.9413
  Johnson, IA
3520  Jackson, MI..............................................   0.9052
  Jackson, MI
3560  Jackson, MS..............................................   0.7790
  Hinds, MS
  Madison, MS
  Rankin, MS
3580  Jackson, TN..............................................   0.8522
  Madison, TN
  Chester, TN
3600  Jacksonville, FL \1\.....................................   0.8969
  Clay, FL
  Duval, FL
  Nassau, FL
  St. Johns, FL
3605  Jacksonville, NC \2\.....................................   0.7939
  Onslow, NC
3610  Jamestown, NY \2\........................................   0.8401
  Chautauqua, NY
3620  Janesville-Beloit, WI....................................   0.8824
  Rock, WI
3640  Jersey City, NJ..........................................   1.1412
  Hudson, NJ
3660  Johnson City-Kingsport-Bristol, TN-VA....................   0.9114
  Carter, TN
  Hawkins, TN
  Sullivan, TN
  Unicoi, TN
  Washington, TN
  Bristol City, VA
  Scott, VA
  Washington, VA
3680  Johnstown, PA \2\........................................   0.8421
  Cambria, PA
  Somerset, PA
3700  Jonesboro, AR............................................   0.7443
  Craighead, AR
3710  Joplin, MO...............................................   0.7541
  Jasper, MO
  Newton, MO
3720  Kalamazoo-Battlecreek, MI................................   1.0668
  Calhoun, MI
  Kalamazoo, MI
  Van Buren, MI
3740  Kankakee, IL.............................................   0.8653
  Kankakee, IL
3760  Kansas City, KS-MO \1\...................................   0.9564
  Johnson, KS
  Leavenworth, KS
  Miami, KS
  Wyandotte, KS
  Cass, MO
  Clay, MO
  Clinton, MO
  Jackson, MO
  Lafayette, MO
  Platte, MO
  Ray, MO
3800  Kenosha, WI..............................................   0.9196
  Kenosha, WI
3810  Killeen-Temple, TX.......................................   1.0252
  Bell, TX
  Coryell, TX
3840  Knoxville, TN............................................   0.8831
  Anderson, TN
  Blount, TN
  Knox, TN
  Loudon, TN
  Sevier, TN
  Union, TN
3850  Kokomo, IN...............................................   0.8416
  Howard, IN
  Tipton, IN
3870  LaCrosse, WI-MN..........................................   0.8749
  Houston, MN
  LaCrosse, WI
3880  Lafayette, LA............................................   0.8227
  Acadia, LA
  Lafayette, LA
  St. Landry, LA
  St. Martin, LA
3920  Lafayette, IN............................................   0.9174
  Clinton, IN
  Tippecanoe, IN
3960  Lake Charles, LA.........................................   0.7776
  Calcasieu, LA
3980  Lakeland-Winter Haven, FL \2\............................   0.8838
  Polk, FL
4000  Lancaster, PA............................................   0.9481
  Lancaster, PA
4040  Lansing-East Lansing, MI.................................   1.0088
  Clinton, MI
  Eaton, MI
  Ingham, MI
4080  Laredo, TX \2\...........................................   0.7404
  Webb, TX
4100  Las Cruces, NM...........................................   0.8658
  Dona Ana, NM
4120  Las Vegas, NV-AZ \1\.....................................   1.0592
  Mohave, AZ
  Clark, NV
  Nye, NV
4150  Lawrence, KS.............................................   0.8608
  Douglas, KS
4200  Lawton, OK...............................................   0.9045
  Comanche, OK
4243  Lewiston-Auburn, ME......................................   0.9536
  Androscoggin, ME
4280  Lexington, KY............................................   0.8416
  Bourbon, KY
  Clark, KY
  Fayette, KY
  Jessamine, KY
  Madison, KY
  Scott, KY
  Woodford, KY
4320  Lima, OH.................................................   0.9185
  Allen, OH
  Auglaize, OH
4360  Lincoln, NE..............................................   0.9231
  Lancaster, NE
4400  Little Rock-North Little Rock, AR........................   0.8490
  Faulkner, AR
  Lonoke, AR
  Pulaski, AR
  Saline, AR
4420  Longview-Marshall, TX....................................   0.8613
  Gregg, TX
  Harrison, TX
  Upshur, TX
4480  Los Angeles-Long Beach, CA \1\...........................   1.2268
  Los Angeles, CA
4520  Louisville, KY-IN........................................   0.9507
  Clark, IN
  Floyd, IN
  Harrison, IN
  Scott, IN
  Bullitt, KY
  Jefferson, KY
  Oldham, KY
4600  Lubbock, TX..............................................   0.8400
  Lubbock, TX
4640  Lynchburg, VA............................................   0.8228
  Amherst, VA
  Bedford, VA
  Bedford City, VA
  Campbell, VA
  Lynchburg City, VA
4680  Macon, GA................................................   0.9227
  Bibb, GA
  Houston, GA
  Jones, GA
  Peach, GA
  Twiggs, GA
4720  Madison, WI..............................................   1.0055
  Dane, WI
4800  Mansfield, OH............................................   0.8639
  Crawford, OH
  Richland, OH
4840  Mayaguez, PR.............................................   0.4475
  Anasco, PR
  Cabo Rojo, PR
  Hormigueros, PR
  Mayaguez, PR
  Sabana Grande, PR
  San German, PR
4880  McAllen-Edinburg-Mission, TX.............................   0.8371
  Hidalgo, TX
4890  Medford-Ashland, OR......................................   1.0354
  Jackson, OR
4900  Melbourne-Titusville-Palm Bay, FL \2\....................   0.8838
  Brevard, Fl
4920  Memphis, TN-AR-MS \1\....................................   0.8589
  Crittenden, AR
  DeSoto, MS
  Fayette, TN
  Shelby, TN
  Tipton, TN
4940  Merced, CA...............................................   1.0947
  Merced, CA
5000  Miami, FL \1\............................................   0.9859
  Dade, FL
5015  Middlesex-Somerset-Hunterdon, NJ \1\.....................   1.0875
  Hunterdon, NJ
  Middlesex, NJ
  Somerset, NJ

[[Page 35510]]

 
5080  Milwaukee-Waukesha, WI \1\...............................   0.9819
  Milwaukee, WI
  Ozaukee, WI
  Washington, WI
  Waukesha, WI
5120  Minneapolis-St. Paul, MN-WI \1\..........................   1.0733
  Anoka, MN
  Carver, MN
  Chisago, MN
  Dakota, MN
  Hennepin, MN
  Isanti, MN
  Ramsey, MN
  Scott, MN
  Sherburne, MN
  Washington, MN
  Wright, MN
  Pierce, WI
  St. Croix, WI
5160  Mobile, AL...............................................   0.8455
  Baldwin, AL
  Mobile, AL
5170  Modesto, CA..............................................   1.0377
  Stanislaus, CA
5190  Monmouth-Ocean, NJ \1\...................................   1.0934
  Monmouth, NJ
  Ocean, NJ
5200  Monroe, LA...............................................   0.8414
  Ouachita, LA
5240  Montgomery, AL...........................................   0.7813
  Autauga, AL
  Elmore, AL
  Montgomery, AL
5280  Muncie, IN...............................................   0.9173
  Delaware, IN
5330  Myrtle Beach, SC.........................................   0.8072
  Horry, SC
5345  Naples, FL...............................................   1.0109
  Collier, FL
5360  Nashville, TN \1\........................................   0.9182
  Cheatham, TN
  Davidson, TN
  Dickson, TN
  Robertson, TN
  RutherfordTN
  Sumner, TN
  Williamson, TN
  Wilson, TN
5380  Nassau-Suffolk, NY \1\...................................   1.3807
  Nassau, NY
  Suffolk, NY
5483  New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT \1\..   1.2619
  Fairfield, CT
  New Haven, CT
5523  New London-Norwich, CT \2\...............................   1.2617
  New London, CT
5560  New Orleans, LA \1\......................................   0.9566
  Jefferson, LA
  Orleans, LA
  Plaquemines, LA
  St. Bernard, LA
  St. Charles, LA
  St. James, LA
  St. John The Baptist, LA
  St. Tammany, LA
5600  New York, NY \1\.........................................   1.4449
  Bronx, NY
  Kings, NY
  New York, NY
  Putnam, NY
  Queens, NY
  Richmond, NY
  Rockland, NY
  Westchester, NY
5640  Newark, NJ \1\...........................................   1.1111
  Essex, NJ
  Morris, NJ
  Sussex, NJ
  Union, NJ
  Warren, NJ
5660  Newburgh, NY-PA..........................................   1.1283
  Orange, NY
  Pike, PA
5720  Norfolk-Virginia Beach-Newport News, VA-NC \1\...........   0.8316
  Currituck, NC
  Chesapeake City, VA
  Gloucester, VA
  Hampton City, VA
  Isle of Wight, VA
  James City, VA
  Mathews, VA
  Newport News City, VA
  Norfolk City, VA
  Poquoson City, VA
  Portsmouth City, VA
  Suffolk City, VA
  Virginia Beach City, VA
  Williamsburg City, VA
  York, VA
5775  Oakland, CA \1\..........................................   1.5158
  Alameda, CA
  Contra Costa, CA
5790  Ocala, FL................................................   0.9032
  Marion, FL
5800  Odessa-Midland, TX.......................................   0.8660
  Ector, TX
  Midland, TX
5880  Oklahoma City, OK \1\....................................   0.8481
  Canadian, OK
  Cleveland, OK
  Logan, OK
  McClain, OK
  Oklahoma, OK
  Pottawatomie, OK
5910  Olympia, WA..............................................   1.0901
  Thurston, WA
5920  Omaha, NE-IA.............................................   0.9421
  Pottawattamie, IA
  Cass, NE
  Douglas, NE
  Sarpy, NE
  Washington, NE
5945  Orange County, CA \1\....................................   1.1532
  Orange, CA
5960  Orlando, FL \1\..........................................   0.9397
  Lake, FL
  Orange, FL
  Osceola, FL
  Seminole, FL
5990  Owensboro, KY \2\........................................   0.7772
  Daviess, KY
6015  Panama City, FL \2\......................................   0.8838
  Bay, FL
6020  Parkersburg-Marietta, WV-OH (West Virginia Hospitals) \2\   0.8046
  Washington, OH
  Wood, WV
6020  Parkersburg-Marietta, WV-OH (Ohio Hospitals) \2\.........   0.8434
  Washington, OH
  Wood, WV
6080  Pensacola, FL \2\........................................   0.8838
  Escambia, FL
  Santa Rosa, FL
6120  Peoria-Pekin, IL.........................................   0.8571
  Peoria, IL
  Tazewell, IL
  Woodford, IL
6160  Philadelphia, PA-NJ \1\..................................   1.1398
  Burlington, NJ
  Camden, NJ
  Gloucester, NJ
  Salem, NJ
  Bucks, PA
  Chester, PA
  Delaware, PA
  Montgomery, PA
  Philadelphia, PA
6200  Phoenix-Mesa, AZ \1\.....................................   0.9606
  Maricopa, AZ
  Pinal, AZ
6240  Pine Bluff, AR...........................................   0.7826
  Jefferson, AR
6280  Pittsburgh, PA \1\.......................................   0.9725
  Allegheny, PA
  Beaver, PA
  Butler, PA
  Fayette, PA
  Washington, PA
  Westmoreland, PA
6323  Pittsfield, MA...........................................   1.0960
  Berkshire, MA
6340  Pocatello, ID............................................   0.9586
  Bannock, ID
6360  Ponce, PR................................................   0.4589
  Guayanilla, PR
  Juana Diaz, PR
  Penuelas, PR
  Ponce, PR
  Villalba, PR
  Yauco, PR
6403  Portland, ME.............................................   0.9627
  Cumberland, ME
  Sagadahoc, ME
  York, ME
6440  Portland-Vancouver, OR-WA \1\............................   1.1344
  Clackamas, OR
  Columbia, OR
  Multnomah, OR
  Washington, OR
  Yamhill, OR
  Clark, WA
6483  Providence-Warwick-Pawtucket, RI \1\.....................   1.1049
  Bristol, RI
  Kent, RI
  Newport, RI
  Providence, RI
  Washington, RI
6520  Provo-Orem, UT...........................................   1.0073
  Utah, UT
6560  Pueblo, CO...............................................   0.8450
  Pueblo, CO
6580  Punta Gorda, FL \2\......................................   0.8838
  Charlotte, FL
6600  Racine, WI...............................................   0.8934
  Racine, WI
6640  Raleigh-Durham-Chapel Hill, NC \2\.......................   0.9818
  Chatham, NC
  Durham, NC
  Franklin, NC
  Johnston, NC
  Orange, NC
  Wake, NC
6660  Rapid City, SD...........................................   0.8345
  Pennington, SD
6680  Reading, PA..............................................   0.9516
  Berks, PA
6690  Redding, CA..............................................   1.1790
  Shasta, CA
6720  Reno, NV.................................................   1.0768
  Washoe, NV
6740  Richland-Kennewick-Pasco, WA \2\.........................   1.0221

[[Page 35511]]

 
  Benton, WA
  Franklin, WA
6760  Richmond-Petersburg, VA..................................   0.9152
  Charles City County, VA
  Chesterfield, VA
  Colonial Heights City, VA
  Dinwiddie, VA
  Goochland, VA
  Hanover, VA
  Henrico, VA
  Hopewell City, VA
  NewKent, VA
  Petersburg City, VA
  Powhatan, VA
  Prince George, VA
  Richmond City, VA
6780  Riverside-San Bernardino, CA \1\.........................   1.1145
  Riverside, CA
  San Bernardino, CA
6800  Roanoke, VA..............................................   0.8402
  Botetourt, VA
  Roanoke, VA
  Roanoke City, VA
  Salem City, VA
6820  Rochester, MN............................................   1.0502
  Olmsted, MN
6840  Rochester, NY \1\........................................   0.9524
  Genesee, NY
  Livingston, NY
  Monroe, NY
  Ontario, NY
  Orleans, NY
  Wayne, NY
6880  Rockford, IL.............................................   0.9081
  Boone, IL
  Ogle, IL
  Winnebago, IL
6895  Rocky Mount, NC..........................................   0.9029
  Edgecombe, NC
  Nash, NC
6920  Sacramento, CA \1\.......................................   1.2202
  El Dorado, CA
  Placer, CA
  Sacramento, CA
6960  Saginaw-Bay City-Midland, MI.............................   0.9564
  Bay, MI
  Midland, MI
  Saginaw, MI
6980  St. Cloud, MN............................................   0.9544
  Benton, MN
  Stearns, MN
7000  St. Joseph, MO...........................................   0.8366
  Andrew, MO
  Buchanan, MO
7040  St. Louis, MO-IL \1\.....................................   0.9130
  Clinton, IL
  Jersey, IL
  Madison, IL
  Monroe, IL
  St. Clair, IL
  Franklin, MO
  Jefferson, MO
  Lincoln, MO
  St. Charles, MO
  St. Louis, MO
  St. Louis City, MO
  Warren, MO
7080  Salem, OR \2\............................................   0.9976
  Marion, OR
  Polk, OR
7120  Salinas, CA..............................................   1.4513
  Monterey, CA
7160  Salt Lake City-Ogden, UT \1\.............................   0.9862
  Davis, UT
  Salt Lake, UT
  Weber, UT
7200  San Angelo, TX...........................................   0.7780
  Tom Green, TX
7240  San Antonio, TX \1\......................................   0.8499
  Bexar, TX
  Comal, TX
  Guadalupe, TX
  Wilson, TX
7320  San Diego, CA \1\........................................   1.2225
  San Diego, CA
7360  San Francisco, CA \1\....................................   1.4091
  Marin, CA
  San Francisco, CA
  San Mateo, CA
7400  San Jose, CA \1\.........................................   1.4332
  Santa Clara, CA
7440  San Juan-Bayamon, PR \1\.................................   0.4625
  Aguas Buenas, PR
  Barceloneta, PR
  Bayamon, PR
  Canovanas, PR
  Carolina, PR
  Catano, PR
  Ceiba, PR
  Comerio, PR
  Corozal, PR
  Dorado, PR
  Fajardo, PR
  Florida, PR
  Guaynabo, PR
  Humacao, PR
  Juncos, PR
  Los Piedras, PR
  Loiza, PR
  Luguillo, PR
  Manati, PR
  Morovis, PR
  Naguabo, PR
  Naranjito, PR
  Rio Grande, PR
  San Juan, PR
  Toa Alta, PR
  Toa Baja, PR
  Trujillo Alto, PR
  Vega Alta, PR
  Vega Baja, PR
  Yabucoa, PR
7460  San Luis Obispo-Atascadero-Paso Robles, CA...............   1.1374
  San Luis Obispo, CA
7480  Santa Barbara-Santa Maria-Lompoc, CA.....................   1.0688
  Santa Barbara, CA
7485  Santa Cruz-Watsonville, CA...............................   1.4187
  Santa Cruz, CA
7490  Santa Fe, NM.............................................   1.0332
  Los Alamos, NM
  Santa Fe, NM
7500  Santa Rosa, CA...........................................   1.2267
  Sonoma, CA
7510  Sarasota-Bradenton, FL...................................   0.9757
  Manatee, FL
  Sarasota, FL
7520  Savannah, GA.............................................   0.8638
  Bryan, GA
  Chatham, GA
  Effingham, GA
7560  Scranton--Wilkes-Barre--Hazleton, PA.....................   0.8539
  Columbia, PA
  Lackawanna, PA
  Luzerne, PA
  Wyoming, PA
7600  Seattle-Bellevue-Everett, WA \1\.........................   1.1375
  Island, WA
  King, WA
  Snohomish, WA
7610  Sharon, PA...............................................   0.8783
  Mercer, PA
7620  Sheboygan, WI \2\........................................   0.8471
  Sheboygan, WI
7640  Sherman-Denison, TX......................................   0.8499
  Grayson, TX
7680  Shreveport-Bossier City, LA..............................   0.9381
  Bossier, LA
  Caddo, LA
  Webster, LA
7720  Sioux City, IA-NE........................................   0.8031
  Woodbury, IA
  Dakota, NE
7760  Sioux Falls, SD..........................................   0.8712
  Lincoln, SD
  Minnehaha, SD
7800  South Bend, IN...........................................   0.9880
  St. Joseph, IN
7840  Spokane, WA..............................................   1.0486
  Spokane, WA
7880  Springfield, IL..........................................   0.8713
  Menard, IL
  Sangamon, IL
7920  Springfield, MO..........................................   0.8036
  Christian, MO
  Greene, MO
  Webster, MO
8003  Springfield, MA \2\......................................   1.0718
  Hampden, MA
  Hampshire, MA
8050  State College, PA........................................   0.9635
  Centre, PA
8080  Steubenville-Weirton, OH-WV..............................   0.8645
  Jefferson, OH
  Brooke, WV
  Hancock, WV
8120  Stockton-Lodi, CA........................................   1.1518
  San Joaquin, CA
8140  Sumter, SC \2\...........................................   0.7921
  Sumter, SC
8160  Syracuse, NY.............................................   0.9480
  Cayuga, NY
  Madison, NY
  Onondaga, NY
  Oswego, NY
8200  Tacoma, WA...............................................   1.1016
  Pierce, WA
8240  Tallahassee, FL \2\......................................   0.8838
  Gadsden, FL
  Leon, FL
8280  Tampa-St. Petersburg-Clearwater, FL \1\..................   0.9196
  Hernando, FL
  Hillsborough, FL
  Pasco, FL
  Pinellas, FL
8320  Terre Haute, IN..........................................   0.8614
  Clay, IN
  Vermillion, IN
  Vigo, IN
8360  Texarkana, AR-Texarkana, TX..............................   0.8699
  Miller, AR
  Bowie, TX
8400  Toledo, OH...............................................   1.0140
  Fulton, OH
  Lucas, OH
  Wood, OH
8440  Topeka, KS...............................................   0.9438
  Shawnee, KS
8480  Trenton, NJ..............................................   1.0380
  Mercer, NJ
8520  Tucson, AZ...............................................   0.9180
  Pima, AZ

[[Page 35512]]

 
8560  Tulsa, OK................................................   0.8074
  Creek, OK
  Osage, OK
  Rogers, OK
  Tulsa, OK
  Wagoner, OK
8600  Tuscaloosa, AL...........................................   0.8187
  Tuscaloosa, AL
8640  Tyler, TX................................................   0.9567
  Smith, TX
8680  Utica-Rome, NY \2\.......................................   0.8401
  Herkimer, NY
  Oneida, NY
8720  Vallejo-Fairfield-Napa, CA...............................   1.3528
  Napa, CA
  Solano, CA
8735  Ventura, CA..............................................   1.0544
  Ventura, CA
8750  Victoria, TX.............................................   0.8474
  Victoria, TX
8760  Vineland-Millville-Bridgeton, NJ.........................   1.0110
  Cumberland, NJ
8780  Visalia-Tulare-Porterville, CA \2\.......................   0.9977
  Tulare, CA
8800  Waco, TX.................................................   0.7696
  McLennan, TX
8840  Washington, DC-MD-VA-WV \1\..............................   1.0911
  District of Columbia, DC
  Calvert, MD
  Charles, MD
  Frederick, MD
  Montgomery, MD
  Prince Georges, MD
  Alexandria City, VA
  Arlington, VA
  Clarke, VA
  Culpeper, VA
  Fairfax, VA
  Fairfax City, VA
  Falls Church City, VA
  Fauquier, VA
  Fredericksburg City, VA
  King George, VA
  Loudoun, VA
  Manassas City, VA
  Manassas Park City, VA
  Prince William, VA
  Spotsylvania, VA
  Stafford, VA
  Warren, VA
  Berkeley, WV
  Jefferson, WV
8920  Waterloo-Cedar Falls, IA.................................   0.8643
  Black Hawk, IA
8940  Wausau, WI...............................................   1.0545
  Marathon, WI
8960  West Palm Beach-Boca Raton, FL...........................   1.0309
  Palm Beach, FL
9000  Wheeling, WV-OH (West Virginia Hospitals) \1\............   0.7966
  Belmont, OH
  Marshall, WV
  Ohio, WV
9000  Wheeling, WV-OH (Ohio Hospitals) \2\.....................   0.8434
  Belmont, OH
  Marshall, WV
  Ohio, WV
9040  Wichita, KS..............................................   0.9403
  Butler, KS
  Harvey, KS
  Sedgwick, KS
9080  Wichita Falls, TX........................................   0.7646
  Archer, TX
  Wichita, TX
9140  Williamsport, PA.........................................   0.8548
  Lycoming, PA
9160  Wilmington-Newark, DE-MD.................................   1.1538
  New Castle, DE
  Cecil, MD
9200  Wilmington, NC...........................................   0.9322
  New Hanover, NC
  Brunswick, NC
9260  Yakima, WA \2\...........................................   1.0221
  Yakima, WA
9270  Yolo, CA.................................................   1.1431
  Yolo, CA
9280  York, PA.................................................   0.9415
  York, PA
9320  Youngstown-Warren, OH....................................   0.9937
  Columbiana, OH
  Mahoning, OH
  Trumbull, OH
9340  Yuba City, CA............................................   1.0324
  Sutter, CA
  Yuba, CA
9360  Yuma, AZ.................................................   0.9732
  Yuma, AZ
------------------------------------------------------------------------
\1\ Large Urban Area
\2\ Hospitals geographically located in the area are assigned the
  statewide rural wage index for FY 1998.

    53. On pages 48035 through 48036, Addendum K is corrected to read 
as follows:
  
[[Page 35512]]


                 Addendum K.--Wage Index for Rural Areas
------------------------------------------------------------------------
                                                                   Wage
                         Nonurban area                            index
------------------------------------------------------------------------
Alabama........................................................   0.7260
Alaska.........................................................   1.2302
Arizona........................................................   0.7989
Arkansas.......................................................   0.6995
California.....................................................   0.9977
Colorado.......................................................   0.8129
Connecticut....................................................   1.2617
Delaware.......................................................   0.8925
Florida........................................................   0.8838
Georgia........................................................   0.7761
Hawaii.........................................................   1.0229
Idaho..........................................................   0.8221
Illinois.......................................................   0.7644
Indiana........................................................   0.8161
Iowa...........................................................   0.7391
Kansas.........................................................   0.7203
Kentucky.......................................................   0.7772
Louisiana......................................................   0.7383
Maine..........................................................   0.8468
Maryland.......................................................   0.8617
Massachusetts..................................................   1.0718
Michigan.......................................................   0.8923
Minnesota......................................................   0.8180
Mississippi....................................................   0.6911
Missouri.......................................................   0.7207
Montana........................................................   0.8302
Nebraska.......................................................   0.7401
Nevada.........................................................   0.8914
New Hampshire..................................................   0.9724
New Jersey \1\.................................................  .......
New Mexico.....................................................   0.8110
New York.......................................................   0.8401
North Carolina.................................................   0.7939
North Dakota...................................................   0.7360
Ohio...........................................................   0.8434
Oklahoma.......................................................   0.7072
Oregon.........................................................   0.9976
Pennsylvania...................................................   0.8421
Puerto Rico....................................................   0.3939
Rhode Island \1\...............................................  .......
South Carolina.................................................   0.7921
South Dakota...................................................   0.6983
Tennessee......................................................   0.7353
Texas..........................................................   0.7404
Utah...........................................................   0.8926
Vermont........................................................   0.9314
Virginia.......................................................   0.7782
Washington.....................................................   1.0221
West Virginia..................................................   0.7966
Wisconsin......................................................   0.8471
Wyoming........................................................   0.8247
------------------------------------------------------------------------
\1\All counties within state are classified as urban.

    54. On page 48036, Addendum L is corrected to read as follows:

       Addendum L.--Wage Index for Hospitals That Are Reclassified
------------------------------------------------------------------------
                                                                   Wage
                              Area                                index
------------------------------------------------------------------------
Abilene, TX....................................................   0.8287
Albuquerque, NM................................................   0.9329
Alexandria, LA.................................................   0.8269
Amarillo, TX...................................................   0.9277
Anchorage, AK..................................................   1.2998
Asheville, NC..................................................   0.9072
Athens, GA.....................................................   0.9087
Atlanta, GA....................................................   0.9823
Austin-San Marcos, TX..........................................   0.9133
Bangor, ME.....................................................   0.9478
Barnstable-Yarmouth, MA........................................   1.3827
Baton Rouge, LA................................................   0.8382
Benton Harbor, MI..............................................   0.8923
Bergen-Passaic, NJ.............................................   1.1570
Billings, MT...................................................   0.9609
Birmingham, AL.................................................   0.9005
Bismarck, ND...................................................   0.7859
Boise City, ID.................................................   0.8887
Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH...............   1.1498
Caguas, PR.....................................................   0.4508
Casper, WY.....................................................   0.9013
Champaign-Urbana, IL...........................................   0.8706
Charlotte-Gastonia-Rock Hill, NC-SC............................   0.9710
Charlottesville, VA............................................   0.8885
Chattanooga, TN-GA.............................................   0.8658
Chicago, IL....................................................   1.0759
Cincinnati, OH-KY-IN...........................................   0.9521
Cleveland-Lorain-Elyria, OH....................................   0.9804
Columbia, MO...................................................   0.8759
Columbus, OH...................................................   0.9793

[[Page 35513]]

 
Dallas, TX.....................................................   0.9674
Davenport-Moline-Rock Island, IA-IL............................   0.8405
Denver, CO.....................................................   1.0386
Des Moines, IA.................................................   0.8837
Detroit, MI....................................................   1.0840
Duluth-Superior, MN-WI.........................................   0.9779
Dutchess County, NY............................................   1.0364
Eugene-Springfield, OR.........................................   1.1659
Fargo-Moorhead, ND-MN..........................................   0.8729
Fayetteville, NC...............................................   0.8491
Flint, MI......................................................   1.1171
Florence, AL...................................................   0.7716
Florence, SC...................................................   0.8711
Ft. Lauderdale, FL.............................................   1.0487
Fort Pierce-Port St. Lucie, FL.................................   1.0008
Fort Walton Beach, FL..........................................   0.8653
Forth Worth-Arlington, TX......................................   0.9997
Gadsden, AL....................................................   0.8815
Gainesville, FL................................................   0.9616
Gary, IN.......................................................   0.9114
Grand Forks, ND-MN.............................................   0.8815
Grand Junction, CO.............................................   0.9491
Great Falls, MT................................................   0.9306
Greeley, CO....................................................   0.9791
Green Bay, WI..................................................   0.9585
Greensboro-Winston-Salem-High Point, NC........................   0.9351
Harrisburg-Lebanon-Carlisle, PA................................   1.0076
Hartford, CT...................................................   1.2373
Honolulu, HI...................................................   1.1817
Houma, LA......................................................   0.7854
Houston, TX....................................................   0.9855
Huntington-Ashland, WV-KY-OH...................................   0.9160
Huntsville, AL.................................................   0.8485
Indianapolis, IN...............................................   0.9848
Iowa City, IA..................................................   0.9208
Jackson, MS....................................................   0.7790
Johnson City-Kingsport-Bristol, TN-VA..........................   0.9114
Jonesboro, AR..................................................   0.7443
Joplin, MO.....................................................   0.7541
Kalamazoo-Battlecreek, MI......................................   1.0668
Kansas City, KS-MO.............................................   0.9564
Knoxville, TN..................................................   0.8831
Lafayette, LA..................................................   0.8227
Lafayette, IN..................................................   0.9174
Lansing-East Lansing, MI.......................................   1.0088
Las Cruces, NM.................................................   0.8658
Las Vegas, NV-AZ...............................................   1.0592
Lexington, KY..................................................   0.8416
Lima, OH.......................................................   0.9185
Lincoln, NE....................................................   0.9035
Little Rock-North Little Rock, AR..............................   0.8490
Longview-Marshall, TX..........................................   0.8509
Los Angeles-Long Beach, CA.....................................   1.2268
Louisville, KY-IN..............................................   0.9507
Macon, GA......................................................   0.9227
Madison, WI....................................................   1.0055
Mansfield, OH..................................................   0.8639
Medford-Ashland, OR............................................   1.0354
Memphis, TN-AR-MS..............................................   0.8589
Milwaukee-Waukesha, WI.........................................   0.9819
Minneapolis-St. Paul, MN-WI....................................   1.0733
Monroe, LA.....................................................   0.8414
Montgomery, AL.................................................   0.7813
Nashville, TN..................................................   0.9182
New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT............   1.2619
New London-Norwich, CT.........................................   1.2258
New Orleans, LA................................................   0.9566
New York, NY...................................................   1.4449
Newark, NJ.....................................................   1.1111
Newburgh, NY-PA................................................   1.1283
Oakland, CA....................................................   1.5158
Odessa-Midland, TX.............................................   0.8516
Oklahoma City, OK..............................................   0.8481
Omaha, NE-IA...................................................   0.9421
Orange County, CA..............................................   1.1532
Peoria-Pekin, IL...............................................   0.8571
Philadelphia, PA-NJ............................................   1.1398
Pittsburgh, PA.................................................   0.9583
Pocatello, ID..................................................   0.9000
Portland, ME...................................................   0.9627
Portland-Vancouver, OR-WA......................................   1.1344
Provo-Orem, UT.................................................   1.0073
Raleigh-Durham-Chapel Hill, NC.................................   0.9818
Rapid City, SD.................................................   0.8345
Rochester, MN..................................................   1.0502
Rockford, IL...................................................   0.9081
Sacramento, CA.................................................   1.2202
Saginaw-Bay City-Midland, MI...................................   0.9564
St. Cloud, MN..................................................   0.9544
St. Louis, MO-IL...............................................   0.9130
Salinas, CA....................................................   1.4299
Salt Lake City-Ogden, UT.......................................   0.9862
San Diego, CA..................................................   1.2225
San Francisco, CA..............................................   1.4091
Santa Fe, NM...................................................   1.0007
Santa Rosa, CA.................................................   1.2146
Seattle-Bellevue-Everett, WA...................................   1.1375
Sherman-Denison, TX............................................   0.8324
Sioux City, IA-NE..............................................   0.8031
Sioux Falls, SD................................................   0.8607
South Bend, IN.................................................   0.9880
Spokane, WA....................................................   1.0311
Springfield, IL................................................   0.8610
Springfield, MO................................................   0.8036
Stockton-Lodi, CA..............................................   1.1518
Syracuse, NY...................................................   0.9480
Tampa-St. Petersburg-Clearwater, FL............................   0.9196
Texarkana, AR-Texarkana, TX....................................   0.8699
Topeka, KS.....................................................   0.9310
Tucson, AZ.....................................................   0.9180
Tulsa, OK......................................................   0.8074
Tyler, TX......................................................   0.9421
Vallejo-Fairfield-Napa, CA.....................................   1.3528
Washington, DC-MD-VA-WV........................................   1.0911
Waterloo-Cedar Falls, IA.......................................   0.8643
Wausau, WI.....................................................   0.9845
Wichita, KS....................................................   0.9157
Wichita Falls, TX..............................................   0.7646
Rural Florida..................................................   0.8838
Rural Louisiana................................................   0.7383
Rural Minnesota................................................   0.8180
Rural Missouri.................................................   0.7207
Rural New Hampshire............................................   0.9724
Rural New Mexico...............................................   0.8110
Rural North Carolina...........................................   0.7939
Rural Oregon...................................................   0.9976
Rural Washington...............................................   1.0221
Rural West Virginia............................................   0.7966
Rural Wyoming..................................................   0.8247
------------------------------------------------------------------------

(Catalog of Federal Domestic Assistance 93.774, Medicare--
Supplementary Medical Insurance Program)

    Dated: June 22, 1999.
Kerry Weems,
Acting Deputy Assistant, Secretary for Information Resources 
Management.
[FR Doc. 99-16550 Filed 6-29-99; 8:45 am]
BILLING CODE 4120-01-P