[Federal Register Volume 69, Number 4 (Wednesday, January 7, 2004)]
[Rules and Regulations]
[Pages 1084-1267]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-32323]
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Part IX
Department of Health and Human Services
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Centers for Medicare & Medicaid Services
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42 CFR Parts 405 and 414
Medicare Program; Changes to Medicare Payment for Drugs and Physician
Fee Schedule Payments for Calendar Year 2004; Interim Final Rule
Federal Register / Vol. 69, No. 4 / Wednesday, January 7, 2004 /
Rules and Regulations
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 405 and 414
[CMS-1372-IFC]
RIN 0938-AM97
Medicare Program; Changes to Medicare Payment for Drugs and
Physician Fee Schedule Payments for Calendar Year 2004
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Interim final rule with comment period.
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SUMMARY: This interim final rule implements the provisions of the
Medicare Prescription Drug, Improvement, and Modernization Act (MPDIMA)
of 2003, Pub. L. 108-173, which are applicable in 2004 to Medicare
payment for covered drugs and physician fee schedule services. These
provisions revise the current payment methodology for Part B covered
drugs and biologicals that are not paid on a cost or prospective
payment basis; make changes to Medicare payment for furnishing or
administering drugs and biologicals; revise the geographic practice
cost indices and change the physician fee schedule conversion factor.
The 2004 physician fee schedule conversion factor will be $37.3374. The
2004 national anesthesia conversion factor (prior to making adjustment
for the geographic practice cost indices) will be $17.4969. The
information contained in this final rule related to payment under the
physician fee schedule supercedes the information contained in the
November 7, 2003, final rule to the extent that the two are
inconsistent. All other provisions of the November 7, 2003, final rule
are unchanged unless otherwise noted. This rule also extends the ``opt-
out'' provisions of 1802(b)(5)(3) of the Social Security Act to
dentists, podiatrists, and optometrists.
DATES: Effective date: These regulations are effective on January 1,
2004.
Comment date: We will consider comments if we receive them at the
appropriate address, as provided in the addresses section, no later
than 5 p.m. on March 8, 2004.
ADDRESSES: In commenting, please refer to file code CMS-1372-FC.
Because of staff and resource limitations, we cannot accept comments by
facsimile (FAX) transmission.
Mail written comments (one original and two copies) to the
following address only: Centers for Medicare & Medicaid Services,
Department of Health and Human Services, Attention: CMS-1372-FC, P.O.
Box 8013, Baltimore, MD 21244-8013.
Please allow sufficient time for us to receive mailed comments on
time in the event of delivery delays.
If you prefer, you may deliver (by hand or courier) your written
comments (one original and two copies) to one of the following
addresses: Room 445-G, Hubert H. Humphrey Building, 200 Independence
Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500 Security
Boulevard, Baltimore, MD 21244-8013.
(Because access to the interior of the HHH Building is not readily
available to persons without Federal government identification,
commenters are encouraged to leave their comments in the CMS drop slots
located in the main lobby of the building. A stamp-in clock is
available if you wish to retain proof of filing by stamping in and
retaining an extra copy of the comments being filed.)
Comments mailed to the addresses indicated as appropriate for hand
or courier delivery may be delayed and could be considered late.
For information on viewing public comments, see the beginning of
the SUPPLEMENTARY INFORMATION section.
FOR FURTHER INFORMATION CONTACT: Jennifer Fan, (410) 786-0548 regarding
Medicare payment for Part B covered drugs and biologicals.
Rick Ensor, (410) 786-5617 regarding provisions related to
geographic practice cost indices.
Diane Milstead, (410) 786-3355 for provisions related to the
physician fee schedule.
Gaysha Brooks, (410) 786-9649 for questions related to obtaining
Medicare physician fee schedule information from the CMS Web site.
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments: Comments received timely will be
available for public inspection as they are processed, generally
beginning approximately 3 weeks after publication of a document, at the
headquarters of the Centers for Medicare & Medicaid Services, 7500
Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of
each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view
public comments, phone (410) 786-7197.
Copies: To order copies of the Federal Register containing this
document, send your request to: New Orders, Superintendent of
Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date
of the issue requested and enclose a check or money order payable to
the Superintendent of Documents, or enclose your Visa or Master Card
number and expiration date. Credit card orders can also be placed by
calling the order desk at (202) 512-1800 or by faxing to (202) 512-
2250. The cost for each copy is $10. As an alternative, you can view
and photocopy the Federal Register document at most libraries
designated as Federal Depository Libraries and at many other public and
academic libraries throughout the country that receive the Federal
Register.
This Federal Register document is also available from the Federal
Register online database through GPO Access, a service of the U.S.
Government Printing Office. The Web site address is http://www.access.gpo.gov/nara/index.html.
Accessing Physician Fee Schedule Web Site and Pricing Information
Information on the physician fee schedule and pricing files can be
found on our home page. You can access this data at the following Web
site: http://cms.hhs.gov/physicians/pfs or you can access this data by
using the following directions:
1. Go to the CMS home page (http://www.cms.hhs.gov).
2. Place your cursor over the word ``Professionals'' in the blue
area near the top of the page. Select ``Physicians'' from the drop-down
menu.
3. Scroll down and under ``Payment/Billing'' select ``Physician Fee
Schedule''.
The Physician Fee Schedule pricing information is contained in two
public use files.
(1) National Physician Fee Schedule Relative Value File--This file
contains all CPT/HCPCS (excluding codes beginning with B, E, L, K, and
0), their short descriptions and a status indicator, which denotes
whether or not the service is priced under the physician fee schedule.
The file also contains the components used in the calculation of the
annual pricing amount (that is, the RVUs, GPCIs, and conversion
factor), anesthesia conversion factors, and the payment policy
indicators used to price the claims with surgical modifiers. This file
does not contain the calculated pricing amounts.
(2) Physician Fee Schedule Payment Amount File National/Carrier--
This file contains the CPT code and the Medicare price for all services
priced under the Physician Fee Schedule. These data can be downloaded
for the entire country, or for a selected carrier (in most cases
[[Page 1085]]
carriers correlate with States). There is no option of requesting data
for selected HCPCS codes. The zip file, which is downloaded, contains a
file named ``PF04pc'', which explains the data contained in each
column. This file also contains a description of pricing localities
used in the Physician Fee Schedule. Due to the size of the national
file (as well as many of the carrier-specific files), these data are
provided in a comma-delimited format, which can be used to populate
database applications. Generally speaking, these data are too large for
Excel, however if a carrier specific file has 3 or fewer localities,
Excel can be used.
Another file that may prove useful is the Zip Code to Carrier
Locality file. This file will map ZIP Codes to CMS carriers and
localities and map Zip Codes to their State and determine whether the
ZIP Code has a rural designation as determined by CMS. You can access
this file at the following Web site: http://cms.hhs.gov/providers/pufdownload/default.asp#alphanu or you can access this data by using
the following directions:
1. Go to the CMS home page (http://www.cms.hhs.gov).
2. Place your cursor over the word ``Professionals'' in the blue
area near the top of the page. Select ``Physicians'' from the drop-down
menu.
3. Scroll down and under ``Payment/Billing'' select ``Medicare
Payment Systems.''
4. Scroll down and under Coding Files select ``Zip Code to Carrier
Locality File.''
Table of Contents
I. Background
A. Medicare Payment for Part B Covered Drugs and the Furnishing
or Administration of Drugs
B. Geographic Practice Cost Indices and Physician Fee Schedule
Conversion Factor
II. Provisions of the Final Rule
A. Application of Market-Based Systems of Medicare Payment for
Part B Drugs
B. Payment for Inhalation Drugs
C. Pharmacy Supplying Fee for Certain Drugs and Biologicals
D. Physician Fee Schedule Provisions Related to the
Administration of Drugs
1. Provisions Related to Budget Neutrality
2. Adjustments in Practice Expense Relative Value Units for
Certain Drug Administration Services beginning with 2004
3. Pricing of Clinical Oncology Nurses in the Practice Expense
Methodology
4. Work Relative Value Units for Certain Drug Administration
Services
5. Adjustments in the Practice Expense Relative Value Units for
Certain Drug Administration Services Beginning with 2005
6. Provisions for Appropriate Reporting and Billing for
Physicians' Services Associated with the Administration of Covered
Outpatient Drugs and Biologicals
7. Treatment of Other Services Currently in the Nonphysician
Work Pool
8. Payment for Multiple Chemotherapy Agents Furnished on a
Single Day through the Push Technique
9. Transitional Adjustment to Medicare Payment for Certain Drug
Administration Services
E. Geographic Practice Cost Indices
F. Adjustments to the Work, Practice Expense and Malpractice
Relative Value Units
G. Anesthesia and Physician Fee Schedule Conversion Factors for
2004
H. Publication of Addenda
III. Private Contracting with Medicare Beneficiaries
IV. Waiver of Proposed Rulemaking and Delay in Effective Date
V. Collection of Information Requirements
VI. Response to Comments
VII. Regulatory Impact Analysis
Addendum A--Explanation and Use of Addendum B
Addendum B--Relative Value Units and Related Information Used in
Determining Medicare Payments for 2004
Addendum C--Codes with Interim Relative Value Units
Addendum D--2004 Geographic Practice Cost Indices by Medicare
Carrier and Locality
Addendum E--2005 Geographic Practice Cost Indices by Medicare
Carrier and Locality
Addendum F--List of Medicare Covered Part B Drugs Under Payment
Reform
I. Background
A. Medicare Payment for Part B Covered Drugs and the Furnishing or
Administration of Drugs
Medicare Part B covers a limited number of prescription drugs and
biologicals. For the purposes of this final rule, the term ``drugs''
will hereafter refer to both drugs and biologicals. Currently, covered
Medicare drugs generally fall into three categories: drugs furnished
incident to a physician's service, durable medical equipment (DME)
drugs, and drugs specifically covered by statute (for example, oral
immunosuppressive drugs). Prior to January 1, 2004, drugs not paid on a
cost or prospective payment basis are paid based on the lower of the
actual charge or 95 percent of the average wholesale price (AWP)
(section 1842(o)(1) of the Social Security Act (the Act), as added by
section 4556 of the Balanced Budget Act of 1997 (Pub. L. 105-33)). In
December 2000, the Congress passed the Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection Act (BIPA). Section 429(a) of BIPA
required the GAO to conduct a study of the current payment methodology.
Section 429(b) of BIPA requires the Secretary, notwithstanding any
other provision of law, to revise the Medicare payment methodology for
drugs based on the GAO study. In September 2001, the GAO presented its
study to the Congress in a report titled, ``Medicare: Payments for
Covered Outpatient Drugs Exceed Providers' Costs'' (GAO-01-1118).
Consistent with the recommendations in the report, we published four
options for revising the current drug payment system in a proposed rule
published August 20, 2003 (68 FR 50428), in the Federal Register. This
proposed rule also discussed changes to Medicare payment under the
physician fee schedule for furnishing or administering certain drugs
and biologicals. However, as discussed in the November 7, 2003, final
rule (68 FR 63196), ``Revisions to Payment Policies Under the Physician
Fee Schedule for Calendar Year 2004'', since the Congress was
considering legislation to address these issues, we were reluctant to
proceed with finalizing the proposals contained in the August 20, 2003,
proposed rule. On November 25, 2003, the Congress enacted the Medicare
Prescription Drug, Improvement, and Modernization Act (MPDIMA) of 2003,
Pub L. 108-173. The President signed Pub. L. 108-173 into law on
December 8, 2003. Sections 303 through 305 of MPDIMA make revisions to
payment methodology for Part B covered drugs that are not paid on a
cost or prospective payment basis. Sections 303 and 304 also require
the Secretary of Health and Human Services to revise Medicare payments
for the administration of drugs made using the physician fee schedule.
We are using this final rule to implement those sections of MPDIMA that
are effective January 1, 2004, and prior to January 1, 2006, and affect
Medicare payment for covered Part B drugs and their administration.
B. Geographic Practice Cost Indices (GPCIs) and Physician Fee Schedule
Conversion Factor
Section 1848(e) of the Act requires that payments vary among
Medicare physician fee schedule areas according to the extent resource
costs vary, as measured by Geographic Practice Cost Indices (GPCIs) for
each of the three fee schedule components--work, practice expense and
malpractice. As explained later in this document, for services provided
on or after January 1, 2004, and prior to January 1, 2007, section 412
of MPDIMA requires that the work GPCI cannot be less than 1.00. Section
602 of MPDIMA requires that work, practice
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expense and malpractice GPCIs otherwise calculated cannot be less than
1.67 for services furnished in Alaska on or after January 1, 2004, or
prior to January 1, 2006.
Sections 1848(d) and (f) of the Act establish a formula for
determining the physician fee schedule update and conversion factor
(CF). As indicated in the November 7, 2003, final rule (68 FR 63239),
the application of the formula in the statute resulted in a 2004
physician fee CF of $35.1339, a reduction of 4.5 percent. However,
section 601 of MPDIMA requires that the update to the physician fee
schedule CF for 2004 cannot be less than 1.5 percent. We are using this
final rule to announce the CF and GPCIs that will be used to determine
physician fee schedule rates in 2004.
II. Provisions of the Final Rule
A. Application of Market-Based Systems of Medicare Payment for Part B
Drugs
1. General Rule
Subject to the other provisions of MPDIMA, section 303(b) of MPDIMA
specifies that drugs not paid on a cost or prospective payment basis
will be paid at 85 percent of the average wholesale price (AWP)
determined as of April 1, 2003.
2. Specific Provisions
Section 303(b)(1) of MPDIMA specifies that for CY 2004 the
following drugs will be paid at 95 percent of the AWP:
[sbull] Blood clotting factors;
[sbull] A drug or biological furnished during 2004 that was not
available for Medicare payment as of April 1, 2003;
[sbull] Pneumococcal and influenza vaccines as well as hepatitis B
vaccine that is furnished to individuals at high or intermediate risk
of contracting hepatitis B (as determined by the Secretary); and
[sbull] A drug or biological furnished during 2004 in connection
with the furnishing of renal dialysis services if separately billed by
renal dialysis facilities.
Section 303(b)(1) of MPDIMA also specifies that infusion drugs will
be paid at 95 percent of the AWP in effect on October 1, 2003, when
furnished through a covered item of durable medical equipment.
Section 303(b)(2) of MPDIMA specifies that the payment for a drug
contained in the table entitled ``Table 3--Medicare Part B Drugs in the
Most Recent GAO and OIG Studies'' published in the August 20, 2003,
proposed rule (68 FR 50445) will be the percentage of the AWP indicated
in the column entitled ``Average of the GAO and OIG data (percent)''.
This percentage will be applied to the AWP determined as of April 1,
2003. However, in the event that the percentage from Table 3 is less
than 80 percent, the percentage applied to the AWP determined as of
April 1, 2003, will be 80 percent. Table 1 below is a reprint of Table
3 from the August 20, 2003, proposed rule. Table 2 highlights the
relevant column from the August 20, 2003, proposed rule table and
applies the 80 percent limit where applicable.
We note that there was a typographical error in Table 3 as
published on August 20, 2003, for J1642 ``Heparin Sodium Lock Flush''.
The percentage in the column specified in MPDIMA is missing for J1642.
Given that this column is calculated as the average of the values in
the preceding two columns for the drugs in this table, we will treat
the missing value as the average of the values in the prior two columns
for J1642, namely 66 percent. This is the percentage that would have
been in that column in the table in the absence of the typographical
error. We believe that this correction is consistent with Congress'
intent to revise the percentage based on the average of accurate GAO
and OIG data. This percentage will be subject to the 80 percent
limitation described above.
We also note that there was another typographical error in Table 3
as published on August 20, 2003, for J9390 ``Vinorelbine Tartrate
(Navelbine).'' The percentage listed under the column titled ``GAO
Average Widely Available Price as a Percent of AWP (2001)'' for J9390
in Table 3 is incorrect and should not have been listed at all since
GAO did not include this drug in its study. The percentage under the
column titled ``OIG Median Catalogue Price as a Percent of AWP (2000)''
is correct. Since the column specified in MPDIMA is calculated as the
average of the values in the preceding two columns for the drugs in
this table, the correct percentage listed for J9390 under this column
will be 81 percent based on the data from OIG. We believe that this
correction is also consistent with Congress' intent to revise rates
based on the average of accurate GAO and OIG data. This is the
percentage that would have been in that column in the table in the
absence of the typographical error.
BILLING CODE 4120-01-P
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[GRAPHIC] [TIFF OMITTED] TR06JA04.000
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[GRAPHIC] [TIFF OMITTED] TR06JA04.001
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[GRAPHIC] [TIFF OMITTED] TR06JA04.002
[[Page 1090]]
[GRAPHIC] [TIFF OMITTED] TR06JA04.003
BILLING CODE 4120-01-C
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Section 303(b)(2) of MPDIMA also provides an opportunity for the
manufacturer of a drug to submit data and information requesting a
different percentage from the percentage indicated in Table 1A or the
85 percent general rule. The Secretary may adjust the percentage based
on this data and information beginning April 1, 2004. Section 303(b) of
MPDIMA specifies that this data and information can be submitted after
October 15, 2003, and before January 1, 2004. As required by the
statute, manufacturers need to submit this data and information before
January 1, 2004. Manufacturers may supplement this data and
information; however, any additional supplemental information should be
received by CMS before 5 p.m. e.s.t. on January 16, 2004. We will use
the supplemental information to help us evaluate the initial submission
of data and information.
We expect that the data and information submitted by a manufacturer
would include the manufacturer's average sales price for the drug for
the most recent quarter available. For the purposes of the exceptions
process, the manufacturer's average sales price is calculated as the
manufacturer's sales to all purchasers in the United States (excluding
sales exempted below) for the quarter divided by the total number of
units of such drug or biological sold by the manufacturer in that
quarter. The submission should also specify the units used in the
calculation (for example, micrograms).
In the calculation of the manufacturer's average sales price, a
manufacturer should include volume discounts, prompt pay discounts,
cash discounts, free goods that are contingent on any purchase
requirement, chargebacks, and rebates (other than rebates under the
Medicaid program). To the extent that there is a lag in the
availability of this information applicable to the quarter, the
manufacturer should apply a methodology based on the most recent 12-
month period available to estimate costs attributable to these price
concessions. The manufacturer should submit a description of the
methodology used to estimate these costs.
In the calculation of the manufacturer's average sales price, a
manufacturer should exclude the following sales as defined for the
Medicaid best price calculation under section 1827(c)(1)(C)(i) of the
Act:
1. Sales to the Indian Health Service, the Department of Veterans
Affairs, a state home as defined for the purposes of the Medicaid best
price calculation, the Department of Defense, the Public Health Service
and entities described in section 340(B)(a)(4) of the Public Health
Act;
2. Sales under the Federal Supply Schedule of the General Services
Administration;
3. Sales under a State pharmaceutical assistance program; and
4. Any depot sales and single award contract sales as defined for
the purposes of the Medicaid best price calculation.
A manufacturer should also exclude sales at a nominal charge. Sales
at a nominal charge are defined as sales below 10 percent of the
average calculated as described above. In other words, after following
the methodology described above, sales below 10 percent of the
resulting average should be excluded and the average recalculated. The
result of this final calculation is the manufacturer's average sales
price for the purpose of the exceptions process.
Note that we would base any changes to the percentage indicated in
Table 1 or the 85 percent general rule only on data that we could make
available to the public.
Section 303(b)(2) of MPDIMA also specifies that we may adjust the
percentage effective January 1, 2004, based on data and information
that a manufacturer submitted by October 15, 2003. We accepted data
from the manufacturer of two biologicals: imiglucerase and alglucerase.
The data and information submitted by the manufacturer indicated that
the manufacturer's average sales price was 94 percent of the average
wholesale price. Based on this data, we will pay for these two
biologicals when furnished in 2004 at 94 percent of the average
wholesale price determined as of April 1, 2003.
B. Payment for Inhalation Drugs
Section 305(a) of MPDIMA specifies that inhalation drugs furnished
through durable medical equipment covered under 1861(n) of the Act will
be paid in accordance with section 1842(o)(4) of the Act, as added by
section 303(b)(2) of MPDIMA. The methodology for determining the
payment for a drug under section 303(b)(2) of MPDIMA is described above
in section II.A.2 of this rule.
C. Pharmacy Supplying Fee for Certain Drugs and Biologicals
Section 303(e)(2) of MPDIMA provides that the Secretary shall pay a
pharmacy supplying fee, less applicable deductible and coinsurance, for
immunosuppressive drugs described in section 1861(s)(2)(J) and oral
anti-cancer and anti-nausea drugs described in subparagraph (Q) and (T)
of the same section as determined appropriate by the Secretary. We
believe that the payment of this fee should be bundled into the current
payment for these drugs and the 2004 payment amounts specified in
section 303(b) of MPDIMA. We do not have data indicating that the 85%
figure is insufficient to cover the cost of supplying these drugs.
However, for 2005, we will re-examine this issue in light of the
average sales price (ASP) data that will be submitted by manufacturers.
D. Physician Fee Schedule Provisions Related to the Administration of
Drugs
As indicated above, sections 303 and 304 of MPDIMA amend section
1848 of the Act for physician fee schedule payments made beginning
January 1, 2004. We are describing our implementation of the parts of
sections 303 and 304 which have a January 1, 2004, effective date.
1. Provisions Related to Budget Neutrality
Section 303(a)(1) of MPDIMA amends section 1848(c) of the Act to
require changes to the practice expense and physician work relative
value units (RVUs) used to determine payment for drug administration
services. In general, section 1848(c)(2)(B)(ii)(II) provides that the
Secretary shall review and may make adjustments to the RVUs if the
changes do not cause the amount of expenditures to increase or decrease
by more than $20 million. Section 303(a) of MPDIMA amends section
1848(c)(2)(B) of the Act to add a new clause (iv) that exempts from
this limitation, any additional expenditures in 2004 attributable to:
(1) The increase in practice expense RVUs for drug administration
services resulting from the use of a practice expense survey meeting
specific criteria described in the statute;
(2) The increase in practice expense RVUs resulting from using
survey data on the compensation of clinical oncology nurses; and
(3) New physician work RVUs that we are adding to the drug
administration services consistent with the new statutory provisions.
In addition, section 303(a)(1) of MPDIMA also modifies section
1848(c)(2)(B) of the Act to provide an exemption from the budget
neutrality requirements in 2005 or 2006 for further increases in
practice expense RVUs for drug administration services that may result
from using additional survey data from physician specialties meeting
specific criteria that we will discuss in
[[Page 1092]]
more detail later in this document. Furthermore, any increase in
spending associated with any coding or policy changes resulting from
the Secretary's review of existing drug administration codes is also
exempted from budget neutrality requirements of section 1848 (c)(2)(B)
by section 303 of MPDIMA. Section 303(a)(3) also requires the Secretary
to review the policy in effect for the administration of more than one
drug administered by the push technique. This change is also exempt
from budget neutrality.
In general, we have met the budget neutrality requirements in the
statute by either applying an adjustment to the physician fee schedule
CF or to the RVUs themselves. However, section 303(a) of MPDIMA
specifically amends the statute to exempt the additional expenditures
that result from changes to the RVUs for drug administration services
from the budget neutrality requirements. Therefore, we will make no
changes to the physician fee schedule CF or physician work RVUs to
account for physician work RVUs being added to drug administration
services. We will add the additional expenditures as a result of these
provisions to the expenditure base in applying our practice expense
methodology.
2. Adjustments in Practice Expense Relative Value Units for Certain
Drug Administration Services Beginning with 2004
Section 303(a)(1)(B) of MPDIMA amends section 1848(c)(2) of the Act
by adding new subparagraph (H), ``Adjustments in Practice Expense
Relative Value Units for Certain Drug Administration Services beginning
in 2004''. Subparagraph (H)(i) requires the Secretary to determine the
practice expense RVUs for 2004 using practice expense surveys submitted
to the Secretary as of January 1, 2003, by a physician specialty
organization in accordance with section 212 of the Medicare, Medicaid,
and SCHIP Balanced Budget Refinement Act (BBRA) of 1999 if the survey:
(1) Covers practice expenses for oncology drug administration services;
and (2) meets criteria established by the Secretary for acceptance of
such surveys.
Section 212 of the BBRA directed the Secretary to establish a
process under which we would accept and use, to the maximum extent
practicable and consistent with sound data practices, data collected or
developed by entities and organizations. In an interim final rule with
comment published in the Federal Register on May 3, 2000 (65 FR 25664),
we established the criteria under which we would accept supplemental
data for use in computing the practice expense RVUs. We subsequently
modified those criteria in the November 1, 2000, physician fee schedule
final rule (65 FR 65383) and the December 31, 2002, final rule (67 FR
79971).
The American Society of Clinical Oncology (ASCO) provided us with a
supplemental survey prior to January 1, 2003, that includes expenses
associated with the administration of chemotherapy drugs. While the
survey meets the criteria we established, we initially decided not to
use the information because of concerns about the data (for more
information, see the December 31, 2003, final rule (67 FR 79973)). In a
proposed rule published in the Federal Register on August 20, 2003 (68
FR 50437), we described subsequent discussions held with ASCO that
resolved our concerns about the data.
Consistent with section 1848(c)(2)(H)(i) of the Act, we are using
the ASCO survey to determine the practice expense RVUs for physician
fee schedule services furnished on or after January 1, 2004, because
it: (1) Was submitted prior to January 1, 2003; (2) includes expenses
for drug administration services; and (3) meets criteria we have
established for use of surveys.
Section 303(j) of MPDIMA applies the amendments made by section 303
for payments for drugs or biologicals and drug administrative services
to physicians in the specialties of hematology, hematology/oncology and
medical oncology. Section 304 indicates that: ``Notwithstanding section
303(j), the amendments made by section 303 shall also apply to payments
for drugs or biologicals and drug administration services furnished by
physicians in specialties other than the specialties of hematology,
hematology/oncology and medical oncology.''
Because the section 303 (a)(1) provisions apply to hematology,
hematology/oncology and medical oncology, we will use the supplemental
survey submitted by ASCO for CMS specialty codes 82 (hematology), 83
(hematology/oncology) and 90 (medical oncology).
The Conference Report indicates that section 304 requires the
Secretary to disregard the (section 303) exemption and apply the
adjustments in section 303 to these other specialties. The Conference
report further indicates the intent in drafting the provisions in this
fashion: ``The intent in drafting the two sections in this manner is to
segregate the savings achieved from adjustments to payments to
oncologists from savings derived from other physician specialties. The
specialties to which the provisions apply are the specialties as used
by the carriers in administering Medicare.''
The purpose of the separation is only to display the budget scoring
effects separately for oncologists from other physician specialties.
There is no substantive policy effect at all from the enactment of the
amendments in this manner. The combined effect of the amendments made
by both section 303(j) and section 304 is that the substantive changes
in both payments for drugs and biologicals as well as drug
administration services apply to physicians of all specialties.
When we use supplemental survey data, we have generally blended the
supplemental survey data with prior survey data from the American
Medical Association's Socioeconomic Monitoring Survey (SMS). However,
section 1848(c)(2)(H)(i) of the Act indicates that the Secretary should
use survey data that meets the specific criteria specified in the
statute. We are using the ASCO survey data and are not blending it with
the prior SMS data.
Because we are not blending the ASCO survey with the SMS data, we
are adopting a consistent policy in 2004 for survey data received in
1999 from the Society for Thoracic Surgery (STS). That is, we will use
the STS supplemental survey data without blending it with the SMS data.
However, we have not made a final decision and will continue to
consider the issue of whether to blend supplemental survey with prior
SMS data or to use specialty submitted supplemental surveys without
blending. At this time, we are not using the ASCO and STS cases as
precedent for our consideration of future survey data. While some may
argue that the inclusion of newer, more specific survey data will
improve the precision of the data underlying the calculation of the
practice expense resource based RVUs, and lead to more stability in the
practice expense methodology, it can also be argued that a specialty
society would only undertake a survey (arguing that existing SMS data
were not sufficiently representative of the specialty's practice
expenses) if it believed that higher practice expense payments for that
specialty could be achieved by submitting additional data. We do not
believe that it would be prudent for the program to commit to the use
of supplemental survey data without blending it with the SMS data for
any and all future supplementary surveys. We will continue to consider
this issue in 2004 when we make proposals for the 2005 physician fee
schedule. At this time, we suggest that supplemental
[[Page 1093]]
survey data should be used without blending only under certain
conditions that would be specified in a future rule. (Note that this
issue does not affect specialties that are not included in the SMS
sample, and for which we have no other previous survey data. In such
cases there would obviously be no SMS survey data to blend.)
We invite comments on this issue and on appropriate criteria for
determining when to employ specialty submitted supplemental surveys
without blending.
Table 2 shows the revised practice expense per hour for each cost
pool for the specialties of cardiac and thoracic surgery and oncology,
hematology/oncology and hematology.
Table 2
----------------------------------------------------------------------------------------------------------------
Clin Admin. Office Med. Med.
Specialty Staff Staff Expense Supplies Equip Other Total
----------------------------------------------------------------------------------------------------------------
Cardiac/Thoracic Surgery........... 19.5 18.0 17.2 2.1 2.1 14.2 73.1
Oncology........................... 53.4 34.7 34.4 16.9 7.4 42.2 189.0
----------------------------------------------------------------------------------------------------------------
3. Pricing of Clinical Oncology Nurses in the Practice Expense
Methodology
Section 1848(c)(2)(H)(ii) of the Act (as added by section 303(a)(1)
of MPDIMA) specifies that if a survey meets the criteria described
above (that is, the survey that is submitted prior to January 1, 2003,
meets criteria established by the Secretary, etc.) and includes data on
wages, salaries and compensation of clinical oncology nurses, the
Secretary will use the data in the methodology for determining the
practice expense RVUs. The ASCO survey meets the criteria specified in
the statute and also includes data on oncology nursing compensation.
For this reason, we are using information from the survey to determine
the wage rate per minute for oncology certified nurses (OCN). The OCN
is included as a practice expense input for the nonchemotherapy
infusion codes (90780 through 90781) and the chemotherapy
administration codes (96400 through 96549). Using information from the
ASCO survey, we determined a wage rate of 0.79 per minute (increase
from the 0.56 per minute we are currently using) for the OCN. We used
this revised wage rate to determine the practice expense RVUs for the
drug administration services shown in Addendum B.
4. Work Relative Value Units for Certain Drug Administration Services
For services furnished on or after January 1, 2004, section
1848(c)(2)(H)(iii) of the Act (as added by section 303(a)(1) of MPDIMA)
requires the Secretary to establish work RVUs for drug administration
services equal to the work RVUs for a level 1 office medical visit for
an established patient (CPT code 99211). Section 1848(c)(2)(H)(iv) of
the Act defines drug administration services as those classified as of
October 1, 2003, within any of the following groups: therapeutic or
diagnostic infusions (excluding chemotherapy); chemotherapy
administration services; and therapeutic, prophylactic, or diagnostic
injections for which there are no work RVUs assigned and for which
national RVUs have been assigned.
CPT code 99211 is a level 1 established patient office visit with
physician work RVUs of 0.17. Consistent with the statute we are adding
physician work RVUs of 0.17 to the following drug administration
services: CPT codes 90780 through 90781, 90782 through 90788, 96400,
96408 through 96425, 96520, and 96530.
Currently, section 15010 of the Medicare Carriers Manual (MCM) does
not allow payment for CPT codes 90782, 90783, 90784 and 90788 unless
these are the only physician fee schedule services provided on that
day. We do pay separately for cancer chemotherapy injections (CPT codes
96400-96549) in addition to an office visit (CPT codes 99211-99215)
furnished on the same day by the same physician. CPT code 99211 does
not require a face-to-face encounter between the physician and the
patient like other office visit services (CPT codes 99212-99215) and
can be used be physicians supervising a nurse performing chemotherapy
administration. Currently, physicians typically bill for CPT code 99211
approximately 34 percent of the time that they are also providing a
drug administration service. We believe that adding physician work to
the drug administration services will subsume the supervision that
physicians billing for a 99211 on the same day are typically providing.
Therefore, we will no longer allow for 99211 to be billed on the same
day as a chemotherapy administration service.
Although less common than CPT 99211, physicians also bill for other
office visit (CPT codes 99212-99215) provided on the same day as
chemotherapy administration. We will continue to allow other office
visits to be billed on the same day as a drug administration service
with modifier 25 indicating that a separately identifiable evaluation
and management service was provided. This policy will make our practice
with chemotherapy administration consistent with all other physician
fee schedule services where we require use of modifier 25 if a
separately identifiable evaluation and management service is provided
on the day as a procedure. Section 15400(D) of the Medicare Carrier
Manual (MCM) describes Medicare payment policy with respect to
chemotherapy administration and ``incident to'' services provided on
the same day. We will be revising section 15400 of the MCM (in addition
to section 15010 that describes ``bundled services'') to reflect that
CPT code 99211 and a chemotherapy administration service cannot be
billed for the same patient on a single day.
5. Adjustments in the Practice Expense Relative Value Units for Certain
Drug Administration Services Beginning with 2005
Section 303(a)(1) of MPDIMA also modifies section 1848(c)(2)(B) of
the Act to provide an exemption from the budget neutrality requirements
in 2005 or 2006 for further increases in practice expense RVUs for drug
administration services that may result from using additional survey
data from physician specialties meeting specific criteria. Section
1848(c)(2)(I) of the Act specifies that the exemption from budget
neutrality will apply for any survey (other than the ASCO survey that
meets the exemption requirement specified by another provision of the
statute) submitted by a specialty group where 40 percent or more of its
payments for Part B services are attributable to the administration of
drugs in 2002 as determined by the Secretary. The statute indicates
that the survey must include expenses for the administration of drugs
and must be received by the Secretary prior to March 1, 2004, to
determine the 2005 practice expense RVUs and prior to March 1, 2005, to
determine the 2006 practice expense RVUs.
[[Page 1094]]
We have reviewed Medicare allowed charge data for 2002. Based on
the 2002 data, we found that the specialties of gynecology/oncology
(specialty code 98) rheumatology (specialty code 66) and urology
(specialty code 30) received more than 40 percent of total Part B
revenues from drugs. We will apply the exemption from budget neutrality
specified in section 1848(c)(2)(I) of the Act for additional
expenditures that result from the increases in drug administration
practice expense RVUs in 2005 or 2006 resulting from use of a survey
that is submitted timely by any of these specialties and otherwise
meets criteria we have established for use of supplemental surveys.
Hematology (specialty 82), hematology/oncology (specialty 83) and
medical oncology (specialty 90) also receive more than 40 percent of
their Medicare revenues from drugs. However, we are already using the
ASCO survey for these specialties and the increase in payment for drug
administration is exempt from budget neutrality by another provision of
the statute.
6. Provisions for Appropriate Reporting and Billing for Physicians'
Services Associated with the Administration of Covered Outpatient Drugs
Section 1848(c)(2)(J) of the Act requires the Secretary to promptly
evaluate existing drug administration codes for physicians' services to
ensure accurate reporting and billing for such services, taking into
account levels of complexity of the administration and resource
consumption. The statute further specifies that the Secretary will use
existing processes for the consideration of coding changes and, to the
extent changes are made, will use the processes to establish relative
values for these services. The Secretary is also required to consult
with physician specialties affected by the provisions that change
Medicare payments for drugs.
We expect to review this issue in the context of all the payment
changes being made by the statute to Medicare payment for drug
administration in order to assure accurate reporting and billing for
such services taking into account levels of complexity of the
administration and resource consumption. The existing processes we plan
to use include review by our Physician's Regulatory Issues Team (PRIT)
and consultation with the AMA's CPT Editorial Committee and physician
specialties affected by changes in payment for drugs and drug
administration. The PRIT, an internal CMS group that is working to
eliminate unnecessary regulations, is reviewing the issue of coding for
drug administration services including section 15400 of the Medicare
Carriers Manual (MCM) that currently governs Medicare policy with
respect to use of CPT codes in the 96400 through 96549 series for
chemotherapy administration.
7. Treatment of Other Services Currently in the Nonphysician Work Pool
The nonphysician work pool is a special interim methodology that we
use to determine practice expense RVUs for many services that do not
have physician work RVUs. The drug administration codes listed above
are currently valued using the nonphysician work pool methodology.
Because we are now assigning work RVUs to these drug administration
codes, they will no longer be included in the nonphysician work pool.
Practice expense RVUs for these services will be computed using the
standard practice expense methodology that applies to all other
physicians' services.
Section 303(a)(2) of MPDIMA requires the Secretary to make
adjustments to the nonphysician work pool methodology for the
determination of practice expense RVUs under the physician fee schedule
so that the practice expense RVUs for services determined under such
methodology are not affected relative to the practice expense RVUs of
services not determined under such methodology as a result of the
amendments made by section 303(a)(2) of MPDIMA. If we made no other
changes, removing drug administration codes from the nonphysician work
pool would result in a reduction to the practice expense RVUs for
services remaining in the nonphysician work pool. Consistent with
section 303(a)(1) of MPDIMA, we are making two changes to the
nonphysician work pool methodology so that the practice expense RVUs
for nonphysician work pool services are not affected relative to other
services.
First, we are changing the practice expense per hour assigned to
the nonphysician work pool. In place of the ``all physician'' average,
we are using a weighted average practice expense per hour of the
specialties that perform the services affected by its calculations.
Specifically, we will use the following revised data in the practice
expense methodology for services remaining in the nonphysician work
pool:
Table 3
----------------------------------------------------------------------------------------------------------------
Clin Admin. Office Med. Med.
Specialty Staff Staff Expense Supplies Equip Other Total
----------------------------------------------------------------------------------------------------------------
Nonphysician Work pool............. 15.8 17.4 21.5 7.9 4.9 15.0 82.6
----------------------------------------------------------------------------------------------------------------
Second, we are adjusting the clinical staff times used in the
creation of the pool. By definition, nonphysician work pool services do
not involve the physician and have no physician time. To create the
nonphysician work pool, we have used clinical staff time per procedure
in the computation. We will now use the total staff time rather than
the previously utilized maximum staff time for developing the 2004
physician fee schedule. Consistent with section 303(a)(2) of MPDIMA,
the change to the practice expense per hour and staff time will result
in no reduction to the practice expense RVUs for the services remaining
in the nonphysician work pool once drug administration services are
removed. By using the maximum staff time, we are assuming that clinical
staff are working concurrently. However, it is possible that clinical
staff are working sequentially and it would be appropriate to use the
total staff time for each service. We are proposing to use the total
staff in place of the maximum staff for developing the 2004 physician
fee schedule since each are equally likely to address staff time
arrangements for non-physician work pool services and the latter
approach will assist in meeting the statutory directive that payment
for non-physician work pool services not be affected by the changes we
are making to drug administration services.
8. Payment for Multiple Chemotherapy Agents Furnished on a Single Day
Through the Push Technique
Section 303(a)(3) of MPDIMA requires the Secretary to review the
policy as in effect October 1, 2003, for section 1848 of the Act for
the administration of more than one drug or biological to an individual
on a single day through the push technique. Subsequent to that review,
the Secretary will modify the
[[Page 1095]]
payment policy as determined to be appropriate. Section 303(a)(3)(C) of
MPDIMA indicates that any change in policy resulting from this review
will be treated as additional expenditures attributable to section
1848(c)(2)(H). (This section relates to the additional expenditures
that result from use of survey data that includes expenses for drug
administration and clinical oncology nurses and requires that we
establish work RVUs equal to a level 1 office visit for drug
administration services. Currently, a level 1 office has 0.17 work
RVUs)
In the November 25, 1991, Federal Register (56 FR 59541), we
specified that Medicare will allow CPT code 96408 (Chemotherapy
administration, intravenous; push technique) to be reported only once
per day even if the physician administers multiple drugs and this
policy is contained in Section 15400 of MCM. In the August 20, 2003,
proposed rule (68 FR 50439) concerning payment reform for part B drugs
under Medicare, we had proposed revising this policy to allow for CPT
code 96408 to be reported once per day for each drug administered. This
revision was supported by commenters.
Upon review of this issue and in acknowledgement that there are
additional resources involved in administering each subsequent drug
which should be considered in a resource-based payment system, we are
changing our policy and will allow for CPT code 96408 to be reported
once per day for each drug administered. The effective date for this
change is for services furnished on or after January 1, 2004. We will
modify section 15400 of the manual consistent with this change. In
addition, as previously mentioned, the PRIT will be reviewing the issue
of use of the chemotherapy administration codes in the 96400 CPT code
series and Medicare's manual provisions on their use.
9. Transitional Adjustment to Medicare Payment for Certain Drug
Administration Services
Section 303(a)(4) of MPDIMA provides for a transitional adjustment
to Medicare payment for drug administration services to reflect
implementation of the amendments made by section 303 of MPDIMA
affecting Medicare's payments for drugs. Specifically, section
303(a)(4) of MPDIMA requires Medicare to increase the physician fee
schedule amounts otherwise determined by 32 percent for 2004 and 3
percent for 2005. Thus, we will determine the payment for CPT codes
90780 through 90781, 90782 through 90788, 96400, 96408 through 96425,
96520, and 96530 based on the work, practice expense and malpractice
RVUs shown in Addendum B and the 2004 CF of $37.3374. Consistent with
section 303(a)(4) of MPDIMA, we will increase the physician fee
schedule amount by an additional 32 percent for 2004. (The physician
fee schedule amounts applicable in 2005 will be increased by 3
percent.)
C. Geographic Practice Cost Indices (GPCIs)
The Act requires that payments vary among physician fee schedule
areas according to the extent that resource costs vary as measured by
the Geographic Practice Cost Indices (GPCIs) for each of the three fee
schedule components: work, practice expense, and malpractice.
Section 412 of MPDIMA amended section 1848(e)(1) of the Act and
establishes a floor of 1.0 for the work geographic index for any
locality to be used for purposes of payment for services furnished on
or after January 1, 2004, and before January 1, 2007. In addition,
section 602 of MPDIMA further amended section 1848(e)(1) of the Act for
purposes of payment for services furnished in Alaska under the
physician fee schedule on or after January 1, 2004, and before January
1, 2006, and sets the practice expense, malpractice and work indices at
1.67 if the index would otherwise be less than 1.67.
Based on these changes to the Act, we are revising the addenda
published in the November 7, 2003, final rule concerning the
transitional 2004 and full 2005 GPCIs (Addendum D and Addendum E,
respectively). No locality will have a work GPCI of less than 1.00 and
the work, practice expense and malpractice GPCIs for Alaska are set at
1.67. Addendum D in the November 7, 2003, final rule listed 58
localities having work GPCIs of less than 1.00. Of these, the range was
from 0.881 for Puerto Rico to 0.998 for ``Rest of New York'' and New
Orleans, Louisiana. Addendum D and E that are included in this final
rule will replace the addenda previously published November 7, 2003.
D. Adjustments to the Work, Practice Expense and Malpractice Relative
Value Units
In the August 15, 2003, proposed rule (68 FR 49058), we proposed to
adjust the work, practice expense and malpractice RVUs to match the
rebased MEI weights. In the November 7, 2003, final rule (68 FR 63245),
we responded to public comments and applied adjustments of -0.57
percent (0.9943) to the physician work RVUs, -0.77 percent (0.9923) to
the practice expense RVUs and 19.86 percent (1.1986) to the malpractice
RVUs. These adjustments were intended to make the aggregate work,
practice expense and malpractice RVUs used to determine payments in
2004 consistent with their respective weights in the rebased MEI.
However, the changes required by MPDIMA change the 2004 work,
practice expense and malpractice RVUs. Provisions that require changes
to the work and practice expense RVUs and exempt them from budget
neutrality will increase the number of work and practice expense RVUs.
As we indicated in the November 7, 2003, final rule, we believe
Medicare payment policy will be improved by adjusting the work,
practice expense and malpractice RVUs to match the revised MEI weights.
By matching the aggregate pools of RVUs to the rebased MEI weights,
Medicare's payments for physician work, practice expense and
malpractice will more closely match the proportion of expenses incurred
by physicians in these categories. Therefore, we are revising the
adjustments applied to the RVUs in the November 7, 2003, final rule
consistent with our goal of making the work, practice expense and
malpractice RVUs match the rebased MEI weights. The revised adjustments
are -0.15 percent (0.9985) for physician work, -1.320 percent (0.9868)
for practice expense, and 20.61 percent (1.2061) for malpractice. We
have incorporated these adjustments into the RVUs shown in Addenda B
and C of this final rule.
E. Anesthesia and Physician Fee Schedule Conversion Factors for 2004
The physician fee schedule update is determined under a methodology
specified by statute. In the November 7, 2003, final rule (68 FR
63251), we used the formula specified in section 1848(d)(4) of the Act
to determine a 4.5 percent reduction to the physician fee schedule CF.
However, section 601 of MPDIMA amended section 1848(d) of the Act to
specify that the update to the single CF for 2004 and 2005 will not be
less than 1.5 percent. Because the statutory formula will yield a 4.5
percent reduction to the physician fee schedule CF and the amendments
to the statute indicate that the update for 2004 cannot be less than
1.5 percent, we will increase the physician fee schedule CF by 1.5
percent for 2004.
The specific calculations to determine the physician fee schedule
and anesthesia CFs for 2004 are explained below.
[[Page 1096]]
[sbull] Physician Fee Schedule Conversion Factor
Under section 1848(d)(1)(A) of the Act, the physician fee schedule
CF is equal to the CF for the previous year multiplied by the update
determined under section 1848(d)(4) of the Act.
We illustrate the calculation for the 2004 physician fee schedule
CF in table 4:
Table 4
------------------------------------------------------------------------
------------------------------------------------------------------------
2003 Conversion Factor.................................. $36.7856
2004 Update............................................. 1.5% (1.015)
2004 Conversion Factor.................................. $37.3374
------------------------------------------------------------------------
[sbull] Anesthesia Fee Schedule Conversion Factor
As described in the November 7, 2003, final rule (68 FR 63252),
anesthesia services do not have RVUs like other physician fee schedule
services. For this reason, we are accounting for the adjustments to
match the revised MEI weights and changes to anesthesia work and
practice expenses through a 1.09 percent 1.0109 adjustment to the
anesthesia fee schedule CF. The 1.09 percent increase reflects a 0.15
percent reduction on the work portion (79 percent), a 2.0 percent
reduction on the practice expense portion (13.7 percent) and a 20.61
percent increase on the malpractice portion (7.2 percent) of the
anesthesia conversion factor. (The adjustment to the practice expense
portion is comprised of 1.3 percent for the MEI weights and 0.7 percent
for the revisions in the practice expense methodology). To determine
the anesthesia fee schedule CF for 2004, we used the following figures:
Table 5
------------------------------------------------------------------------
------------------------------------------------------------------------
2003 Conversion Factor............................... $17.0522
Adjustments for Work and Practice Expense............ 1.09% (1.0109)
2004 Update.......................................... 1.5% (1.0150)
2004 Conversion Factor............................... $17.4969
------------------------------------------------------------------------
F. Publication of Addenda
The addenda included in this final rule concerning RVUs and Related
Information Used in Determining Medicare Payments for 2004 (Addenda A,
B and C) and GPCIs by Medicare Carrier and Locality (Addenda D and E)
replace the addenda published November 7, 2003 (68 FR 63261). The
revised addenda reflect changes required by MPDIMA as well as
corrections to minor errors contained in the addenda published November
7, 2003.
III. Private Contracting With Medicare Beneficiaries
Section 4507 of the Balanced Budget Act of 1997 added section
1802(b) to the Act. This section provides that physicians and certain
nonphysician practitioners may opt out of Medicare and enter into
private contracts with Medicare beneficiaries. Under these contracts,
no limits apply to what physicians or nonphysician practitioners can
charge beneficiaries. Physicians opting out of Medicare file an
affidavit with the Medicare carrier in which they agree to opt out of
Medicare for a period of 2 years and to meet certain other criteria. In
general, the statute requires that during that two-year period,
physicians and nonphysician practitioners who have filed affidavits
opting out of Medicare have private contracts with all Medicare
beneficiaries to whom they furnish Medicare covered services. These
contracts may not be entered into at a time when a beneficiary needs
emergency or urgent care services.
Moreover, the statute requires that the private contract be in
writing and be signed by the Medicare beneficiary before any item or
service is provided in accordance with the contract and that:
[sbull] The beneficiary agrees not to submit a claim (or to request
that the physician or practitioner submit a claim) with Medicare for
Medicare covered services.
[sbull] The beneficiary agrees to be responsible, whether through
insurance or otherwise, for services furnished under a private
contract.
[sbull] The beneficiary acknowledges that no limits (including the
limits under section 1848(g) of the Social Security Act) apply to
amounts that are charged under the private contract.
[sbull] The beneficiary acknowledges that no payment will be made
under a Medigap plan, and other insurers may elect not to make payment
for services furnished under the private contract.
[sbull] The beneficiary acknowledges that Medicare may make payment
for covered services if the service was received from a physician or
non-physician practitioner with whom the beneficiary has not signed a
private contract.
Prior to enactment of MPDIMA, section 1802(b)(5)(B) of the Act
limited the types of physicians who could choose to opt out of Medicare
to doctors of medicine and doctors of osteopathy. Section 603 of MPDIMA
amends section 1802(b)(5)(B) of the Act to include dentists,
podiatrists, and optometrists, in certain circumstances, in the
definition of physicians who may opt out of Medicare. We are making
conforming changes to our regulations to reflect this change in the
statute.
IV. Waiver of Proposed Rulemaking and Delay in Effective Date
We ordinarily publish a notice of proposed rulemaking in the
Federal Register and invite public comment on a proposed rule. The
notice of proposed rulemaking includes a reference to the legal
authority under which the rule is proposed, and the terms and substance
of the proposed rule or a description of the subjects and issues
involved. This procedure can be waived, however, if an agency finds
good cause that notice-and-comment procedure is impracticable,
unnecessary, or contrary to the public interest and incorporates a
statement of the finding and its reasons in the rule issued. In
addition, the Administrative Procedure Act (APA) normally requires a
30-day delay in the effective date of a final rule. Furthermore, the
Congressional Review Act (CRA) generally requires an agency to delay
the effective date of a major rule by 60-days in order to allow for
congressional review of the agency action.
Section 1871 of the Act provides for publication of a notice of
proposed rulemaking and opportunity for public comment before CMS
issues a final rule. However, section 1871(b)(2)(B) provides an
exception when a law establishes a specific deadline for implementation
of a provision and the deadline is less than 150 days after the law's
date of enactment. MPDIMA was enacted by Congress on November 25, 2003,
and signed into law by the President on December 8, 2003. The
provisions of this rule that amend the physician fee schedule and drug
payment rate are required to be implemented January 1, 2004. Therefore,
these provisions are subject to waiver of proposed rulemaking and
public comment in accordance with section 1871(b)(2)(B) of the Act.
Even if section 1871(b)(2)(B) of the Act were not directly
applicable here, we would find good cause to waive the requirement for
publication of an notice of proposed rulemaking and public comment on
the grounds that it is impracticable, unnecessary, and contrary to the
public interest. This final rule, with the exception of implementation
of billing for a level 1 office visit and pharmacy supplying fee and
the technical correction of minor errors in the November rule, merely
sets out the non-discretionary provisions of MPDIMA with respect to
payment under the physician fee schedule and drug AWP methodology.
Because the rule is generally ministerial, we believe that pursuing
notice and comment is
[[Page 1097]]
unnecessary. Moreover, because such process would prevent
congressionally-mandated revisions, updates, and increases in payment
under the physician fee schedule for 2004, we find that pursuing such
process would be both impracticable and contrary to the public
interest.
For these same reasons, we are waiving the 30-day delay in
effective date contained in 5 U.S.C. section 553(d).
With respect to the requirement of a 60-day delay in the effective
date of any final rule pursuant to the CRA, see 5 U.S.C. section 801,
the CRA provides that the 60-day delayed effective date shall not apply
to any rule ``which an agency for good cause finds . . . that notice
and public procedure thereon are impracticable, unnecessary, or
contrary to the public interest'' (5 U.S.C. section 808(2)). For the
reasons set forth above, we believe that additional notice-and-comment
rulemaking on this subject would be impracticable, unnecessary, or
contrary to the public interest. Therefore, we do not believe that the
CRA requires a 60-day delay in the effective date of this final rule.
V. Response to Comments
Because of the large number of items of correspondence we normally
receive on Federal Register documents published for comment, we are not
able to acknowledge or respond to them individually. We will consider
all comments we receive by the date and time specified in the DATES
section of this preamble, and, if we proceed with a subsequent
document, we will respond to the major comments in the preamble to that
document.
VI. Collection of Information Requirements
Under the Paperwork Reduction Act (PRA) of 1995, we are required to
provide 60-day notice in the Federal Register and solicit public
comment before a collection of information requirement is submitted to
the Office of Management and Budget (OMB) for review and approval. In
order to fairly evaluate whether an information collection should be
approved by OMB, section 3506(c)(2)(A) of the PRA of 1995 requires that
we solicit comment on the following issues:
The need for the information collection and its usefulness in
carrying out the proper functions of our agency.
[sbull] The accuracy of our estimate of the information collection
burden.
[sbull] The quality, utility, and clarity of the information to be
collected.
[sbull] Recommendations to minimize the information collection
burden on the affected public, including automated collection
techniques.
Therefore, we are soliciting public comments on each of these
issues for the information collection requirement discussed below.
The following information collection requirement and associated
burden are subject to the PRA.
Sec. 414.707 Basis of payment
Under paragraph (a)(7) of this section, a manufacturer requesting a
drug payment exception to the default 85 percent used in the general
rule or the percentage specified in Table 1 will have to submit data
and information including the manufacturer's average sales price for
the drug. The burden associated with this requirement is the time
involved in providing us the information for the submission due before
January 1, 2004, and the optional supplemental submission due by
January 16, 2004. We believe that it would take an average of one hour
to submit the request and the necessary data and information. Given the
universe of approximately 450 Medicare drug codes and assuming an
average of 10 manufacturers per drug code, the maximum aggregate burden
associated with this activity would be 4500 hours.
We are soliciting public comment on this requirement in conjunction
with a request for emergency approval of this information collection so
that manufacturers may submit their requests during the statutorily
prescribed timeframe. These requirements were submitted to OMB for
review and are approved by OMB under OMB control number 0938-0913.
If you comment on any of these information collection and record
keeping requirements, please mail copies directly to the following:
Centers for Medicare & Medicaid Services, Office of Strategic
Operations and Regulatory Affairs, Regulations Development and
Issuances Group, Attn: Julie Brown, CMS-1372-FC, Room C5-16-03, 7500
Security Boulevard, Baltimore, MD 21244-1850; and Office of Information
and Regulatory Affairs, Office of Management and Budget, Room 10235,
New Executive Office Building, Washington, DC 20503, Attn: Brenda
Aguilar, CMS Desk Officer.
Comments submitted to OMB may also be emailed to the following
address: email: [email protected]; or faxed to OMB at (202) 395-
6974.
VII. Regulatory Impact Analysis
We have examined the impact of this rule as required by Executive
Order 12866 (September 1993, Regulatory Planning and Review), the
Regulatory Flexibility Act (RFA) (September 16, 1980, Pub. L. 96-354),
section 1102(b) of the Social Security Act, the Unfunded Mandates
Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132.
Executive Order 12866 directs agencies to assess all costs and benefits
of available regulatory alternatives and, when regulation is necessary,
to select regulatory approaches that maximize net benefits (including
potential economic, environmental, public health and safety effects,
distributive impacts, and equity). A regulatory impact analysis must be
prepared for final rules with economically significant effects (that
is, a final rule that would have an annual effect on the economy of
$100 million or more in any 1 year, or would adversely affect in a
material way the economy, a sector of the economy, productivity,
competition, jobs, the environment, public health or safety, or State,
local, or tribal governments or communities). We estimate that the
combined effect of the physician fee schedule update and GPCI
provisions included in this final rule will increase Medicare spending
by $1.0 billion in FY 2004. We have simulated the effect of both the
drug payment and physician fee schedule changes that we are adopting in
this final rule. We are making several changes to the physician fee
schedule RVUs in this final rule. In general, section
1848(c)(2)(B)(ii)(II) of the Act requires that changes to RVUs cannot
increase or decrease expenditures more than $20 million from the amount
of expenditures that would have resulted with such adjustments.
However, section 303(a)(1) of the MPDIMA specifically exempts the
changes we are making to the RVUs in this final rule from the budget
neutrality requirements of section 1848(c)(2)(B)(ii)(II) of the Act.
Thus, the changes that we are making to the physician fee schedule RVUs
will increase aggregate spending for Medicare physician fee schedule
services. Because the changes in this final rule will increase Medicare
spending by more than $1.0 billion in FY 2004, we are considering this
final rule to be economically significant. Therefore, this final rule
is a major rule and we have prepared a regulatory impact analysis. The
table 6 below shows our estimates of the fiscal year 2004 impact of
specific MPDIMA provisions we are implementing in this final rule
(rounded to the nearest $0.1 billion).
[[Page 1098]]
Table 6
------------------------------------------------------------------------
FY 2004
Section Description impact ($ in
billions)
------------------------------------------------------------------------
303............................ Competitive Acquisition $0.0
of Covered Outpatient
Drugs.
304............................ Application to Certain -0.1
Specialties.
305............................ Payment for Inhalation -0.1
Drugs.
412............................ Work GPCI Floor for 0.2
Physicians.
601............................ Update Revisions....... 0.8
602............................ Services in Alaska..... 0.0
------------------------------------------------------------------------
The RFA requires that we analyze regulatory options for small
businesses and other entities. We prepare a Regulatory Flexibility
Analysis unless we certify that a rule would not have a significant
economic impact on a substantial number of small entities. The analysis
must include a justification concerning the reason action is being
taken, the kinds and number of small entities the rule affects, and an
explanation of any meaningful options that achieve the objectives and
less significant adverse economic impact on the small entities.
Section 1102(b) of the Act requires us to prepare a regulatory
impact analysis for any proposed rule that may have a significant
impact on the operations of a substantial number of small rural
hospitals. This analysis must conform to the provisions of section 603
of the RFA. For purposes of section 1102(b) of the Act, we define a
small rural hospital as a hospital that is located outside a
Metropolitan Statistical Area and has fewer than 100 beds.
For purposes of the RFA, physicians, non-physician practitioners,
and suppliers are considered small businesses if they generate revenues
of $6 million or less. Approximately 95 percent of physicians (except
mental health specialists) are considered to be small entities. There
are about 875,000 physicians, other practitioners and medical suppliers
that receive Medicare payment under the physician fee schedule. There
are in excess of 20,000 physicians and other practitioners that receive
Medicare payment for drugs. These physicians are concentrated in the
specialties of oncology, urology and rheumatology. Of the physicians in
these specialties, approximately 40 percent are in oncology and 45
percent in urology.
For purposes of the RFA, approximately 98 percent of suppliers of
DME and prosthetic devices are considered small businesses according to
the Small Business Administration's (SBA) size standards. We estimate
that 106,000 entities bill Medicare for DME, prosthetics, orthotics,
surgical dressings, and other equipment and supplies each year. Total
Medicare expenditures for DME are approximately $7.7 billion per year,
of which approximately $1.4 billion are for DME drugs.
The analysis and discussion provided in this section as well as
elsewhere in this final rule complies with the RFA requirements.
Section 202 of the Unfunded Mandates Reform Act of 1995 also requires
that agencies assess anticipated costs and benefits before issuing any
rule that may result in expenditure in any 1 year by State, local, or
tribal governments, in the aggregate, or by the private sector, of $110
million. This final rule would not impose unfunded mandates on State,
local, or tribal governments, or on the private sector of more than
$110 million.
We have examined this final rule in accordance with Executive Order
13132 and have determined that this regulation would not have any
significant impact on the rights, roles, or responsibilities of State,
local, or tribal governments.
We have prepared the following analysis, which together with the
rest of this preamble meets all assessment requirements. It explains
the rationale for, and purposes of, the rule, details the costs and
benefits of the rule, analyzes alternatives, and presents the measures
we propose to use to minimize the burden on small entities. This final
rule changes Medicare payment rates for drugs and their administration
as well as other physician fee schedule services. We are providing
information for each of the policy changes in the relevant sections of
this final rule. We are unaware of any relevant Federal rules that
duplicate, overlap or conflict with this final rule. The relevant
sections of this final rule contain a description of significant
alternatives if applicable.
A. Application of Market-Based Systems of Medicare Payment for Part B
Drugs
As described in more detail earlier in this final rule, effective
January 1, 2004, with some exceptions, section 303(b) of MPDIMA
specifies that drugs not paid on a cost or prospective payment basis
will be paid at 85 percent of the average wholesale price determined as
of April 1, 2003. Section 303(a) directs the Secretary to make changes
to the physician fee schedule that will increase Medicare spending for
physicians' services. Section 303 applies only to oncology payments
while section 304 indicates that identical provisions to those in
section 303 apply to other physicians. We have estimated that section
303 of MPDIMA would have no cost in FY 2004 and that section 304 would
save $0.1 billion in FY 2004.
B. Payment for Inhalation Drugs
Section 305(a) of MPDIMA specifies that inhalation drugs furnished
through durable medical equipment covered under 1861(n) of the Act will
be paid at 80 percent of the average wholesale price determined as of
April 1, 2003. We estimated savings associated with implementing
section 305(a) of the MPDIMA is $0.1 billion in FY 2004.
C. Pharmacy Supplying Fee for Certain Drugs and Biologicals
Section 303(e)(2) provides for payment of a pharmacy supplying fee,
less applicable deductible and coinsurance, for immunosuppressive drugs
described in subparagraph (J) of section 1861(s)(2) and oral anti-
cancer and anti-nausea drugs described in subparagraphs (Q) and (T) of
such section. The payment of this fee is bundled into the current
payment for these drugs and the 2004 payment amounts specified in
section 303(b). This provision has no impact on Medicare expenditures
in 2004.
D. Physician Fee Schedule Provisions Related to the Administration of
Drugs
As indicated above, we are making changes to the work and practice
expense RVUs under the provisions of section 1848(c)(2) of the Act as
amended by section 303 of MPDIMA. In general, under section 1848(c)(2)
of the Act, adjustments to RVUs may not cause the amount of
expenditures to differ by more than $20 million from the amount of
expenditures that would have
[[Page 1099]]
resulted without such adjustments. However, section 303(a)(1) of the
MPDIMA specifically exempts the changes we are making to the RVUs in
this final rule from the budget neutrality requirements of section
1848(c)(2)(B)(ii)(II). As described above, consistent with section
303(a)(1), we are making several changes to the physician fee schedule
work and practice expense RVUs.
Table 6A shows the specialty level impact on payment of changes
being made for CY 2004. The payment impacts reflect averages for each
specialty based on Medicare utilization. The payment impact for an
individual physician would be different from the average, based on the
mix of services the physician provides. The average change in total
revenues would be less than the impact displayed here since physicians
furnish services to both Medicare and non-Medicare patients and
specialties may receive substantial Medicare revenues for services that
are not paid under the physician fee schedule. For instance,
oncologists receive approximately 20 percent of their Medicare revenues
from physician fee schedule services and approximately 77 percent of
their Medicare revenues from drugs. Table 6A shows only the payment
impact on physician fee schedule services. Table 11 below shows the
combined impact of the physician fee schedule and drug payment changes
for selected specialties and suppliers that receive a high percentage
of their Medicare revenues from drugs.
We modeled the impact of all changes to the relative value units
and illustrated their effect in table 6A. The column labeled ``Impact
11/7/2003 Final Rule Pre-MEI Weight Adjustments'' shows the combined
effect of all of the relative value unit changes contained in the
August 15, 2003, proposed rule and the November 7, 2003, final rule
other than the adjustments to make the aggregate work, practice expense
and malpractice RVUs match the MEI weights. (For a description of the
impact of the provisions of the August 15, 2003, proposed rule see 68
FR 49060-49065. For a description of the impact of additional impacts
resulting from the November 7, 2003, final rule, see 68 FR 63252-
63253). As described below, we have revised the MEI weight adjustments
and will illustrate their impact once we show the effect of all other
provisions that change RVUs.
The column labeled ``Section 303 and 304 Changes without Transition
Payments'' shows the impact of changes made in this final rule
implementing section 303 and 304 of MPDIMA other than section 303(a)(4)
that requires a ``transitional adjustment'' that increases payments for
specific drug administration services by an additional 32 percent in
2004. This column shows the effect of increases in payments for drug
administration services resulting from the higher work and practice
expense RVUs required by section 303 and 304 of MPDIMA as well allowing
oncologists to bill for multiple drug administrations by the ``push''
technique on a single day. In addition, because there will be no same
day billing of a level 1 office visit and a drug administration
service, the impacts shown include the effect of fewer office visit
billings by the minority of oncologists who billed for such services.
Taken together, these provisions will increase payments to oncologists
by an estimated 27 percent. We estimate that payments to other
physicians that provide drug administration services (rheumatology,
infectious disease, obstetrics/gynecology) will increase by 1 to 2
percent. The revision to the practice expense per hour for cardiac and
thoracic surgeons will increase their payments by an estimated 1
percent. All of the other increases shown in the table are a result of
changes that we are making to the non-physician work pool. These
changes will increase payments to physicians, practitioners and
suppliers (Allergy/Immunology, Radiation Oncology, Radiology,
Audiology, Diagnostic Testing Facility and Portable X-Ray suppliers)
that provide services affected by the non-physician work pool
calculations by approximately 1 percent. There will be little or no
change in payments for all other specialties from the changes we are
making in this interim final rule because the changes to the RVUs
resulting from MPDIMA are exempt from the budget neutrality
requirements of section 1848(c)(2)(ii)(II) of the Act.
The column labeled ``Transition Payments'' shows the impact on
payment from the 32 percent increase in payment for drug administration
services required by section 303(a)(4) of MPDIMA. This provision will
have an effect on only those specialties that provide drug
administration services and is estimated to increase payments to
oncologists by an additional 14 percent. We estimate that payments to
other physicians that provide drug administration services (infectious
disease, obstetrics/gynecology rheumatology and urology) will increase
by 1 to 2 percent.
We also modeled the effect of adjusting the RVUs to match the new
MEI weights. Because we are increasing the malpractice RVUs by more
than 20 percent, adjusting the RVUs to match the new MEI weights will
result in an increase in payment for those specialties that perform
services with high malpractice RVUs. Payments to anesthesiology,
cardiac surgery, emergency medicine, neurosurgery, orthopedic surgery,
thoracic surgery and vascular surgery will increase by approximately 1
percent. There will be a small impact on payment to all other
physicians, practitioners and suppliers from the adjustments that
reduce physician work and practice expense RVUs to match the new MEI
weights. The total change in payment from provisions of the November 7,
2003, final rule and this final rule are shown in the total column.
BILLING CODE 4120-01-P
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In general, the statutory methodology for updating the physician
fee schedule conversion factor is specified in section 1848(d)(4) of
the Act. However, section 1848(d)(5) specifies that the update to the
conversion factor for 2004 and 2005 shall not be less than 1.5 percent.
Application of the statutory methodology of section 1848(d)(4) of the
Act would reduce the physician fee schedule conversion factor by 4.5
percent. However, because section 1848(d)(5) of the Act indicates that
the update can be no less than 1.5 percent, we are increasing the 2004
physician fee schedule conversion factor by 1.5 percent. In table 7, we
are showing the estimated change in average payments by specialty based
on provisions of this final rule and the estimated physician fee
schedule update.
[[Page 1102]]
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[[Page 1103]]
[GRAPHIC] [TIFF OMITTED] TR06JA04.007
In the November 7, 2003, final rule, we showed the impact of all
RVUs changes and a 4.5 percent reduction in the physician fee schedule
conversion factor. In the table below, we are showing the effect of
MPDIMA on payment for physician fee schedule services relative to the
changes that would have occurred in 2004 under current law had MPDIMA
not been enacted. That is, because the physician fee schedule
conversion factor would have been reduced by 4.5 percent to $35.1339
and MPDIMA requires that it be increased by 1.5 percent to $37.3374,
MPDIMA provisions affecting the update increased average physician fee
schedule rates by 6.3 percent ($37.3374/$35.339 - 1 = 1.063 or 6.3
percent). Furthermore, MPDIMA required changes to relative value units
that also resulted in further average increases in Medicare payment for
physician fee schedule services. The following table also includes the
impact of the GPCI provision that does not allow a work GPCI to be less
than 1.0 and another one that increases the Alaska GPCI to 1.67.
However, the impact on any specific physician, practitioner or supplier
will be different than the average depending upon on whether the
individual is located in Alaska or an area that would have had a GPCI
that is less than 1.0.
The column labeled ``Impact 11/7/2003'' final rule shows the
impacts from table 27 of the November 7, 2003, final rule (68 FR
63256). The next column shows the impacts from table 7 and an estimate
of the increase in payments due to the GPCI provisions. The percentage
difference between these columns isolates the impact of the MPDIMA
provisions we are adopting in this final rule and are shown in the last
column.
[[Page 1104]]
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[[Page 1105]]
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Table 9 shows the impact on payments for selected high volume
procedures of all of the changes previously discussed. This table shows
the combined impact of the change in the work, practice expense and
malpractice RVUs and the estimated physician fee schedule update on
total payment for the procedure. There are separate columns that show
the change in the facility rates and the non-facility rates. For an
explanation of facility and non-facility practice expense refer to
Sec. 414.22(b)(5)(i). The figures in tables 9 and 10 show the impact
of the RVU changes and the physician fee schedule update but do not
include the impact of the GPCI changes.
[[Page 1106]]
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[[Page 1107]]
[GRAPHIC] [TIFF OMITTED] TR06JA04.012
[[Page 1108]]
The next table shows the change in payments from 2003 to 2004 for
selected high volume drug administration services. This table shows the
impact of the increases in the physician work and practice expense
RVUs, the 1.5 percent increase in the physician fee schedule conversion
factor and the additional 32 percent ``transition adjustment'' required
by section 303(a)(4) of MPDIMA in 2004.
[GRAPHIC] [TIFF OMITTED] TR06JA04.013
Table 11 shows the combined impact of changes we are making to
Medicare drug and physician fee schedule payments on selected
specialties/medical suppliers that receive a significant portion of
their total Medicare revenues from drugs. These figures do not include
the impact of the legislated increases in the GPCI. The table shows the
amount and proportion of total Medicare revenues received from drugs
and physician fee schedule services (DME fee schedule services for DME/
Other Medical Suppliers). We note that these impacts and percentages
represent averages for each specialty or supplier. The percentages and
impacts for any individual physician or DME supplier are dependent on
the mix of drugs and physician fee schedule services they provide to
Medicare beneficiaries. These tables are intended to illustrate the
combined payment impact in a single year across all of the services
that these specialties or suppliers perform using the most recent data
available to us. The first two columns of table 11 list the specialty
and its combined Medicare revenues from all sources. The next three
columns show estimated total Medicare drug revenues, the proportion of
total revenues represented by drugs and the percent change in Medicare
drug payments estimated in the first year. The revenue reduction shown
includes the effect of limiting decreases in drug payments to 15
percent, the maximum reduction allowed in 2004 consistent with section
1842(o)(4)(D) of the Act (as added by section 303(b) of MPDIMA). The
following three columns show analogous information for physician fee
schedule services. The last column shows the combined percentage change
across all Medicare revenues. For example, as indicated in the table,
approximately 77 percent of total Medicare revenues for oncologists are
attributed to drugs. As indicated in the next column, we estimate that
Medicare revenues from drugs will decline by approximately 12 percent
for oncologists as a result of policies adopted in this interim final
rule or about $510 million. We are increasing oncology physician fee
schedule payments by 47 percent in this interim final rule or about
$510 million. We estimated that the one-year decrease in drug payments
and increase in physician fee schedule payments resulting from this
final rule will produce virtually no net change in total Medicare
payments for oncologists.
For DME/Other Medical Suppliers, 42 and 58 percent of Medicare
revenues respectively are received from drugs and DME fee schedule
services. These suppliers will receive an approximate reduction of 13
percent in their Medicare drug revenues the first year. The total
reduction in payment in one year across all of the services they
provide will be approximately 6 percent.
In general, the other physician specialties receive a smaller share
of their total Medicare revenues from drugs than oncologists. However,
they are also less affected by the payment increases for drug
administration services. Taken together, we estimate a net change in
revenues from the drug and drug administration payment changes for
urology (-4 percent), rheumatology (-2 percent), obstetrics/gynecology
(+1 percent) and infectious disease (+4 percent).
[[Page 1109]]
[GRAPHIC] [TIFF OMITTED] TR06JA04.014
[[Page 1110]]
C. Geographic Practice Cost Indices (GPCIs) Changes
Section 412 of MPDIMA amended section 1848(e)(1) of the Act and
establishes a floor of 1.0 for the work geographic index for any
locality to be used for purposes of payment for services furnished on
or after January 1, 2004, and before January 1, 2007. In addition,
section 602 of MPDIMA further amended 1848 (e)(1) of the Act for
purposes of payment for services furnished in Alaska under the
physician fee schedule on or after January 1, 2004, and before January
1, 2006, and sets the practice expense, malpractice and work indices at
1.67 if such index would otherwise be less than 1.67. The impact of the
MPDIMA provisions on the work GPCI is illustrated in Table 12.
An impact of these legislative changes to the GPCI can also be
demonstrated by a comparison of area geographic adjustment factors
(GAFs). The GAFs are a weighted composite of each area's work, practice
expense, and malpractice expense GPCIs using the national GPCI cost
share weights. While we do not actually use the GAFs in computing the
fee schedule payment for a specific service, they are useful in
comparing overall area costs and payments. The actual effect on payment
for any specific service will deviate from the GAF to the extent that
the service's proportions of work, practice expenses, and malpractice
expense RVUs differ from those of the GAF. Table 13 shows the effects
of the legislative revisions to the GPCIs on area GAFs for 2004. As
directed by the legislation no locality will have a work GPCI of less
than 1.00 and the work, practice expense and malpractice GPCIs for
Alaska are set at 1.67. Tables 12 and 13 are sorted by decreasing
percent change in work GPCI and GAF respectively.
[[Page 1111]]
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[[Page 1112]]
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[[Page 1113]]
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[[Page 1114]]
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[[Page 1115]]
[GRAPHIC] [TIFF OMITTED] TR06JA04.019
BILLING CODE 4120-01-C
We estimate the cost of the provisions affecting the GPCI will
increase Medicare spending by 0.2 billion in FY 2004.
E. Alternatives Considered
For the most part, this interim final implements prescriptive
provisions of MPDIMA and the statute does not permit us to exercise our
discretion. Nevertheless, the preamble identifies ancillary policies
and rationale for our decisions.
For instance, the statutory provisions requiring changes to
Medicare's payments for drugs were prescriptive. We did not consider
any alternatives because of the clear direction in the statute to
determine Medicare prices for drugs in 2004. Similarly, the provisions
of the statute with respect to the GPCI were also prescriptive and did
not allow for us to consider any alternatives. While we considered
using the formula contained in section 1848(d)(4) of the Act to update
the physician fee schedule conversion factor, its application would
result in a reduction of 4.5 percent and would be inconsistent with the
MPDIMA provision requiring an update to the physician fee schedule
conversion factor for 2004 of not less than 1.5 percent. With respect
to the provisions of this final rule that require changes to Medicare
payments for the administration of drugs, we generally did not find
that the statute permitted discretion. Nevertheless, earlier in the
preamble of this final rule, we provided detailed descriptions of the
statutory provisions and its requirements and, where possible, of the
alternatives we considered.
F. Impact on Beneficiaries
Although changes in physicians' payments were large when the
physician fee schedule was implemented in 1992, we detected no problems
with beneficiary access to care. We do not believe that there would be
any problem with access to care as a result of the changes in this
rule. For the most part, we are increasing payments for physicians fee
schedule services that otherwise would be reduced. We don't believe the
drug payment changes will have an impact on beneficiary access to
services but we will continue to monitor this issue.
We estimate that beneficiary liability will increase in CY 2004 by
$1.0 billion for the physician fee schedule provisions relative to
current law. Payment changes we are making in this final rule for drug
administration will increase beneficiary liability. However, we
estimate that the provisions that change Medicare's drug payments to
oncologists (section 303 of MPDIMA), other physicians (section 304 of
MPDIMA) and inhalation drugs (section 305 of MPDIMA) will offset the
additional beneficiary liability for drug administration. We estimate
that the net effect of changes to payment for drugs and drug
administration will result in savings to beneficiaries of approximately
$100 million in CY 2004.
In accordance with the provisions of Executive Order 12866, this
regulation was reviewed by the Office of Management and Budget.
List of Subjects
42 CFR Part 405
Administrative practice and procedure, Health facilities, Health
professions, Kidney diseases, Medical devices, Medicare, Reporting and
recordkeeping requirements, Rural areas, X-rays.
42 CFR Part 414
Administrative practice and procedure, Health facilities, Health
professions, Kidney diseases, Medicare, Reporting and recordkeeping
requirements, Rural areas, X-rays.
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare--Supplementary Medical Insurance Program.)
[[Page 1116]]
Dated: December 15, 2003.
Thomas A Scully,
Administrator, Centers for Medicare & Medicaid Services.
Approved: December 24, 2003.
Tommy G. Thompson,
Secretary.
For the reasons set forth in the preamble, the Centers for Medicare
& Medicaid Services amends 42 CFR chapter IV as follows:
PART 405--FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED
0
1. The authority citation for part 405 continues to read as follows:
Authority: Secs. 1102, 1802, and 1871 of the Social Security Act
(42 U.S.C. 1302, 1395a, and 1395hh).
0
2. Section 405.400 is amended by revising the definition of
``physician'' to read as follows:
Sec. 405.400 Definitions.
* * * * *
Physician means a doctor of medicine; doctor of osteopathy; doctor
of dental surgery or of dental medicine; doctor of podiatric medicine;
or doctor of optometry who is legally authorized to practice medicine,
osteopathy, dental surgery, dental medicine, podiatric medicine, or
optometry by the State in which he performs such function and who is
acting within the scope of his license when he performs such functions.
* * * * *
0
3. Section 405.517 is amended by--
0
A. Redesignating the text of paragraph (a) as paragraph (a)(1) and
adding a heading;
0
B. Adding a new paragraph (a)(2).
Sec. 405.517 Payment for drugs and biologicals that are not paid on a
cost or prospective payment basis.
(a) Applicability. (1) Payment for drugs and biologicals before
January 1, 2004. * * *
(2) Payment for drugs and biologicals on or after January 1, 2004.
Effective January 1, 2004, payment for drugs and biologicals that are
not paid on a cost or prospective payment basis are paid in accordance
with Part 414, subpart I of this chapter.
* * * * *
PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
0
4. The authority citation for part 414 continues to read as follows:
Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social
Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).
0
5. The list in Sec. 414.1 is amended by adding a new entry in
numerical order as follows:
Sec. 414.1 Basis and scope.
* * * * *
1842(o)--Rules for payment of certain drugs and biologicals.
* * * * *
0
6. A new subpart I is added to read as follows:
Subpart I--Payment for Drugs and Biologicals
Sec.
414.701 Purpose.
414.704 Definitions.
414.707 Basis of payment.
Sec. 414.701 Purpose.
This subpart implements section 1842(o) of the Social Security Act
by specifying the methodology for determining the payment allowance
limit for drugs and biologicals covered under Part B of Title XVIII of
the Act (hereafter in this subpart referred to as the ``program'') that
are not paid on a cost or prospective payment system basis. Examples of
drugs that are subject to the rules contained in this subpart are:
drugs furnished incident to a physician's service; durable medical
equipment (DME) drugs; separately billable drugs at independent
dialysis facilities not under the ESRD composite rate; statutorily
covered drugs, for example, influenza, pneumococcal and hepatitis
vaccines, antigens, hemophilia blood clotting factor, immunosuppressive
drugs and certain oral anti-cancer drugs.
Sec. 414.704 Definitions.
As used in this subpart, the following definition applies. Drug
refers to both drugs and biologicals.
Sec. 414.707 Basis of payment.
(a) Method of payment. (1) Payment for a drug in calendar year 2004
is based on the lesser of--
(i) The actual charge on the claim for program benefits; or
(ii) 85 percent of the average wholesale price determined as of
April 1, 2003, subject to the exceptions as specified in paragraphs
(a)(2) through (a)(8) of this section.
(2) The payment limits for the following drugs are calculated using
95 percent of the average wholesale price:
(i) Blood clotting factors.
(ii) A drug or biological furnished during 2004 that was not
available for Medicare payment as of April 1, 2003.
(iii) Pneumococcal and influenza vaccines as well as hepatitis B
vaccine that is furnished to individuals at high or intermediate risk
of contracting hepatitis B (as determined by the Secretary).
(iv) A drug or biological furnished during 2004 in connection with
the furnishing of renal dialysis services if separately billed by renal
dialysis facilities.
(3) The payment limits for infusion drugs furnished through a
covered item of durable medical equipment are calculated using 95
percent of the average wholesale price in effect on October 1, 2003.
(4) The payments limits for drugs contained in the following table
are calculated based on the percentages of the average wholesale price
determined as of April 1, 2003 that are specified in the table.
------------------------------------------------------------------------
Percentage
used to
calculate
Drug 2004
payment
limit
------------------------------------------------------------------------
EPOETIN ALFA............................................... 87
LEUPROLIDE ACETATE......................................... 81
GOSERELIN ACETATE.......................................... 80
RITUXIMAB.................................................. 81
PACLITAXEL................................................. 81
DOCETAXEL.................................................. 80
CARBOPLATIN................................................ 81
IRINOTECAN................................................. 80
GEMCITABINE HCL............................................ 80
PAMIDRONATE DISODIUM....................................... 85
DOLASETRON MESYLATE........................................ 80
FILGRASTIM................................................. 81
HYLAN G-F 20............................................... 82
MYCOPHENOLATE MOFETIL...................................... 86
GRANISETRON HCL............................................ 80
ONDANSETRON................................................ 87
VINORELBINE TARTATE........................................ 81
SARGRAMOSTIM............................................... 80
TOPOTECAN.................................................. 84
IPRATROPIUM BROMIDE........................................ 80
ALBUTEROL SULFATE.......................................... 80
IMMUNE GLOBULIN............................................ 80
LEUCOVORIN CALCIUM......................................... 80
DOXORUBICIN HCL............................................ 80
DEXAMETHOSONE SODIUM PHOSPHATE............................. 86
HEPARIN SODIUM LOCK-FLUSH.................................. 80
CROMOLYN SODIUM............................................ 80
ACETYLCYSTEINE............................................. 80
------------------------------------------------------------------------
(5) The payment limits for imiglucerase and alglucerase are
calculated using 94 percent of the average wholesale price determined
as of April 1, 2003.
(6) Exception. The payment limit for a drug otherwise subject to
paragraph (a)(1)(ii) or paragraph (a)(4) of this section may be
calculated using the percentage of the average wholesale price as the
Secretary deems appropriate based on data and information submitted by
the drug manufacturer.
(i) The manufacturer must submit data after October 15, 2003 and
before January 1, 2004.
(ii) The percentage only applies for drugs furnished on or after
April 1, 2004.
[[Page 1117]]
(7) In the case of blood and blood products (other than blood
clotting factors), the payment limits shall be determined in the same
manner as such payment limit was determined on October 1, 2003.
(b) Mandatory assignment. Effective with services furnished on or
after February 1, 2001, payment for any drug covered under Part B of
Medicare may be made on an assignment-related basis only. All billers
must accept the program allowed charge as payment in full and may not
bill nor collect from the beneficiary any amount other than the unmet
Part B deductible and Part B coinsurance amounts, if applicable.
Violations of this requirement may subject the supplier to sanctions,
as provided by the statute (See Sec. 402 of this chapter).
Note: These addenda will not appear in the Code of Federal
Regulations.
Addendum A--Explanation and Use of Addenda B
The addenda on the following pages provide various data
pertaining to the Medicare fee schedule for physicians' services
furnished in 2004. Addendum B contains the RVUs for work, non-
facility practice expense, facility practice expense, and
malpractice expense, and other information for all services included
in the physician fee schedule.
In previous years, we have listed many services in Addendum B
that are not paid under the physician fee schedule. To avoid
publishing as many pages of codes for these services, we are not
including clinical laboratory codes and most alpha-numeric codes
(Healthcare Common Procedure Coding System (HCPCS) codes not
included in CPT) in Addendum B.
Addendum B--2004 Relative Value Units and Related Information Used in
Determining Medicare Payments for 2004
This addendum contains the following information for each CPT
code and alphanumeric HCPCS code, except for alphanumeric codes
beginning with B (enteral and parenteral therapy), E (durable
medical equipment), K (temporary codes for nonphysicians' services
or items), or L (orthotics), and codes for anesthesiology.
1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number
for the service. Alphanumeric HCPCS codes are included at the end of
this addendum.
2. Modifier. A modifier is shown if there is a technical
component (modifier TC) and a professional component (PC) (modifier
-26) for the service. If there is a PC and a TC for the service,
Addendum B contains three entries for the code: One for the global
values (both professional and technical); one for modifier -26 (PC);
and one for modifier TC. The global service is not designated by a
modifier, and physicians must bill using the code without a modifier
if the physician furnishes both the PC and the TC of the service.
Modifier -53 is shown for a discontinued procedure. There will
be RVUs for the code (CPT code 45378) with this modifier.
3. Status indicator. This indicator shows whether the CPT/HCPCS
code is in the physician fee schedule and whether it is separately
payable if the service is covered.
A = Active code. These codes are separately payable under the
fee schedule if covered. There will be RVUs for codes with this
status. The presence of an ``A'' indicator does not mean that
Medicare has made a national decision regarding the coverage of the
service. Carriers remain responsible for coverage decisions in the
absence of a national Medicare policy.
B = Bundled code. Payment for covered services is always bundled
into payment for other services not specified. If RVUs are shown,
they are not used for Medicare payment. If these services are
covered, payment for them is subsumed by the payment for the
services to which they are incident. (An example is a telephone call
from a hospital nurse regarding care of a patient.)
C = Carrier-priced code. Carriers will establish RVUs and
payment amounts for these services, generally on a case-by-case
basis following review of documentation, such as an operative
report.
D = Deleted code. These codes are deleted effective with the
beginning of the calendar year.
E = Excluded from physician fee schedule by regulation. These
codes are for items or services that we chose to exclude from the
physician fee schedule payment by regulation. No RVUs are shown, and
no payment may be made under the physician fee schedule for these
codes. Payment for them, if they are covered, continues under
reasonable charge or other payment procedures.
F = Deleted/discontinued codes. Code not subject to a 90-day
grace period.
G = Code not valid for Medicare purposes. Medicare does not
recognize codes assigned this status. Medicare uses another code for
reporting of, and payment for, these services.
H = Deleted modifier. Either the TC or PC component shown for
the code has been deleted, and the deleted component is shown in the
data base with the H status indicator. (Code subject to a 90-day
grace period.)
I = Not valid for Medicare purposes. Medicare uses another code
for the reporting of, and the payment for these services. (Code NOT
subject to a 90-day grace period.)
N = Noncovered service. These codes are noncovered services.
Medicare payment may not be made for these codes. If RVUs are shown,
they are not used for Medicare payment.
P = Bundled or excluded code. There are no RVUs for these
services. No separate payment should be made for them under the
physician fee schedule.
[sbull] If the item or service is covered as incident to a
physician's service and is furnished on the same day as a
physician's service, payment for it is bundled into the payment for
the physician's service to which it is incident (an example is an
elastic bandage furnished by a physician incident to a physician's
service).
[sbull] If the item or service is covered as other than incident
to a physician's service, it is excluded from the physician fee
schedule (for example, colostomy supplies) and is paid under the
other payment provisions of the Act.
R = Restricted coverage. Special coverage instructions apply. If
the service is covered and no RVUs are shown, it is carrier-priced.
T = Injections. There are RVUs for these services, but they are
only paid if there are no other services payable under the physician
fee schedule billed on the same date by the same provider. If any
other services payable under the physician fee schedule are billed
on the same date by the same provider, these services are bundled
into the service(s) for which payment is made.
X = Exclusion by law. These codes represent an item or service
that is not within the definition of ``physicians' services'' for
physician fee schedule payment purposes. No RVUs are shown for these
codes, and no payment may be made under the physician fee schedule.
(Examples are ambulance services and clinical diagnostic laboratory
services.)
4. Description of code. This is an abbreviated version of the
narrative description of the code.
5. Physician work RVUs. These are the RVUs for the physician
work for this service in 2003. Codes that are not used for Medicare
payment are identified with a ``+.''
6. Non-facility practice expense RVUs. These are the fully
implemented resource-based practice expense RVUs for non-facility
settings.
7. Facility practice expense RVUs. These are the fully
implemented resource-based practice expense RVUs for facility
settings.
8. Malpractice expense RVUs. These are the RVUs for the
malpractice expense for the service for 2004.
9. Non-facility total. This is the sum of the work, fully
implemented non-facility practice expense, and malpractice expense
RVUs.
10. Facility total. This is the sum of the work, fully
implemented facility practice expense, and malpractice expense RVUs.
11. Global period. This indicator shows the number of days in
the global period for the code (0, 10, or 90 days). An explanation
of the alpha codes follows:
MMM = The code describes a service furnished in uncomplicated
maternity cases including antepartum care, delivery, and postpartum
care. The usual global surgical concept does not apply. See the 1999
Physicians' Current Procedural Terminology for specific definitions.
XXX = The global concept does not apply.
YYY = The global period is to be set by the carrier (for
example, unlisted surgery codes).
ZZZ = Code related to another service that is always included in
the global period of the other service. (Note: Physician work and
practice expense are associated with intra service time and in some
instances the post service time.)
--------------------
\1\ CPT codes and descriptions only are copyright 2003 American Medical
Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 2003 American Dental Association. All rights reserved.
\3\ + Indicates RVUs are not used for Medicare payment.
[[Page 1118]]
Addendum B.--Relative Value Units (RVUS) and Related Information
--------------------------------------------------------------------------------------------------------------------------------------------------------
Physician Non- Mal- Non-
CPT\1\ HCPCS\2\ MOD Status Description work facility Facility practice facility Facility Global
RVUs\3\ PE RVUs PE RVUs RVUs total total
--------------------------------------------------------------------------------------------------------------------------------------------------------
0001F............... .............. I Blood pressure, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
measured.
0001T............... .............. C Endovas repr abdo ao 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aneurys.
0002F............... .............. I Tobacco use, smoking, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assess.
0002T............... .............. D endo repair abd aa 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aorto uni.
0003F............... .............. I Tobacco use, non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
smoking.
0003T............... .............. C Cervicography........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0004F............... .............. I Tobacco use txmnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
counseling.
0005F............... .............. I Tobacco use txmnt, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pharmacol.
0005T............... .............. C Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cv art.
0006F............... .............. I Statin therapy, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prescribed.
0006T............... .............. C Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cv art.
0007F............... .............. I Beta-blocker thx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prescribed.
0007T............... .............. C Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cv art.
0008F............... .............. I Ace inhibitor thx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prescribed.
0008T............... .............. C Upper gi endoscopy w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suture.
0009F............... .............. I Assess anginal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
symptom/level.
0009T............... .............. C Endometrial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cryoablation.
0010F............... .............. I Assess anginal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
symptom/level.
0010T............... .............. C Tb test, gamma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
interferon.
0011F............... .............. I Oral antiplat thx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prescribed.
0012T............... .............. C Osteochondral knee 0.00 0.00 0.00 0.00 0.00 0.00 XXX
autograft.
0013T............... .............. C Osteochondral knee 0.00 0.00 0.00 0.00 0.00 0.00 XXX
allograft.
0014T............... .............. C Meniscal transplant, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
knee.
0016T............... .............. C Thermotx choroid vasc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lesion.
0017T............... .............. C Photocoagulat macular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
drusen.
0018T............... .............. C Transcranial magnetic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stimul.
0019T............... .............. I Extracorp shock wave 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tx, ms.
0020T............... .............. C Extracorp shock wave 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tx, ft.
0021T............... .............. C Fetal oximetry, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trnsvag/cerv.
0023T............... .............. C Phenotype drug test, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hiv 1.
0024T............... .............. C Transcath cardiac 0.00 0.00 0.00 0.00 0.00 0.00 XXX
reduction.
0025T............... .............. D Ultrasonic pachymetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0026T............... .............. C Measure remnant 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lipoproteins.
0027T............... .............. C Endoscopic epidural 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lysis.
0028T............... .............. C Dexa body composition 0.00 0.00 0.00 0.00 0.00 0.00 XXX
study.
0029T............... .............. C Magnetic tx for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
incontinence.
0030T............... .............. C Antiprothrombin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
0031T............... .............. C Speculoscopy......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0032T............... .............. C Speculoscopy w/direct 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sample.
0033T............... .............. C Endovasc taa repr 0.00 0.00 0.00 0.00 0.00 0.00 XXX
incl subcl.
0034T............... .............. C Endovasc taa repr w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
subcl.
0035T............... .............. C Insert endovasc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosth, taa.
0036T............... .............. C Endovasc prosth, taa, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
add-on.
0037T............... .............. C Artery transpose/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
endovas taa.
0038T............... .............. C Rad endovasc taa rpr 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/cover.
0039T............... .............. C Rad s/i, endovasc taa 0.00 0.00 0.00 0.00 0.00 0.00 XXX
repair.
0040T............... .............. C Rad s/i, endovasc taa 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosth.
0041T............... .............. C Detect ur infect agnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/cpas.
0042T............... .............. C Ct perfusion w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
contrast, cbf.
0043T............... .............. C Co expired gas 0.00 0.00 0.00 0.00 0.00 0.00 XXX
analysis.
0044T............... .............. C Whole body 0.00 0.00 0.00 0.00 0.00 0.00 XXX
photography.
0045T............... .............. C Whole body 0.00 0.00 0.00 0.00 0.00 0.00 XXX
photography.
0046T............... .............. C Cath lavage, mammary 0.00 0.00 0.00 0.00 0.00 0.00 XXX
duct(s.
0047T............... .............. C Cath lavage, mammary 0.00 0.00 0.00 0.00 0.00 0.00 XXX
duct(s).
0048T............... .............. C Implant ventricular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
0049T............... .............. C External circulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assist.
0050T............... .............. C Removal circulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assist.
0051T............... .............. C Implant total heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX
system.
0052T............... .............. C Replace component 0.00 0.00 0.00 0.00 0.00 0.00 XXX
heart syst.
0053T............... .............. C Replace component 0.00 0.00 0.00 0.00 0.00 0.00 XXX
heart syst.
0054T............... .............. C Bone surgery using 0.00 0.00 0.00 0.00 0.00 0.00 XXX
computer.
0055T............... .............. C Bone surgery using 0.00 0.00 0.00 0.00 0.00 0.00 XXX
computer.
0056T............... .............. C Bone surgery using 0.00 0.00 0.00 0.00 0.00 0.00 XXX
computer.
0057T............... .............. C Uppr gi scope w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thrml txmnt.
0058T............... .............. C Cryopreservation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ovary tiss.
0059T............... .............. C Cryopreservation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oocyte.
0060T............... .............. C Electrical impedance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
scan.
0061T............... .............. C Destruction of tumor, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
breast.
10021............... .............. A Fna w/o image........ 1.27 2.20 0.54 0.08 3.55 1.89 XXX
10022............... .............. A Fna w/image.......... 1.27 2.61 0.42 0.06 3.94 1.75 XXX
10040............... .............. A Acne surgery......... 1.18 1.02 0.68 0.06 2.26 1.92 010
10060............... .............. A Drainage of skin 1.17 1.20 0.94 0.10 2.47 2.21 010
abscess.
10061............... .............. A Drainage of skin 2.40 1.81 1.51 0.21 4.42 4.12 010
abscess.
10080............... .............. A Drainage of pilonidal 1.17 3.13 1.14 0.11 4.41 2.42 010
cyst.
10081............... .............. A Drainage of pilonidal 2.45 4.11 1.51 0.23 6.79 4.19 010
cyst.
[[Page 1119]]
10120............... .............. A Remove foreign body.. 1.22 1.46 0.41 0.12 2.80 1.75 010
10121............... .............. A Remove foreign body.. 2.69 3.33 1.88 0.30 6.32 4.87 010
10140............... .............. A Drainage of hematoma/ 1.53 1.51 0.91 0.18 3.22 2.62 010
fluid.
10160............... .............. A Puncture drainage of 1.20 0.73 0.46 0.13 2.06 1.79 010
lesion.
10180............... .............. A Complex drainage, 2.25 3.25 2.08 0.30 5.80 4.63 010
wound.
11000............... .............. A Debride infected skin 0.60 0.57 0.22 0.06 1.23 0.88 000
11001............... .............. A Debride infected skin 0.30 0.23 0.11 0.02 0.55 0.43 ZZZ
add-on.
11010............... .............. A Debride skin, fx..... 4.19 6.74 2.33 0.54 11.47 7.06 010
11011............... .............. A Debride skin/muscle, 4.94 8.03 2.37 0.64 13.61 7.95 000
fx.
11012............... .............. A Debride skin/muscle/ 6.87 12.01 3.86 1.07 19.95 11.80 000
bone, fx.
11040............... .............. A Debride skin, partial 0.50 0.51 0.21 0.06 1.07 0.77 000
11041............... .............. A Debride skin, full... 0.82 0.65 0.33 0.07 1.54 1.22 000
11042............... .............. A Debride skin/tissue.. 1.12 0.97 0.45 0.11 2.20 1.68 000
11043............... .............. A Debride tissue/muscle 2.38 3.41 2.61 0.29 6.08 5.28 010
11044............... .............. A Debride tissue/muscle/ 3.06 4.50 3.77 0.41 7.97 7.24 010
bone.
11055............... .............. R Trim skin lesion..... 0.43 0.55 0.17 0.02 1.00 0.62 000
11056............... .............. R Trim skin lesions, 2 0.61 0.63 0.24 0.04 1.28 0.89 000
to 4.
11057............... .............. R Trim skin lesions, 0.79 0.73 0.31 0.05 1.57 1.15 000
over 4.
11100............... .............. A Biopsy, skin lesion.. 0.81 1.26 0.37 0.05 2.12 1.23 000
11101............... .............. A Biopsy, skin add-on.. 0.41 0.34 0.19 0.02 0.77 0.62 ZZZ
11200............... .............. A Removal of skin tags. 0.77 1.06 0.77 0.05 1.88 1.59 010
11201............... .............. A Remove skin tags add- 0.29 0.16 0.12 0.02 0.47 0.43 ZZZ
on.
11300............... .............. A Shave skin lesion.... 0.51 1.00 0.22 0.04 1.55 0.77 000
11301............... .............. A Shave skin lesion.... 0.85 1.12 0.37 0.05 2.02 1.27 000
11302............... .............. A Shave skin lesion.... 1.05 1.31 0.46 0.06 2.42 1.57 000
11303............... .............. A Shave skin lesion.... 1.24 1.59 0.52 0.07 2.90 1.83 000
11305............... .............. A Shave skin lesion.... 0.67 0.84 0.27 0.05 1.56 0.99 000
11306............... .............. A Shave skin lesion.... 0.99 1.11 0.41 0.06 2.16 1.46 000
11307............... .............. A Shave skin lesion.... 1.14 1.29 0.49 0.06 2.49 1.69 000
11308............... .............. A Shave skin lesion.... 1.41 1.45 0.59 0.08 2.94 2.08 000
11310............... .............. A Shave skin lesion.... 0.73 1.12 0.33 0.05 1.90 1.11 000
11311............... .............. A Shave skin lesion.... 1.05 1.24 0.48 0.06 2.35 1.59 000
11312............... .............. A Shave skin lesion.... 1.20 1.44 0.55 0.07 2.71 1.82 000
11313............... .............. A Shave skin lesion.... 1.62 1.82 0.72 0.11 3.55 2.45 000
11400............... .............. A Exc tr-ext b9+marg 0.85 2.00 0.89 0.07 2.92 1.81 010
0.5 < cm.
11401............... .............. A Exc tr-ext b9+marg 1.23 2.07 1.03 0.11 3.41 2.37 010
0.6-1 cm.
11402............... .............. A Exc tr-ext b9+marg 1.51 2.25 1.10 0.14 3.90 2.75 010
1.1-2 cm.
11403............... .............. A Exc tr-ext b9+marg 1.79 2.42 1.33 0.19 4.40 3.31 010
2.1-3 cm.
11404............... .............. A Exc tr-ext b9+marg 2.06 2.73 1.41 0.22 5.01 3.69 010
3.1-4 cm.
11406............... .............. A Exc tr-ext b9+marg 2.76 3.10 1.67 0.30 6.16 4.73 010
4.0 cm.
11420............... .............. A Exc h-f-nk-sp b9+marg 0.98 1.77 0.94 0.10 2.85 2.02 010
0.5 <.
11421............... .............. A Exc h-f-nk-sp b9+marg 1.42 2.08 1.12 0.13 3.63 2.67 010
0.6-1.
11422............... .............. A Exc h-f-nk-sp b9+marg 1.63 2.27 1.34 0.17 4.07 3.14 010
1.1-2.
11423............... .............. A Exc h-f-nk-sp b9+marg 2.01 2.61 1.46 0.21 4.83 3.68 010
2.1-3.
11424............... .............. A Exc h-f-nk-sp b9+marg 2.43 2.82 1.61 0.25 5.50 4.29 010
3.1-4.
11426............... .............. A Exc h-f-nk-sp b9+marg 3.77 3.52 2.11 0.41 7.70 6.29 010
4 cm.
11440............... .............. A Exc face-mm b9+marg 1.06 2.28 1.33 0.10 3.44 2.49 010
0.5 < cm.
11441............... .............. A Exc face-mm b9+marg 1.48 2.40 1.51 0.13 4.01 3.12 010
0.6-1 cm.
11442............... .............. A Exc face-mm b9+marg 1.72 2.59 1.58 0.17 4.48 3.47 010
1.1-2 cm.
11443............... .............. A Exc face-mm b9+marg 2.29 2.97 1.83 0.22 5.48 4.34 010
2.1-3 cm.
11444............... .............. A Exc face-mm b9+marg 3.14 3.54 2.19 0.30 6.98 5.63 010
3.1-4 cm.
11446............... .............. A Exc face-mm b9+marg 4.48 4.11 2.78 0.36 8.95 7.62 010
4 cm.
11450............... .............. A Removal, sweat gland 2.73 5.11 2.03 0.31 8.15 5.07 090
lesion.
11451............... .............. A Removal, sweat gland 3.94 6.74 2.56 0.47 11.15 6.97 090
lesion.
11462............... .............. A Removal, sweat gland 2.51 5.20 2.02 0.28 7.99 4.81 090
lesion.
11463............... .............. A Removal, sweat gland 3.94 6.96 2.69 0.48 11.38 7.11 090
lesion.
11470............... .............. A Removal, sweat gland 3.25 5.14 2.27 0.36 8.75 5.88 090
lesion.
11471............... .............. A Removal, sweat gland 4.40 6.85 2.78 0.48 11.73 7.66 090
lesion.
11600............... .............. A Exc tr-ext mlg+marg 1.31 2.65 0.98 0.11 4.07 2.40 010
0.5 < cm.
11601............... .............. A Exc tr-ext mlg+marg 1.80 2.72 1.23 0.14 4.66 3.17 010
0.6-1 cm.
11602............... .............. A Exc tr-ext mlg+marg 1.95 2.86 1.27 0.16 4.97 3.38 010
1.1-2 cm.
11603............... .............. A Exc tr-ext mlg+marg 2.19 3.11 1.33 0.19 5.49 3.71 010
2.1-3 cm.
11604............... .............. A Exc tr-ext mlg+marg 2.40 3.41 1.40 0.22 6.03 4.02 010
3.1-4 cm.
11606............... .............. A Exc tr-ext mlg+marg 3.42 4.11 1.75 0.34 7.87 5.51 010
4 cm.
11620............... .............. A Exc h-f-nk-sp 1.19 2.62 0.96 0.11 3.92 2.26 010
mlg+marg 0.5 <.
11621............... .............. A Exc h-f-nk-sp 1.76 2.73 1.25 0.14 4.63 3.15 010
mlg+marg 0.6-1.
11622............... .............. A Exc h-f-nk-sp 2.09 3.00 1.39 0.18 5.27 3.66 010
mlg+marg 1.1-2.
11623............... .............. A Exc h-f-nk-sp 2.61 3.36 1.59 0.24 6.21 4.44 010
mlg+marg 2.1-3.
11624............... .............. A Exc h-f-nk-sp 3.06 3.79 1.78 0.30 7.15 5.14 010
mlg+marg 3.1-4.
11626............... .............. A Exc h-f-nk-sp mlg+mar 4.29 4.70 2.40 0.42 9.41 7.11 010
4 cm.
11640............... .............. A Exc face-mm 1.35 2.69 1.12 0.12 4.16 2.59 010
malig+marg 0.5 <.
11641............... .............. A Exc face-mm 2.16 3.06 1.54 0.18 5.40 3.88 010
malig+marg 0.6-1.
11642............... .............. A Exc face-mm 2.59 3.44 1.73 0.22 6.25 4.54 010
malig+marg 1.1-2.
11643............... .............. A Exc face-mm 3.10 3.85 1.96 0.29 7.24 5.35 010
malig+marg 2.1-3.
11644............... .............. A Exc face-mm 4.02 4.74 2.47 0.40 9.16 6.89 010
malig+marg 3.1-4.
[[Page 1120]]
11646............... .............. A Exc face-mm mlg+marg 5.94 5.81 3.49 0.55 12.30 9.98 010
4 cm.
11719............... .............. R Trim nail(s)......... 0.17 0.25 0.07 0.01 0.43 0.25 000
11720............... .............. A Debride nail, 1-5.... 0.32 0.34 0.13 0.02 0.68 0.47 000
11721............... .............. A Debride nail, 6 or 0.54 0.43 0.21 0.05 1.02 0.80 000
more.
11730............... .............. A Removal of nail plate 1.13 1.02 0.43 0.11 2.26 1.67 000
11732............... .............. A Remove nail plate, 0.57 0.43 0.22 0.06 1.06 0.85 ZZZ
add-on.
11740............... .............. A Drain blood from 0.37 0.85 0.14 0.04 1.26 0.55 000
under nail.
11750............... .............. A Removal of nail bed.. 1.86 2.13 1.72 0.19 4.18 3.77 010
11752............... .............. A Remove nail bed/ 2.67 2.95 2.95 0.40 6.02 6.02 010
finger tip.
11755............... .............. A Biopsy, nail unit.... 1.31 1.10 0.54 0.07 2.48 1.92 000
11760............... .............. A Repair of nail bed... 1.58 1.84 1.21 0.21 3.63 3.00 010
11762............... .............. A Reconstruction of 2.89 2.27 1.83 0.39 5.55 5.11 010
nail bed.
11765............... .............. A Excision of nail 0.69 1.14 0.52 0.06 1.89 1.27 010
fold, toe.
11770............... .............. A Removal of pilonidal 2.61 3.52 1.51 0.29 6.42 4.41 010
lesion.
11771............... .............. A Removal of pilonidal 5.73 5.70 3.33 0.68 12.11 9.74 090
lesion.
11772............... .............. A Removal of pilonidal 6.97 7.17 3.87 0.82 14.96 11.66 090
lesion.
11900............... .............. A Injection into skin 0.52 0.65 0.22 0.02 1.19 0.76 000
lesions.
11901............... .............. A Added skin lesions 0.80 0.66 0.36 0.04 1.50 1.20 000
injection.
11920............... .............. R Correct skin color 1.61 1.99 0.78 0.21 3.81 2.60 000
defects.
11921............... .............. R Correct skin color 1.93 2.36 0.98 0.25 4.54 3.16 000
defects.
11922............... .............. R Correct skin color 0.49 0.37 0.25 0.06 0.92 0.80 ZZZ
defects.
11950............... .............. R Therapy for contour 0.84 1.15 0.40 0.07 2.06 1.31 000
defects.
11951............... .............. R Therapy for contour 1.19 1.50 0.51 0.12 2.81 1.82 000
defects.
11952............... .............. R Therapy for contour 1.69 1.87 0.68 0.21 3.77 2.58 000
defects.
11954............... .............. R Therapy for contour 1.85 2.44 0.91 0.23 4.52 2.99 000
defects.
11960............... .............. A Insert tissue 9.07 NA 10.52 1.06 NA 20.65 090
expander(s).
11970............... .............. A Replace tissue 7.05 NA 6.10 0.93 NA 14.08 090
expander.
11971............... .............. A Remove tissue 2.13 7.10 4.76 0.25 9.48 7.14 090
expander(s).
11975............... .............. N Insert contraceptive +1.48 1.42 0.57 0.17 3.07 2.22 XXX
cap.
11976............... .............. R Removal of 1.78 1.70 0.68 0.21 3.69 2.67 000
contraceptive cap.
11977............... .............. N Removal/reinsert +3.30 2.27 1.26 0.37 5.94 4.93 XXX
contra cap.
11980............... .............. A Implant hormone 1.48 1.10 0.54 0.12 2.70 2.14 000
pellet(s).
11981............... .............. A Insert drug implant 1.48 1.74 0.68 0.17 3.39 2.33 XXX
device.
11982............... .............. A Remove drug implant 1.78 1.97 0.84 0.21 3.96 2.83 XXX
device.
11983............... .............. A Remove/insert drug 3.30 2.32 1.47 0.37 5.99 5.14 XXX
implant.
12001............... .............. A Repair superficial 1.70 2.00 0.49 0.16 3.86 2.35 010
wound(s).
12002............... .............. A Repair superficial 1.86 2.06 0.93 0.18 4.10 2.97 010
wound(s).
12004............... .............. A Repair superficial 2.24 2.36 1.05 0.21 4.81 3.50 010
wound(s).
12005............... .............. A Repair superficial 2.86 2.85 1.23 0.28 5.99 4.37 010
wound(s).
12006............... .............. A Repair superficial 3.66 3.43 1.54 0.37 7.46 5.57 010
wound(s).
12007............... .............. A Repair superficial 4.11 3.86 1.84 0.45 8.42 6.40 010
wound(s).
12011............... .............. A Repair superficial 1.76 2.16 0.50 0.17 4.09 2.43 010
wound(s).
12013............... .............. A Repair superficial 1.99 2.31 0.97 0.19 4.49 3.15 010
wound(s).
12014............... .............. A Repair superficial 2.46 2.61 1.09 0.22 5.29 3.77 010
wound(s).
12015............... .............. A Repair superficial 3.19 3.19 1.28 0.29 6.67 4.76 010
wound(s).
12016............... .............. A Repair superficial 3.92 3.60 1.56 0.39 7.91 5.87 010
wound(s).
12017............... .............. A Repair superficial 4.70 NA 1.91 0.47 NA 7.08 010
wound(s).
12018............... .............. A Repair superficial 5.52 NA 2.27 0.55 NA 8.34 010
wound(s).
12020............... .............. A Closure of split 2.62 2.65 1.75 0.29 5.56 4.66 010
wound.
12021............... .............. A Closure of split 1.84 1.74 1.41 0.23 3.81 3.48 010
wound.
12031............... .............. A Layer closure of 2.15 2.31 0.81 0.18 4.64 3.14 010
wound(s).
12032............... .............. A Layer closure of 2.47 3.88 1.84 0.18 6.53 4.49 010
wound(s).
12034............... .............. A Layer closure of 2.92 3.17 1.41 0.25 6.34 4.58 010
wound(s).
12035............... .............. A Layer closure of 3.42 5.26 2.18 0.36 9.04 5.96 010
wound(s).
12036............... .............. A Layer closure of 4.04 5.36 2.38 0.49 9.89 6.91 010
wound(s).
12037............... .............. A Layer closure of 4.66 6.41 2.78 0.59 11.66 8.03 010
wound(s).
12041............... .............. A Layer closure of 2.37 2.47 0.87 0.21 5.05 3.45 010
wound(s).
12042............... .............. A Layer closure of 2.74 3.21 1.37 0.21 6.16 4.32 010
wound(s).
12044............... .............. A Layer closure of 3.14 3.20 1.56 0.29 6.63 4.99 010
wound(s).
12045............... .............. A Layer closure of 3.63 3.67 2.17 0.41 7.71 6.21 010
wound(s).
12046............... .............. A Layer closure of 4.24 6.57 2.76 0.48 11.29 7.48 010
wound(s).
12047............... .............. A Layer closure of 4.64 6.42 3.10 0.49 11.55 8.23 010
wound(s).
12051............... .............. A Layer closure of 2.47 3.23 1.36 0.19 5.89 4.02 010
wound(s).
12052............... .............. A Layer closure of 2.77 3.17 1.34 0.21 6.15 4.32 010
wound(s).
12053............... .............. A Layer closure of 3.12 3.22 1.50 0.24 6.58 4.86 010
wound(s).
12054............... .............. A Layer closure of 3.45 3.54 1.60 0.30 7.29 5.35 010
wound(s).
12055............... .............. A Layer closure of 4.42 4.54 2.14 0.42 9.38 6.98 010
wound(s).
12056............... .............. A Layer closure of 5.23 6.76 3.07 0.52 12.51 8.82 010
wound(s).
12057............... .............. A Layer closure of 5.95 6.10 3.76 0.60 12.65 10.31 010
wound(s).
13100............... .............. A Repair of wound or 3.12 3.51 1.78 0.25 6.88 5.15 010
lesion.
13101............... .............. A Repair of wound or 3.91 3.75 2.22 0.27 7.93 6.40 010
lesion.
13102............... .............. A Repair wound/lesion 1.24 0.74 0.57 0.12 2.10 1.93 ZZZ
add-on.
13120............... .............. A Repair of wound or 3.30 3.61 1.82 0.28 7.19 5.40 010
lesion.
13121............... .............. A Repair of wound or 4.32 3.97 2.32 0.30 8.59 6.94 010
lesion.
13122............... .............. A Repair wound/lesion 1.44 0.87 0.63 0.14 2.45 2.21 ZZZ
add-on.
[[Page 1121]]
13131............... .............. A Repair of wound or 3.78 3.88 2.14 0.30 7.96 6.22 010
lesion.
13132............... .............. A Repair of wound or 5.94 4.68 3.17 0.39 11.01 9.50 010
lesion.
13133............... .............. A Repair wound/lesion 2.19 1.19 1.03 0.21 3.59 3.43 ZZZ
add-on.
13150............... .............. A Repair of wound or 3.80 5.50 2.61 0.35 9.65 6.76 010
lesion.
13151............... .............. A Repair of wound or 4.44 5.40 3.03 0.34 10.18 7.81 010
lesion.
13152............... .............. A Repair of wound or 6.32 6.08 3.93 0.46 12.86 10.71 010
lesion.
13153............... .............. A Repair wound/lesion 2.38 1.34 1.14 0.22 3.94 3.74 ZZZ
add-on.
13160............... .............. A Late closure of wound 10.46 NA 7.14 1.44 NA 19.04 090
14000............... .............. A Skin tissue 5.88 8.52 5.12 0.55 14.95 11.55 090
rearrangement.
14001............... .............. A Skin tissue 8.46 9.94 6.59 0.78 19.18 15.83 090
rearrangement.
14020............... .............. A Skin tissue 6.58 9.17 5.99 0.60 16.35 13.17 090
rearrangement.
14021............... .............. A Skin tissue 10.04 10.45 7.74 0.83 21.32 18.61 090
rearrangement.
14040............... .............. A Skin tissue 7.86 8.25 6.86 0.66 16.77 15.38 090
rearrangement.
14041............... .............. A Skin tissue 11.47 10.64 8.68 0.86 22.97 21.01 090
rearrangement.
14060............... .............. A Skin tissue 8.49 9.08 7.69 0.71 18.28 16.89 090
rearrangement.
14061............... .............. A Skin tissue 12.27 11.66 9.51 0.90 24.83 22.68 090
rearrangement.
14300............... .............. A Skin tissue 11.74 11.19 9.17 1.06 23.99 21.97 090
rearrangement.
14350............... .............. A Skin tissue 9.60 NA 7.12 1.31 NA 18.03 090
rearrangement.
15000............... .............. A Skin graft........... 3.99 3.81 2.20 0.45 8.25 6.64 000
15001............... .............. A Skin graft add-on.... 1.00 1.36 0.41 0.13 2.49 1.54 ZZZ
15050............... .............. A Skin pinch graft..... 4.29 5.97 4.74 0.55 10.81 9.58 090
15100............... .............. A Skin split graft..... 9.04 12.63 7.80 1.13 22.80 17.97 090
15101............... .............. A Skin split graft add- 1.72 3.83 1.66 0.22 5.77 3.60 ZZZ
on.
15120............... .............. A Skin split graft..... 9.82 10.78 7.77 1.09 21.69 18.68 090
15121............... .............. A Skin split graft add- 2.67 4.58 1.87 0.33 7.58 4.87 ZZZ
on.
15200............... .............. A Skin full graft...... 8.02 10.71 6.00 0.88 19.61 14.90 090
15201............... .............. A Skin full graft add- 1.32 1.04 0.62 0.17 2.53 2.11 ZZZ
on.
15220............... .............. A Skin full graft...... 7.86 10.59 6.43 0.82 19.27 15.11 090
15221............... .............. A Skin full graft add- 1.19 0.91 0.56 0.14 2.24 1.89 ZZZ
on.
15240............... .............. A Skin full graft...... 9.03 10.15 7.65 0.96 20.14 17.64 090
15241............... .............. A Skin full graft add- 1.86 1.45 0.92 0.21 3.52 2.99 ZZZ
on.
15260............... .............. A Skin full graft...... 10.04 9.88 8.60 0.76 20.68 19.40 090
15261............... .............. A Skin full graft add- 2.23 2.72 1.42 0.21 5.16 3.86 ZZZ
on.
15342............... .............. A Cultured skin graft, 1.00 1.83 0.55 0.11 2.94 1.66 010
25 cm.
15343............... .............. A Culture skn graft 0.25 0.27 0.10 0.02 0.54 0.37 ZZZ
addl 25 cm.
15350............... .............. A Skin homograft....... 3.99 8.22 4.83 0.51 12.72 9.33 090
15351............... .............. A Skin homograft add-on 1.00 0.94 0.39 0.13 2.07 1.52 ZZZ
15400............... .............. A Skin heterograft..... 3.99 4.18 4.10 0.48 8.65 8.57 090
15401............... .............. A Skin heterograft add- 1.00 1.22 0.44 0.13 2.35 1.57 ZZZ
on.
15570............... .............. A Form skin pedicle 9.20 9.17 6.68 1.16 19.53 17.04 090
flap.
15572............... .............. A Form skin pedicle 9.26 8.38 6.25 1.12 18.76 16.63 090
flap.
15574............... .............. A Form skin pedicle 9.87 8.79 6.95 1.11 19.77 17.93 090
flap.
15576............... .............. A Form skin pedicle 8.68 9.39 6.42 0.87 18.94 15.97 090
flap.
15600............... .............. A Skin graft........... 1.91 7.04 2.70 0.23 9.18 4.84 090
15610............... .............. A Skin graft........... 2.42 3.73 3.03 0.30 6.45 5.75 090
15620............... .............. A Skin graft........... 2.94 7.46 3.67 0.34 10.74 6.95 090
15630............... .............. A Skin graft........... 3.27 6.84 3.93 0.34 10.45 7.54 090
15650............... .............. A Transfer skin pedicle 3.96 6.70 4.02 0.43 11.09 8.41 090
flap.
15732............... .............. A Muscle-skin graft, 17.81 18.05 12.22 1.81 37.67 31.84 090
head/neck.
15734............... .............. A Muscle-skin graft, 17.76 17.84 12.34 2.30 37.90 32.40 090
trunk.
15736............... .............. A Muscle-skin graft, 16.25 18.16 11.22 2.15 36.56 29.62 090
arm.
15738............... .............. A Muscle-skin graft, 17.89 17.93 11.74 2.35 38.17 31.98 090
leg.
15740............... .............. A Island pedicle flap 10.23 9.81 7.88 0.75 20.79 18.86 090
graft.
15750............... .............. A Neurovascular pedicle 11.39 NA 9.04 1.40 NA 21.83 090
graft.
15756............... .............. A Free myo/skin flap 35.18 NA 20.69 3.75 NA 59.62 090
microvasc.
15757............... .............. A Free skin flap, 35.18 NA 21.73 4.06 NA 60.97 090
microvasc.
15758............... .............. A Free fascial flap, 35.05 NA 21.72 4.25 NA 61.02 090
microvasc.
15760............... .............. A Composite skin graft. 8.73 9.71 7.02 0.87 19.31 16.62 090
15770............... .............. A Derma-fat-fascia 7.51 NA 6.69 0.94 NA 15.14 090
graft.
15775............... .............. R Hair transplant punch 3.95 2.78 1.32 0.52 7.25 5.79 000
grafts.
15776............... .............. R Hair transplant punch 5.53 5.39 2.81 0.72 11.64 9.06 000
grafts.
15780............... .............. A Abrasion treatment of 7.28 7.07 7.07 0.49 14.84 14.84 090
skin.
15781............... .............. A Abrasion treatment of 4.84 5.35 5.35 0.33 10.52 10.52 090
skin.
15782............... .............. A Abrasion treatment of 4.31 4.30 4.30 0.25 8.86 8.86 090
skin.
15783............... .............. A Abrasion treatment of 4.28 4.92 4.17 0.31 9.51 8.76 090
skin.
15786............... .............. A Abrasion, lesion, 2.03 1.63 1.27 0.13 3.79 3.43 010
single.
15787............... .............. A Abrasion, lesions, 0.33 0.32 0.16 0.02 0.67 0.51 ZZZ
add-on.
15788............... .............. R Chemical peel, face, 2.09 3.34 2.27 0.13 5.56 4.49 090
epiderm.
15789............... .............. R Chemical peel, face, 4.91 6.39 4.91 0.33 11.63 10.15 090
dermal.
15792............... .............. R Chemical peel, 1.86 3.16 2.76 0.12 5.14 4.74 090
nonfacial.
15793............... .............. A Chemical peel, 3.73 NA 4.14 0.21 NA 8.08 090
nonfacial.
15810............... .............. A Salabrasion.......... 4.73 3.87 3.87 0.51 9.11 9.11 090
15811............... .............. A Salabrasion.......... 5.38 6.31 5.52 0.63 12.32 11.53 090
15819............... .............. A Plastic surgery, neck 9.37 NA 7.20 0.93 NA 17.50 090
15820............... .............. A Revision of lower 5.14 6.85 5.34 0.36 12.35 10.84 090
eyelid.
[[Page 1122]]
15821............... .............. A Revision of lower 5.71 7.23 5.52 0.37 13.31 11.60 090
eyelid.
15822............... .............. A Revision of upper 4.44 5.80 4.36 0.27 10.51 9.07 090
eyelid.
15823............... .............. A Revision of upper 7.04 7.79 6.24 0.39 15.22 13.67 090
eyelid.
15824............... .............. R Removal of forehead 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15825............... .............. R Removal of neck 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15826............... .............. R Removal of brow 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15828............... .............. R Removal of face 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15829............... .............. R Removal of skin 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15831............... .............. A Excise excessive skin 12.38 NA 8.22 1.57 NA 22.17 090
tissue.
15832............... .............. A Excise excessive skin 11.57 NA 8.38 1.46 NA 21.41 090
tissue.
15833............... .............. A Excise excessive skin 10.62 NA 8.24 1.41 NA 20.27 090
tissue.
15834............... .............. A Excise excessive skin 10.83 NA 7.71 1.42 NA 19.96 090
tissue.
15835............... .............. A Excise excessive skin 11.65 11.40 7.63 1.36 24.41 20.64 090
tissue.
15836............... .............. A Excise excessive skin 9.33 NA 6.81 1.15 NA 17.29 090
tissue.
15837............... .............. A Excise excessive skin 8.42 7.90 7.00 0.94 17.26 16.36 090
tissue.
15838............... .............. A Excise excessive skin 7.12 NA 6.09 0.70 NA 13.91 090
tissue.
15839............... .............. A Excise excessive skin 9.37 7.84 6.21 1.06 18.27 16.64 090
tissue.
15840............... .............. A Graft for face nerve 13.24 NA 10.05 1.39 NA 24.68 090
palsy.
15841............... .............. A Graft for face nerve 23.23 NA 15.08 3.20 NA 41.51 090
palsy.
15842............... .............. A Flap for face nerve 37.90 NA 23.01 4.81 NA 65.72 090
palsy.
15845............... .............. A Skin and muscle 12.55 NA 9.36 0.96 NA 22.87 090
repair, face.
15850............... .............. B Removal of sutures... +0.78 1.58 0.30 0.05 2.41 1.13 XXX
15851............... .............. A Removal of sutures... 0.86 1.72 0.34 0.06 2.64 1.26 000
15852............... .............. A Dressing change not 0.86 1.87 0.36 0.08 2.81 1.30 000
for burn.
15860............... .............. A Test for blood flow 1.95 1.28 0.79 0.16 3.39 2.90 000
in graft.
15876............... .............. R Suction assisted 0.00 0.00 0.00 0.00 0.00 0.00 000
lipectomy.
15877............... .............. R Suction assisted 0.00 0.00 0.00 0.00 0.00 0.00 000
lipectomy.
15878............... .............. R Suction assisted 0.00 0.00 0.00 0.00 0.00 0.00 000
lipectomy.
15879............... .............. R Suction assisted 0.00 0.00 0.00 0.00 0.00 0.00 000
lipectomy.
15920............... .............. A Removal of tail bone 7.94 NA 5.61 1.00 NA 14.55 090
ulcer.
15922............... .............. A Removal of tail bone 9.89 NA 7.31 1.28 NA 18.48 090
ulcer.
15931............... .............. A Remove sacrum 9.23 NA 5.75 1.15 NA 16.13 090
pressure sore.
15933............... .............. A Remove sacrum 10.83 NA 7.94 1.37 NA 20.14 090
pressure sore.
15934............... .............. A Remove sacrum 12.67 NA 8.15 1.63 NA 22.45 090
pressure sore.
15935............... .............. A Remove sacrum 14.55 NA 10.40 1.88 NA 26.83 090
pressure sore.
15936............... .............. A Remove sacrum 12.36 NA 8.36 1.59 NA 22.31 090
pressure sore.
15937............... .............. A Remove sacrum 14.19 NA 9.96 1.82 NA 25.97 090
pressure sore.
15940............... .............. A Remove hip pressure 9.33 NA 6.23 1.18 NA 16.74 090
sore.
15941............... .............. A Remove hip pressure 11.41 NA 9.58 1.48 NA 22.47 090
sore.
15944............... .............. A Remove hip pressure 11.44 NA 8.70 1.46 NA 21.60 090
sore.
15945............... .............. A Remove hip pressure 12.67 NA 9.74 1.66 NA 24.07 090
sore.
15946............... .............. A Remove hip pressure 21.54 NA 14.41 2.80 NA 38.75 090
sore.
15950............... .............. A Remove thigh pressure 7.53 NA 5.47 0.96 NA 13.96 090
sore.
15951............... .............. A Remove thigh pressure 10.70 NA 7.95 1.37 NA 20.02 090
sore.
15952............... .............. A Remove thigh pressure 11.37 NA 7.83 1.44 NA 20.64 090
sore.
15953............... .............. A Remove thigh pressure 12.61 NA 9.07 1.66 NA 23.34 090
sore.
15956............... .............. A Remove thigh pressure 15.50 NA 10.85 1.98 NA 28.33 090
sore.
15958............... .............. A Remove thigh pressure 15.46 NA 11.13 2.00 NA 28.59 090
sore.
15999............... .............. C Removal of pressure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
sore.
16000............... .............. A Initial treatment of 0.89 0.86 0.27 0.07 1.82 1.23 000
burn(s).
16010............... .............. A Treatment of burn(s). 0.87 0.66 0.63 0.08 1.61 1.58 000
16015............... .............. A Treatment of burn(s). 2.35 NA 1.15 0.27 NA 3.77 000
16020............... .............. A Treatment of burn(s). 0.80 1.31 0.61 0.07 2.18 1.48 000
16025............... .............. A Treatment of burn(s). 1.85 1.79 0.97 0.19 3.83 3.01 000
16030............... .............. A Treatment of burn(s). 2.08 2.20 1.12 0.22 4.50 3.42 000
16035............... .............. A Incision of burn 3.74 NA 1.47 0.43 NA 5.64 090
scab, initi.
16036............... .............. A Escharotomy; add'l 1.50 NA 0.60 0.13 NA 2.23 ZZZ
incision.
17000............... .............. A Destroy benign/premlg 0.60 0.98 0.32 0.04 1.62 0.96 010
lesion.
17003............... .............. A Destroy lesions, 2-14 0.15 0.11 0.07 0.01 0.27 0.23 ZZZ
17004............... .............. A Destroy lesions, 15 2.79 2.32 1.29 0.14 5.25 4.22 010
or more.
17106............... .............. A Destruction of skin 4.58 4.87 3.34 0.34 9.79 8.26 090
lesions.
17107............... .............. A Destruction of skin 9.15 7.52 5.45 0.64 17.31 15.24 090
lesions.
17108............... .............. A Destruction of skin 13.18 9.68 7.68 1.07 23.93 21.93 090
lesions.
17110............... .............. A Destruct lesion, 1-14 0.65 1.63 0.49 0.05 2.33 1.19 010
17111............... .............. A Destruct lesion, 15 0.92 1.68 0.59 0.05 2.65 1.56 010
or more.
17250............... .............. A Chemical cautery, 0.50 1.23 0.35 0.05 1.78 0.90 000
tissue.
17260............... .............. A Destruction of skin 0.91 1.28 0.44 0.05 2.24 1.40 010
lesions.
17261............... .............. A Destruction of skin 1.17 1.62 0.59 0.06 2.85 1.82 010
lesions.
17262............... .............. A Destruction of skin 1.58 1.89 0.78 0.08 3.55 2.44 010
lesions.
17263............... .............. A Destruction of skin 1.79 2.07 0.86 0.10 3.96 2.75 010
lesions.
17264............... .............. A Destruction of skin 1.94 2.23 0.89 0.10 4.27 2.93 010
lesions.
17266............... .............. A Destruction of skin 2.34 2.53 0.99 0.13 5.00 3.46 010
lesions.
17270............... .............. A Destruction of skin 1.32 1.71 0.64 0.07 3.10 2.03 010
lesions.
17271............... .............. A Destruction of skin 1.49 1.79 0.74 0.07 3.35 2.30 010
lesions.
17272............... .............. A Destruction of skin 1.77 2.00 0.88 0.08 3.85 2.73 010
lesions.
[[Page 1123]]
17273............... .............. A Destruction of skin 2.05 2.21 0.99 0.11 4.37 3.15 010
lesions.
17274............... .............. A Destruction of skin 2.59 2.58 1.20 0.13 5.30 3.92 010
lesions.
17276............... .............. A Destruction of skin 3.20 2.97 1.44 0.18 6.35 4.82 010
lesions.
17280............... .............. A Destruction of skin 1.17 1.62 0.57 0.06 2.85 1.80 010
lesions.
17281............... .............. A Destruction of skin 1.72 1.91 0.86 0.08 3.71 2.66 010
lesions.
17282............... .............. A Destruction of skin 2.04 2.17 1.01 0.11 4.32 3.16 010
lesions.
17283............... .............. A Destruction of skin 2.64 2.56 1.25 0.13 5.33 4.02 010
lesions.
17284............... .............. A Destruction of skin 3.21 2.94 1.52 0.17 6.32 4.90 010
lesions.
17286............... .............. A Destruction of skin 4.43 3.71 2.19 0.27 8.41 6.89 010
lesions.
17304............... .............. A 1 stage mohs, up to 5 7.59 8.09 3.57 0.37 16.05 11.53 000
spec.
17305............... .............. A 2 stage mohs, up to 5 2.85 3.81 1.34 0.14 6.80 4.33 000
spec.
17306............... .............. A 3 stage mohs, up to 5 2.85 3.83 1.35 0.14 6.82 4.34 000
spec.
17307............... .............. A Mohs addl stage up to 2.85 3.78 1.37 0.14 6.77 4.36 000
5 spec.
17310............... .............. A Mohs any stage 5 spec each.
17340............... .............. A Cryotherapy of skin.. 0.76 0.37 0.31 0.05 1.18 1.12 010
17360............... .............. A Skin peel therapy.... 1.43 1.46 0.75 0.07 2.96 2.25 010
17380............... .............. R Hair removal by 0.00 0.00 0.00 0.00 0.00 0.00 000
electrolysis.
17999............... .............. C Skin tissue procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
19000............... .............. A Drainage of breast 0.84 2.03 0.36 0.08 2.95 1.28 000
lesion.
19001............... .............. A Drain breast lesion 0.42 0.79 0.14 0.04 1.25 0.60 ZZZ
add-on.
19020............... .............. A Incision of breast 3.56 6.00 2.77 0.42 9.98 6.75 090
lesion.
19030............... .............. A Injection for breast 1.53 3.37 0.50 0.08 4.98 2.11 000
x-ray.
19100............... .............. A Bx breast percut w/o 1.27 2.15 0.42 0.12 3.54 1.81 000
image.
19101............... .............. A Biopsy of breast, 3.18 4.69 1.68 0.24 8.11 5.10 010
open.
19102............... .............. A Bx breast percut w/ 2.00 3.98 0.66 0.16 6.14 2.82 000
image.
19103............... .............. A Bx breast percut w/ 3.69 12.07 1.23 0.19 15.95 5.11 000
device.
19110............... .............. A Nipple exploration... 4.29 5.82 3.06 0.53 10.64 7.88 090
19112............... .............. A Excise breast duct 3.66 5.80 2.68 0.46 9.92 6.80 090
fistula.
19120............... .............. A Removal of breast 5.55 4.58 3.08 0.68 10.81 9.31 090
lesion.
19125............... .............. A Excision, breast 6.05 4.83 3.30 0.74 11.62 10.09 090
lesion.
19126............... .............. A Excision, addl breast 2.93 NA 1.01 0.36 NA 4.30 ZZZ
lesion.
19140............... .............. A Removal of breast 5.13 7.29 3.42 0.63 13.05 9.18 090
tissue.
19160............... .............. A Removal of breast 5.98 NA 3.45 0.74 NA 10.17 090
tissue.
19162............... .............. A Remove breast tissue, 13.51 NA 6.38 1.66 NA 21.55 090
nodes.
19180............... .............. A Removal of breast.... 8.79 NA 5.06 1.06 NA 14.91 090
19182............... .............. A Removal of breast.... 7.72 NA 4.81 0.95 NA 13.48 090
19200............... .............. A Removal of breast.... 15.47 NA 8.04 1.82 NA 25.33 090
19220............... .............. A Removal of breast.... 15.70 NA 8.30 1.88 NA 25.88 090
19240............... .............. A Removal of breast.... 15.98 NA 8.28 1.95 NA 26.21 090
19260............... .............. A Removal of chest wall 15.42 NA 11.30 1.98 NA 28.70 090
lesion.
19271............... .............. A Revision of chest 18.87 NA 18.23 2.74 NA 39.84 090
wall.
19272............... .............. A Extensive chest wall 21.52 NA 19.18 3.06 NA 43.76 090
surgery.
19290............... .............. A Place needle wire, 1.27 3.01 0.41 0.07 4.35 1.75 000
breast.
19291............... .............. A Place needle wire, 0.63 1.75 0.21 0.04 2.42 0.88 ZZZ
breast.
19295............... .............. A Place breast clip, 0.00 2.77 NA 0.01 2.78 NA ZZZ
percut.
19316............... .............. A Suspension of breast. 10.67 NA 7.59 1.39 NA 19.65 090
19318............... .............. A Reduction of large 15.60 NA 11.20 2.04 NA 28.84 090
breast.
19324............... .............. A Enlarge breast....... 5.84 NA 4.92 0.76 NA 11.52 090
19325............... .............. A Enlarge breast with 8.44 NA 6.59 1.09 NA 16.12 090
implant.
19328............... .............. A Removal of breast 5.67 NA 5.07 0.74 NA 11.48 090
implant.
19330............... .............. A Removal of implant 7.58 NA 6.07 0.98 NA 14.63 090
material.
19340............... .............. A Immediate breast 6.32 NA 3.12 0.82 NA 10.26 ZZZ
prosthesis.
19342............... .............. A Delayed breast 11.18 NA 8.97 1.46 NA 21.61 090
prosthesis.
19350............... .............. A Breast reconstruction 8.91 14.20 7.11 1.15 24.26 17.17 090
19355............... .............. A Correct inverted 7.56 12.80 5.00 0.96 21.32 13.52 090
nipple(s).
19357............... .............. A Breast reconstruction 18.13 NA 13.85 2.36 NA 34.34 090
19361............... .............. A Breast reconstruction 19.23 NA 11.78 2.51 NA 33.52 090
19364............... .............. A Breast reconstruction 40.94 NA 23.64 4.72 NA 69.30 090
19366............... .............. A Breast reconstruction 21.25 NA 11.23 2.74 NA 35.22 090
19367............... .............. A Breast reconstruction 25.69 NA 16.57 3.35 NA 45.61 090
19368............... .............. A Breast reconstruction 32.37 NA 20.26 4.23 NA 56.86 090
19369............... .............. A Breast reconstruction 29.78 NA 19.79 3.91 NA 53.48 090
19370............... .............. A Surgery of breast 8.04 NA 6.95 1.04 NA 16.03 090
capsule.
19371............... .............. A Removal of breast 9.34 NA 7.87 1.22 NA 18.43 090
capsule.
19380............... .............. A Revise breast 9.13 NA 7.76 1.18 NA 18.07 090
reconstruction.
19396............... .............. A Design custom breast 2.17 5.78 0.99 0.28 8.23 3.44 000
implant.
19499............... .............. C Breast surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
20000............... .............. A Incision of abscess.. 2.12 2.36 1.61 0.21 4.69 3.94 010
20005............... .............. A Incision of deep 3.41 3.34 2.12 0.41 7.16 5.94 010
abscess.
20100............... .............. A Explore wound, neck.. 10.06 5.79 4.38 1.19 17.04 15.63 010
20101............... .............. A Explore wound, chest. 3.22 2.96 1.61 0.29 6.47 5.12 010
20102............... .............. A Explore wound, 3.93 3.51 1.80 0.42 7.86 6.15 010
abdomen.
20103............... .............. A Explore wound, 5.29 4.14 3.23 0.69 10.12 9.21 010
extremity.
20150............... .............. A Excise epiphyseal bar 13.67 NA 7.21 1.16 NA 22.04 090
20200............... .............. A Muscle biopsy........ 1.46 3.19 0.78 0.21 4.86 2.45 000
[[Page 1124]]
20205............... .............. A Deep muscle biopsy... 2.35 4.14 1.21 0.28 6.77 3.84 000
20206............... .............. A Needle biopsy, muscle 0.99 3.17 0.35 0.07 4.23 1.41 000
20220............... .............. A Bone biopsy, trocar/ 1.27 4.73 2.69 0.07 6.07 4.03 000
needle.
20225............... .............. A Bone biopsy, trocar/ 1.87 4.92 2.96 0.13 6.92 4.96 000
needle.
20240............... .............. A Bone biopsy, 3.23 NA 2.60 0.40 NA 6.23 010
excisional.
20245............... .............. A Bone biopsy, 7.77 NA 6.36 0.53 NA 14.66 010
excisional.
20250............... .............. A Open bone biopsy..... 5.02 NA 4.54 0.60 NA 10.16 010
20251............... .............. A Open bone biopsy..... 5.55 NA 5.17 0.95 NA 11.67 010
20500............... .............. A Injection of sinus 1.23 5.88 3.89 0.12 7.23 5.24 010
tract.
20501............... .............. A Inject sinus tract 0.76 3.03 0.25 0.04 3.83 1.05 000
for x-ray.
20520............... .............. A Removal of foreign 1.85 2.25 1.81 0.21 4.31 3.87 010
body.
20525............... .............. A Removal of foreign 3.49 3.43 2.66 0.48 7.40 6.63 010
body.
20526............... .............. A Ther injection, carp 0.94 0.97 0.51 0.07 1.98 1.52 000
tunnel.
20550............... .............. A Inj tendon sheath/ 0.75 0.71 0.24 0.07 1.53 1.06 000
ligament.
20551............... .............. A Inj tendon origin/ 0.75 0.68 0.34 0.07 1.50 1.16 000
insertion.
20552............... .............. A Inj trigger point, 1/ 0.66 0.73 0.21 0.07 1.46 0.94 000
2 muscl.
20553............... .............. A Inject trigger 0.75 0.84 0.23 0.07 1.66 1.05 000
points, =/ 3.
20600............... .............. A Drain/inject, joint/ 0.66 0.64 0.36 0.07 1.37 1.09 000
bursa.
20605............... .............. A Drain/inject, joint/ 0.68 0.75 0.37 0.07 1.50 1.12 000
bursa.
20610............... .............. A Drain/inject, joint/ 0.79 0.94 0.41 0.10 1.83 1.30 000
bursa.
20612............... .............. A Aspirate/inj ganglion 0.70 0.71 0.34 0.07 1.48 1.11 000
cyst.
20615............... .............. A Treatment of bone 2.28 2.54 1.83 0.23 5.05 4.34 010
cyst.
20650............... .............. A Insert and remove 2.23 2.42 1.94 0.34 4.99 4.51 010
bone pin.
20660............... .............. A Apply, rem fixation 2.51 3.07 1.70 0.58 6.16 4.79 000
device.
20661............... .............. A Application of head 4.88 NA 4.95 1.11 NA 10.94 090
brace.
20662............... .............. A Application of pelvis 6.06 NA 5.43 0.98 NA 12.47 090
brace.
20663............... .............. A Application of thigh 5.42 NA 4.76 0.93 NA 11.11 090
brace.
20664............... .............. A Halo brace 8.05 NA 7.03 1.80 NA 16.88 090
application.
20665............... .............. A Removal of fixation 1.31 2.05 1.30 0.21 3.57 2.82 010
device.
20670............... .............. A Removal of support 1.74 6.69 3.93 0.28 8.71 5.95 010
implant.
20680............... .............. A Removal of support 3.34 3.22 3.22 0.55 7.11 7.11 090
implant.
20690............... .............. A Apply bone fixation 3.51 NA 2.47 0.57 NA 6.55 090
device.
20692............... .............. A Apply bone fixation 6.40 NA 3.73 0.72 NA 10.85 090
device.
20693............... .............. A Adjust bone fixation 5.85 NA 5.54 1.03 NA 12.42 090
device.
20694............... .............. A Remove bone fixation 4.15 6.86 4.49 0.69 11.70 9.33 090
device.
20802............... .............. A Replantation, arm, 41.09 NA 21.40 7.01 NA 69.50 090
complete.
20805............... .............. A Replant forearm, 49.93 NA 35.06 4.76 NA 89.75 090
complete.
20808............... .............. A Replantation hand, 61.56 NA 43.43 7.83 NA 112.82 090
complete.
20816............... .............. A Replantation digit, 30.89 NA 39.17 3.63 NA 73.69 090
complete.
20822............... .............. A Replantation digit, 25.55 NA 35.90 3.70 NA 65.15 090
complete.
20824............... .............. A Replantation thumb, 30.89 NA 38.12 4.20 NA 73.21 090
complete.
20827............... .............. A Replantation thumb, 26.37 NA 37.95 3.87 NA 68.19 090
complete.
20838............... .............. A Replantation foot, 41.35 NA 22.70 7.06 NA 71.11 090
complete.
20900............... .............. A Removal of bone for 5.57 7.31 5.79 0.93 13.81 12.29 090
graft.
20902............... .............. A Removal of bone for 7.54 NA 6.86 1.28 NA 15.68 090
graft.
20910............... .............. A Remove cartilage for 5.33 7.11 5.44 0.60 13.04 11.37 090
graft.
20912............... .............. A Remove cartilage for 6.34 NA 6.09 0.66 NA 13.09 090
graft.
20920............... .............. A Removal of fascia for 5.30 NA 4.37 0.65 NA 10.32 090
graft.
20922............... .............. A Removal of fascia for 6.60 6.73 5.06 1.06 14.39 12.72 090
graft.
20924............... .............. A Removal of tendon for 6.47 NA 5.92 0.99 NA 13.38 090
graft.
20926............... .............. A Removal of tissue for 5.52 NA 4.93 0.88 NA 11.33 090
graft.
20930............... .............. B Spinal bone allograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX
20931............... .............. A Spinal bone allograft 1.81 NA 0.93 0.41 NA 3.15 ZZZ
20936............... .............. B Spinal bone autograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX
20937............... .............. A Spinal bone autograft 2.79 NA 1.46 0.52 NA 4.77 ZZZ
20938............... .............. A Spinal bone autograft 3.02 NA 1.56 0.63 NA 5.21 ZZZ
20950............... .............. A Fluid pressure, 1.26 1.36 1.01 0.19 2.81 2.46 000
muscle.
20955............... .............. A Fibula bone graft, 39.15 NA 25.01 5.25 NA 69.41 090
microvasc.
20956............... .............. A Iliac bone graft, 39.21 NA 24.86 6.96 NA 71.03 090
microvasc.
20957............... .............. A Mt bone graft, 40.59 NA 19.08 6.92 NA 66.59 090
microvasc.
20962............... .............. A Other bone graft, 39.21 NA 26.41 6.26 NA 71.88 090
microvasc.
20969............... .............. A Bone/skin graft, 43.85 NA 27.48 5.23 NA 76.56 090
microvasc.
20970............... .............. A Bone/skin graft, 43.00 NA 25.84 5.60 NA 74.44 090
iliac crest.
20972............... .............. A Bone/skin graft, 42.93 21.79 20.14 7.32 72.04 70.39 090
metatarsal.
20973............... .............. A Bone/skin graft, 45.69 NA 25.29 5.61 NA 76.59 090
great toe.
20974............... .............. A Electrical bone 0.62 0.62 0.55 0.11 1.35 1.28 000
stimulation.
20975............... .............. A Electrical bone 2.60 NA 1.73 0.51 NA 4.84 000
stimulation.
20979............... .............. A Us bone stimulation.. 0.62 0.77 0.34 0.05 1.44 1.01 000
20982............... .............. A Ablate, bone tumor(s) 7.27 105.35 2.99 0.69 113.31 10.95 000
perq.
20999............... .............. C Musculoskeletal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
21010............... .............. A Incision of jaw joint 10.12 NA 7.25 0.65 NA 18.02 090
21015............... .............. A Resection of facial 5.28 NA 5.53 0.63 NA 11.44 090
tumor.
21025............... .............. A Excision of bone, 10.04 10.20 8.21 0.95 21.19 19.20 090
lower jaw.
21026............... .............. A Excision of facial 4.84 6.94 5.53 0.48 12.26 10.85 090
bone(s).
21029............... .............. A Contour of face bone 7.70 8.60 6.27 0.89 17.19 14.86 090
lesion.
[[Page 1125]]
21030............... .............. A Excise max/zygoma b9 4.49 6.84 4.31 0.72 12.05 9.52 090
tumor.
21031............... .............. A Remove exostosis, 3.24 4.58 3.14 0.34 8.16 6.72 090
mandible.
21032............... .............. A Remove exostosis, 3.24 4.63 3.25 0.33 8.20 6.82 090
maxilla.
21034............... .............. A Excise max/zygoma mlg 16.15 13.56 11.32 1.65 31.36 29.12 090
tumor.
21040............... .............. A Excise mandible 4.49 6.87 4.14 0.23 11.59 8.86 090
lesion.
21044............... .............. A Removal of jaw bone 11.84 NA 8.68 1.05 NA 21.57 090
lesion.
21045............... .............. A Extensive jaw surgery 16.15 NA 11.43 1.45 NA 29.03 090
21046............... .............. A Remove mandible cyst 12.98 NA 12.69 1.22 NA 26.89 090
complex.
21047............... .............. A Excise lwr jaw cyst w/ 18.72 NA 13.44 1.85 NA 34.01 090
repair.
21048............... .............. A Remove maxilla cyst 13.48 NA 12.97 1.22 NA 27.67 090
complex.
21049............... .............. A Excis uppr jaw cyst w/ 17.97 NA 13.03 1.22 NA 32.22 090
repair.
21050............... .............. A Removal of jaw joint. 10.75 NA 10.26 1.01 NA 22.02 090
21060............... .............. A Remove jaw joint 10.21 NA 9.80 1.40 NA 21.41 090
cartilage.
21070............... .............. A Remove coronoid 8.19 NA 7.03 0.81 NA 16.03 090
process.
21076............... .............. A Prepare face/oral 13.40 12.71 10.17 1.64 27.75 25.21 010
prosthesis.
21077............... .............. A Prepare face/oral 33.70 32.20 26.20 4.14 70.04 64.04 090
prosthesis.
21079............... .............. A Prepare face/oral 22.31 22.21 17.49 1.92 46.44 41.72 090
prosthesis.
21080............... .............. A Prepare face/oral 25.06 25.22 19.77 3.08 53.36 47.91 090
prosthesis.
21081............... .............. A Prepare face/oral 22.85 22.95 17.79 2.26 48.06 42.90 090
prosthesis.
21082............... .............. A Prepare face/oral 20.84 19.88 15.99 1.76 42.48 38.59 090
prosthesis.
21083............... .............. A Prepare face/oral 19.27 19.35 14.73 2.36 40.98 36.36 090
prosthesis.
21084............... .............. A Prepare face/oral 22.48 22.71 17.68 1.89 47.08 42.05 090
prosthesis.
21085............... .............. A Prepare face/oral 8.99 8.52 6.88 0.78 18.29 16.65 010
prosthesis.
21086............... .............. A Prepare face/oral 24.88 24.30 19.60 2.24 51.42 46.72 090
prosthesis.
21087............... .............. A Prepare face/oral 24.88 23.89 19.41 2.68 51.45 46.97 090
prosthesis.
21088............... .............. C Prepare face/oral 0.00 0.00 0.00 0.00 0.00 0.00 090
prosthesis.
21089............... .............. C Prepare face/oral 0.00 0.00 0.00 0.00 0.00 0.00 090
prosthesis.
21100............... .............. A Maxillofacial 4.21 5.62 4.62 0.22 10.05 9.05 090
fixation.
21110............... .............. A Interdental fixation. 5.20 7.02 5.66 0.34 12.56 11.20 090
21116............... .............. A Injection, jaw joint 0.81 7.32 0.34 0.06 8.19 1.21 000
x-ray.
21120............... .............. A Reconstruction of 4.92 8.83 5.30 0.35 14.10 10.57 090
chin.
21121............... .............. A Reconstruction of 7.63 10.43 6.65 0.68 18.74 14.96 090
chin.
21122............... .............. A Reconstruction of 8.51 NA 7.08 0.71 NA 16.30 090
chin.
21123............... .............. A Reconstruction of 11.14 NA 8.26 1.40 NA 20.80 090
chin.
21125............... .............. A Augmentation, lower 10.60 11.82 8.28 0.87 23.29 19.75 090
jaw bone.
21127............... .............. A Augmentation, lower 11.10 14.52 9.11 0.92 26.54 21.13 090
jaw bone.
21137............... .............. A Reduction of forehead 9.81 NA 7.44 0.64 NA 17.89 090
21138............... .............. A Reduction of forehead 12.17 NA 9.31 1.77 NA 23.25 090
21139............... .............. A Reduction of forehead 14.59 NA 9.78 1.23 NA 25.60 090
21141............... .............. A Reconstruct midface, 18.07 NA 13.88 1.97 NA 33.92 090
lefort.
21142............... .............. A Reconstruct midface, 18.78 NA 13.08 1.40 NA 33.26 090
lefort.
21143............... .............. A Reconstruct midface, 19.55 NA 14.09 1.09 NA 34.73 090
lefort.
21145............... .............. A Reconstruct midface, 19.91 NA 14.15 2.52 NA 36.58 090
lefort.
21146............... .............. A Reconstruct midface, 20.68 NA 15.59 2.57 NA 38.84 090
lefort.
21147............... .............. A Reconstruct midface, 21.74 NA 15.29 1.83 NA 38.86 090
lefort.
21150............... .............. A Reconstruct midface, 25.20 NA 14.12 1.31 NA 40.63 090
lefort.
21151............... .............. A Reconstruct midface, 28.26 NA 17.92 2.39 NA 48.57 090
lefort.
21154............... .............. A Reconstruct midface, 30.47 NA 20.18 5.86 NA 56.51 090
lefort.
21155............... .............. A Reconstruct midface, 34.40 NA 22.30 6.61 NA 63.31 090
lefort.
21159............... .............. A Reconstruct midface, 42.32 NA 24.47 8.13 NA 74.92 090
lefort.
21160............... .............. A Reconstruct midface, 46.37 NA 24.41 5.29 NA 76.07 090
lefort.
21172............... .............. A Reconstruct orbit/ 27.76 NA 14.07 2.30 NA 44.13 090
forehead.
21175............... .............. A Reconstruct orbit/ 33.12 NA 18.31 6.22 NA 57.65 090
forehead.
21179............... .............. A Reconstruct entire 22.22 NA 14.86 2.99 NA 40.07 090
forehead.
21180............... .............. A Reconstruct entire 25.15 NA 16.07 2.59 NA 43.81 090
forehead.
21181............... .............. A Contour cranial bone 9.89 NA 7.81 1.17 NA 18.87 090
lesion.
21182............... .............. A Reconstruct cranial 32.14 NA 19.66 3.05 NA 54.85 090
bone.
21183............... .............. A Reconstruct cranial 35.26 NA 21.36 3.32 NA 59.94 090
bone.
21184............... .............. A Reconstruct cranial 38.18 NA 22.55 4.97 NA 65.70 090
bone.
21188............... .............. A Reconstruction of 22.43 NA 15.18 2.23 NA 39.84 090
midface.
21193............... .............. A Reconst lwr jaw w/o 17.12 NA 12.97 1.85 NA 31.94 090
graft.
21194............... .............. A Reconst lwr jaw w/ 19.81 NA 14.06 1.68 NA 35.55 090
graft.
21195............... .............. A Reconst lwr jaw w/o 17.21 NA 13.26 1.45 NA 31.92 090
fixation.
21196............... .............. A Reconst lwr jaw w/ 18.88 NA 13.88 1.95 NA 34.71 090
fixation.
21198............... .............. A Reconstr lwr jaw 14.14 NA 10.90 1.27 NA 26.31 090
segment.
21199............... .............. A Reconstr lwr jaw w/ 15.98 NA 9.19 1.52 NA 26.69 090
advance.
21206............... .............. A Reconstruct upper jaw 14.08 NA 10.81 1.22 NA 26.11 090
bone.
21208............... .............. A Augmentation of 10.21 14.49 9.28 1.11 25.81 20.60 090
facial bones.
21209............... .............. A Reduction of facial 6.71 11.89 7.23 0.72 19.32 14.66 090
bones.
21210............... .............. A Face bone graft...... 10.21 13.69 9.41 1.06 24.96 20.68 090
21215............... .............. A Lower jaw bone graft. 10.75 13.48 9.61 1.25 25.48 21.61 090
21230............... .............. A Rib cartilage graft.. 10.75 NA 8.57 1.16 NA 20.48 090
21235............... .............. A Ear cartilage graft.. 6.71 11.37 7.10 0.63 18.71 14.44 090
21240............... .............. A Reconstruction of jaw 14.03 NA 12.70 1.39 NA 28.12 090
joint.
21242............... .............. A Reconstruction of jaw 12.93 NA 12.21 1.69 NA 26.83 090
joint.
[[Page 1126]]
21243............... .............. A Reconstruction of jaw 20.76 NA 17.87 2.23 NA 40.86 090
joint.
21244............... .............. A Reconstruction of 11.84 NA 10.06 1.15 NA 23.05 090
lower jaw.
21245............... .............. A Reconstruction of jaw 11.84 16.10 9.73 1.06 29.00 22.63 090
21246............... .............. A Reconstruction of jaw 12.45 14.55 9.85 1.46 28.46 23.76 090
21247............... .............. A Reconstruct lower jaw 22.60 NA 17.93 2.67 NA 43.20 090
bone.
21248............... .............. A Reconstruction of jaw 11.46 13.02 9.31 1.22 25.70 21.99 090
21249............... .............. A Reconstruction of jaw 17.49 16.58 12.66 1.68 35.75 31.83 090
21255............... .............. A Reconstruct lower jaw 16.69 NA 12.78 1.36 NA 30.83 090
bone.
21256............... .............. A Reconstruction of 16.17 NA 12.17 1.25 NA 29.59 090
orbit.
21260............... .............. A Revise eye sockets... 16.50 NA 8.96 1.51 NA 26.97 090
21261............... .............. A Revise eye sockets... 31.44 NA 19.21 2.65 NA 53.30 090
21263............... .............. A Revise eye sockets... 28.38 NA 12.86 2.61 NA 43.85 090
21267............... .............. A Revise eye sockets... 18.87 NA 13.22 1.63 NA 33.72 090
21268............... .............. A Revise eye sockets... 24.44 NA 15.32 0.95 NA 40.71 090
21270............... .............. A Augmentation, cheek 10.21 11.90 8.10 0.88 22.99 19.19 090
bone.
21275............... .............. A Revision, 11.22 NA 8.74 1.24 NA 21.20 090
orbitofacial bones.
21280............... .............. A Revision of eyelid... 6.02 NA 6.07 0.33 NA 12.42 090
21282............... .............. A Revision of eyelid... 3.48 NA 4.68 0.25 NA 8.41 090
21295............... .............. A Revision of jaw 1.53 NA 2.82 0.16 NA 4.51 090
muscle/bone.
21296............... .............. A Revision of jaw 4.24 NA 4.43 0.36 NA 9.03 090
muscle/bone.
21299............... .............. C Cranio/maxillofacial 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
21300............... .............. A Treatment of skull 0.72 2.38 0.26 0.11 3.21 1.09 000
fracture.
21310............... .............. A Treatment of nose 0.58 2.34 0.15 0.06 2.98 0.79 000
fracture.
21315............... .............. A Treatment of nose 1.51 3.03 1.27 0.14 4.68 2.92 010
fracture.
21320............... .............. A Treatment of nose 1.85 4.25 1.84 0.18 6.28 3.87 010
fracture.
21325............... .............. A Treatment of nose 3.76 NA 3.75 0.37 NA 7.88 090
fracture.
21330............... .............. A Treatment of nose 5.37 NA 5.28 0.58 NA 11.23 090
fracture.
21335............... .............. A Treatment of nose 8.60 NA 6.81 0.77 NA 16.18 090
fracture.
21336............... .............. A Treat nasal septal 5.71 NA 6.07 0.54 NA 12.32 090
fracture.
21337............... .............. A Treat nasal septal 2.70 5.11 3.69 0.27 8.08 6.66 090
fracture.
21338............... .............. A Treat nasoethmoid 6.45 NA 5.99 0.64 NA 13.08 090
fracture.
21339............... .............. A Treat nasoethmoid 8.08 NA 6.75 0.92 NA 15.75 090
fracture.
21340............... .............. A Treatment of nose 10.75 NA 8.70 1.03 NA 20.48 090
fracture.
21343............... .............. A Treatment of sinus 12.93 NA 10.14 1.28 NA 24.35 090
fracture.
21344............... .............. A Treatment of sinus 19.69 NA 13.71 2.07 NA 35.47 090
fracture.
21345............... .............. A Treat nose/jaw 8.15 11.54 7.90 0.72 20.41 16.77 090
fracture.
21346............... .............. A Treat nose/jaw 10.59 13.18 9.03 1.03 24.80 20.65 090
fracture.
21347............... .............. A Treat nose/jaw 12.67 NA 9.77 1.37 NA 23.81 090
fracture.
21348............... .............. A Treat nose/jaw 16.66 NA 11.31 1.81 NA 29.78 090
fracture.
21355............... .............. A Treat cheek bone 3.76 4.70 2.37 0.35 8.81 6.48 010
fracture.
21356............... .............. A Treat cheek bone 4.14 11.67 3.22 0.43 16.24 7.79 010
fracture.
21360............... .............. A Treat cheek bone 6.45 13.89 6.19 0.63 20.97 13.27 090
fracture.
21365............... .............. A Treat cheek bone 14.93 NA 11.77 1.57 NA 28.27 090
fracture.
21366............... .............. A Treat cheek bone 17.74 NA 11.64 1.70 NA 31.08 090
fracture.
21385............... .............. A Treat eye socket 9.15 NA 7.07 0.77 NA 16.99 090
fracture.
21386............... .............. A Treat eye socket 9.15 NA 7.48 0.92 NA 17.55 090
fracture.
21387............... .............. A Treat eye socket 9.69 NA 7.54 0.94 NA 18.17 090
fracture.
21390............... .............. A Treat eye socket 10.11 NA 8.01 0.84 NA 18.96 090
fracture.
21395............... .............. A Treat eye socket 12.66 NA 9.32 1.31 NA 23.29 090
fracture.
21400............... .............. A Treat eye socket 1.40 3.72 2.10 0.14 5.26 3.64 090
fracture.
21401............... .............. A Treat eye socket 3.26 5.05 3.87 0.41 8.72 7.54 090
fracture.
21406............... .............. A Treat eye socket 7.00 NA 6.35 0.71 NA 14.06 090
fracture.
21407............... .............. A Treat eye socket 8.60 NA 7.14 0.81 NA 16.55 090
fracture.
21408............... .............. A Treat eye socket 12.36 NA 9.21 1.50 NA 23.07 090
fracture.
21421............... .............. A Treat mouth roof 5.13 9.92 6.16 0.51 15.56 11.80 090
fracture.
21422............... .............. A Treat mouth roof 8.31 11.28 7.10 0.83 20.42 16.24 090
fracture.
21423............... .............. A Treat mouth roof 10.38 NA 8.49 1.15 NA 20.02 090
fracture.
21431............... .............. A Treat craniofacial 7.04 10.66 6.84 0.70 18.40 14.58 090
fracture.
21432............... .............. A Treat craniofacial 8.60 NA 6.19 0.66 NA 15.45 090
fracture.
21433............... .............. A Treat craniofacial 25.31 NA 16.83 2.97 NA 45.11 090
fracture.
21435............... .............. A Treat craniofacial 17.22 NA 12.96 2.00 NA 32.18 090
fracture.
21436............... .............. A Treat craniofacial 28.00 NA 18.42 2.80 NA 49.22 090
fracture.
21440............... .............. A Treat dental ridge 2.70 8.05 4.11 0.27 11.02 7.08 090
fracture.
21445............... .............. A Treat dental ridge 5.37 10.45 6.28 0.66 16.48 12.31 090
fracture.
21450............... .............. A Treat lower jaw 2.97 10.65 3.76 0.28 13.90 7.01 090
fracture.
21451............... .............. A Treat lower jaw 4.86 8.77 5.76 0.47 14.10 11.09 090
fracture.
21452............... .............. A Treat lower jaw 1.98 7.85 3.56 0.17 10.00 5.71 090
fracture.
21453............... .............. A Treat lower jaw 5.53 10.50 6.83 0.59 16.62 12.95 090
fracture.
21454............... .............. A Treat lower jaw 6.45 NA 6.54 0.66 NA 13.65 090
fracture.
21461............... .............. A Treat lower jaw 8.08 12.52 8.30 0.88 21.48 17.26 090
fracture.
21462............... .............. A Treat lower jaw 9.78 14.06 9.02 0.96 24.80 19.76 090
fracture.
21465............... .............. A Treat lower jaw 11.89 NA 10.05 1.01 NA 22.95 090
fracture.
21470............... .............. A Treat lower jaw 15.32 NA 12.24 1.64 NA 29.20 090
fracture.
21480............... .............. A Reset dislocated jaw. 0.61 1.95 0.19 0.06 2.62 0.86 000
21485............... .............. A Reset dislocated jaw. 3.98 5.94 4.80 0.37 10.29 9.15 090
[[Page 1127]]
21490............... .............. A Repair dislocated jaw 11.84 NA 9.90 1.58 NA 23.32 090
21493............... .............. A Treat hyoid bone 1.27 NA 2.84 0.12 NA 4.23 090
fracture.
21494............... .............. A Treat hyoid bone 6.27 NA 5.70 0.53 NA 12.50 090
fracture.
21495............... .............. A Treat hyoid bone 5.68 NA 5.99 0.49 NA 12.16 090
fracture.
21497............... .............. A Interdental wiring... 3.85 6.54 5.01 0.37 10.76 9.23 090
21499............... .............. C Head surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
21501............... .............. A Drain neck/chest 3.80 4.70 3.95 0.43 8.93 8.18 090
lesion.
21502............... .............. A Drain chest lesion... 7.11 NA 5.70 0.95 NA 13.76 090
21510............... .............. A Drainage of bone 5.73 NA 5.72 0.81 NA 12.26 090
lesion.
21550............... .............. A Biopsy of neck/chest. 2.06 3.64 1.74 0.16 5.86 3.96 010
21555............... .............. A Remove lesion, neck/ 4.34 5.06 3.17 0.49 9.89 8.00 090
chest.
21556............... .............. A Remove lesion, neck/ 5.56 NA 4.11 0.62 NA 10.29 090
chest.
21557............... .............. A Remove tumor, neck/ 8.87 NA 5.44 1.03 NA 15.34 090
chest.
21600............... .............. A Partial removal of 6.88 NA 5.80 0.98 NA 13.66 090
rib.
21610............... .............. A Partial removal of 14.59 NA 9.04 2.23 NA 25.86 090
rib.
21615............... .............. A Removal of rib....... 9.86 NA 6.73 1.45 NA 18.04 090
21616............... .............. A Removal of rib and 12.02 NA 8.05 1.58 NA 21.65 090
nerves.
21620............... .............. A Partial removal of 6.78 NA 6.07 0.93 NA 13.78 090
sternum.
21627............... .............. A Sternal debridement.. 6.80 NA 6.46 0.99 NA 14.25 090
21630............... .............. A Extensive sternum 17.35 NA 11.99 2.35 NA 31.69 090
surgery.
21632............... .............. A Extensive sternum 18.11 NA 11.18 2.61 NA 31.90 090
surgery.
21685............... .............. A Hyoid myotomy & 12.98 NA 10.09 1.52 NA 24.59 090
suspension.
21700............... .............. A Revision of neck 6.18 6.08 4.86 0.37 12.63 11.41 090
muscle.
21705............... .............. A Revision of neck 9.59 NA 5.63 1.11 NA 16.33 090
muscle/rib.
21720............... .............. A Revision of neck 5.67 5.47 4.64 0.96 12.10 11.27 090
muscle.
21725............... .............. A Revision of neck 6.98 NA 5.52 1.09 NA 13.59 090
muscle.
21740............... .............. A Reconstruction of 16.48 NA 8.60 2.45 NA 27.53 090
sternum.
21742............... .............. C Repair stern/nuss w/o 0.00 0.00 0.00 0.00 0.00 0.00 090
scope.
21743............... .............. C Repair sternum/nuss w/ 0.00 0.00 0.00 0.00 0.00 0.00 090
scope.
21750............... .............. A Repair of sternum 10.75 NA 6.14 1.63 NA 18.52 090
separation.
21800............... .............. A Treatment of rib 0.96 2.10 1.40 0.11 3.17 2.47 090
fracture.
21805............... .............. A Treatment of rib 2.75 NA 3.35 0.35 NA 6.45 090
fracture.
21810............... .............. A Treatment of rib 6.85 NA 5.03 0.72 NA 12.60 090
fracture(s).
21820............... .............. A Treat sternum 1.28 2.63 1.83 0.18 4.09 3.29 090
fracture.
21825............... .............. A Treat sternum 7.40 NA 6.69 1.01 NA 15.10 090
fracture.
21899............... .............. C Neck/chest surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
21920............... .............. A Biopsy soft tissue of 2.06 3.28 1.49 0.14 5.48 3.69 010
back.
21925............... .............. A Biopsy soft tissue of 4.48 6.63 3.35 0.53 11.64 8.36 090
back.
21930............... .............. A Remove lesion, back 4.99 5.48 3.46 0.59 11.06 9.04 090
or flank.
21935............... .............. A Remove tumor, back... 17.93 NA 10.20 2.26 NA 30.39 090
22100............... .............. A Remove part of neck 9.72 NA 7.63 1.87 NA 19.22 090
vertebra.
22101............... .............. A Remove part, thorax 9.80 NA 7.87 1.82 NA 19.49 090
vertebra.
22102............... .............. A Remove part, lumbar 9.80 NA 8.08 1.76 NA 19.64 090
vertebra.
22103............... .............. A Remove extra spine 2.34 NA 1.21 0.45 NA 4.00 ZZZ
segment.
22110............... .............. A Remove part of neck 12.72 NA 9.27 2.65 NA 24.64 090
vertebra.
22112............... .............. A Remove part, thorax 12.79 NA 9.33 2.36 NA 24.48 090
vertebra.
22114............... .............. A Remove part, lumbar 12.79 NA 9.31 2.39 NA 24.49 090
vertebra.
22116............... .............. A Remove extra spine 2.32 NA 1.17 0.48 NA 3.97 ZZZ
segment.
22210............... .............. A Revision of neck 23.78 NA 15.51 5.10 NA 44.39 090
spine.
22212............... .............. A Revision of thorax 19.39 NA 13.27 3.35 NA 36.01 090
spine.
22214............... .............. A Revision of lumbar 19.42 NA 13.78 3.35 NA 36.55 090
spine.
22216............... .............. A Revise, extra spine 6.03 NA 3.14 1.18 NA 10.35 ZZZ
segment.
22220............... .............. A Revision of neck 21.34 NA 13.79 4.40 NA 39.53 090
spine.
22222............... .............. A Revision of thorax 21.49 NA 11.61 3.71 NA 36.81 090
spine.
22224............... .............. A Revision of lumbar 21.49 NA 14.24 3.86 NA 39.59 090
spine.
22226............... .............. A Revise, extra spine 6.03 NA 3.11 1.22 NA 10.36 ZZZ
segment.
22305............... .............. A Treat spine process 2.05 3.19 2.39 0.35 5.59 4.79 090
fracture.
22310............... .............. A Treat spine fracture. 2.61 4.88 4.11 0.45 7.94 7.17 090
22315............... .............. A Treat spine fracture. 8.83 13.42 7.53 1.65 23.90 18.01 090
22318............... .............. A Treat odontoid fx w/o 21.47 NA 13.52 5.14 NA 40.13 090
graft.
22319............... .............. A Treat odontoid fx w/ 23.96 NA 14.90 5.74 NA 44.60 090
graft.
22325............... .............. A Treat spine fracture. 18.27 NA 12.15 3.15 NA 33.57 090
22326............... .............. A Treat neck spine 19.56 NA 12.83 4.27 NA 36.66 090
fracture.
22327............... .............. A Treat thorax spine 19.17 NA 12.44 3.32 NA 34.93 090
fracture.
22328............... .............. A Treat each add spine 4.60 NA 2.28 0.80 NA 7.68 ZZZ
fx.
22505............... .............. A Manipulation of spine 1.87 NA 0.94 0.33 NA 3.14 010
22520............... .............. A Percut vertebroplasty 8.90 101.62 4.34 1.19 111.71 14.43 010
thor.
22521............... .............. A Percut vertebroplasty 8.33 89.47 4.18 1.12 98.92 13.63 010
lumb.
22522............... .............. A Percut vertebroplasty 4.30 NA 1.69 0.40 NA 6.39 ZZZ
add'l.
22532............... .............. A Lat thorax spine 23.96 NA 14.82 4.56 NA 43.34 090
fusion.
22533............... .............. A Lat lumbar spine 23.09 NA 13.48 3.84 NA 40.41 090
fusion.
22534............... .............. A Lat thor/lumb, add'l 5.99 NA 3.04 1.18 NA 10.21 ZZZ
seg.
22548............... .............. A Neck spine fusion.... 25.78 NA 15.83 6.01 NA 47.62 090
22554............... .............. A Neck spine fusion.... 18.59 NA 12.32 4.23 NA 35.14 090
22556............... .............. A Thorax spine fusion.. 23.42 NA 14.68 4.56 NA 42.66 090
[[Page 1128]]
22558............... .............. A Lumbar spine fusion.. 22.25 NA 13.24 3.84 NA 39.33 090
22585............... .............. A Additional spinal 5.52 NA 2.80 1.18 NA 9.50 ZZZ
fusion.
22590............... .............. A Spine & skull spinal 20.48 NA 13.29 4.60 NA 38.37 090
fusion.
22595............... .............. A Neck spinal fusion... 19.36 NA 12.80 4.37 NA 36.53 090
22600............... .............. A Neck spine fusion.... 16.12 NA 11.14 3.49 NA 30.75 090
22610............... .............. A Thorax spine fusion.. 16.00 NA 11.32 3.21 NA 30.53 090
22612............... .............. A Lumbar spine fusion.. 20.97 NA 14.09 3.96 NA 39.02 090
22614............... .............. A Spine fusion, extra 6.43 NA 3.36 1.25 NA 11.04 ZZZ
segment.
22630............... .............. A Lumbar spine fusion.. 20.81 NA 13.55 4.57 NA 38.93 090
22632............... .............. A Spine fusion, extra 5.22 NA 2.67 1.09 NA 8.98 ZZZ
segment.
22800............... .............. A Fusion of spine...... 18.22 NA 12.64 3.27 NA 34.13 090
22802............... .............. A Fusion of spine...... 30.83 NA 19.48 5.33 NA 55.64 090
22804............... .............. A Fusion of spine...... 36.22 NA 22.58 6.31 NA 65.11 090
22808............... .............. A Fusion of spine...... 26.23 NA 16.25 5.26 NA 47.74 090
22810............... .............. A Fusion of spine...... 30.22 NA 18.29 5.42 NA 53.93 090
22812............... .............. A Fusion of spine...... 32.65 NA 19.95 5.63 NA 58.23 090
22818............... .............. A Kyphectomy, 1-2 31.78 NA 18.86 6.04 NA 56.68 090
segments.
22819............... .............. A Kyphectomy, 3 or more 36.39 NA 20.03 6.27 NA 62.69 090
22830............... .............. A Exploration of spinal 10.83 NA 7.89 2.09 NA 20.81 090
fusion.
22840............... .............. A Insert spine fixation 12.52 NA 6.51 2.45 NA 21.48 ZZZ
device.
22841............... .............. B Insert spine fixation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
22842............... .............. A Insert spine fixation 12.56 NA 6.53 2.46 NA 21.55 ZZZ
device.
22843............... .............. A Insert spine fixation 13.44 NA 6.63 2.53 NA 22.60 ZZZ
device.
22844............... .............. A Insert spine fixation 16.42 NA 8.78 2.92 NA 28.12 ZZZ
device.
22845............... .............. A Insert spine fixation 11.94 NA 6.11 2.68 NA 20.73 ZZZ
device.
22846............... .............. A Insert spine fixation 12.40 NA 6.36 2.73 NA 21.49 ZZZ
device.
22847............... .............. A Insert spine fixation 13.78 NA 7.06 2.85 NA 23.69 ZZZ
device.
22848............... .............. A Insert pelv fixation 5.99 NA 3.20 1.06 NA 10.25 ZZZ
device.
22849............... .............. A Reinsert spinal 18.48 NA 11.76 3.46 NA 33.70 090
fixation.
22850............... .............. A Remove spine fixation 9.51 NA 7.00 1.82 NA 18.33 090
device.
22851............... .............. A Apply spine prosth 6.70 NA 3.37 1.34 NA 11.41 ZZZ
device.
22852............... .............. A Remove spine fixation 9.00 NA 6.79 1.69 NA 17.48 090
device.
22855............... .............. A Remove spine fixation 15.11 NA 9.72 3.30 NA 28.13 090
device.
22899............... .............. C Spine surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
22900............... .............. A Remove abdominal wall 5.79 NA 3.28 0.70 NA 9.77 090
lesion.
22999............... .............. C Abdomen surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
23000............... .............. A Removal of calcium 4.35 5.18 4.16 0.60 10.13 9.11 090
deposits.
23020............... .............. A Release shoulder 8.92 NA 7.58 1.48 NA 17.98 090
joint.
23030............... .............. A Drain shoulder lesion 3.42 3.01 2.93 0.51 6.94 6.86 010
23031............... .............. A Drain shoulder bursa. 2.74 2.69 2.69 0.40 5.83 5.83 010
23035............... .............. A Drain shoulder bone 8.60 NA 8.51 1.44 NA 18.55 090
lesion.
23040............... .............. A Exploratory shoulder 9.19 NA 7.85 1.54 NA 18.58 090
surgery.
23044............... .............. A Exploratory shoulder 7.11 NA 6.50 1.17 NA 14.78 090
surgery.
23065............... .............. A Biopsy shoulder 2.27 2.81 1.54 0.17 5.25 3.98 010
tissues.
23066............... .............. A Biopsy shoulder 4.15 5.10 4.07 0.60 9.85 8.82 090
tissues.
23075............... .............. A Removal of shoulder 2.39 2.24 1.82 0.30 4.93 4.51 010
lesion.
23076............... .............. A Removal of shoulder 7.62 NA 5.78 1.05 NA 14.45 090
lesion.
23077............... .............. A Remove tumor of 16.07 NA 10.76 2.18 NA 29.01 090
shoulder.
23100............... .............. A Biopsy of shoulder 6.02 NA 5.69 0.98 NA 12.69 090
joint.
23101............... .............. A Shoulder joint 5.57 NA 5.39 0.93 NA 11.89 090
surgery.
23105............... .............. A Remove shoulder joint 8.22 NA 7.17 1.36 NA 16.75 090
lining.
23106............... .............. A Incision of 5.95 NA 5.77 0.99 NA 12.71 090
collarbone joint.
23107............... .............. A Explore treat 8.61 NA 7.39 1.44 NA 17.44 090
shoulder joint.
23120............... .............. A Partial removal, 7.10 NA 6.48 1.19 NA 14.77 090
collar bone.
23125............... .............. A Removal of collar 9.38 NA 7.63 1.53 NA 18.54 090
bone.
23130............... .............. A Remove shoulder bone, 7.54 NA 7.10 1.28 NA 15.92 090
part.
23140............... .............. A Removal of bone 6.88 NA 5.41 0.99 NA 13.28 090
lesion.
23145............... .............. A Removal of bone 9.08 NA 7.58 1.50 NA 18.16 090
lesion.
23146............... .............. A Removal of bone 7.82 NA 7.13 1.34 NA 16.29 090
lesion.
23150............... .............. A Removal of humerus 8.47 NA 6.97 1.37 NA 16.81 090
lesion.
23155............... .............. A Removal of humerus 10.33 NA 8.46 1.45 NA 20.24 090
lesion.
23156............... .............. A Removal of humerus 8.67 NA 7.38 1.42 NA 17.47 090
lesion.
23170............... .............. A Remove collar bone 6.85 NA 6.36 1.01 NA 14.22 090
lesion.
23172............... .............. A Remove shoulder blade 6.89 NA 6.41 1.15 NA 14.45 090
lesion.
23174............... .............. A Remove humerus lesion 9.50 NA 8.37 1.57 NA 19.44 090
23180............... .............. A Remove collar bone 8.52 NA 9.21 1.42 NA 19.15 090
lesion.
23182............... .............. A Remove shoulder blade 8.14 NA 8.89 1.30 NA 18.33 090
lesion.
23184............... .............. A Remove humerus lesion 9.37 NA 9.54 1.50 NA 20.41 090
23190............... .............. A Partial removal of 7.23 NA 6.23 1.17 NA 14.63 090
scapula.
23195............... .............. A Removal of head of 9.80 NA 7.76 1.66 NA 19.22 090
humerus.
23200............... .............. A Removal of collar 12.06 NA 8.97 1.79 NA 22.82 090
bone.
23210............... .............. A Removal of shoulder 12.47 NA 9.30 1.94 NA 23.71 090
blade.
23220............... .............. A Partial removal of 14.54 NA 10.87 2.45 NA 27.86 090
humerus.
23221............... .............. A Partial removal of 17.71 NA 11.84 3.03 NA 32.58 090
humerus.
23222............... .............. A Partial removal of 23.88 NA 15.85 4.06 NA 43.79 090
humerus.
[[Page 1129]]
23330............... .............. A Remove shoulder 1.85 1.98 1.91 0.22 4.05 3.98 010
foreign body.
23331............... .............. A Remove shoulder 7.37 NA 6.79 1.23 NA 15.39 090
foreign body.
23332............... .............. A Remove shoulder 11.60 NA 9.31 1.95 NA 22.86 090
foreign body.
23350............... .............. A Injection for 1.00 3.85 0.33 0.06 4.91 1.39 000
shoulder x-ray.
23395............... .............. A Muscle 16.82 NA 12.74 2.76 NA 32.32 090
transfer,shoulder/
arm.
23397............... .............. A Muscle transfers..... 16.11 NA 11.40 2.70 NA 30.21 090
23400............... .............. A Fixation of shoulder 13.52 NA 10.16 2.30 NA 25.98 090
blade.
23405............... .............. A Incision of tendon & 8.36 NA 7.01 1.35 NA 16.72 090
muscle.
23406............... .............. A Incise tendon(s) & 10.77 NA 8.41 1.79 NA 20.97 090
muscle(s).
23410............... .............. A Repair rotator cuff, 12.43 NA 9.40 2.07 NA 23.90 090
acute.
23412............... .............. A Repair rotator cuff, 13.29 NA 9.90 2.24 NA 25.43 090
chronic.
23415............... .............. A Release of shoulder 9.96 NA 7.97 1.68 NA 19.61 090
ligament.
23420............... .............. A Repair of shoulder... 13.28 NA 10.78 2.24 NA 26.30 090
23430............... .............. A Repair biceps tendon. 9.97 NA 8.11 1.69 NA 19.77 090
23440............... .............. A Remove/transplant 10.46 NA 8.29 1.77 NA 20.52 090
tendon.
23450............... .............. A Repair shoulder 13.38 NA 9.87 2.24 NA 25.49 090
capsule.
23455............... .............. A Repair shoulder 14.35 NA 10.45 2.42 NA 27.22 090
capsule.
23460............... .............. A Repair shoulder 15.35 NA 11.37 2.62 NA 29.34 090
capsule.
23462............... .............. A Repair shoulder 15.28 NA 10.78 2.61 NA 28.67 090
capsule.
23465............... .............. A Repair shoulder 15.83 NA 11.30 1.94 NA 29.07 090
capsule.
23466............... .............. A Repair shoulder 14.20 NA 11.27 2.41 NA 27.88 090
capsule.
23470............... .............. A Reconstruct shoulder 17.12 NA 12.13 2.89 NA 32.14 090
joint.
23472............... .............. A Reconstruct shoulder 21.07 NA 14.27 2.86 NA 38.20 090
joint.
23480............... .............. A Revision of collar 11.16 NA 8.77 1.88 NA 21.81 090
bone.
23485............... .............. A Revision of collar 13.41 NA 9.91 2.22 NA 25.54 090
bone.
23490............... .............. A Reinforce clavicle... 11.84 NA 8.81 1.34 NA 21.99 090
23491............... .............. A Reinforce shoulder 14.19 NA 10.70 2.41 NA 27.30 090
bones.
23500............... .............. A Treat clavicle 2.08 3.66 2.57 0.31 6.05 4.96 090
fracture.
23505............... .............. A Treat clavicle 3.68 5.33 3.76 0.60 9.61 8.04 090
fracture.
23515............... .............. A Treat clavicle 7.40 NA 6.52 1.24 NA 15.16 090
fracture.
23520............... .............. A Treat clavicle 2.16 3.65 2.71 0.31 6.12 5.18 090
dislocation.
23525............... .............. A Treat clavicle 3.59 5.27 3.88 0.53 9.39 8.00 090
dislocation.
23530............... .............. A Treat clavicle 7.30 NA 6.03 1.03 NA 14.36 090
dislocation.
23532............... .............. A Treat clavicle 8.00 NA 6.92 1.36 NA 16.28 090
dislocation.
23540............... .............. A Treat clavicle 2.23 4.26 2.46 0.29 6.78 4.98 090
dislocation.
23545............... .............. A Treat clavicle 3.25 4.50 3.38 0.47 8.22 7.10 090
dislocation.
23550............... .............. A Treat clavicle 7.23 NA 6.38 1.13 NA 14.74 090
dislocation.
23552............... .............. A Treat clavicle 8.44 NA 7.26 1.42 NA 17.12 090
dislocation.
23570............... .............. A Treat shoulder blade 2.23 3.67 2.87 0.35 6.25 5.45 090
fx.
23575............... .............. A Treat shoulder blade 4.05 5.76 4.24 0.64 10.45 8.93 090
fx.
23585............... .............. A Treat scapula 8.95 NA 7.60 1.51 NA 18.06 090
fracture.
23600............... .............. A Treat humerus 2.93 5.73 3.82 0.47 9.13 7.22 090
fracture.
23605............... .............. A Treat humerus 4.86 6.59 4.96 0.81 12.26 10.63 090
fracture.
23615............... .............. A Treat humerus 9.34 NA 8.69 1.58 NA 19.61 090
fracture.
23616............... .............. A Treat humerus 21.24 NA 14.13 3.59 NA 38.96 090
fracture.
23620............... .............. A Treat humerus 2.40 5.20 3.23 0.39 7.99 6.02 090
fracture.
23625............... .............. A Treat humerus 3.92 6.33 4.56 0.64 10.89 9.12 090
fracture.
23630............... .............. A Treat humerus 7.34 NA 6.59 1.24 NA 15.17 090
fracture.
23650............... .............. A Treat shoulder 3.38 4.69 2.88 0.37 8.44 6.63 090
dislocation.
23655............... .............. A Treat shoulder 4.56 NA 4.16 0.63 NA 9.35 090
dislocation.
23660............... .............. A Treat shoulder 7.48 NA 6.36 1.22 NA 15.06 090
dislocation.
23665............... .............. A Treat islocation/ 4.46 6.58 4.93 0.72 11.76 10.11 090
fracture.
23670............... .............. A Treat dislocation/ 7.89 NA 6.82 1.33 NA 16.04 090
fracture.
23675............... .............. A Treat dislocation/ 6.04 7.56 6.06 1.00 14.60 13.10 090
fracture.
23680............... .............. A Treat dislocation/ 10.04 NA 8.09 1.68 NA 19.81 090
fracture.
23700............... .............. A Fixation of shoulder. 2.52 NA 2.30 0.42 NA 5.24 010
23800............... .............. A Fusion of shoulder 14.14 NA 10.46 2.38 NA 26.98 090
joint.
23802............... .............. A Fusion of shoulder 16.58 NA 10.23 2.82 NA 29.63 090
joint.
23900............... .............. A Amputation of arm & 19.69 NA 11.91 2.98 NA 34.58 090
girdle.
23920............... .............. A Amputation at 14.59 NA 10.09 2.32 NA 27.00 090
shoulder joint.
23921............... .............. A Amputation follow-up 5.48 5.16 5.16 0.94 11.58 11.58 090
surgery.
23929............... .............. C Shoulder surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
23930............... .............. A Drainage of arm 2.94 2.71 2.35 0.39 6.04 5.68 010
lesion.
23931............... .............. A Drainage of arm bursa 1.79 2.43 2.19 0.25 4.47 4.23 010
23935............... .............. A Drain arm/elbow bone 6.08 NA 6.13 1.01 NA 13.22 090
lesion.
24000............... .............. A Exploratory elbow 5.81 NA 5.36 0.93 NA 12.10 090
surgery.
24006............... .............. A Release elbow joint.. 9.30 NA 7.69 1.53 NA 18.52 090
24065............... .............. A Biopsy arm/elbow soft 2.08 2.10 1.78 0.17 4.35 4.03 010
tissue.
24066............... .............. A Biopsy arm/elbow soft 5.20 5.76 4.27 0.74 11.70 10.21 090
tissue.
24075............... .............. A Remove arm/elbow 3.91 5.05 3.67 0.52 9.48 8.10 090
lesion.
24076............... .............. A Remove arm/elbow 6.29 NA 5.09 0.84 NA 12.22 090
lesion.
24077............... .............. A Remove tumor of arm/ 11.74 NA 8.65 1.59 NA 21.98 090
elbow.
24100............... .............. A Biopsy elbow joint 4.92 NA 4.49 0.75 NA 10.16 090
lining.
24101............... .............. A Explore/treat elbow 6.12 NA 5.86 1.01 NA 12.99 090
joint.
24102............... .............. A Remove elbow joint 8.02 NA 6.83 1.31 NA 16.16 090
lining.
[[Page 1130]]
24105............... .............. A Removal of elbow 3.60 NA 4.35 0.59 NA 8.54 090
bursa.
24110............... .............. A Remove humerus lesion 7.38 NA 6.71 1.19 NA 15.28 090
24115............... .............. A Remove/graft bone 9.62 NA 7.35 1.39 NA 18.36 090
lesion.
24116............... .............. A Remove/graft bone 11.79 NA 9.11 2.00 NA 22.90 090
lesion.
24120............... .............. A Remove elbow lesion.. 6.64 NA 5.88 1.05 NA 13.57 090
24125............... .............. A Remove/graft bone 7.88 NA 6.18 1.06 NA 15.12 090
lesion.
24126............... .............. A Remove/graft bone 8.30 NA 6.97 1.09 NA 16.36 090
lesion.
24130............... .............. A Removal of head of 6.24 NA 5.95 1.05 NA 13.24 090
radius.
24134............... .............. A Removal of arm bone 9.72 NA 9.18 1.58 NA 20.48 090
lesion.
24136............... .............. A Remove radius bone 7.98 NA 7.41 1.03 NA 16.42 090
lesion.
24138............... .............. A Remove elbow bone 8.04 NA 7.67 1.35 NA 17.06 090
lesion.
24140............... .............. A Partial removal of 9.17 NA 9.49 1.48 NA 20.14 090
arm bone.
24145............... .............. A Partial removal of 7.57 NA 8.15 1.22 NA 16.94 090
radius.
24147............... .............. A Partial removal of 7.53 NA 8.64 1.25 NA 17.42 090
elbow.
24149............... .............. A Radical resection of 14.18 NA 11.41 2.29 NA 27.88 090
elbow.
24150............... .............. A Extensive humerus 13.25 NA 10.10 2.18 NA 25.53 090
surgery.
24151............... .............. A Extensive humerus 15.56 NA 11.67 2.64 NA 29.87 090
surgery.
24152............... .............. A Extensive radius 10.04 NA 7.85 1.44 NA 19.33 090
surgery.
24153............... .............. A Extensive radius 11.52 NA 5.83 0.77 NA 18.12 090
surgery.
24155............... .............. A Removal of elbow 11.71 NA 8.41 1.71 NA 21.83 090
joint.
24160............... .............. A Remove elbow joint 7.82 NA 6.77 1.29 NA 15.88 090
implant.
24164............... .............. A Remove radius head 6.22 NA 5.66 1.01 NA 12.89 090
implant.
24200............... .............. A Removal of arm 1.76 1.97 1.67 0.18 3.91 3.61 010
foreign body.
24201............... .............. A Removal of arm 4.55 5.68 4.34 0.68 10.91 9.57 090
foreign body.
24220............... .............. A Injection for elbow x- 1.31 10.32 0.44 0.08 11.71 1.83 000
ray.
24300............... .............. A Manipulate elbow w/ 3.74 NA 5.48 0.59 NA 9.81 090
anesth.
24301............... .............. A Muscle/tendon 10.18 NA 8.18 1.57 NA 19.93 090
transfer.
24305............... .............. A Arm tendon 7.44 NA 6.68 1.18 NA 15.30 090
lengthening.
24310............... .............. A Revision of arm 5.97 NA 5.72 0.89 NA 12.58 090
tendon.
24320............... .............. A Repair of arm tendon. 10.54 NA 7.74 1.21 NA 19.49 090
24330............... .............. A Revision of arm 9.59 NA 7.86 1.46 NA 18.91 090
muscles.
24331............... .............. A Revision of arm 10.63 NA 8.60 1.70 NA 20.93 090
muscles.
24332............... .............. A Tenolysis, triceps... 7.44 NA 6.58 0.93 NA 14.95 090
24340............... .............. A Repair of biceps 7.88 NA 6.91 1.30 NA 16.09 090
tendon.
24341............... .............. A Repair arm tendon/ 7.89 NA 7.75 1.30 NA 16.94 090
muscle.
24342............... .............. A Repair of ruptured 10.60 NA 8.46 1.79 NA 20.85 090
tendon.
24343............... .............. A Repr elbow lat ligmnt 8.64 NA 7.93 1.36 NA 17.93 090
w/tiss.
24344............... .............. A Reconstruct elbow lat 13.98 NA 11.31 2.21 NA 27.50 090
ligmnt.
24345............... .............. A Repr elbw med ligmnt 8.64 NA 7.83 1.36 NA 17.83 090
w/tissu.
24346............... .............. A Reconstruct elbow med 13.98 NA 11.17 2.21 NA 27.36 090
ligmnt.
24350............... .............. A Repair of tennis 5.24 NA 5.52 0.87 NA 11.63 090
elbow.
24351............... .............. A Repair of tennis 5.90 NA 5.86 0.99 NA 12.75 090
elbow.
24352............... .............. A Repair of tennis 6.42 NA 6.12 1.09 NA 13.63 090
elbow.
24354............... .............. A Repair of tennis 6.47 NA 6.08 1.06 NA 13.61 090
elbow.
24356............... .............. A Revision of tennis 6.67 NA 6.26 1.09 NA 14.02 090
elbow.
24360............... .............. A Reconstruct elbow 12.32 NA 9.35 2.04 NA 23.71 090
joint.
24361............... .............. A Reconstruct elbow 14.06 NA 10.44 2.35 NA 26.85 090
joint.
24362............... .............. A Reconstruct elbow 14.97 NA 9.97 2.32 NA 27.26 090
joint.
24363............... .............. A Replace elbow joint.. 18.46 NA 13.53 3.04 NA 35.03 090
24365............... .............. A Reconstruct head of 8.38 NA 7.09 1.34 NA 16.81 090
radius.
24366............... .............. A Reconstruct head of 9.12 NA 7.43 1.54 NA 18.09 090
radius.
24400............... .............. A Revision of humerus.. 11.04 NA 8.91 1.85 NA 21.80 090
24410............... .............. A Revision of humerus.. 14.80 NA 10.43 2.28 NA 27.51 090
24420............... .............. A Revision of humerus.. 13.42 NA 10.66 2.20 NA 26.28 090
24430............... .............. A Repair of humerus.... 12.79 NA 9.75 2.17 NA 24.71 090
24435............... .............. A Repair humerus with 13.15 NA 10.83 2.22 NA 26.20 090
graft.
24470............... .............. A Revision of elbow 8.73 NA 7.62 1.48 NA 17.83 090
joint.
24495............... .............. A Decompression of 8.11 NA 9.05 1.11 NA 18.27 090
forearm.
24498............... .............. A Reinforce humerus.... 11.90 NA 9.28 2.01 NA 23.19 090
24500............... .............. A Treat humerus 3.21 5.40 3.61 0.49 9.10 7.31 090
fracture.
24505............... .............. A Treat humerus 5.16 7.29 5.28 0.87 13.32 11.31 090
fracture.
24515............... .............. A Treat humerus 11.63 NA 9.34 1.97 NA 22.94 090
fracture.
24516............... .............. A Treat humerus 11.63 NA 9.11 1.97 NA 22.71 090
fracture.
24530............... .............. A Treat humerus 3.49 5.39 3.94 0.57 9.45 8.00 090
fracture.
24535............... .............. A Treat humerus 6.86 8.39 6.40 1.16 16.41 14.42 090
fracture.
24538............... .............. A Treat humerus 9.42 NA 8.69 1.51 NA 19.62 090
fracture.
24545............... .............. A Treat humerus 10.44 NA 8.42 1.77 NA 20.63 090
fracture.
24546............... .............. A Treat humerus 15.67 NA 11.31 2.63 NA 29.61 090
fracture.
24560............... .............. A Treat humerus 2.80 5.07 3.21 0.42 8.29 6.43 090
fracture.
24565............... .............. A Treat humerus 5.55 7.28 5.40 0.89 13.72 11.84 090
fracture.
24566............... .............. A Treat humerus 7.78 NA 8.11 1.33 NA 17.22 090
fracture.
24575............... .............. A Treat humerus 10.64 NA 8.30 1.74 NA 20.68 090
fracture.
24576............... .............. A Treat humerus 2.86 4.94 3.59 0.46 8.26 6.91 090
fracture.
24577............... .............. A Treat humerus 5.78 7.56 5.69 0.98 14.32 12.45 090
fracture.
24579............... .............. A Treat humerus 11.58 NA 8.83 1.95 NA 22.36 090
fracture.
[[Page 1131]]
24582............... .............. A Treat humerus 8.54 NA 9.01 1.45 NA 19.00 090
fracture.
24586............... .............. A Treat elbow fracture. 15.19 NA 11.11 2.56 NA 28.86 090
24587............... .............. A Treat elbow fracture. 15.14 NA 10.91 2.58 NA 28.63 090
24600............... .............. A Treat elbow 4.22 5.57 3.52 0.59 10.38 8.33 090
dislocation.
24605............... .............. A Treat elbow 5.41 NA 5.25 0.87 NA 11.53 090
dislocation.
24615............... .............. A Treat elbow 9.41 NA 7.73 1.58 NA 18.72 090
dislocation.
24620............... .............. A Treat elbow fracture. 6.97 NA 6.11 1.09 NA 14.17 090
24635............... .............. A Treat elbow fracture. 13.17 NA 14.21 2.22 NA 29.60 090
24640............... .............. A Treat elbow 1.20 1.93 0.87 0.13 3.26 2.20 010
dislocation.
24650............... .............. A Treat radius fracture 2.16 4.55 2.73 0.34 7.05 5.23 090
24655............... .............. A Treat radius fracture 4.39 6.76 4.69 0.70 11.85 9.78 090
24665............... .............. A Treat radius fracture 8.13 NA 7.48 1.36 NA 16.97 090
24666............... .............. A Treat radius fracture 9.48 NA 8.05 1.59 NA 19.12 090
24670............... .............. A Treat ulnar fracture. 2.54 4.44 3.01 0.40 7.38 5.95 090
24675............... .............. A Treat ulnar fracture. 4.71 6.72 4.82 0.78 12.21 10.31 090
24685............... .............. A Treat ulnar fracture. 8.79 NA 7.52 1.48 NA 17.79 090
24800............... .............. A Fusion of elbow joint 11.18 NA 8.71 1.70 NA 21.59 090
24802............... .............. A Fusion/graft of elbow 13.67 NA 10.32 2.28 NA 26.27 090
joint.
24900............... .............. A Amputation of upper 9.59 NA 7.35 1.42 NA 18.36 090
arm.
24920............... .............. A Amputation of upper 9.53 NA 7.52 1.47 NA 18.52 090
arm.
24925............... .............. A Amputation follow-up 7.06 NA 6.27 1.15 NA 14.48 090
surgery.
24930............... .............. A Amputation follow-up 10.23 NA 7.52 1.48 NA 19.23 090
surgery.
24931............... .............. A Amputate upper arm & 12.70 NA 6.11 1.88 NA 20.69 090
implant.
24935............... .............. A Revision of 15.54 NA 8.42 1.91 NA 25.87 090
amputation.
24940............... .............. C Revision of upper arm 0.00 0.00 0.00 0.00 0.00 0.00 090
24999............... .............. C Upper arm/elbow 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
25000............... .............. A Incision of tendon 3.37 NA 6.95 0.54 NA 10.86 090
sheath.
25001............... .............. A Incise flexor carpi 3.37 NA 4.09 0.54 NA 8.00 090
radialis.
25020............... .............. A Decompress forearm 1 5.91 NA 9.94 0.92 NA 16.77 090
space.
25023............... .............. A Decompress forearm 1 12.94 NA 15.45 1.83 NA 30.22 090
space.
25024............... .............. A Decompress forearm 2 9.49 NA 7.52 1.50 NA 18.51 090
spaces.
25025............... .............. A Decompress forearm 2 16.52 NA 10.00 2.63 NA 29.15 090
spaces.
25028............... .............. A Drainage of forearm 5.24 NA 8.48 0.74 NA 14.46 090
lesion.
25031............... .............. A Drainage of forearm 4.13 NA 8.25 0.60 NA 12.98 090
bursa.
25035............... .............. A Treat forearm bone 7.35 NA 14.03 1.18 NA 22.56 090
lesion.
25040............... .............. A Explore/treat wrist 7.17 NA 7.34 1.16 NA 15.67 090
joint.
25065............... .............. A Biopsy forearm soft 1.99 2.79 2.79 0.14 4.92 4.92 010
tissues.
25066............... .............. A Biopsy forearm soft 4.12 NA 7.24 0.59 NA 11.95 090
tissues.
25075............... .............. A Removel forearm 3.73 NA 6.13 0.48 NA 10.34 090
lesion subcu.
25076............... .............. A Removel forearm 4.91 NA 9.98 0.71 NA 15.60 090
lesion deep.
25077............... .............. A Remove tumor, forearm/ 9.75 NA 12.68 1.33 NA 23.76 090
wrist.
25085............... .............. A Incision of wrist 5.49 NA 7.30 0.86 NA 13.65 090
capsule.
25100............... .............. A Biopsy of wrist joint 3.89 NA 5.41 0.60 NA 9.90 090
25101............... .............. A Explore/treat wrist 4.68 NA 5.96 0.72 NA 11.36 090
joint.
25105............... .............. A Remove wrist joint 5.84 NA 7.48 0.93 NA 14.25 090
lining.
25107............... .............. A Remove wrist joint 6.42 NA 8.41 0.99 NA 15.82 090
cartilage.
25110............... .............. A Remove wrist tendon 3.91 NA 7.26 0.58 NA 11.75 090
lesion.
25111............... .............. A Remove wrist tendon 3.38 NA 4.83 0.51 NA 8.72 090
lesion.
25112............... .............. A Reremove wrist tendon 4.52 NA 5.43 0.65 NA 10.60 090
lesion.
25115............... .............. A Remove wrist/forearm 8.81 NA 14.44 1.34 NA 24.59 090
lesion.
25116............... .............. A Remove wrist/forearm 7.10 NA 13.53 1.09 NA 21.72 090
lesion.
25118............... .............. A Excise wrist tendon 4.36 NA 5.88 0.66 NA 10.90 090
sheath.
25119............... .............. A Partial removal of 6.03 NA 7.77 0.96 NA 14.76 090
ulna.
25120............... .............. A Removal of forearm 6.09 NA 12.44 0.98 NA 19.51 090
lesion.
25125............... .............. A Remove/graft forearm 7.47 NA 13.21 1.23 NA 21.91 090
lesion.
25126............... .............. A Remove/graft forearm 7.54 NA 13.31 1.21 NA 22.06 090
lesion.
25130............... .............. A Removal of wrist 5.25 NA 6.51 0.80 NA 12.56 090
lesion.
25135............... .............. A Remove & graft wrist 6.88 NA 7.53 1.07 NA 15.48 090
lesion.
25136............... .............. A Remove & graft wrist 5.96 NA 6.68 0.70 NA 13.34 090
lesion.
25145............... .............. A Remove forearm bone 6.36 NA 12.47 0.99 NA 19.82 090
lesion.
25150............... .............. A Partial removal of 7.08 NA 8.41 1.16 NA 16.65 090
ulna.
25151............... .............. A Partial removal of 7.38 NA 13.08 1.12 NA 21.58 090
radius.
25170............... .............. A Extensive forearm 11.07 NA 15.46 1.83 NA 28.36 090
surgery.
25210............... .............. A Removal of wrist bone 5.94 NA 6.90 0.88 NA 13.72 090
25215............... .............. A Removal of wrist 7.88 NA 8.89 1.23 NA 18.00 090
bones.
25230............... .............. A Partial removal of 5.22 NA 6.22 0.80 NA 12.24 090
radius.
25240............... .............. A Partial removal of 5.16 NA 7.09 0.83 NA 13.08 090
ulna.
25246............... .............. A Injection for wrist x- 1.45 10.05 0.48 0.08 11.58 2.01 000
ray.
25248............... .............. A Remove forearm 5.13 NA 8.75 0.65 NA 14.53 090
foreign body.
25250............... .............. A Removal of wrist 6.59 NA 6.00 1.01 NA 13.60 090
prosthesis.
25251............... .............. A Removal of wrist 9.56 NA 7.82 1.39 NA 18.77 090
prosthesis.
25259............... .............. A Manipulate wrist w/ 3.74 NA 5.48 0.60 NA 9.82 090
anesthes.
25260............... .............. A Repair forearm tendon/ 7.79 NA 13.90 1.17 NA 22.86 090
muscle.
25263............... .............. A Repair forearm tendon/ 7.81 NA 13.81 1.13 NA 22.75 090
muscle.
25265............... .............. A Repair forearm tendon/ 9.87 NA 14.70 1.44 NA 26.01 090
muscle.
[[Page 1132]]
25270............... .............. A Repair forearm tendon/ 5.99 NA 12.60 0.92 NA 19.51 090
muscle.
25272............... .............. A Repair forearm tendon/ 7.03 NA 13.30 1.07 NA 21.40 090
muscle.
25274............... .............. A Repair forearm tendon/ 8.74 NA 14.02 1.37 NA 24.13 090
muscle.
25275............... .............. A Repair forearm tendon 8.49 NA 7.47 1.36 NA 17.32 090
sheath.
25280............... .............. A Revise wrist/forearm 7.21 NA 13.03 1.10 NA 21.34 090
tendon.
25290............... .............. A Incise wrist/forearm 5.28 NA 15.53 0.80 NA 21.61 090
tendon.
25295............... .............. A Release wrist/forearm 6.54 NA 12.59 1.04 NA 20.17 090
tendon.
25300............... .............. A Fusion of tendons at 8.79 NA 8.52 1.29 NA 18.60 090
wrist.
25301............... .............. A Fusion of tendons at 8.39 NA 8.16 1.30 NA 17.85 090
wrist.
25310............... .............. A Transplant forearm 8.13 NA 13.44 1.22 NA 22.79 090
tendon.
25312............... .............. A Transplant forearm 9.56 NA 14.32 1.47 NA 25.35 090
tendon.
25315............... .............. A Revise palsy hand 10.18 NA 14.89 1.52 NA 26.59 090
tendon(s).
25316............... .............. A Revise palsy hand 12.31 NA 16.66 2.10 NA 31.07 090
tendon(s).
25320............... .............. A Repair/revise wrist 10.75 NA 11.21 1.59 NA 23.55 090
joint.
25332............... .............. A Revise wrist joint... 11.39 NA 9.06 1.76 NA 22.21 090
25335............... .............. A Realignment of hand.. 12.86 NA 11.72 2.00 NA 26.58 090
25337............... .............. A Reconstruct ulna/ 10.15 NA 11.07 1.58 NA 22.80 090
radioulnar.
25350............... .............. A Revision of radius... 8.77 NA 14.28 1.41 NA 24.46 090
25355............... .............. A Revision of radius... 10.15 NA 14.90 1.74 NA 26.79 090
25360............... .............. A Revision of ulna..... 8.42 NA 14.17 1.41 NA 24.00 090
25365............... .............. A Revise radius & ulna. 12.38 NA 15.93 2.01 NA 30.32 090
25370............... .............. A Revise radius or ulna 13.34 NA 16.30 2.27 NA 31.91 090
25375............... .............. A Revise radius & ulna. 13.02 NA 16.72 2.22 NA 31.96 090
25390............... .............. A Shorten radius or 10.38 NA 14.91 1.66 NA 26.95 090
ulna.
25391............... .............. A Lengthen radius or 13.63 NA 16.87 2.09 NA 32.59 090
ulna.
25392............... .............. A Shorten radius & ulna 13.93 NA 16.24 2.09 NA 32.26 090
25393............... .............. A Lengthen radius & 15.85 NA 17.88 2.26 NA 35.99 090
ulna.
25394............... .............. A Repair carpal bone, 10.38 NA 8.23 1.69 NA 20.30 090
shorten.
25400............... .............. A Repair radius or ulna 10.90 NA 15.49 1.81 NA 28.20 090
25405............... .............. A Repair/graft radius 14.36 NA 17.58 2.35 NA 34.29 090
or ulna.
25415............... .............. A Repair radius & ulna. 13.33 NA 16.81 2.26 NA 32.40 090
25420............... .............. A Repair/graft radius & 16.31 NA 18.56 2.65 NA 37.52 090
ulna.
25425............... .............. A Repair/graft radius 13.19 NA 22.08 1.94 NA 37.21 090
or ulna.
25426............... .............. A Repair/graft radius & 15.80 NA 17.29 2.69 NA 35.78 090
ulna.
25430............... .............. A Vasc graft into 9.24 NA 7.28 1.29 NA 17.81 090
carpal bone.
25431............... .............. A Repair nonunion 10.42 NA 8.23 0.68 NA 19.33 090
carpal bone.
25440............... .............. A Repair/graft wrist 10.42 NA 9.41 1.70 NA 21.53 090
bone.
25441............... .............. A Reconstruct wrist 12.88 NA 9.88 2.21 NA 24.97 090
joint.
25442............... .............. A Reconstruct wrist 10.83 NA 8.77 1.50 NA 21.10 090
joint.
25443............... .............. A Reconstruct wrist 10.37 NA 8.65 1.57 NA 20.59 090
joint.
25444............... .............. A Reconstruct wrist 11.13 NA 9.07 1.72 NA 21.92 090
joint.
25445............... .............. A Reconstruct wrist 9.68 NA 7.87 1.52 NA 19.07 090
joint.
25446............... .............. A Wrist replacement.... 16.53 NA 11.81 2.65 NA 30.99 090
25447............... .............. A Repair wrist joint(s) 10.35 NA 8.54 1.62 NA 20.51 090
25449............... .............. A Remove wrist joint 14.47 NA 10.57 2.13 NA 27.17 090
implant.
25450............... .............. A Revision of wrist 7.86 NA 10.41 1.06 NA 19.33 090
joint.
25455............... .............. A Revision of wrist 9.48 NA 11.33 1.29 NA 22.10 090
joint.
25490............... .............. A Reinforce radius..... 9.53 NA 14.03 1.44 NA 25.00 090
25491............... .............. A Reinforce ulna....... 9.95 NA 14.79 1.70 NA 26.44 090
25492............... .............. A Reinforce radius and 12.31 NA 15.58 1.95 NA 29.84 090
ulna.
25500............... .............. A Treat fracture of 2.45 3.99 2.71 0.34 6.78 5.50 090
radius.
25505............... .............. A Treat fracture of 5.20 7.22 5.25 0.83 13.25 11.28 090
radius.
25515............... .............. A Treat fracture of 9.17 NA 7.47 1.47 NA 18.11 090
radius.
25520............... .............. A Treat fracture of 6.25 7.44 5.87 1.03 14.72 13.15 090
radius.
25525............... .............. A Treat fracture of 12.22 NA 9.94 2.03 NA 24.19 090
radius.
25526............... .............. A Treat fracture of 12.96 NA 13.59 2.17 NA 28.72 090
radius.
25530............... .............. A Treat fracture of 2.09 4.14 2.80 0.33 6.56 5.22 090
ulna.
25535............... .............. A Treat fracture of 5.13 6.85 5.17 0.82 12.80 11.12 090
ulna.
25545............... .............. A Treat fracture of 8.89 NA 7.65 1.48 NA 18.02 090
ulna.
25560............... .............. A Treat fracture radius 2.44 4.04 2.64 0.33 6.81 5.41 090
& ulna.
25565............... .............. A Treat fracture radius 5.62 7.35 5.32 0.92 13.89 11.86 090
& ulna.
25574............... .............. A Treat fracture radius 7.00 NA 7.13 1.16 NA 15.29 090
& ulna.
25575............... .............. A Treat fracture radius/ 10.43 NA 9.39 1.76 NA 21.58 090
ulna.
25600............... .............. A Treat fracture radius/ 2.63 4.47 2.94 0.41 7.51 5.98 090
ulna.
25605............... .............. A Treat fracture radius/ 5.80 8.03 6.01 0.98 14.81 12.79 090
ulna.
25611............... .............. A Treat fracture radius/ 7.76 NA 8.84 1.30 NA 17.90 090
ulna.
25620............... .............. A Treat fracture radius/ 8.54 NA 7.28 1.41 NA 17.23 090
ulna.
25622............... .............. A Treat wrist bone 2.61 4.64 3.12 0.40 7.65 6.13 090
fracture.
25624............... .............. A Treat wrist bone 4.52 6.98 4.90 0.74 12.24 10.16 090
fracture.
25628............... .............. A Treat wrist bone 8.42 NA 7.81 1.37 NA 17.60 090
fracture.
25630............... .............. A Treat wrist bone 2.88 4.57 2.94 0.45 7.90 6.27 090
fracture.
25635............... .............. A Treat wrist bone 4.38 6.75 3.89 0.47 11.60 8.74 090
fracture.
25645............... .............. A Treat wrist bone 7.24 NA 6.79 1.12 NA 15.15 090
fracture.
25650............... .............. A Treat wrist bone 3.05 4.83 3.22 0.45 8.33 6.72 090
fracture.
25651............... .............. A Pin ulnar styloid 5.35 NA 5.39 0.87 NA 11.61 090
fracture.
[[Page 1133]]
25652............... .............. A Treat fracture ulnar 7.59 NA 6.85 1.23 NA 15.67 090
styloid.
25660............... .............. A Treat wrist 4.75 NA 4.66 0.71 NA 10.12 090
dislocation.
25670............... .............. A Treat wrist 7.91 NA 7.08 1.29 NA 16.28 090
dislocation.
25671............... .............. A Pin radioulnar 5.99 NA 5.98 0.98 NA 12.95 090
dislocation.
25675............... .............. A Treat wrist 4.66 6.49 4.61 0.69 11.84 9.96 090
dislocation.
25676............... .............. A Treat wrist 8.03 NA 7.32 1.33 NA 16.68 090
dislocation.
25680............... .............. A Treat wrist fracture. 5.98 NA 4.75 0.74 NA 11.47 090
25685............... .............. A Treat wrist fracture. 9.77 NA 7.87 1.51 NA 19.15 090
25690............... .............. A Treat wrist 5.49 NA 5.39 0.94 NA 11.82 090
dislocation.
25695............... .............. A Treat wrist 8.33 NA 7.19 1.29 NA 16.81 090
dislocation.
25800............... .............. A Fusion of wrist joint 9.75 NA 9.10 1.57 NA 20.42 090
25805............... .............. A Fusion/graft of wrist 11.26 NA 10.24 1.82 NA 23.32 090
joint.
25810............... .............. A Fusion/graft of wrist 10.55 NA 9.88 1.65 NA 22.08 090
joint.
25820............... .............. A Fusion of hand bones. 7.44 NA 7.88 1.16 NA 16.48 090
25825............... .............. A Fuse hand bones with 9.26 NA 9.22 1.45 NA 19.93 090
graft.
25830............... .............. A Fusion, radioulnar 10.04 NA 14.69 1.53 NA 26.26 090
jnt/ulna.
25900............... .............. A Amputation of forearm 9.00 NA 12.89 1.30 NA 23.19 090
25905............... .............. A Amputation of forearm 9.11 NA 12.82 1.28 NA 23.21 090
25907............... .............. A Amputation follow-up 7.79 NA 12.21 1.22 NA 21.22 090
surgery.
25909............... .............. A Amputation follow-up 8.95 NA 12.76 1.29 NA 23.00 090
surgery.
25915............... .............. A Amputation of forearm 17.05 NA 19.51 2.91 NA 39.47 090
25920............... .............. A Amputate hand at 8.67 NA 8.00 1.28 NA 17.95 090
wrist.
25922............... .............. A Amputate hand at 7.41 NA 7.25 1.12 NA 15.78 090
wrist.
25924............... .............. A Amputation follow-up 8.45 NA 8.22 1.29 NA 17.96 090
surgery.
25927............... .............. A Amputation of hand... 8.79 NA 12.15 1.23 NA 22.17 090
25929............... .............. A Amputation follow-up 7.58 NA 6.06 1.07 NA 14.71 090
surgery.
25931............... .............. A Amputation follow-up 7.80 NA 12.06 1.06 NA 20.92 090
surgery.
25999............... .............. C Forearm or wrist 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
26010............... .............. A Drainage of finger 1.54 5.67 1.66 0.17 7.38 3.37 010
abscess.
26011............... .............. A Drainage of finger 2.19 9.08 2.31 0.30 11.57 4.80 010
abscess.
26020............... .............. A Drain hand tendon 4.66 NA 5.57 0.71 NA 10.94 090
sheath.
26025............... .............. A Drainage of palm 4.81 NA 5.36 0.72 NA 10.89 090
bursa.
26030............... .............. A Drainage of palm 5.92 NA 6.00 0.87 NA 12.79 090
bursa(s).
26034............... .............. A Treat hand bone 6.22 NA 6.27 0.95 NA 13.44 090
lesion.
26035............... .............. A Decompress fingers/ 9.50 NA 8.10 1.35 NA 18.95 090
hand.
26037............... .............. A Decompress fingers/ 7.24 NA 6.60 1.05 NA 14.89 090
hand.
26040............... .............. A Release palm 3.33 NA 3.99 0.54 NA 7.86 090
contracture.
26045............... .............. A Release palm 5.55 NA 5.56 0.89 NA 12.00 090
contracture.
26055............... .............. A Incise finger tendon 2.69 14.54 3.85 0.43 17.66 6.97 090
sheath.
26060............... .............. A Incision of finger 2.81 NA 3.45 0.42 NA 6.68 090
tendon.
26070............... .............. A Explore/treat hand 3.68 NA 3.36 0.42 NA 7.46 090
joint.
26075............... .............. A Explore/treat finger 3.78 NA 3.76 0.48 NA 8.02 090
joint.
26080............... .............. A Explore/treat finger 4.23 NA 4.78 0.63 NA 9.64 090
joint.
26100............... .............. A Biopsy hand joint 3.66 NA 4.10 0.54 NA 8.30 090
lining.
26105............... .............. A Biopsy finger joint 3.70 NA 4.17 0.54 NA 8.41 090
lining.
26110............... .............. A Biopsy finger joint 3.52 NA 3.98 0.53 NA 8.03 090
lining.
26115............... .............. A Removel hand lesion 3.85 13.33 4.67 0.58 17.76 9.10 090
subcut.
26116............... .............. A Removel hand lesion, 5.52 NA 5.92 0.83 NA 12.27 090
deep.
26117............... .............. A Remove tumor, hand/ 8.54 NA 7.03 1.22 NA 16.79 090
finger.
26121............... .............. A Release palm 7.53 NA 6.90 1.13 NA 15.56 090
contracture.
26123............... .............. A Release palm 9.28 NA 8.74 1.41 NA 19.43 090
contracture.
26125............... .............. A Release palm 4.60 NA 2.46 0.69 NA 7.75 ZZZ
contracture.
26130............... .............. A Remove wrist joint 5.41 NA 5.30 0.78 NA 11.49 090
lining.
26135............... .............. A Revise finger joint, 6.95 NA 6.39 1.05 NA 14.39 090
each.
26140............... .............. A Revise finger joint, 6.16 NA 5.97 0.92 NA 13.05 090
each.
26145............... .............. A Tendon excision, palm/ 6.31 NA 5.98 0.93 NA 13.22 090
finger.
26160............... .............. A Remove tendon sheath 3.15 12.69 4.04 0.47 16.31 7.66 090
lesion.
26170............... .............. A Removal of palm 4.76 NA 4.88 0.72 NA 10.36 090
tendon, each.
26180............... .............. A Removal of finger 5.17 NA 5.35 0.77 NA 11.29 090
tendon.
26185............... .............. A Remove finger bone... 5.24 NA 5.91 0.81 NA 11.96 090
26200............... .............. A Remove hand bone 5.50 NA 5.29 0.86 NA 11.65 090
lesion.
26205............... .............. A Remove/graft bone 7.69 NA 6.84 1.15 NA 15.68 090
lesion.
26210............... .............. A Removal of finger 5.14 NA 5.36 0.77 NA 11.27 090
lesion.
26215............... .............. A Remove/graft finger 7.09 NA 6.26 0.93 NA 14.28 090
lesion.
26230............... .............. A Partial removal of 6.32 NA 5.85 1.01 NA 13.18 090
hand bone.
26235............... .............. A Partial removal, 6.18 NA 5.75 0.94 NA 12.87 090
finger bone.
26236............... .............. A Partial removal, 5.31 NA 5.28 0.80 NA 11.39 090
finger bone.
26250............... .............. A Extensive hand 7.54 NA 6.38 1.11 NA 15.03 090
surgery.
26255............... .............. A Extensive hand 12.41 NA 9.35 1.27 NA 23.03 090
surgery.
26260............... .............. A Extensive finger 7.02 NA 6.14 1.00 NA 14.16 090
surgery.
26261............... .............. A Extensive finger 9.08 NA 6.23 1.01 NA 16.32 090
surgery.
26262............... .............. A Partial removal of 5.66 NA 5.29 0.84 NA 11.79 090
finger.
26320............... .............. A Removal of implant 3.97 NA 4.25 0.59 NA 8.81 090
from hand.
26340............... .............. A Manipulate finger w/ 2.50 NA 4.74 0.36 NA 7.60 090
anesth.
26350............... .............. A Repair finger/hand 5.98 NA 15.49 0.88 NA 22.35 090
tendon.
[[Page 1134]]
26352............... .............. A Repair/graft hand 7.67 NA 16.08 1.12 NA 24.87 090
tendon.
26356............... .............. A Repair finger/hand 8.06 NA 18.91 1.19 NA 28.16 090
tendon.
26357............... .............. A Repair finger/hand 8.57 NA 16.53 1.23 NA 26.33 090
tendon.
26358............... .............. A Repair/graft hand 9.13 NA 17.43 1.29 NA 27.85 090
tendon.
26370............... .............. A Repair finger/hand 7.10 NA 15.95 1.09 NA 24.14 090
tendon.
26372............... .............. A Repair/graft hand 8.75 NA 17.32 1.28 NA 27.35 090
tendon.
26373............... .............. A Repair finger/hand 8.15 NA 16.87 1.18 NA 26.20 090
tendon.
26390............... .............. A Revise hand/finger 9.18 NA 13.92 1.31 NA 24.41 090
tendon.
26392............... .............. A Repair/graft hand 10.24 NA 17.66 1.52 NA 29.42 090
tendon.
26410............... .............. A Repair hand tendon... 4.62 NA 12.59 0.69 NA 17.90 090
26412............... .............. A Repair/graft hand 6.30 NA 13.92 0.96 NA 21.18 090
tendon.
26415............... .............. A Excision, hand/finger 8.33 NA 12.28 0.93 NA 21.54 090
tendon.
26416............... .............. A Graft hand or finger 9.36 NA 15.21 1.45 NA 26.02 090
tendon.
26418............... .............. A Repair finger tendon. 4.24 NA 12.95 0.60 NA 17.79 090
26420............... .............. A Repair/graft finger 6.76 NA 14.26 1.00 NA 22.02 090
tendon.
26426............... .............. A Repair finger/hand 6.14 NA 13.78 0.93 NA 20.85 090
tendon.
26428............... .............. A Repair/graft finger 7.20 NA 14.58 1.01 NA 22.79 090
tendon.
26432............... .............. A Repair finger tendon. 4.01 NA 10.69 0.58 NA 15.28 090
26433............... .............. A Repair finger tendon. 4.55 NA 11.37 0.68 NA 16.60 090
26434............... .............. A Repair/graft finger 6.08 NA 12.06 0.86 NA 19.00 090
tendon.
26437............... .............. A Realignment of 5.81 NA 11.98 0.89 NA 18.68 090
tendons.
26440............... .............. A Release palm/finger 5.01 NA 14.18 0.75 NA 19.94 090
tendon.
26442............... .............. A Release palm & finger 8.15 NA 16.61 1.13 NA 25.89 090
tendon.
26445............... .............. A Release hand/finger 4.30 NA 13.93 0.65 NA 18.88 090
tendon.
26449............... .............. A Release forearm/hand 6.99 NA 16.39 1.01 NA 24.39 090
tendon.
26450............... .............. A Incision of palm 3.66 NA 7.58 0.55 NA 11.79 090
tendon.
26455............... .............. A Incision of finger 3.63 NA 7.50 0.57 NA 11.70 090
tendon.
26460............... .............. A Incise hand/finger 3.45 NA 7.32 0.53 NA 11.30 090
tendon.
26471............... .............. A Fusion of finger 5.72 NA 11.65 0.88 NA 18.25 090
tendons.
26474............... .............. A Fusion of finger 5.31 NA 11.84 0.83 NA 17.98 090
tendons.
26476............... .............. A Tendon lengthening... 5.17 NA 11.37 0.75 NA 17.29 090
26477............... .............. A Tendon shortening.... 5.14 NA 11.54 0.72 NA 17.40 090
26478............... .............. A Lengthening of hand 5.79 NA 12.24 0.93 NA 18.96 090
tendon.
26479............... .............. A Shortening of hand 5.73 NA 12.08 0.92 NA 18.73 090
tendon.
26480............... .............. A Transplant hand 6.68 NA 15.68 1.01 NA 23.37 090
tendon.
26483............... .............. A Transplant/graft hand 8.28 NA 16.12 1.24 NA 25.64 090
tendon.
26485............... .............. A Transplant palm 7.69 NA 16.01 1.13 NA 24.83 090
tendon.
26489............... .............. A Transplant/graft palm 9.54 NA 12.54 1.18 NA 23.26 090
tendon.
26490............... .............. A Revise thumb tendon.. 8.40 NA 13.16 1.27 NA 22.83 090
26492............... .............. A Tendon transfer with 9.61 NA 13.97 1.44 NA 25.02 090
graft.
26494............... .............. A Hand tendon/muscle 8.46 NA 13.61 1.36 NA 23.43 090
transfer.
26496............... .............. A Revise thumb tendon.. 9.58 NA 13.61 1.41 NA 24.60 090
26497............... .............. A Finger tendon 9.56 NA 13.96 1.41 NA 24.93 090
transfer.
26498............... .............. A Finger tendon 13.98 NA 16.55 2.10 NA 32.63 090
transfer.
26499............... .............. A Revision of finger... 8.97 NA 13.50 1.13 NA 23.60 090
26500............... .............. A Hand tendon 5.95 NA 12.12 0.80 NA 18.87 090
reconstruction.
26502............... .............. A Hand tendon 7.13 NA 12.58 1.05 NA 20.76 090
reconstruction.
26504............... .............. A Hand tendon 7.46 NA 13.01 1.01 NA 21.48 090
reconstruction.
26508............... .............. A Release thumb 6.00 NA 12.11 0.92 NA 19.03 090
contracture.
26510............... .............. A Thumb tendon transfer 5.42 NA 11.79 0.86 NA 18.07 090
26516............... .............. A Fusion of knuckle 7.14 NA 12.65 1.09 NA 20.88 090
joint.
26517............... .............. A Fusion of knuckle 8.82 NA 13.96 1.16 NA 23.94 090
joints.
26518............... .............. A Fusion of knuckle 9.01 NA 13.77 1.36 NA 24.14 090
joints.
26520............... .............. A Release knuckle 5.29 NA 14.63 0.78 NA 20.70 090
contracture.
26525............... .............. A Release finger 5.32 NA 14.74 0.80 NA 20.86 090
contracture.
26530............... .............. A Revise knuckle joint. 6.68 NA 6.02 1.04 NA 13.74 090
26531............... .............. A Revise knuckle with 7.90 NA 6.99 1.22 NA 16.11 090
implant.
26535............... .............. A Revise finger joint.. 5.23 NA 3.69 0.80 NA 9.72 090
26536............... .............. A Revise/implant finger 6.36 NA 9.74 0.96 NA 17.06 090
joint.
26540............... .............. A Repair hand joint.... 6.42 NA 12.35 0.98 NA 19.75 090
26541............... .............. A Repair hand joint 8.61 NA 13.83 1.35 NA 23.79 090
with graft.
26542............... .............. A Repair hand joint 6.77 NA 12.39 1.05 NA 20.21 090
with graft.
26545............... .............. A Reconstruct finger 6.91 NA 12.79 0.95 NA 20.65 090
joint.
26546............... .............. A Repair nonunion hand. 8.91 NA 15.20 1.37 NA 25.48 090
26548............... .............. A Reconstruct finger 8.02 NA 13.39 1.18 NA 22.59 090
joint.
26550............... .............. A Construct thumb 21.21 NA 18.16 2.17 NA 41.54 090
replacement.
26551............... .............. A Great toe-hand 46.51 NA 33.71 7.92 NA 88.14 090
transfer.
26553............... .............. A Single transfer, toe- 46.20 NA 23.22 2.40 NA 71.82 090
hand.
26554............... .............. A Double transfer, toe- 54.87 NA 38.02 9.36 NA 102.25 090
hand.
26555............... .............. A Positional change of 16.61 NA 18.67 2.57 NA 37.85 090
finger.
26556............... .............. A Toe joint transfer... 47.19 NA 34.50 8.04 NA 89.73 090
26560............... .............. A Repair of web finger. 5.37 NA 10.28 0.72 NA 16.37 090
26561............... .............. A Repair of web finger. 10.90 NA 12.93 0.83 NA 24.66 090
26562............... .............. A Repair of web finger. 14.98 NA 17.59 1.18 NA 33.75 090
26565............... .............. A Correct metacarpal 6.73 NA 12.46 1.01 NA 20.20 090
flaw.
[[Page 1135]]
26567............... .............. A Correct finger 6.81 NA 12.39 1.01 NA 20.21 090
deformity.
26568............... .............. A Lengthen metacarpal/ 9.07 NA 16.09 1.33 NA 26.49 090
finger.
26580............... .............. A Repair hand deformity 18.15 NA 13.98 1.76 NA 33.89 090
26587............... .............. A Reconstruct extra 14.03 NA 9.05 1.35 NA 24.43 090
finger.
26590............... .............. A Repair finger 17.93 NA 14.40 1.59 NA 33.92 090
deformity.
26591............... .............. A Repair muscles of 3.25 NA 10.44 0.45 NA 14.14 090
hand.
26593............... .............. A Release muscles of 5.30 NA 11.51 0.77 NA 17.58 090
hand.
26596............... .............. A Excision constricting 8.94 NA 9.01 1.05 NA 19.00 090
tissue.
26600............... .............. A Treat metacarpal 1.96 4.08 2.64 0.30 6.34 4.90 090
fracture.
26605............... .............. A Treat metacarpal 2.85 5.25 3.58 0.46 8.56 6.89 090
fracture.
26607............... .............. A Treat metacarpal 5.35 NA 6.35 0.84 NA 12.54 090
fracture.
26608............... .............. A Treat metacarpal 5.35 NA 6.35 0.88 NA 12.58 090
fracture.
26615............... .............. A Treat metacarpal 5.32 NA 5.53 0.84 NA 11.69 090
fracture.
26641............... .............. A Treat thumb 3.93 5.40 3.58 0.51 9.84 8.02 090
dislocation.
26645............... .............. A Treat thumb fracture. 4.40 6.10 4.17 0.65 11.15 9.22 090
26650............... .............. A Treat thumb fracture. 5.71 NA 6.76 0.93 NA 13.40 090
26665............... .............. A Treat thumb fracture. 7.59 NA 6.80 1.17 NA 15.56 090
26670............... .............. A Treat hand 3.68 4.89 3.03 0.43 9.00 7.14 090
dislocation.
26675............... .............. A Treat hand 4.63 6.23 4.41 0.68 11.54 9.72 090
dislocation.
26676............... .............. A Pin hand dislocation. 5.51 NA 6.79 0.92 NA 13.22 090
26685............... .............. A Treat hand 6.97 NA 6.26 1.15 NA 14.38 090
dislocation.
26686............... .............. A Treat hand 7.93 NA 7.03 1.27 NA 16.23 090
dislocation.
26700............... .............. A Treat knuckle 3.68 4.65 2.96 0.42 8.75 7.06 090
dislocation.
26705............... .............. A Treat knuckle 4.18 6.03 4.24 0.60 10.81 9.02 090
dislocation.
26706............... .............. A Pin knuckle 5.11 NA 5.09 0.77 NA 10.97 090
dislocation.
26715............... .............. A Treat knuckle 5.73 NA 5.71 0.90 NA 12.34 090
dislocation.
26720............... .............. A Treat finger 1.66 3.89 2.60 0.24 5.79 4.50 090
fracture, each.
26725............... .............. A Treat finger 3.33 6.09 4.04 0.52 9.94 7.89 090
fracture, each.
26727............... .............. A Treat finger 5.22 NA 6.40 0.83 NA 12.45 090
fracture, each.
26735............... .............. A Treat finger 5.97 NA 5.86 0.93 NA 12.76 090
fracture, each.
26740............... .............. A Treat finger 1.94 3.56 2.69 0.29 5.79 4.92 090
fracture, each.
26742............... .............. A Treat finger 3.84 5.81 3.85 0.59 10.24 8.28 090
fracture, each.
26746............... .............. A Treat finger 5.80 NA 5.91 0.89 NA 12.60 090
fracture, each.
26750............... .............. A Treat finger 1.70 3.14 2.08 0.23 5.07 4.01 090
fracture, each.
26755............... .............. A Treat finger 3.10 4.81 3.05 0.45 8.36 6.60 090
fracture, each.
26756............... .............. A Pin finger fracture, 4.38 NA 6.04 0.68 NA 11.10 090
each.
26765............... .............. A Treat finger 4.16 NA 4.78 0.62 NA 9.56 090
fracture, each.
26770............... .............. A Treat finger 3.02 4.40 2.55 0.33 7.75 5.90 090
dislocation.
26775............... .............. A Treat finger 3.70 5.85 3.82 0.52 10.07 8.04 090
dislocation.
26776............... .............. A Pin finger 4.79 NA 6.21 0.76 NA 11.76 090
dislocation.
26785............... .............. A Treat finger 4.20 NA 4.81 0.65 NA 9.66 090
dislocation.
26820............... .............. A Thumb fusion with 8.25 NA 13.63 1.34 NA 23.22 090
graft.
26841............... .............. A Fusion of thumb...... 7.12 NA 13.53 1.17 NA 21.82 090
26842............... .............. A Thumb fusion with 8.23 NA 13.71 1.33 NA 23.27 090
graft.
26843............... .............. A Fusion of hand joint. 7.60 NA 12.68 1.19 NA 21.47 090
26844............... .............. A Fusion/graft of hand 8.72 NA 13.68 1.35 NA 23.75 090
joint.
26850............... .............. A Fusion of knuckle.... 6.96 NA 12.56 1.07 NA 20.59 090
26852............... .............. A Fusion of knuckle 8.45 NA 13.25 1.27 NA 22.97 090
with graft.
26860............... .............. A Fusion of finger 4.68 NA 11.55 0.72 NA 16.95 090
joint.
26861............... .............. A Fusion of finger jnt, 1.74 NA 0.93 0.27 NA 2.94 ZZZ
add-on.
26862............... .............. A Fusion/graft of 7.36 NA 12.75 1.11 NA 21.22 090
finger joint.
26863............... .............. A Fuse/graft added 3.89 NA 2.12 0.62 NA 6.63 ZZZ
joint.
26910............... .............. A Amputate metacarpal 7.59 NA 11.70 1.09 NA 20.38 090
bone.
26951............... .............. A Amputation of finger/ 4.58 NA 10.62 0.68 NA 15.88 090
thumb.
26952............... .............. A Amputation of finger/ 6.30 NA 12.23 0.89 NA 19.42 090
thumb.
26989............... .............. C Hand/finger surgery.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
26990............... .............. A Drainage of pelvis 7.47 NA 7.63 1.11 NA 16.21 090
lesion.
26991............... .............. A Drainage of pelvis 6.67 7.47 5.94 1.03 15.17 13.64 090
bursa.
26992............... .............. A Drainage of bone 13.00 NA 10.86 2.11 NA 25.97 090
lesion.
27000............... .............. A Incision of hip 5.61 NA 5.29 0.92 NA 11.82 090
tendon.
27001............... .............. A Incision of hip 6.93 NA 6.15 1.15 NA 14.23 090
tendon.
27003............... .............. A Incision of hip 7.33 NA 6.55 1.12 NA 15.00 090
tendon.
27005............... .............. A Incision of hip 9.65 NA 7.85 1.64 NA 19.14 090
tendon.
27006............... .............. A Incision of hip 9.67 NA 7.99 1.60 NA 19.26 090
tendons.
27025............... .............. A Incision of hip/thigh 11.14 NA 8.60 1.66 NA 21.40 090
fascia.
27030............... .............. A Drainage of hip joint 12.99 NA 9.66 2.18 NA 24.83 090
27033............... .............. A Exploration of hip 13.37 NA 9.93 2.26 NA 25.56 090
joint.
27035............... .............. A Denervation of hip 16.66 NA 12.33 2.05 NA 31.04 090
joint.
27036............... .............. A Excision of hip joint/ 12.86 NA 10.03 2.17 NA 25.06 090
muscle.
27040............... .............. A Biopsy of soft 2.87 2.62 2.05 0.25 5.74 5.17 010
tissues.
27041............... .............. A Biopsy of soft 9.88 NA 6.73 1.22 NA 17.83 090
tissues.
27047............... .............. A Remove hip/pelvis 7.44 6.55 4.99 0.95 14.94 13.38 090
lesion.
27048............... .............. A Remove hip/pelvis 6.24 NA 5.04 0.88 NA 12.16 090
lesion.
27049............... .............. A Remove tumor, hip/ 13.64 NA 8.81 1.93 NA 24.38 090
pelvis.
27050............... .............. A Biopsy of sacroiliac 4.35 NA 4.48 0.64 NA 9.47 090
joint.
[[Page 1136]]
27052............... .............. A Biopsy of hip joint.. 6.22 NA 5.89 1.03 NA 13.14 090
27054............... .............. A Removal of hip joint 8.53 NA 7.36 1.41 NA 17.30 090
lining.
27060............... .............. A Removal of ischial 5.42 NA 4.84 0.72 NA 10.98 090
bursa.
27062............... .............. A Remove femur lesion/ 5.36 NA 5.22 0.89 NA 11.47 090
bursa.
27065............... .............. A Removal of hip bone 5.89 NA 5.54 0.92 NA 12.35 090
lesion.
27066............... .............. A Removal of hip bone 10.31 NA 8.51 1.71 NA 20.53 090
lesion.
27067............... .............. A Remove/graft hip bone 13.81 NA 10.67 2.35 NA 26.83 090
lesion.
27070............... .............. A Partial removal of 10.70 NA 9.78 1.64 NA 22.12 090
hip bone.
27071............... .............. A Partial removal of 11.44 NA 10.75 1.82 NA 24.01 090
hip bone.
27075............... .............. A Extensive hip surgery 34.95 NA 19.68 2.68 NA 57.31 090
27076............... .............. A Extensive hip surgery 22.09 NA 14.79 3.45 NA 40.33 090
27077............... .............. A Extensive hip surgery 39.94 NA 23.10 3.84 NA 66.88 090
27078............... .............. A Extensive hip surgery 13.42 NA 10.43 2.01 NA 25.86 090
27079............... .............. A Extensive hip surgery 13.73 NA 10.09 2.24 NA 26.06 090
27080............... .............. A Removal of tail bone. 6.38 NA 5.08 0.96 NA 12.42 090
27086............... .............. A Remove hip foreign 1.87 2.01 1.87 0.21 4.09 3.95 010
body.
27087............... .............. A Remove hip foreign 8.53 NA 6.71 1.31 NA 16.55 090
body.
27090............... .............. A Removal of hip 11.13 NA 8.65 1.87 NA 21.65 090
prosthesis.
27091............... .............. A Removal of hip 22.11 NA 13.86 3.75 NA 39.72 090
prosthesis.
27093............... .............. A Injection for hip x- 1.30 12.21 0.48 0.11 13.62 1.89 000
ray.
27095............... .............. A Injection for hip x- 1.50 10.76 0.52 0.12 12.38 2.14 000
ray.
27096............... .............. A Inject sacroiliac 1.40 9.35 0.33 0.10 10.85 1.83 000
joint.
27097............... .............. A Revision of hip 8.79 NA 6.47 1.47 NA 16.73 090
tendon.
27098............... .............. A Transfer tendon to 8.82 NA 7.10 1.50 NA 17.42 090
pelvis.
27100............... .............. A Transfer of abdominal 11.06 NA 8.73 1.89 NA 21.68 090
muscle.
27105............... .............. A Transfer of spinal 11.75 NA 9.20 2.00 NA 22.95 090
muscle.
27110............... .............. A Transfer of iliopsoas 13.24 NA 9.33 1.66 NA 24.23 090
muscle.
27111............... .............. A Transfer of iliopsoas 12.13 NA 9.18 1.79 NA 23.10 090
muscle.
27120............... .............. A Reconstruction of hip 17.98 NA 11.74 2.95 NA 32.67 090
socket.
27122............... .............. A Reconstruction of hip 14.96 NA 10.91 2.51 NA 28.38 090
socket.
27125............... .............. A Partial hip 14.67 NA 10.49 2.47 NA 27.63 090
replacement.
27130............... .............. A Total hip 20.09 NA 13.21 3.40 NA 36.70 090
arthroplasty.
27132............... .............. A Total hip 23.27 NA 15.48 3.93 NA 42.68 090
arthroplasty.
27134............... .............. A Revise hip joint 28.48 NA 17.69 4.79 NA 50.96 090
replacement.
27137............... .............. A Revise hip joint 21.14 NA 13.82 3.58 NA 38.54 090
replacement.
27138............... .............. A Revise hip joint 22.14 NA 14.28 3.75 NA 40.17 090
replacement.
27140............... .............. A Transplant femur 12.22 NA 9.41 2.01 NA 23.64 090
ridge.
27146............... .............. A Incision of hip bone. 17.40 NA 12.27 2.74 NA 32.41 090
27147............... .............. A Revision of hip bone. 20.55 NA 13.34 3.15 NA 37.04 090
27151............... .............. A Incision of hip bones 22.48 NA 8.21 3.76 NA 34.45 090
27156............... .............. A Revision of hip bones 24.59 NA 16.10 4.20 NA 44.89 090
27158............... .............. A Revision of pelvis... 19.71 NA 11.24 3.14 NA 34.09 090
27161............... .............. A Incision of neck of 16.68 NA 12.09 2.80 NA 31.57 090
femur.
27165............... .............. A Incision/fixation of 17.88 NA 12.85 3.03 NA 33.76 090
femur.
27170............... .............. A Repair/graft femur 16.05 NA 11.30 2.65 NA 30.00 090
head/neck.
27175............... .............. A Treat slipped 8.45 NA 6.58 1.44 NA 16.47 090
epiphysis.
27176............... .............. A Treat slipped 12.03 NA 8.98 2.03 NA 23.04 090
epiphysis.
27177............... .............. A Treat slipped 15.06 NA 10.83 2.54 NA 28.43 090
epiphysis.
27178............... .............. A Treat slipped 11.97 NA 8.40 2.03 NA 22.40 090
epiphysis.
27179............... .............. A Revise head/neck of 12.96 NA 9.92 2.22 NA 25.10 090
femur.
27181............... .............. A Treat slipped 14.66 NA 10.15 2.10 NA 26.91 090
epiphysis.
27185............... .............. A Revision of femur 9.17 NA 7.58 1.56 NA 18.31 090
epiphysis.
27187............... .............. A Reinforce hip bones.. 13.52 NA 10.33 2.28 NA 26.13 090
27193............... .............. A Treat pelvic ring 5.55 7.10 5.74 0.93 13.58 12.22 090
fracture.
27194............... .............. A Treat pelvic ring 9.64 8.75 7.50 1.59 19.98 18.73 090
fracture.
27200............... .............. A Treat tail bone 1.84 3.04 2.17 0.27 5.15 4.28 090
fracture.
27202............... .............. A Treat tail bone 7.03 NA 17.65 0.83 NA 25.51 090
fracture.
27215............... .............. A Treat pelvic 10.03 NA 7.17 1.65 NA 18.85 090
fracture(s).
27216............... .............. A Treat pelvic ring 15.17 NA 9.72 2.59 NA 27.48 090
fracture.
27217............... .............. A Treat pelvic ring 14.09 NA 10.15 2.35 NA 26.59 090
fracture.
27218............... .............. A Treat pelvic ring 20.12 NA 11.50 3.44 NA 35.06 090
fracture.
27220............... .............. A Treat hip socket 6.17 7.06 5.51 1.03 14.26 12.71 090
fracture.
27222............... .............. A Treat hip socket 12.68 NA 9.88 2.13 NA 24.69 090
fracture.
27226............... .............. A Treat hip wall 14.89 NA 7.92 2.50 NA 25.31 090
fracture.
27227............... .............. A Treat hip fracture(s) 23.41 NA 15.35 3.91 NA 42.67 090
27228............... .............. A Treat hip fracture(s) 27.12 NA 17.57 4.55 NA 49.24 090
27230............... .............. A Treat thigh fracture. 5.49 6.51 5.04 0.88 12.88 11.41 090
27232............... .............. A Treat thigh fracture. 10.66 NA 7.18 1.75 NA 19.59 090
27235............... .............. A Treat thigh fracture. 12.14 NA 9.39 2.06 NA 23.59 090
27236............... .............. A Treat thigh fracture. 15.58 NA 10.93 2.63 NA 29.14 090
27238............... .............. A Treat thigh fracture. 5.51 NA 5.09 0.92 NA 11.52 090
27240............... .............. A Treat thigh fracture. 12.48 NA 9.37 2.04 NA 23.89 090
27244............... .............. A Treat thigh fracture. 15.92 NA 11.26 2.69 NA 29.87 090
27245............... .............. A Treat thigh fracture. 20.28 NA 13.70 3.44 NA 37.42 090
27246............... .............. A Treat thigh fracture. 4.70 5.66 4.41 0.80 11.16 9.91 090
[[Page 1137]]
27248............... .............. A Treat thigh fracture. 10.43 NA 8.19 1.75 NA 20.37 090
27250............... .............. A Treat hip dislocation 6.94 NA 4.77 0.82 NA 12.53 090
27252............... .............. A Treat hip dislocation 10.37 NA 7.39 1.65 NA 19.41 090
27253............... .............. A Treat hip dislocation 12.90 NA 9.72 2.18 NA 24.80 090
27254............... .............. A Treat hip dislocation 18.23 NA 12.03 3.04 NA 33.30 090
27256............... .............. A Treat hip dislocation 4.11 3.43 2.09 0.59 8.13 6.79 010
27257............... .............. A Treat hip dislocation 5.21 NA 2.88 0.68 NA 8.77 010
27258............... .............. A Treat hip dislocation 15.41 NA 10.91 2.48 NA 28.80 090
27259............... .............. A Treat hip dislocation 21.52 NA 14.16 3.61 NA 39.29 090
27265............... .............. A Treat hip dislocation 5.04 NA 4.76 0.78 NA 10.58 090
27266............... .............. A Treat hip dislocation 7.48 NA 6.27 1.25 NA 15.00 090
27275............... .............. A Manipulation of hip 2.27 NA 2.13 0.37 NA 4.77 010
joint.
27280............... .............. A Fusion of sacroiliac 13.37 NA 10.30 2.39 NA 26.06 090
joint.
27282............... .............. A Fusion of pubic bones 11.32 NA 8.23 1.37 NA 20.92 090
27284............... .............. A Fusion of hip joint.. 23.41 NA 14.83 2.85 NA 41.09 090
27286............... .............. A Fusion of hip joint.. 23.41 NA 15.81 2.86 NA 42.08 090
27290............... .............. A Amputation of leg at 23.25 NA 14.16 3.55 NA 40.96 090
hip.
27295............... .............. A Amputation of leg at 18.62 NA 11.54 2.83 NA 32.99 090
hip.
27299............... .............. C Pelvis/hip joint 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
27301............... .............. A Drain thigh/knee 6.48 7.34 5.88 0.96 14.78 13.32 090
lesion.
27303............... .............. A Drainage of bone 8.27 NA 7.24 1.37 NA 16.88 090
lesion.
27305............... .............. A Incise thigh tendon & 5.91 NA 5.36 0.93 NA 12.20 090
fascia.
27306............... .............. A Incision of thigh 4.61 NA 4.80 0.75 NA 10.16 090
tendon.
27307............... .............. A Incision of thigh 5.79 NA 5.52 0.94 NA 12.25 090
tendons.
27310............... .............. A Exploration of knee 9.26 NA 7.54 1.56 NA 18.36 090
joint.
27315............... .............. A Partial removal, 6.96 NA 4.83 0.95 NA 12.74 090
thigh nerve.
27320............... .............. A Partial removal, 6.29 NA 5.12 0.94 NA 12.35 090
thigh nerve.
27323............... .............. A Biopsy, thigh soft 2.28 2.19 1.92 0.21 4.68 4.41 010
tissues.
27324............... .............. A Biopsy, thigh soft 4.89 NA 4.35 0.71 NA 9.95 090
tissues.
27327............... .............. A Removal of thigh 4.46 5.34 3.91 0.60 10.40 8.97 090
lesion.
27328............... .............. A Removal of thigh 5.56 NA 4.57 0.80 NA 10.93 090
lesion.
27329............... .............. A Remove tumor, thigh/ 14.12 NA 9.51 2.03 NA 25.66 090
knee.
27330............... .............. A Biopsy, knee joint 4.96 NA 4.61 0.80 NA 10.37 090
lining.
27331............... .............. A Explore/treat knee 5.87 NA 5.51 0.98 NA 12.36 090
joint.
27332............... .............. A Removal of knee 8.26 NA 7.08 1.39 NA 16.73 090
cartilage.
27333............... .............. A Removal of knee 7.29 NA 6.60 1.24 NA 15.13 090
cartilage.
27334............... .............. A Remove knee joint 8.69 NA 7.38 1.46 NA 17.53 090
lining.
27335............... .............. A Remove knee joint 9.99 NA 8.18 1.70 NA 19.87 090
lining.
27340............... .............. A Removal of kneecap 4.17 NA 4.53 0.70 NA 9.40 090
bursa.
27345............... .............. A Removal of knee cyst. 5.91 NA 5.61 0.98 NA 12.50 090
27347............... .............. A Remove knee cyst..... 5.77 NA 5.42 0.92 NA 12.11 090
27350............... .............. A Removal of kneecap... 8.16 NA 7.19 1.39 NA 16.74 090
27355............... .............. A Remove femur lesion.. 7.64 NA 6.81 1.29 NA 15.74 090
27356............... .............. A Remove femur lesion/ 9.47 NA 7.88 1.56 NA 18.91 090
graft.
27357............... .............. A Remove femur lesion/ 10.51 NA 8.70 1.79 NA 21.00 090
graft.
27358............... .............. A Remove femur lesion/ 4.73 NA 2.54 0.81 NA 8.08 ZZZ
fixation.
27360............... .............. A Partial removal, leg 10.48 NA 9.95 1.71 NA 22.14 090
bone(s).
27365............... .............. A Extensive leg surgery 16.25 NA 11.67 2.73 NA 30.65 090
27370............... .............. A Injection for knee x- 0.96 12.01 0.32 0.07 13.04 1.35 000
ray.
27372............... .............. A Removal of foreign 5.06 6.00 4.69 0.75 11.81 10.50 090
body.
27380............... .............. A Repair of kneecap 7.15 NA 7.25 1.21 NA 15.61 090
tendon.
27381............... .............. A Repair/graft kneecap 10.32 NA 9.05 1.74 NA 21.11 090
tendon.
27385............... .............. A Repair of thigh 7.75 NA 7.59 1.31 NA 16.65 090
muscle.
27386............... .............. A Repair/graft of thigh 10.54 NA 9.46 1.80 NA 21.80 090
muscle.
27390............... .............. A Incision of thigh 5.32 NA 5.26 0.83 NA 11.41 090
tendon.
27391............... .............. A Incision of thigh 7.19 NA 6.63 1.19 NA 15.01 090
tendons.
27392............... .............. A Incision of thigh 9.19 NA 7.72 1.48 NA 18.39 090
tendons.
27393............... .............. A Lengthening of thigh 6.38 NA 5.85 1.09 NA 13.32 090
tendon.
27394............... .............. A Lengthening of thigh 8.49 NA 7.28 1.41 NA 17.18 090
tendons.
27395............... .............. A Lengthening of thigh 11.71 NA 9.38 1.97 NA 23.06 090
tendons.
27396............... .............. A Transplant of thigh 7.85 NA 7.07 1.34 NA 16.26 090
tendon.
27397............... .............. A Transplants of thigh 11.26 NA 9.03 1.91 NA 22.20 090
tendons.
27400............... .............. A Revise thigh muscles/ 9.01 NA 7.34 1.42 NA 17.77 090
tendons.
27403............... .............. A Repair of knee 8.32 NA 7.14 1.40 NA 16.86 090
cartilage.
27405............... .............. A Repair of knee 8.64 NA 7.46 1.46 NA 17.56 090
ligament.
27407............... .............. A Repair of knee 10.26 NA 8.30 1.66 NA 20.22 090
ligament.
27409............... .............. A Repair of knee 12.88 NA 9.91 2.11 NA 24.90 090
ligaments.
27418............... .............. A Repair degenerated 10.83 NA 8.85 1.82 NA 21.50 090
kneecap.
27420............... .............. A Revision of unstable 9.82 NA 8.05 1.66 NA 19.53 090
kneecap.
27422............... .............. A Revision of unstable 9.77 NA 8.07 1.65 NA 19.49 090
kneecap.
27424............... .............. A Revision/removal of 9.80 NA 8.04 1.66 NA 19.50 090
kneecap.
27425............... .............. A Lat retinacular 5.21 NA 5.49 0.88 NA 11.58 090
release open.
27427............... .............. A Reconstruction, knee. 9.35 NA 7.74 1.56 NA 18.65 090
27428............... .............. A Reconstruction, knee. 13.98 NA 11.10 2.35 NA 27.43 090
27429............... .............. A Reconstruction, knee. 15.50 NA 12.34 2.63 NA 30.47 090
[[Page 1138]]
27430............... .............. A Revision of thigh 9.66 NA 7.96 1.63 NA 19.25 090
muscles.
27435............... .............. A Incision of knee 9.48 NA 8.36 1.60 NA 19.44 090
joint.
27437............... .............. A Revise kneecap....... 8.45 NA 7.11 1.42 NA 16.98 090
27438............... .............. A Revise kneecap with 11.21 NA 8.43 1.88 NA 21.52 090
implant.
27440............... .............. A Revision of knee 10.41 NA 5.97 1.71 NA 18.09 090
joint.
27441............... .............. A Revision of knee 10.80 NA 6.65 1.80 NA 19.25 090
joint.
27442............... .............. A Revision of knee 11.87 NA 8.80 2.03 NA 22.70 090
joint.
27443............... .............. A Revision of knee 10.91 NA 8.59 1.83 NA 21.33 090
joint.
27445............... .............. A Revision of knee 17.65 NA 12.23 3.00 NA 32.88 090
joint.
27446............... .............. A Revision of knee 15.82 NA 11.15 2.68 NA 29.65 090
joint.
27447............... .............. A Total knee 21.45 NA 14.46 3.62 NA 39.53 090
arthroplasty.
27448............... .............. A Incision of thigh.... 11.04 NA 8.65 1.82 NA 21.51 090
27450............... .............. A Incision of thigh.... 13.96 NA 10.59 2.36 NA 26.91 090
27454............... .............. A Realignment of thigh 17.53 NA 12.50 2.97 NA 33.00 090
bone.
27455............... .............. A Realignment of knee.. 12.80 NA 9.87 2.15 NA 24.82 090
27457............... .............. A Realignment of knee.. 13.43 NA 9.91 2.27 NA 25.61 090
27465............... .............. A Shortening of thigh 13.85 NA 10.34 2.24 NA 26.43 090
bone.
27466............... .............. A Lengthening of thigh 16.31 NA 11.87 2.32 NA 30.50 090
bone.
27468............... .............. A Shorten/lengthen 18.94 NA 12.45 3.23 NA 34.62 090
thighs.
27470............... .............. A Repair of thigh...... 16.05 NA 11.83 2.70 NA 30.58 090
27472............... .............. A Repair/graft of thigh 17.69 NA 12.72 3.00 NA 33.41 090
27475............... .............. A Surgery to stop leg 8.63 NA 7.22 1.36 NA 17.21 090
growth.
27477............... .............. A Surgery to stop leg 9.84 NA 7.73 1.58 NA 19.15 090
growth.
27479............... .............. A Surgery to stop leg 12.78 NA 9.86 2.18 NA 24.82 090
growth.
27485............... .............. A Surgery to stop leg 8.83 NA 7.38 1.50 NA 17.71 090
growth.
27486............... .............. A Revise/replace knee 19.24 NA 13.34 3.26 NA 35.84 090
joint.
27487............... .............. A Revise/replace knee 25.23 NA 16.41 4.27 NA 45.91 090
joint.
27488............... .............. A Removal of knee 15.72 NA 11.54 2.67 NA 29.93 090
prosthesis.
27495............... .............. A Reinforce thigh...... 15.53 NA 11.47 2.63 NA 29.63 090
27496............... .............. A Decompression of 6.10 NA 5.72 0.93 NA 12.75 090
thigh/knee.
27497............... .............. A Decompression of 7.16 NA 5.66 1.01 NA 13.83 090
thigh/knee.
27498............... .............. A Decompression of 7.98 NA 6.11 1.17 NA 15.26 090
thigh/knee.
27499............... .............. A Decompression of 8.99 NA 6.99 1.42 NA 17.40 090
thigh/knee.
27500............... .............. A Treatment of thigh 5.91 7.01 4.99 0.96 13.88 11.86 090
fracture.
27501............... .............. A Treatment of thigh 5.91 7.57 5.66 1.00 14.48 12.57 090
fracture.
27502............... .............. A Treatment of thigh 10.56 NA 8.10 1.80 NA 20.46 090
fracture.
27503............... .............. A Treatment of thigh 10.56 NA 8.26 1.80 NA 20.62 090
fracture.
27506............... .............. A Treatment of thigh 17.42 NA 12.70 2.81 NA 32.93 090
fracture.
27507............... .............. A Treatment of thigh 13.97 NA 9.88 2.35 NA 26.20 090
fracture.
27508............... .............. A Treatment of thigh 5.82 6.97 5.32 0.96 13.75 12.10 090
fracture.
27509............... .............. A Treatment of thigh 7.70 NA 7.90 1.30 NA 16.90 090
fracture.
27510............... .............. A Treatment of thigh 9.12 NA 7.17 1.52 NA 17.81 090
fracture.
27511............... .............. A Treatment of thigh 13.62 NA 11.19 2.30 NA 27.11 090
fracture.
27513............... .............. A Treatment of thigh 17.89 NA 13.83 3.03 NA 34.75 090
fracture.
27514............... .............. A Treatment of thigh 17.27 NA 13.29 2.91 NA 33.47 090
fracture.
27516............... .............. A Treat thigh fx growth 5.36 7.27 5.38 0.89 13.52 11.63 090
plate.
27517............... .............. A Treat thigh fx growth 8.77 8.89 7.35 1.47 19.13 17.59 090
plate.
27519............... .............. A Treat thigh fx growth 15.00 NA 11.61 2.52 NA 29.13 090
plate.
27520............... .............. A Treat kneecap 2.86 5.22 3.41 0.46 8.54 6.73 090
fracture.
27524............... .............. A Treat kneecap 9.99 NA 8.14 1.69 NA 19.82 090
fracture.
27530............... .............. A Treat knee fracture.. 3.77 5.88 4.26 0.62 10.27 8.65 090
27532............... .............. A Treat knee fracture.. 7.29 7.82 6.26 1.23 16.34 14.78 090
27535............... .............. A Treat knee fracture.. 11.48 NA 10.09 1.94 NA 23.51 090
27536............... .............. A Treat knee fracture.. 15.63 NA 11.48 2.64 NA 29.75 090
27538............... .............. A Treat knee 4.86 7.07 5.08 0.81 12.74 10.75 090
fracture(s).
27540............... .............. A Treat knee fracture.. 13.08 NA 9.46 2.17 NA 24.71 090
27550............... .............. A Treat knee 5.75 6.57 4.92 0.82 13.14 11.49 090
dislocation.
27552............... .............. A Treat knee 7.89 NA 6.86 1.33 NA 16.08 090
dislocation.
27556............... .............. A Treat knee 14.39 NA 11.66 2.42 NA 28.47 090
dislocation.
27557............... .............. A Treat knee 16.74 NA 13.12 2.86 NA 32.72 090
dislocation.
27558............... .............. A Treat knee 17.69 NA 13.08 3.03 NA 33.80 090
dislocation.
27560............... .............. A Treat kneecap 3.81 5.58 3.29 0.48 9.87 7.58 090
dislocation.
27562............... .............. A Treat kneecap 5.78 NA 4.79 0.83 NA 11.40 090
dislocation.
27566............... .............. A Treat kneecap 12.21 NA 9.26 2.09 NA 23.56 090
dislocation.
27570............... .............. A Fixation of knee 1.74 NA 1.81 0.29 NA 3.84 010
joint.
27580............... .............. A Fusion of knee....... 19.34 NA 14.75 3.26 NA 37.35 090
27590............... .............. A Amputate leg at thigh 12.01 NA 7.10 1.63 NA 20.74 090
27591............... .............. A Amputate leg at thigh 12.66 NA 8.87 1.97 NA 23.50 090
27592............... .............. A Amputate leg at thigh 10.00 NA 6.59 1.41 NA 18.00 090
27594............... .............. A Amputation follow-up 6.91 NA 5.45 0.99 NA 13.35 090
surgery.
27596............... .............. A Amputation follow-up 10.58 NA 7.22 1.50 NA 19.30 090
surgery.
27598............... .............. A Amputate lower leg at 10.51 NA 7.32 1.50 NA 19.33 090
knee.
27599............... .............. C Leg surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
27600............... .............. A Decompression of 5.64 NA 4.75 0.82 NA 11.21 090
lower leg.
27601............... .............. A Decompression of 5.63 NA 5.04 0.83 NA 11.50 090
lower leg.
[[Page 1139]]
27602............... .............. A Decompression of 7.34 NA 5.33 1.03 NA 13.70 090
lower leg.
27603............... .............. A Drain lower leg 4.93 10.64 4.85 0.68 16.25 10.46 090
lesion.
27604............... .............. A Drain lower leg bursa 4.46 8.58 4.53 0.65 13.69 9.64 090
27605............... .............. A Incision of achilles 2.87 8.80 2.34 0.46 12.13 5.67 010
tendon.
27606............... .............. A Incision of achilles 4.13 10.03 3.40 0.69 14.85 8.22 010
tendon.
27607............... .............. A Treat lower leg bone 7.96 NA 6.58 1.30 NA 15.84 090
lesion.
27610............... .............. A Explore/treat ankle 8.33 NA 7.06 1.39 NA 16.78 090
joint.
27612............... .............. A Exploration of ankle 7.32 NA 6.12 1.22 NA 14.66 090
joint.
27613............... .............. A Biopsy lower leg soft 2.17 3.77 1.76 0.19 6.13 4.12 010
tissue.
27614............... .............. A Biopsy lower leg soft 5.65 8.78 4.63 0.75 15.18 11.03 090
tissue.
27615............... .............. A Remove tumor, lower 12.54 NA 10.56 1.68 NA 24.78 090
leg.
27618............... .............. A Remove lower leg 5.08 9.10 4.21 0.65 14.83 9.94 090
lesion.
27619............... .............. A Remove lower leg 8.39 10.62 6.17 1.22 20.23 15.78 090
lesion.
27620............... .............. A Explore/treat ankle 5.97 NA 5.50 1.00 NA 12.47 090
joint.
27625............... .............. A Remove ankle joint 8.29 NA 6.54 1.40 NA 16.23 090
lining.
27626............... .............. A Remove ankle joint 8.90 NA 7.00 1.48 NA 17.38 090
lining.
27630............... .............. A Removal of tendon 4.79 8.99 4.46 0.72 14.50 9.97 090
lesion.
27635............... .............. A Remove lower leg bone 7.77 NA 6.84 1.28 NA 15.89 090
lesion.
27637............... .............. A Remove/graft leg bone 9.84 NA 8.35 1.66 NA 19.85 090
lesion.
27638............... .............. A Remove/graft leg bone 10.55 NA 8.39 1.77 NA 20.71 090
lesion.
27640............... .............. A Partial removal of 11.35 NA 10.81 1.86 NA 24.02 090
tibia.
27641............... .............. A Partial removal of 9.23 NA 8.83 1.47 NA 19.53 090
fibula.
27645............... .............. A Extensive lower leg 14.15 NA 12.34 2.39 NA 28.88 090
surgery.
27646............... .............. A Extensive lower leg 12.64 NA 11.34 1.87 NA 25.85 090
surgery.
27647............... .............. A Extensive ankle/heel 12.22 NA 7.85 1.98 NA 22.05 090
surgery.
27648............... .............. A Injection for ankle x- 0.96 9.45 0.33 0.06 10.47 1.35 000
ray.
27650............... .............. A Repair achilles 9.68 NA 7.51 1.63 NA 18.82 090
tendon.
27652............... .............. A Repair/graft achilles 10.31 NA 8.01 1.75 NA 20.07 090
tendon.
27654............... .............. A Repair of achilles 10.00 NA 7.23 1.70 NA 18.93 090
tendon.
27656............... .............. A Repair leg fascia 4.56 9.93 4.01 0.58 15.07 9.15 090
defect.
27658............... .............. A Repair of leg tendon, 4.97 9.18 4.77 0.82 14.97 10.56 090
each.
27659............... .............. A Repair of leg tendon, 6.80 11.30 5.80 1.16 19.26 13.76 090
each.
27664............... .............. A Repair of leg tendon, 4.58 11.26 4.74 0.76 16.60 10.08 090
each.
27665............... .............. A Repair of leg tendon, 5.39 11.05 5.18 0.90 17.34 11.47 090
each.
27675............... .............. A Repair lower leg 7.17 NA 5.79 1.22 NA 14.18 090
tendons.
27676............... .............. A Repair lower leg 8.41 NA 6.77 1.39 NA 16.57 090
tendons.
27680............... .............. A Release of lower leg 5.73 NA 5.19 0.96 NA 11.88 090
tendon.
27681............... .............. A Release of lower leg 6.81 NA 5.96 1.11 NA 13.88 090
tendons.
27685............... .............. A Revision of lower leg 6.49 8.11 5.51 1.10 15.70 13.10 090
tendon.
27686............... .............. A Revise lower leg 7.45 12.57 6.59 1.27 21.29 15.31 090
tendons.
27687............... .............. A Revision of calf 6.23 NA 5.42 1.06 NA 12.71 090
tendon.
27690............... .............. A Revise lower leg 8.70 NA 6.45 1.47 NA 16.62 090
tendon.
27691............... .............. A Revise lower leg 9.95 NA 7.81 1.69 NA 19.45 090
tendon.
27692............... .............. A Revise additional leg 1.87 NA 0.93 0.31 NA 3.11 ZZZ
tendon.
27695............... .............. A Repair of ankle 6.50 NA 5.92 1.09 NA 13.51 090
ligament.
27696............... .............. A Repair of ankle 8.26 NA 6.50 1.40 NA 16.16 090
ligaments.
27698............... .............. A Repair of ankle 9.35 NA 6.98 1.58 NA 17.91 090
ligament.
27700............... .............. A Revision of ankle 9.28 NA 5.62 1.50 NA 16.40 090
joint.
27702............... .............. A Reconstruct ankle 13.65 NA 10.32 2.32 NA 26.29 090
joint.
27703............... .............. A Reconstruction, ankle 15.85 NA 11.09 2.70 NA 29.64 090
joint.
27704............... .............. A Removal of ankle 7.61 NA 5.52 0.74 NA 13.87 090
implant.
27705............... .............. A Incision of tibia.... 10.36 NA 8.23 1.74 NA 20.33 090
27707............... .............. A Incision of fibula... 4.36 NA 5.01 0.72 NA 10.09 090
27709............... .............. A Incision of tibia & 9.94 NA 8.16 1.68 NA 19.78 090
fibula.
27712............... .............. A Realignment of lower 14.23 NA 10.72 2.41 NA 27.36 090
leg.
27715............... .............. A Revision of lower leg 14.37 NA 10.84 2.41 NA 27.62 090
27720............... .............. A Repair of tibia...... 11.77 NA 9.45 2.00 NA 23.22 090
27722............... .............. A Repair/graft of tibia 11.80 NA 9.21 1.99 NA 23.00 090
27724............... .............. A Repair/graft of tibia 18.17 NA 12.45 2.53 NA 33.15 090
27725............... .............. A Repair of lower leg.. 15.57 NA 11.88 2.65 NA 30.10 090
27727............... .............. A Repair of lower leg.. 13.99 NA 10.41 2.22 NA 26.62 090
27730............... .............. A Repair of tibia 7.40 17.74 6.45 0.90 26.04 14.75 090
epiphysis.
27732............... .............. A Repair of fibula 5.31 11.60 5.00 0.76 17.67 11.07 090
epiphysis.
27734............... .............. A Repair lower leg 8.47 NA 6.42 1.03 NA 15.92 090
epiphyses.
27740............... .............. A Repair of leg 9.29 20.61 7.93 1.58 31.48 18.80 090
epiphyses.
27742............... .............. A Repair of leg 10.28 12.50 7.26 1.87 24.65 19.41 090
epiphyses.
27745............... .............. A Reinforce tibia...... 10.05 NA 8.21 1.66 NA 19.92 090
27750............... .............. A Treatment of tibia 3.19 5.37 3.77 0.52 9.08 7.48 090
fracture.
27752............... .............. A Treatment of tibia 5.83 7.38 5.49 0.99 14.20 12.31 090
fracture.
27756............... .............. A Treatment of tibia 6.77 NA 6.52 1.13 NA 14.42 090
fracture.
27758............... .............. A Treatment of tibia 11.65 NA 9.19 1.83 NA 22.67 090
fracture.
27759............... .............. A Treatment of tibia 13.74 NA 10.32 2.33 NA 26.39 090
fracture.
27760............... .............. A Treatment of ankle 3.01 5.25 3.53 0.47 8.73 7.01 090
fracture.
27762............... .............. A Treatment of ankle 5.24 7.12 5.16 0.86 13.22 11.26 090
fracture.
27766............... .............. A Treatment of ankle 8.35 NA 7.16 1.41 NA 16.92 090
fracture.
[[Page 1140]]
27780............... .............. A Treatment of fibula 2.65 4.92 3.21 0.40 7.97 6.26 090
fracture.
27781............... .............. A Treatment of fibula 4.39 6.35 4.49 0.69 11.43 9.57 090
fracture.
27784............... .............. A Treatment of fibula 7.10 NA 6.45 1.18 NA 14.73 090
fracture.
27786............... .............. A Treatment of ankle 2.84 5.09 3.33 0.45 8.38 6.62 090
fracture.
27788............... .............. A Treatment of ankle 4.44 6.46 4.50 0.74 11.64 9.68 090
fracture.
27792............... .............. A Treatment of ankle 7.65 NA 6.90 1.29 NA 15.84 090
fracture.
27808............... .............. A Treatment of ankle 2.83 5.68 3.60 0.46 8.97 6.89 090
fracture.
27810............... .............. A Treatment of ankle 5.12 6.95 4.99 0.86 12.93 10.97 090
fracture.
27814............... .............. A Treatment of ankle 10.66 NA 8.55 1.81 NA 21.02 090
fracture.
27816............... .............. A Treatment of ankle 2.89 4.99 3.40 0.45 8.33 6.74 090
fracture.
27818............... .............. A Treatment of ankle 5.49 7.06 5.04 0.89 13.44 11.42 090
fracture.
27822............... .............. A Treatment of ankle 10.98 NA 10.63 1.56 NA 23.17 090
fracture.
27823............... .............. A Treatment of ankle 12.98 NA 11.49 1.99 NA 26.46 090
fracture.
27824............... .............. A Treat lower leg 2.89 5.56 3.74 0.47 8.92 7.10 090
fracture.
27825............... .............. A Treat lower leg 6.18 8.19 5.86 1.03 15.40 13.07 090
fracture.
27826............... .............. A Treat lower leg 8.53 NA 8.87 1.44 NA 18.84 090
fracture.
27827............... .............. A Treat lower leg 14.04 NA 12.71 2.36 NA 29.11 090
fracture.
27828............... .............. A Treat lower leg 16.21 NA 13.85 2.74 NA 32.80 090
fracture.
27829............... .............. A Treat lower leg joint 5.48 NA 6.77 0.93 NA 13.18 090
27830............... .............. A Treat lower leg 3.78 5.12 3.83 0.53 9.43 8.14 090
dislocation.
27831............... .............. A Treat lower leg 4.55 NA 4.43 0.74 NA 9.72 090
dislocation.
27832............... .............. A Treat lower leg 6.48 NA 6.16 1.10 NA 13.74 090
dislocation.
27840............... .............. A Treat ankle 4.57 NA 3.89 0.57 NA 9.03 090
dislocation.
27842............... .............. A Treat ankle 6.20 NA 5.08 0.92 NA 12.20 090
dislocation.
27846............... .............. A Treat ankle 9.78 NA 7.91 1.64 NA 19.33 090
dislocation.
27848............... .............. A Treat ankle 11.18 NA 9.71 1.87 NA 22.76 090
dislocation.
27860............... .............. A Fixation of ankle 2.34 NA 2.01 0.37 NA 4.72 010
joint.
27870............... .............. A Fusion of ankle 13.89 NA 10.50 2.35 NA 26.74 090
joint, open.
27871............... .............. A Fusion of 9.16 NA 7.62 1.56 NA 18.34 090
tibiofibular joint.
27880............... .............. A Amputation of lower 11.83 NA 7.46 1.66 NA 20.95 090
leg.
27881............... .............. A Amputation of lower 12.32 NA 9.01 1.92 NA 23.25 090
leg.
27882............... .............. A Amputation of lower 8.93 NA 6.93 1.24 NA 17.10 090
leg.
27884............... .............. A Amputation follow-up 8.20 NA 6.10 1.15 NA 15.45 090
surgery.
27886............... .............. A Amputation follow-up 9.31 NA 6.82 1.36 NA 17.49 090
surgery.
27888............... .............. A Amputation of foot at 9.66 NA 7.60 1.52 NA 18.78 090
ankle.
27889............... .............. A Amputation of foot at 9.97 NA 6.74 1.44 NA 18.15 090
ankle.
27892............... .............. A Decompression of leg. 7.38 NA 5.85 1.04 NA 14.27 090
27893............... .............. A Decompression of leg. 7.34 NA 5.74 1.09 NA 14.17 090
27894............... .............. A Decompression of leg. 10.47 NA 7.93 1.51 NA 19.91 090
27899............... .............. C Leg/ankle surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
28001............... .............. A Drainage of bursa of 2.73 5.82 3.51 0.37 8.92 6.61 010
foot.
28002............... .............. A Treatment of foot 4.61 7.22 4.64 0.68 12.51 9.93 010
infection.
28003............... .............. A Treatment of foot 8.40 7.68 6.04 1.24 17.32 15.68 090
infection.
28005............... .............. A Treat foot bone 8.67 NA 6.36 1.37 NA 16.40 090
lesion.
28008............... .............. A Incision of foot 4.44 5.68 3.55 0.68 10.80 8.67 090
fascia.
28010............... .............. A Incision of toe 2.84 5.53 2.91 0.47 8.84 6.22 090
tendon.
28011............... .............. A Incision of toe 4.13 7.42 4.24 0.70 12.25 9.07 090
tendons.
28020............... .............. A Exploration of foot 5.00 7.07 4.20 0.77 12.84 9.97 090
joint.
28022............... .............. A Exploration of foot 4.66 6.09 3.93 0.75 11.50 9.34 090
joint.
28024............... .............. A Exploration of toe 4.37 6.20 3.99 0.60 11.17 8.96 090
joint.
28030............... .............. A Removal of foot nerve 6.14 NA 3.58 1.03 NA 10.75 090
28035............... .............. A Decompression of 5.08 5.54 4.03 0.86 11.48 9.97 090
tibia nerve.
28043............... .............. A Excision of foot 3.53 5.79 3.28 0.54 9.86 7.35 090
lesion.
28045............... .............. A Excision of foot 4.71 6.12 3.71 0.75 11.58 9.17 090
lesion.
28046............... .............. A Resection of tumor, 10.16 9.42 7.34 1.36 20.94 18.86 090
foot.
28050............... .............. A Biopsy of foot joint 4.24 5.78 3.66 0.66 10.68 8.56 090
lining.
28052............... .............. A Biopsy of foot joint 3.93 5.97 3.56 0.62 10.52 8.11 090
lining.
28054............... .............. A Biopsy of toe joint 3.44 5.82 3.36 0.54 9.80 7.34 090
lining.
28060............... .............. A Partial removal, foot 5.22 6.39 4.03 0.83 12.44 10.08 090
fascia.
28062............... .............. A Removal of foot 6.51 7.13 4.19 1.03 14.67 11.73 090
fascia.
28070............... .............. A Removal of foot joint 5.09 5.96 3.89 0.82 11.87 9.80 090
lining.
28072............... .............. A Removal of foot joint 4.57 6.43 4.32 0.77 11.77 9.66 090
lining.
28080............... .............. A Removal of foot 3.57 5.93 3.70 0.60 10.10 7.87 090
lesion.
28086............... .............. A Excise foot tendon 4.77 9.50 4.69 0.80 15.07 10.26 090
sheath.
28088............... .............. A Excise foot tendon 3.85 7.04 4.00 0.63 11.52 8.48 090
sheath.
28090............... .............. A Removal of foot 4.40 6.02 3.55 0.69 11.11 8.64 090
lesion.
28092............... .............. A Removal of toe 3.63 6.33 3.61 0.55 10.51 7.79 090
lesions.
28100............... .............. A Removal of ankle/heel 5.65 9.21 4.81 0.92 15.78 11.38 090
lesion.
28102............... .............. A Remove/graft foot 7.72 NA 6.05 1.17 NA 14.94 090
lesion.
28103............... .............. A Remove/graft foot 6.49 8.41 4.76 1.07 15.97 12.32 090
lesion.
28104............... .............. A Removal of foot 5.11 6.35 4.05 0.83 12.29 9.99 090
lesion.
28106............... .............. A Remove/graft foot 7.15 NA 4.59 1.22 NA 12.96 090
lesion.
28107............... .............. A Remove/graft foot 5.55 7.24 4.32 0.89 13.68 10.76 090
lesion.
28108............... .............. A Removal of toe 4.15 5.44 3.36 0.63 10.22 8.14 090
lesions.
28110............... .............. A Part removal of 4.07 6.03 3.68 0.59 10.69 8.34 090
metatarsal.
[[Page 1141]]
28111............... .............. A Part removal of 5.00 7.18 4.18 0.76 12.94 9.94 090
metatarsal.
28112............... .............. A Part removal of 4.48 6.69 4.06 0.72 11.89 9.26 090
metatarsal.
28113............... .............. A Part removal of 4.78 6.81 4.66 0.76 12.35 10.20 090
metatarsal.
28114............... .............. A Removal of metatarsal 9.78 11.93 8.52 1.64 23.35 19.94 090
heads.
28116............... .............. A Revision of foot..... 7.74 7.20 5.22 1.24 16.18 14.20 090
28118............... .............. A Removal of heel bone. 5.95 7.13 4.53 0.95 14.03 11.43 090
28119............... .............. A Removal of heel spur. 5.38 6.21 3.87 0.89 12.48 10.14 090
28120............... .............. A Part removal of ankle/ 5.39 8.67 5.07 0.83 14.89 11.29 090
heel.
28122............... .............. A Partial removal of 7.28 7.89 5.69 1.16 16.33 14.13 090
foot bone.
28124............... .............. A Partial removal of 4.80 6.08 4.06 0.78 11.66 9.64 090
toe.
28126............... .............. A Partial removal of 3.51 5.34 3.51 0.59 9.44 7.61 090
toe.
28130............... .............. A Removal of ankle bone 8.10 NA 6.70 1.34 NA 16.14 090
28140............... .............. A Removal of metatarsal 6.90 8.26 5.00 1.01 16.17 12.91 090
28150............... .............. A Removal of toe....... 4.08 5.98 3.78 0.63 10.69 8.49 090
28153............... .............. A Partial removal of 3.65 5.40 3.08 0.59 9.64 7.32 090
toe.
28160............... .............. A Partial removal of 3.73 5.68 3.83 0.62 10.03 8.18 090
toe.
28171............... .............. A Extensive foot 9.59 NA 5.69 1.36 NA 16.64 090
surgery.
28173............... .............. A Extensive foot 8.79 8.26 5.64 1.25 18.30 15.68 090
surgery.
28175............... .............. A Extensive foot 6.04 6.68 4.10 0.90 13.62 11.04 090
surgery.
28190............... .............. A Removal of foot 1.96 6.51 3.47 0.19 8.66 5.62 010
foreign body.
28192............... .............. A Removal of foot 4.63 6.43 3.72 0.63 11.69 8.98 090
foreign body.
28193............... .............. A Removal of foot 5.72 6.35 4.11 0.76 12.83 10.59 090
foreign body.
28200............... .............. A Repair of foot tendon 4.59 5.94 3.71 0.71 11.24 9.01 090
28202............... .............. A Repair/graft of foot 6.83 8.16 4.63 1.04 16.03 12.50 090
tendon.
28208............... .............. A Repair of foot tendon 4.36 5.72 3.46 0.71 10.79 8.53 090
28210............... .............. A Repair/graft of foot 6.34 7.12 4.19 0.93 14.39 11.46 090
tendon.
28220............... .............. A Release of foot 4.52 5.56 3.56 0.76 10.84 8.84 090
tendon.
28222............... .............. A Release of foot 5.61 5.95 4.23 0.93 12.49 10.77 090
tendons.
28225............... .............. A Release of foot 3.65 5.26 3.07 0.60 9.51 7.32 090
tendon.
28226............... .............. A Release of foot 4.52 5.61 3.85 0.75 10.88 9.12 090
tendons.
28230............... .............. A Incision of foot 4.23 5.62 3.81 0.71 10.56 8.75 090
tendon(s).
28232............... .............. A Incision of toe 3.38 5.66 3.44 0.58 9.62 7.40 090
tendon.
28234............... .............. A Incision of foot 3.36 5.81 3.47 0.55 9.72 7.38 090
tendon.
28238............... .............. A Revision of foot 7.72 7.97 5.07 1.30 16.99 14.09 090
tendon.
28240............... .............. A Release of big toe... 4.35 5.59 3.63 0.74 10.68 8.72 090
28250............... .............. A Revision of foot 5.91 6.53 4.25 0.98 13.42 11.14 090
fascia.
28260............... .............. A Release of midfoot 7.95 7.09 5.14 1.30 16.34 14.39 090
joint.
28261............... .............. A Revision of foot 11.71 8.91 7.34 2.00 22.62 21.05 090
tendon.
28262............... .............. A Revision of foot and 15.81 14.32 11.44 2.68 32.81 29.93 090
ankle.
28264............... .............. A Release of midfoot 10.33 8.51 7.82 1.76 20.60 19.91 090
joint.
28270............... .............. A Release of foot 4.75 5.90 4.19 0.81 11.46 9.75 090
contracture.
28272............... .............. A Release of toe joint, 3.79 5.14 3.04 0.63 9.56 7.46 090
each.
28280............... .............. A Fusion of toes....... 5.18 7.25 4.52 0.87 13.30 10.57 090
28285............... .............. A Repair of hammertoe.. 4.58 5.96 3.85 0.77 11.31 9.20 090
28286............... .............. A Repair of hammertoe.. 4.55 5.74 3.67 0.77 11.06 8.99 090
28288............... .............. A Partial removal of 4.73 6.69 5.30 0.78 12.20 10.81 090
foot bone.
28289............... .............. A Repair hallux rigidus 7.03 8.97 6.21 1.16 17.16 14.40 090
28290............... .............. A Correction of bunion. 5.65 7.02 5.28 0.95 13.62 11.88 090
28292............... .............. A Correction of bunion. 7.03 7.80 5.75 1.18 16.01 13.96 090
28293............... .............. A Correction of bunion. 9.14 10.84 6.01 1.54 21.52 16.69 090
28294............... .............. A Correction of bunion. 8.55 7.64 5.08 1.40 17.59 15.03 090
28296............... .............. A Correction of bunion. 9.17 8.14 5.80 1.54 18.85 16.51 090
28297............... .............. A Correction of bunion. 9.17 9.11 6.74 1.58 19.86 17.49 090
28298............... .............. A Correction of bunion. 7.93 7.31 5.40 1.35 16.59 14.68 090
28299............... .............. A Correction of bunion. 10.56 8.71 6.41 1.50 20.77 18.47 090
28300............... .............. A Incision of heel bone 9.53 13.10 7.07 1.58 24.21 18.18 090
28302............... .............. A Incision of ankle 9.54 13.11 6.95 1.39 24.04 17.88 090
bone.
28304............... .............. A Incision of midfoot 9.15 8.16 5.80 1.21 18.52 16.16 090
bones.
28305............... .............. A Incise/graft midfoot 10.48 10.90 6.80 0.66 22.04 17.94 090
bones.
28306............... .............. A Incision of 5.85 7.19 4.25 0.98 14.02 11.08 090
metatarsal.
28307............... .............. A Incision of 6.32 11.59 5.33 0.86 18.77 12.51 090
metatarsal.
28308............... .............. A Incision of 5.28 6.07 3.76 0.89 12.24 9.93 090
metatarsal.
28309............... .............. A Incision of 12.76 NA 8.05 1.98 NA 22.79 090
metatarsals.
28310............... .............. A Revision of big toe.. 5.42 6.24 3.96 0.92 12.58 10.30 090
28312............... .............. A Revision of toe...... 4.54 5.98 4.11 0.75 11.27 9.40 090
28313............... .............. A Repair deformity of 5.00 6.43 5.45 0.82 12.25 11.27 090
toe.
28315............... .............. A Removal of sesamoid 4.85 5.82 3.67 0.80 11.47 9.32 090
bone.
28320............... .............. A Repair of foot bones. 9.17 NA 6.76 1.53 NA 17.46 090
28322............... .............. A Repair of metatarsals 8.33 10.13 6.33 1.41 19.87 16.07 090
28340............... .............. A Resect enlarged toe 6.97 7.06 4.41 1.18 15.21 12.56 090
tissue.
28341............... .............. A Resect enlarged toe.. 8.40 7.23 4.95 1.42 17.05 14.77 090
28344............... .............. A Repair extra toe(s).. 4.25 6.78 3.69 0.72 11.75 8.66 090
28345............... .............. A Repair webbed toe(s). 5.91 6.99 4.79 1.01 13.91 11.71 090
28360............... .............. A Reconstruct cleft 13.32 NA 10.50 2.27 NA 26.09 090
foot.
28400............... .............. A Treatment of heel 2.16 4.28 2.98 0.35 6.79 5.49 090
fracture.
[[Page 1142]]
28405............... .............. A Treatment of heel 4.56 5.51 4.53 0.76 10.83 9.85 090
fracture.
28406............... .............. A Treatment of heel 6.30 NA 6.80 1.05 NA 14.15 090
fracture.
28415............... .............. A Treat heel fracture.. 15.95 NA 13.24 2.70 NA 31.89 090
28420............... .............. A Treat/graft heel 16.62 NA 12.97 2.76 NA 32.35 090
fracture.
28430............... .............. A Treatment of ankle 2.09 4.07 2.61 0.33 6.49 5.03 090
fracture.
28435............... .............. A Treatment of ankle 3.39 4.49 3.63 0.57 8.45 7.59 090
fracture.
28436............... .............. A Treatment of ankle 4.70 NA 5.90 0.80 NA 11.40 090
fracture.
28445............... .............. A Treat ankle fracture. 15.60 NA 11.02 1.56 NA 28.18 090
28450............... .............. A Treat midfoot 1.90 4.07 2.52 0.30 6.27 4.72 090
fracture, each.
28455............... .............. A Treat midfoot 3.09 3.97 3.41 0.52 7.58 7.02 090
fracture, each.
28456............... .............. A Treat midfoot 2.68 NA 4.21 0.43 NA 7.32 090
fracture.
28465............... .............. A Treat midfoot 7.00 NA 6.37 1.05 NA 14.42 090
fracture, each.
28470............... .............. A Treat metatarsal 1.99 3.87 2.48 0.31 6.17 4.78 090
fracture.
28475............... .............. A Treat metatarsal 2.97 4.05 3.19 0.49 7.51 6.65 090
fracture.
28476............... .............. A Treat metatarsal 3.37 NA 4.99 0.55 NA 8.91 090
fracture.
28485............... .............. A Treat metatarsal 5.70 NA 5.55 0.96 NA 12.21 090
fracture.
28490............... .............. A Treat big toe 1.09 2.21 1.73 0.16 3.46 2.98 090
fracture.
28495............... .............. A Treat big toe 1.58 2.50 2.06 0.23 4.31 3.87 090
fracture.
28496............... .............. A Treat big toe 2.33 9.72 3.63 0.39 12.44 6.35 090
fracture.
28505............... .............. A Treat big toe 3.80 9.71 4.70 0.60 14.11 9.10 090
fracture.
28510............... .............. A Treatment of toe 1.09 1.98 1.69 0.16 3.23 2.94 090
fracture.
28515............... .............. A Treatment of toe 1.46 2.33 1.99 0.21 4.00 3.66 090
fracture.
28525............... .............. A Treat toe fracture... 3.32 9.30 4.25 0.53 13.15 8.10 090
28530............... .............. A Treat sesamoid bone 1.06 2.08 1.46 0.16 3.30 2.68 090
fracture.
28531............... .............. A Treat sesamoid bone 2.35 8.98 2.51 0.40 11.73 5.26 090
fracture.
28540............... .............. A Treat foot 2.04 2.87 2.67 0.29 5.20 5.00 090
dislocation.
28545............... .............. A Treat foot 2.45 2.86 2.86 0.40 5.71 5.71 090
dislocation.
28546............... .............. A Treat foot 3.20 7.89 4.84 0.55 11.64 8.59 090
dislocation.
28555............... .............. A Repair foot 6.29 11.49 6.54 1.06 18.84 13.89 090
dislocation.
28570............... .............. A Treat foot 1.66 2.89 2.29 0.27 4.82 4.22 090
dislocation.
28575............... .............. A Treat foot 3.31 4.37 4.03 0.54 8.22 7.88 090
dislocation.
28576............... .............. A Treat foot 4.16 10.15 5.51 0.68 14.99 10.35 090
dislocation.
28585............... .............. A Repair foot 7.98 8.14 6.53 1.36 17.48 15.87 090
dislocation.
28600............... .............. A Treat foot 1.89 3.29 2.66 0.29 5.47 4.84 090
dislocation.
28605............... .............. A Treat foot 2.71 3.74 3.61 0.42 6.87 6.74 090
dislocation.
28606............... .............. A Treat foot 4.89 16.02 6.01 0.82 21.73 11.72 090
dislocation.
28615............... .............. A Repair foot 7.76 NA 7.98 1.31 NA 17.05 090
dislocation.
28630............... .............. A Treat toe dislocation 1.70 1.22 1.12 0.21 3.13 3.03 010
28635............... .............. A Treat toe dislocation 1.91 1.66 1.49 0.29 3.86 3.69 010
28636............... .............. A Treat toe dislocation 2.77 6.14 3.07 0.47 9.38 6.31 010
28645............... .............. A Repair toe 4.21 5.66 3.50 0.70 10.57 8.41 090
dislocation.
28660............... .............. A Treat toe dislocation 1.23 1.61 1.16 0.13 2.97 2.52 010
28665............... .............. A Treat toe dislocation 1.92 1.65 1.63 0.29 3.86 3.84 010
28666............... .............. A Treat toe dislocation 2.66 5.93 2.24 0.46 9.05 5.36 010
28675............... .............. A Repair of toe 2.92 8.81 3.77 0.49 12.22 7.18 090
dislocation.
28705............... .............. A Fusion of foot bones. 18.77 NA 12.43 2.57 NA 33.77 090
28715............... .............. A Fusion of foot bones. 13.08 NA 9.74 2.22 NA 25.04 090
28725............... .............. A Fusion of foot bones. 11.59 NA 8.30 1.97 NA 21.86 090
28730............... .............. A Fusion of foot bones. 10.74 NA 8.47 1.82 NA 21.03 090
28735............... .............. A Fusion of foot bones. 10.83 NA 7.86 1.82 NA 20.51 090
28737............... .............. A Revision of foot 9.63 NA 6.87 1.64 NA 18.14 090
bones.
28740............... .............. A Fusion of foot bones. 8.01 11.59 6.43 1.36 20.96 15.80 090
28750............... .............. A Fusion of big toe 7.29 12.97 6.59 1.24 21.50 15.12 090
joint.
28755............... .............. A Fusion of big toe 4.73 6.83 3.86 0.80 12.36 9.39 090
joint.
28760............... .............. A Fusion of big toe 7.74 8.04 5.62 1.29 17.07 14.65 090
joint.
28800............... .............. A Amputation of midfoot 8.20 NA 6.04 1.18 NA 15.42 090
28805............... .............. A Amputation thru 8.38 NA 5.90 1.17 NA 15.45 090
metatarsal.
28810............... .............. A Amputation toe & 6.20 NA 4.76 0.84 NA 11.80 090
metatarsal.
28820............... .............. A Amputation of toe.... 4.40 8.50 4.10 0.62 13.52 9.12 090
28825............... .............. A Partial amputation of 3.58 7.91 3.79 0.52 12.01 7.89 090
toe.
28899............... .............. C Foot/toes surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
29000............... .............. A Application of body 2.25 3.09 1.72 0.36 5.70 4.33 000
cast.
29010............... .............. A Application of body 2.06 3.30 1.73 0.33 5.69 4.12 000
cast.
29015............... .............. A Application of body 2.41 3.01 1.58 0.25 5.67 4.24 000
cast.
29020............... .............. A Application of body 2.11 3.30 1.41 0.19 5.60 3.71 000
cast.
29025............... .............. A Application of body 2.40 3.22 1.83 0.31 5.93 4.54 000
cast.
29035............... .............. A Application of body 1.77 3.45 1.54 0.29 5.51 3.60 000
cast.
29040............... .............. A Application of body 2.22 2.57 1.51 0.42 5.21 4.15 000
cast.
29044............... .............. A Application of body 2.12 3.80 1.85 0.35 6.27 4.32 000
cast.
29046............... .............. A Application of body 2.41 3.27 2.02 0.41 6.09 4.84 000
cast.
29049............... .............. A Application of figure 0.89 1.24 0.54 0.14 2.27 1.57 000
eight.
29055............... .............. A Application of 1.78 2.81 1.43 0.29 4.88 3.50 000
shoulder cast.
29058............... .............. A Application of 1.31 1.50 0.73 0.17 2.98 2.21 000
shoulder cast.
29065............... .............. A Application of long 0.87 1.26 0.74 0.14 2.27 1.75 000
arm cast.
29075............... .............. A Application of 0.77 1.20 0.67 0.13 2.10 1.57 000
forearm cast.
[[Page 1143]]
29085............... .............. A Apply hand/wrist cast 0.87 1.23 0.63 0.13 2.23 1.63 000
29086............... .............. A Apply finger cast.... 0.62 0.93 0.51 0.07 1.62 1.20 000
29105............... .............. A Apply long arm splint 0.87 1.18 0.52 0.13 2.18 1.52 000
29125............... .............. A Apply forearm splint. 0.59 0.99 0.40 0.07 1.65 1.06 000
29126............... .............. A Apply forearm splint. 0.77 1.19 0.46 0.07 2.03 1.30 000
29130............... .............. A Application of finger 0.50 0.45 0.17 0.06 1.01 0.73 000
splint.
29131............... .............. A Application of finger 0.55 0.73 0.24 0.04 1.32 0.83 000
splint.
29200............... .............. A Strapping of chest... 0.65 0.75 0.36 0.05 1.45 1.06 000
29220............... .............. A Strapping of low back 0.64 0.72 0.39 0.08 1.44 1.11 000
29240............... .............. A Strapping of shoulder 0.71 0.86 0.37 0.06 1.63 1.14 000
29260............... .............. A Strapping of elbow or 0.55 0.75 0.34 0.05 1.35 0.94 000
wrist.
29280............... .............. A Strapping of hand or 0.51 0.81 0.34 0.05 1.37 0.90 000
finger.
29305............... .............. A Application of hip 2.03 3.19 1.71 0.35 5.57 4.09 000
cast.
29325............... .............. A Application of hip 2.32 3.37 1.89 0.37 6.06 4.58 000
casts.
29345............... .............. A Application of long 1.40 1.69 1.04 0.23 3.32 2.67 000
leg cast.
29355............... .............. A Application of long 1.53 1.65 1.10 0.24 3.42 2.87 000
leg cast.
29358............... .............. A Apply long leg cast 1.43 1.96 1.07 0.23 3.62 2.73 000
brace.
29365............... .............. A Application of long 1.18 1.58 0.93 0.21 2.97 2.32 000
leg cast.
29405............... .............. A Apply short leg cast. 0.86 1.17 0.70 0.14 2.17 1.70 000
29425............... .............. A Apply short leg cast. 1.01 1.18 0.72 0.17 2.36 1.90 000
29435............... .............. A Apply short leg cast. 1.18 1.49 0.91 0.21 2.88 2.30 000
29440............... .............. A Addition of walker to 0.57 0.67 0.28 0.08 1.32 0.93 000
cast.
29445............... .............. A Apply rigid leg cast. 1.78 1.75 0.96 0.29 3.82 3.03 000
29450............... .............. A Application of leg 2.08 1.45 1.10 0.16 3.69 3.34 000
cast.
29505............... .............. A Application, long leg 0.69 1.15 0.46 0.07 1.91 1.22 000
splint.
29515............... .............. A Application lower leg 0.73 0.85 0.47 0.08 1.66 1.28 000
splint.
29520............... .............. A Strapping of hip..... 0.54 0.87 0.45 0.02 1.43 1.01 000
29530............... .............. A Strapping of knee.... 0.57 0.80 0.35 0.05 1.42 0.97 000
29540............... .............. A Strapping of ankle 0.51 0.41 0.32 0.05 0.97 0.88 000
and/or ft.
29550............... .............. A Strapping of toes.... 0.47 0.41 0.28 0.06 0.94 0.81 000
29580............... .............. A Application of paste 0.57 0.65 0.36 0.06 1.28 0.99 000
boot.
29590............... .............. A Application of foot 0.76 0.50 0.30 0.07 1.33 1.13 000
splint.
29700............... .............. A Removal/revision of 0.57 0.88 0.28 0.08 1.53 0.93 000
cast.
29705............... .............. A Removal/revision of 0.76 0.79 0.38 0.12 1.67 1.26 000
cast.
29710............... .............. A Removal/revision of 1.34 1.49 0.70 0.21 3.04 2.25 000
cast.
29715............... .............. A Removal/revision of 0.94 1.14 0.40 0.10 2.18 1.44 000
cast.
29720............... .............. A Repair of body cast.. 0.68 1.10 0.38 0.12 1.90 1.18 000
29730............... .............. A Windowing of cast.... 0.75 0.78 0.36 0.12 1.65 1.23 000
29740............... .............. A Wedging of cast...... 1.12 1.12 0.49 0.18 2.42 1.79 000
29750............... .............. A Wedging of clubfoot 1.26 1.04 0.58 0.19 2.49 2.03 000
cast.
29799............... .............. C Casting/strapping 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
29800............... .............. A Jaw arthroscopy/ 6.42 NA 7.12 1.01 NA 14.55 090
surgery.
29804............... .............. A Jaw arthroscopy/ 8.13 NA 8.41 0.80 NA 17.34 090
surgery.
29805............... .............. A Shoulder arthroscopy, 5.88 NA 5.65 1.01 NA 12.54 090
dx.
29806............... .............. A Shoulder arthroscopy/ 14.35 NA 10.94 2.41 NA 27.70 090
surgery.
29807............... .............. A Shoulder arthroscopy/ 13.88 NA 10.78 2.34 NA 27.00 090
surgery.
29819............... .............. A Shoulder arthroscopy/ 7.61 NA 6.66 1.29 NA 15.56 090
surgery.
29820............... .............. A Shoulder arthroscopy/ 7.06 NA 6.12 1.19 NA 14.37 090
surgery.
29821............... .............. A Shoulder arthroscopy/ 7.71 NA 6.68 1.30 NA 15.69 090
surgery.
29822............... .............. A Shoulder arthroscopy/ 7.42 NA 6.56 1.25 NA 15.23 090
surgery.
29823............... .............. A Shoulder arthroscopy/ 8.16 NA 7.09 1.39 NA 16.64 090
surgery.
29824............... .............. A Shoulder arthroscopy/ 8.24 NA 7.33 1.39 NA 16.96 090
surgery.
29825............... .............. A Shoulder arthroscopy/ 7.61 NA 6.64 1.28 NA 15.53 090
surgery.
29826............... .............. A Shoulder arthroscopy/ 8.98 NA 7.41 1.52 NA 17.91 090
surgery.
29827............... .............. A Arthroscop rotator 15.34 NA 11.32 2.24 NA 28.90 090
cuff repr.
29830............... .............. A Elbow arthroscopy.... 5.75 NA 5.25 0.95 NA 11.95 090
29834............... .............. A Elbow arthroscopy/ 6.27 NA 5.72 1.04 NA 13.03 090
surgery.
29835............... .............. A Elbow arthroscopy/ 6.47 NA 5.77 1.06 NA 13.30 090
surgery.
29836............... .............. A Elbow arthroscopy/ 7.54 NA 6.66 1.28 NA 15.48 090
surgery.
29837............... .............. A Elbow arthroscopy/ 6.86 NA 6.02 1.16 NA 14.04 090
surgery.
29838............... .............. A Elbow arthroscopy/ 7.70 NA 6.76 1.29 NA 15.75 090
surgery.
29840............... .............. A Wrist arthroscopy.... 5.53 NA 5.24 0.83 NA 11.60 090
29843............... .............. A Wrist arthroscopy/ 6.00 NA 5.54 0.99 NA 12.53 090
surgery.
29844............... .............. A Wrist arthroscopy/ 6.36 NA 5.71 1.04 NA 13.11 090
surgery.
29845............... .............. A Wrist arthroscopy/ 7.51 NA 6.38 1.01 NA 14.90 090
surgery.
29846............... .............. A Wrist arthroscopy/ 6.74 NA 5.95 1.07 NA 13.76 090
surgery.
29847............... .............. A Wrist arthroscopy/ 7.07 NA 6.10 1.10 NA 14.27 090
surgery.
29848............... .............. A Wrist endoscopy/ 5.43 NA 5.49 0.87 NA 11.79 090
surgery.
29850............... .............. A Knee arthroscopy/ 8.18 NA 5.04 0.89 NA 14.11 090
surgery.
29851............... .............. A Knee arthroscopy/ 13.08 NA 9.66 2.18 NA 24.92 090
surgery.
29855............... .............. A Tibial arthroscopy/ 10.60 NA 8.60 1.81 NA 21.01 090
surgery.
29856............... .............. A Tibial arthroscopy/ 14.12 NA 10.51 2.41 NA 27.04 090
surgery.
29860............... .............. A Hip arthroscopy, dx.. 8.04 NA 6.82 1.37 NA 16.23 090
29861............... .............. A Hip arthroscopy/ 9.14 NA 7.22 1.56 NA 17.92 090
surgery.
29862............... .............. A Hip arthroscopy/ 9.89 NA 8.39 1.68 NA 19.96 090
surgery.
[[Page 1144]]
29863............... .............. A Hip arthroscopy/ 9.89 NA 8.34 1.69 NA 19.92 090
surgery.
29870............... .............. A Knee arthroscopy, dx. 5.06 NA 4.80 0.81 NA 10.67 090
29871............... .............. A Knee arthroscopy/ 6.54 NA 5.76 1.06 NA 13.36 090
drainage.
29873............... .............. A Knee arthroscopy/ 5.99 NA 6.37 0.88 NA 13.24 090
surgery.
29874............... .............. A Knee arthroscopy/ 7.04 NA 5.97 1.05 NA 14.06 090
surgery.
29875............... .............. A Knee arthroscopy/ 6.30 NA 5.74 1.06 NA 13.10 090
surgery.
29876............... .............. A Knee arthroscopy/ 7.91 NA 6.88 1.34 NA 16.13 090
surgery.
29877............... .............. A Knee arthroscopy/ 7.34 NA 6.59 1.24 NA 15.17 090
surgery.
29879............... .............. A Knee arthroscopy/ 8.03 NA 6.97 1.36 NA 16.36 090
surgery.
29880............... .............. A Knee arthroscopy/ 8.49 NA 7.21 1.44 NA 17.14 090
surgery.
29881............... .............. A Knee arthroscopy/ 7.75 NA 6.82 1.31 NA 15.88 090
surgery.
29882............... .............. A Knee arthroscopy/ 8.64 NA 7.10 1.31 NA 17.05 090
surgery.
29883............... .............. A Knee arthroscopy/ 11.03 NA 8.90 1.60 NA 21.53 090
surgery.
29884............... .............. A Knee arthroscopy/ 7.32 NA 6.55 1.24 NA 15.11 090
surgery.
29885............... .............. A Knee arthroscopy/ 9.08 NA 7.81 1.53 NA 18.42 090
surgery.
29886............... .............. A Knee arthroscopy/ 7.53 NA 6.70 1.28 NA 15.51 090
surgery.
29887............... .............. A Knee arthroscopy/ 9.03 NA 7.78 1.53 NA 18.34 090
surgery.
29888............... .............. A Knee arthroscopy/ 13.88 NA 10.09 2.35 NA 26.32 090
surgery.
29889............... .............. A Knee arthroscopy/ 15.98 NA 12.23 2.54 NA 30.75 090
surgery.
29891............... .............. A Ankle arthroscopy/ 8.39 NA 7.35 1.41 NA 17.15 090
surgery.
29892............... .............. A Ankle arthroscopy/ 8.99 NA 7.59 1.52 NA 18.10 090
surgery.
29893............... .............. A Scope, plantar 5.21 6.14 3.92 0.89 12.24 10.02 090
fasciotomy.
29894............... .............. A Ankle arthroscopy/ 7.20 NA 5.39 1.22 NA 13.81 090
surgery.
29895............... .............. A Ankle arthroscopy/ 6.98 NA 5.39 1.17 NA 13.54 090
surgery.
29897............... .............. A Ankle arthroscopy/ 7.17 NA 5.78 1.22 NA 14.17 090
surgery.
29898............... .............. A Ankle arthroscopy/ 8.31 NA 6.11 1.37 NA 15.79 090
surgery.
29899............... .............. A Ankle arthroscopy/ 13.89 NA 9.84 2.35 NA 26.08 090
surgery.
29900............... .............. A Mcp joint 5.41 NA 5.69 0.90 NA 12.00 090
arthroscopy, dx.
29901............... .............. A Mcp joint 6.12 NA 6.09 1.03 NA 13.24 090
arthroscopy, surg.
29902............... .............. A Mcp joint 6.69 NA 6.37 1.12 NA 14.18 090
arthroscopy, surg.
29999............... .............. C Arthroscopy of joint. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
30000............... .............. A Drainage of nose 1.43 4.19 1.41 0.12 5.74 2.96 010
lesion.
30020............... .............. A Drainage of nose 1.43 3.35 1.48 0.10 4.88 3.01 010
lesion.
30100............... .............. A Intranasal biopsy.... 0.94 2.05 0.82 0.07 3.06 1.83 000
30110............... .............. A Removal of nose 1.63 3.36 1.58 0.14 5.13 3.35 010
polyp(s).
30115............... .............. A Removal of nose 4.34 NA 4.02 0.37 NA 8.73 090
polyp(s).
30117............... .............. A Removal of intranasal 3.16 4.38 3.28 0.27 7.81 6.71 090
lesion.
30118............... .............. A Removal of intranasal 9.68 NA 7.27 0.80 NA 17.75 090
lesion.
30120............... .............. A Revision of nose..... 5.26 5.53 5.48 0.49 11.28 11.23 090
30124............... .............. A Removal of nose 3.10 NA 3.03 0.24 NA 6.37 090
lesion.
30125............... .............. A Removal of nose 7.15 NA 5.92 0.65 NA 13.72 090
lesion.
30130............... .............. A Removal of turbinate 3.37 NA 3.51 0.27 NA 7.15 090
bones.
30140............... .............. A Removal of turbinate 3.42 NA 3.97 0.29 NA 7.68 090
bones.
30150............... .............. A Partial removal of 9.13 NA 7.66 0.92 NA 17.71 090
nose.
30160............... .............. A Removal of nose...... 9.57 NA 7.65 0.94 NA 18.16 090
30200............... .............. A Injection treatment 0.78 1.70 0.77 0.07 2.55 1.62 000
of nose.
30210............... .............. A Nasal sinus therapy.. 1.08 2.17 1.32 0.10 3.35 2.50 010
30220............... .............. A Insert nasal septal 1.54 4.50 1.54 0.13 6.17 3.21 010
button.
30300............... .............. A Remove nasal foreign 1.04 4.84 1.96 0.08 5.96 3.08 010
body.
30310............... .............. A Remove nasal foreign 1.96 NA 3.20 0.17 NA 5.33 010
body.
30320............... .............. A Remove nasal foreign 4.51 NA 4.49 0.43 NA 9.43 090
body.
30400............... .............. R Reconstruction of 9.82 NA 9.16 0.96 NA 19.94 090
nose.
30410............... .............. R Reconstruction of 12.96 NA 10.94 1.30 NA 25.20 090
nose.
30420............... .............. R Reconstruction of 15.86 NA 12.42 1.50 NA 29.78 090
nose.
30430............... .............. R Revision of nose..... 7.20 NA 8.10 0.75 NA 16.05 090
30435............... .............. R Revision of nose..... 11.69 NA 10.62 1.33 NA 23.64 090
30450............... .............. R Revision of nose..... 18.62 NA 14.10 1.85 NA 34.57 090
30460............... .............. A Revision of nose..... 9.95 NA 7.75 1.03 NA 18.73 090
30462............... .............. A Revision of nose..... 19.54 NA 13.67 2.32 NA 35.53 090
30465............... .............. A Repair nasal stenosis 11.62 NA 7.67 1.17 NA 20.46 090
30520............... .............. A Repair of nasal 5.69 NA 5.15 0.49 NA 11.33 090
septum.
30540............... .............. A Repair nasal defect.. 7.74 NA 5.62 0.64 NA 14.00 090
30545............... .............. A Repair nasal defect.. 11.36 NA 8.64 0.96 NA 20.96 090
30560............... .............. A Release of nasal 1.26 4.92 2.16 0.11 6.29 3.53 010
adhesions.
30580............... .............. A Repair upper jaw 6.68 7.17 6.12 0.60 14.45 13.40 090
fistula.
30600............... .............. A Repair mouth/nose 6.01 6.32 5.52 0.84 13.17 12.37 090
fistula.
30620............... .............. A Intranasal 5.96 NA 5.78 0.54 NA 12.28 090
reconstruction.
30630............... .............. A Repair nasal septum 7.11 NA 6.18 0.62 NA 13.91 090
defect.
30801............... .............. A Cauterization, inner 1.09 2.17 2.07 0.10 3.36 3.26 010
nose.
30802............... .............. A Cauterization, inner 2.03 2.71 2.58 0.18 4.92 4.79 010
nose.
30901............... .............. A Control of nosebleed. 1.21 1.36 0.33 0.11 2.68 1.65 000
30903............... .............. A Control of nosebleed. 1.54 2.80 0.50 0.14 4.48 2.18 000
30905............... .............. A Control of nosebleed. 1.97 3.57 0.76 0.18 5.72 2.91 000
30906............... .............. A Repeat control of 2.45 3.96 1.20 0.21 6.62 3.86 000
nosebleed.
30915............... .............. A Ligation, nasal sinus 7.19 NA 5.82 0.60 NA 13.61 090
artery.
[[Page 1145]]
30920............... .............. A Ligation, upper jaw 9.82 NA 7.49 0.83 NA 18.14 090
artery.
30930............... .............. A Therapy, fracture of 1.26 NA 1.65 0.11 NA 3.02 010
nose.
30999............... .............. C Nasal surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
31000............... .............. A Irrigation, maxillary 1.15 2.91 1.41 0.10 4.16 2.66 010
sinus.
31002............... .............. A Irrigation, sphenoid 1.91 NA 3.29 0.17 NA 5.37 010
sinus.
31020............... .............. A Exploration, 2.94 4.12 3.51 0.24 7.30 6.69 090
maxillary sinus.
31030............... .............. A Exploration, 5.91 5.64 4.81 0.51 12.06 11.23 090
maxillary sinus.
31032............... .............. A Explore sinus, remove 6.56 NA 5.60 0.57 NA 12.73 090
polyps.
31040............... .............. A Exploration behind 9.41 NA 6.27 0.86 NA 16.54 090
upper jaw.
31050............... .............. A Exploration, sphenoid 5.27 NA 4.50 0.47 NA 10.24 090
sinus.
31051............... .............. A Sphenoid sinus 7.10 NA 5.86 0.66 NA 13.62 090
surgery.
31070............... .............. A Exploration of 4.27 NA 4.20 0.36 NA 8.83 090
frontal sinus.
31075............... .............. A Exploration of 9.15 NA 7.21 0.77 NA 17.13 090
frontal sinus.
31080............... .............. A Removal of frontal 11.40 NA 8.44 0.94 NA 20.78 090
sinus.
31081............... .............. A Removal of frontal 12.73 NA 9.46 2.22 NA 24.41 090
sinus.
31084............... .............. A Removal of frontal 13.49 NA 10.04 1.16 NA 24.69 090
sinus.
31085............... .............. A Removal of frontal 14.18 NA 10.41 1.42 NA 26.01 090
sinus.
31086............... .............. A Removal of frontal 12.84 NA 9.86 1.09 NA 23.79 090
sinus.
31087............... .............. A Removal of frontal 13.08 NA 9.79 1.39 NA 24.26 090
sinus.
31090............... .............. A Exploration of 9.52 NA 8.59 0.80 NA 18.91 090
sinuses.
31200............... .............. A Removal of ethmoid 4.96 NA 5.02 0.30 NA 10.28 090
sinus.
31201............... .............. A Removal of ethmoid 8.36 NA 6.82 0.70 NA 15.88 090
sinus.
31205............... .............. A Removal of ethmoid 10.22 NA 7.63 0.70 NA 18.55 090
sinus.
31225............... .............. A Removal of upper jaw. 19.20 NA 13.74 1.66 NA 34.60 090
31230............... .............. A Removal of upper jaw. 21.91 NA 15.12 1.89 NA 38.92 090
31231............... .............. A Nasal endoscopy, dx.. 1.10 3.55 0.92 0.10 4.75 2.12 000
31233............... .............. A Nasal/sinus 2.18 4.49 1.51 0.19 6.86 3.88 000
endoscopy, dx.
31235............... .............. A Nasal/sinus 2.64 5.10 1.76 0.22 7.96 4.62 000
endoscopy, dx.
31237............... .............. A Nasal/sinus 2.98 5.40 1.91 0.25 8.63 5.14 000
endoscopy, surg.
31238............... .............. A Nasal/sinus 3.26 5.45 2.12 0.28 8.99 5.66 000
endoscopy, surg.
31239............... .............. A Nasal/sinus 8.69 NA 8.28 0.55 NA 17.52 010
endoscopy, surg.
31240............... .............. A Nasal/sinus 2.61 NA 1.76 0.22 NA 4.59 000
endoscopy, surg.
31254............... .............. A Revision of ethmoid 4.64 NA 2.89 0.39 NA 7.92 000
sinus.
31255............... .............. A Removal of ethmoid 6.95 NA 4.15 0.59 NA 11.69 000
sinus.
31256............... .............. A Exploration maxillary 3.29 NA 2.14 0.28 NA 5.71 000
sinus.
31267............... .............. A Endoscopy, maxillary 5.45 NA 3.34 0.46 NA 9.25 000
sinus.
31276............... .............. A Sinus endoscopy, 8.84 NA 5.17 0.75 NA 14.76 000
surgical.
31287............... .............. A Nasal/sinus 3.91 NA 2.49 0.33 NA 6.73 000
endoscopy, surg.
31288............... .............. A Nasal/sinus 4.57 NA 2.85 0.39 NA 7.81 000
endoscopy, surg.
31290............... .............. A Nasal/sinus 17.21 NA 12.15 1.45 NA 30.81 010
endoscopy, surg.
31291............... .............. A Nasal/sinus 18.16 NA 12.55 2.09 NA 32.80 010
endoscopy, surg.
31292............... .............. A Nasal/sinus 14.74 NA 10.71 1.19 NA 26.64 010
endoscopy, surg.
31293............... .............. A Nasal/sinus 16.19 NA 11.52 1.17 NA 28.88 010
endoscopy, surg.
31294............... .............. A Nasal/sinus 19.03 NA 13.00 1.25 NA 33.28 010
endoscopy, surg.
31299............... .............. C Sinus surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
31300............... .............. A Removal of larynx 14.27 NA 12.03 1.19 NA 27.49 090
lesion.
31320............... .............. A Diagnostic incision, 5.25 NA 7.24 0.48 NA 12.97 090
larynx.
31360............... .............. A Removal of larynx.... 17.05 NA 13.95 1.45 NA 32.45 090
31365............... .............. A Removal of larynx.... 24.12 NA 17.63 2.07 NA 43.82 090
31367............... .............. A Partial removal of 21.83 NA 17.41 1.89 NA 41.13 090
larynx.
31368............... .............. A Partial removal of 27.05 NA 21.00 2.29 NA 50.34 090
larynx.
31370............... .............. A Partial removal of 21.35 NA 17.05 1.82 NA 40.22 090
larynx.
31375............... .............. A Partial removal of 20.18 NA 15.35 1.72 NA 37.25 090
larynx.
31380............... .............. A Partial removal of 20.18 NA 15.31 1.69 NA 37.18 090
larynx.
31382............... .............. A Partial removal of 20.49 NA 16.56 1.74 NA 38.79 090
larynx.
31390............... .............. A Removal of larynx & 27.49 NA 21.24 2.35 NA 51.08 090
pharynx.
31395............... .............. A Reconstruct larynx & 31.04 NA 25.13 2.74 NA 58.91 090
pharynx.
31400............... .............. A Revision of larynx... 10.29 NA 10.00 0.87 NA 21.16 090
31420............... .............. A Removal of epiglottis 10.20 NA 9.80 0.86 NA 20.86 090
31500............... .............. A Insert emergency 2.33 NA 0.55 0.18 NA 3.06 000
airway.
31502............... .............. A Change of windpipe 0.65 1.49 0.26 0.05 2.19 0.96 000
airway.
31505............... .............. A Diagnostic 0.61 1.57 0.64 0.05 2.23 1.30 000
laryngoscopy.
31510............... .............. A Laryngoscopy with 1.92 3.42 1.28 0.18 5.52 3.38 000
biopsy.
31511............... .............. A Remove foreign body, 2.16 3.25 1.11 0.19 5.60 3.46 000
larynx.
31512............... .............. A Removal of larynx 2.07 3.34 1.39 0.19 5.60 3.65 000
lesion.
31513............... .............. A Injection into vocal 2.10 NA 1.49 0.18 NA 3.77 000
cord.
31515............... .............. A Laryngoscopy for 1.80 3.71 1.10 0.14 5.65 3.04 000
aspiration.
31520............... .............. A Diagnostic 2.56 NA 1.60 0.21 NA 4.37 000
laryngoscopy.
31525............... .............. A Diagnostic 2.63 3.86 1.70 0.22 6.71 4.55 000
laryngoscopy.
31526............... .............. A Diagnostic 2.57 NA 1.75 0.22 NA 4.54 000
laryngoscopy.
31527............... .............. A Laryngoscopy for 3.27 NA 1.90 0.25 NA 5.42 000
treatment.
31528............... .............. A Laryngoscopy and 2.37 NA 1.45 0.19 NA 4.01 000
dilation.
31529............... .............. A Laryngoscopy and 2.68 NA 1.72 0.22 NA 4.62 000
dilation.
31530............... .............. A Operative 3.38 NA 1.98 0.29 NA 5.65 000
laryngoscopy.
31531............... .............. A Operative 3.58 NA 2.31 0.30 NA 6.19 000
laryngoscopy.
[[Page 1146]]
31535............... .............. A Operative 3.16 NA 2.02 0.27 NA 5.45 000
laryngoscopy.
31536............... .............. A Operative 3.55 NA 2.29 0.30 NA 6.14 000
laryngoscopy.
31540............... .............. A Operative 4.12 NA 2.59 0.35 NA 7.06 000
laryngoscopy.
31541............... .............. A Operative 4.52 NA 2.81 0.39 NA 7.72 000
laryngoscopy.
31560............... .............. A Operative 5.45 NA 3.17 0.46 NA 9.08 000
laryngoscopy.
31561............... .............. A Operative 5.99 NA 3.38 0.51 NA 9.88 000
laryngoscopy.
31570............... .............. A Laryngoscopy with 3.86 5.74 2.42 0.29 9.89 6.57 000
injection.
31571............... .............. A Laryngoscopy with 4.26 NA 2.63 0.36 NA 7.25 000
injection.
31575............... .............. A Diagnostic 1.10 1.88 0.91 0.10 3.08 2.11 000
laryngoscopy.
31576............... .............. A Laryngoscopy with 1.97 3.62 1.31 0.16 5.75 3.44 000
biopsy.
31577............... .............. A Remove foreign body, 2.47 3.74 1.57 0.21 6.42 4.25 000
larynx.
31578............... .............. A Removal of larynx 2.84 4.25 1.56 0.24 7.33 4.64 000
lesion.
31579............... .............. A Diagnostic 2.26 3.80 1.52 0.19 6.25 3.97 000
laryngoscopy.
31580............... .............. A Revision of larynx... 12.36 NA 11.12 1.05 NA 24.53 090
31582............... .............. A Revision of larynx... 21.59 NA 17.42 1.83 NA 40.84 090
31584............... .............. A Treat larynx fracture 19.61 NA 14.58 1.71 NA 35.90 090
31585............... .............. A Treat larynx fracture 4.63 NA 5.59 0.36 NA 10.58 090
31586............... .............. A Treat larynx fracture 8.02 NA 8.36 0.68 NA 17.06 090
31587............... .............. A Revision of larynx... 11.97 NA 10.05 1.06 NA 23.08 090
31588............... .............. A Revision of larynx... 13.09 NA 13.10 1.11 NA 27.30 090
31590............... .............. A Reinnervate larynx... 6.96 NA 8.81 0.60 NA 16.37 090
31595............... .............. A Larynx nerve surgery. 8.33 NA 7.65 0.75 NA 16.73 090
31599............... .............. C Larynx surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
31600............... .............. A Incision of windpipe. 7.17 NA 3.20 0.41 NA 10.78 000
31601............... .............. A Incision of windpipe. 4.44 NA 2.41 0.47 NA 7.32 000
31603............... .............. A Incision of windpipe. 4.14 NA 1.72 0.42 NA 6.28 000
31605............... .............. A Incision of windpipe. 3.57 NA 1.19 0.40 NA 5.16 000
31610............... .............. A Incision of windpipe. 8.75 NA 7.45 0.83 NA 17.03 090
31611............... .............. A Surgery/speech 5.63 NA 5.95 0.48 NA 12.06 090
prosthesis.
31612............... .............. A Puncture/clear 0.91 1.12 0.36 0.07 2.10 1.34 000
windpipe.
31613............... .............. A Repair windpipe 4.58 NA 5.42 0.45 NA 10.45 090
opening.
31614............... .............. A Repair windpipe 7.11 NA 7.81 0.62 NA 15.54 090
opening.
31615............... .............. A Visualization of 2.09 2.63 1.20 0.17 4.89 3.46 000
windpipe.
31622............... .............. A Dx bronchoscope/wash. 2.78 4.17 0.89 0.17 7.12 3.84 000
31623............... .............. A Dx bronchoscope/brush 2.88 5.05 0.89 0.17 8.10 3.94 000
31624............... .............. A Dx bronchoscope/ 2.88 4.28 0.90 0.16 7.32 3.94 000
lavage.
31625............... .............. A Bronchoscopy w/ 3.36 5.37 1.26 0.19 8.92 4.81 000
biopsy(s).
31628............... .............. A Bronchoscopy/lung bx, 3.80 5.53 1.34 0.17 9.50 5.31 000
each.
31629............... .............. A Bronchoscopy/needle 3.36 NA 1.22 0.16 NA 4.74 000
bx, each.
31630............... .............. A Bronchoscopy dilate/ 3.81 NA 2.00 0.36 NA 6.17 000
fx repr.
31631............... .............. A Bronchoscopy, dilate 4.36 NA 2.02 0.37 NA 6.75 000
w/stent.
31632............... .............. A Bronchoscopy/lung bx, 1.03 0.76 0.32 0.17 1.96 1.52 ZZZ
add'l.
31633............... .............. A Bronchoscopy/needle 1.32 0.91 0.40 0.17 2.40 1.89 ZZZ
bx add'l.
31635............... .............. A Bronchoscopy w/fb 3.67 NA 1.67 0.25 NA 5.59 000
removal.
31640............... .............. A Bronchoscopy w/tumor 4.93 NA 2.35 0.45 NA 7.73 000
excise.
31641............... .............. A Bronchoscopy, treat 5.02 NA 2.12 0.36 NA 7.50 000
blockage.
31643............... .............. A Diag bronchoscope/ 3.49 NA 1.31 0.18 NA 4.98 000
catheter.
31645............... .............. A Bronchoscopy, clear 3.16 NA 1.20 0.16 NA 4.52 000
airways.
31646............... .............. A Bronchoscopy, reclear 2.72 NA 1.08 0.14 NA 3.94 000
airway.
31656............... .............. A Bronchoscopy, inj for 2.17 NA 0.93 0.12 NA 3.22 000
x-ray.
31700............... .............. A Insertion of airway 1.34 2.05 0.69 0.08 3.47 2.11 000
catheter.
31708............... .............. A Instill airway 1.41 NA 0.58 0.07 NA 2.06 000
contrast dye.
31710............... .............. A Insertion of airway 1.30 NA 0.71 0.07 NA 2.08 000
catheter.
31715............... .............. A Injection for 1.11 NA 0.59 0.07 NA 1.77 000
bronchus x-ray.
31717............... .............. A Bronchial brush 2.12 2.96 0.87 0.11 5.19 3.10 000
biopsy.
31720............... .............. A Clearance of airways. 1.06 1.45 0.33 0.07 2.58 1.46 000
31725............... .............. A Clearance of airways. 1.96 1.87 0.58 0.12 3.95 2.66 000
31730............... .............. A Intro, windpipe wire/ 2.85 2.22 1.09 0.18 5.25 4.12 000
tube.
31750............... .............. A Repair of windpipe... 13.00 NA 11.57 1.23 NA 25.80 090
31755............... .............. A Repair of windpipe... 15.91 NA 14.20 1.39 NA 31.50 090
31760............... .............. A Repair of windpipe... 22.32 NA 10.82 1.79 NA 34.93 090
31766............... .............. A Reconstruction of 30.38 NA 13.76 3.81 NA 47.95 090
windpipe.
31770............... .............. A Repair/graft of 22.48 NA 10.34 2.74 NA 35.56 090
bronchus.
31775............... .............. A Reconstruct bronchus. 23.50 NA 11.89 3.51 NA 38.90 090
31780............... .............. A Reconstruct windpipe. 17.69 NA 11.14 1.87 NA 30.70 090
31781............... .............. A Reconstruct windpipe. 23.49 NA 12.22 2.46 NA 38.17 090
31785............... .............. A Remove windpipe 17.20 NA 10.26 1.64 NA 29.10 090
lesion.
31786............... .............. A Remove windpipe 23.94 NA 13.20 2.65 NA 39.79 090
lesion.
31800............... .............. A Repair of windpipe 7.42 NA 4.88 0.81 NA 13.11 090
injury.
31805............... .............. A Repair of windpipe 13.11 NA 7.29 1.75 NA 22.15 090
injury.
31820............... .............. A Closure of windpipe 4.48 5.52 4.93 0.42 10.42 9.83 090
lesion.
31825............... .............. A Repair of windpipe 6.80 7.61 7.06 0.60 15.01 14.46 090
defect.
31830............... .............. A Revise windpipe scar. 4.49 5.68 5.30 0.43 10.60 10.22 090
31899............... .............. C Airways surgical 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
32000............... .............. A Drainage of chest.... 1.54 3.13 0.48 0.08 4.75 2.10 000
[[Page 1147]]
32002............... .............. A Treatment of 2.19 3.32 0.84 0.13 5.64 3.16 000
collapsed lung.
32005............... .............. A Treat lung lining 2.19 6.58 0.70 0.21 8.98 3.10 000
chemically.
32020............... .............. A Insertion of chest 3.97 NA 1.45 0.43 NA 5.85 000
tube.
32035............... .............. A Exploration of chest. 8.66 NA 5.91 1.23 NA 15.80 090
32036............... .............. A Exploration of chest. 9.67 NA 6.49 1.45 NA 17.61 090
32095............... .............. A Biopsy through chest 8.35 NA 5.42 1.19 NA 14.96 090
wall.
32100............... .............. A Exploration/biopsy of 15.22 NA 7.88 1.75 NA 24.85 090
chest.
32110............... .............. A Explore/repair chest. 22.97 NA 10.81 1.97 NA 35.75 090
32120............... .............. A Re-exploration of 11.52 NA 7.13 1.71 NA 20.36 090
chest.
32124............... .............. A Explore chest free 12.70 NA 7.27 1.82 NA 21.79 090
adhesions.
32140............... .............. A Removal of lung 13.91 NA 7.75 2.03 NA 23.69 090
lesion(s).
32141............... .............. A Remove/treat lung 13.98 NA 7.62 2.07 NA 23.67 090
lesions.
32150............... .............. A Removal of lung 14.13 NA 7.68 1.93 NA 23.74 090
lesion(s).
32151............... .............. A Remove lung foreign 14.19 NA 8.07 1.80 NA 24.06 090
body.
32160............... .............. A Open chest heart 9.29 NA 5.32 1.22 NA 15.83 090
massage.
32200............... .............. A Drain, open, lung 15.27 NA 8.66 1.76 NA 25.69 090
lesion.
32201............... .............. A Drain, percut, lung 3.99 NA 1.30 0.22 NA 5.51 000
lesion.
32215............... .............. A Treat chest lining... 11.31 NA 6.96 1.62 NA 19.89 090
32220............... .............. A Release of lung...... 23.96 NA 13.02 2.88 NA 39.86 090
32225............... .............. A Partial release of 13.94 NA 7.72 2.05 NA 23.71 090
lung.
32310............... .............. A Removal of chest 13.42 NA 7.46 1.99 NA 22.87 090
lining.
32320............... .............. A Free/remove chest 23.96 NA 12.22 3.02 NA 39.20 090
lining.
32400............... .............. A Needle biopsy chest 1.76 1.70 0.55 0.08 3.54 2.39 000
lining.
32402............... .............. A Open biopsy chest 7.55 NA 5.17 1.10 NA 13.82 090
lining.
32405............... .............. A Biopsy, lung or 1.93 2.14 0.63 0.11 4.18 2.67 000
mediastinum.
32420............... .............. A Puncture/clear lung.. 2.18 NA 0.83 0.13 NA 3.14 000
32440............... .............. A Removal of lung...... 24.96 NA 12.96 3.09 NA 41.01 090
32442............... .............. A Sleeve pneumonectomy. 26.20 NA 14.82 3.76 NA 44.78 090
32445............... .............. A Removal of lung...... 25.05 NA 14.13 3.75 NA 42.93 090
32480............... .............. A Partial removal of 23.71 NA 12.12 2.70 NA 38.53 090
lung.
32482............... .............. A Bilobectomy.......... 24.96 NA 12.97 2.83 NA 40.76 090
32484............... .............. A Segmentectomy........ 20.66 NA 11.44 3.06 NA 35.16 090
32486............... .............. A Sleeve lobectomy..... 23.88 NA 13.30 3.62 NA 40.80 090
32488............... .............. A Completion 25.67 NA 13.84 3.84 NA 43.35 090
pneumonectomy.
32491............... .............. R Lung volume reduction 21.22 NA 12.68 3.21 NA 37.11 090
32500............... .............. A Partial removal of 21.97 NA 12.40 2.13 NA 36.50 090
lung.
32501............... .............. A Repair bronchus add- 4.68 NA 1.54 0.68 NA 6.90 ZZZ
on.
32520............... .............. A Remove lung & revise 21.65 NA 11.36 3.27 NA 36.28 090
chest.
32522............... .............. A Remove lung & revise 24.16 NA 12.17 3.43 NA 39.76 090
chest.
32525............... .............. A Remove lung & revise 26.46 NA 12.86 3.92 NA 43.24 090
chest.
32540............... .............. A Removal of lung 14.62 NA 9.68 2.22 NA 26.52 090
lesion.
32601............... .............. A Thoracoscopy, 5.45 NA 2.42 0.76 NA 8.63 000
diagnostic.
32602............... .............. A Thoracoscopy, 5.95 NA 2.58 0.84 NA 9.37 000
diagnostic.
32603............... .............. A Thoracoscopy, 7.80 NA 3.09 0.92 NA 11.81 000
diagnostic.
32604............... .............. A Thoracoscopy, 8.77 NA 3.53 1.17 NA 13.47 000
diagnostic.
32605............... .............. A Thoracoscopy, 6.92 NA 2.97 1.04 NA 10.93 000
diagnostic.
32606............... .............. A Thoracoscopy, 8.39 NA 3.39 1.19 NA 12.97 000
diagnostic.
32650............... .............. A Thoracoscopy, 10.73 NA 6.80 1.51 NA 19.04 090
surgical.
32651............... .............. A Thoracoscopy, 12.89 NA 7.26 1.81 NA 21.96 090
surgical.
32652............... .............. A Thoracoscopy, 18.63 NA 10.19 2.77 NA 31.59 090
surgical.
32653............... .............. A Thoracoscopy, 12.85 NA 7.01 1.87 NA 21.73 090
surgical.
32654............... .............. A Thoracoscopy, 12.42 NA 7.57 1.82 NA 21.81 090
surgical.
32655............... .............. A Thoracoscopy, 13.08 NA 7.27 1.85 NA 22.20 090
surgical.
32656............... .............. A Thoracoscopy, 12.89 NA 7.97 1.94 NA 22.80 090
surgical.
32657............... .............. A Thoracoscopy, 13.63 NA 7.72 1.98 NA 23.33 090
surgical.
32658............... .............. A Thoracoscopy, 11.61 NA 7.38 1.77 NA 20.76 090
surgical.
32659............... .............. A Thoracoscopy, 11.57 NA 7.49 1.68 NA 20.74 090
surgical.
32660............... .............. A Thoracoscopy, 17.40 NA 9.52 2.52 NA 29.44 090
surgical.
32661............... .............. A Thoracoscopy, 13.23 NA 7.83 2.00 NA 23.06 090
surgical.
32662............... .............. A Thoracoscopy, 16.42 NA 8.85 2.42 NA 27.69 090
surgical.
32663............... .............. A Thoracoscopy, 18.44 NA 10.81 2.75 NA 32.00 090
surgical.
32664............... .............. A Thoracoscopy, 14.18 NA 7.67 2.05 NA 23.90 090
surgical.
32665............... .............. A Thoracoscopy, 15.52 NA 8.17 2.16 NA 25.85 090
surgical.
32800............... .............. A Repair lung hernia... 13.67 NA 7.49 1.82 NA 22.98 090
32810............... .............. A Close chest after 13.03 NA 7.59 1.87 NA 22.49 090
drainage.
32815............... .............. A Close bronchial 23.12 NA 11.04 3.43 NA 37.59 090
fistula.
32820............... .............. A Reconstruct injured 21.45 NA 12.29 2.79 NA 36.53 090
chest.
32850............... .............. X Donor pneumonectomy.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
32851............... .............. A Lung transplant, 38.57 NA 27.97 5.91 NA 72.45 090
single.
32852............... .............. A Lung transplant with 41.74 NA 33.35 6.24 NA 81.33 090
bypass.
32853............... .............. A Lung transplant, 47.74 NA 31.96 7.39 NA 87.09 090
double.
32854............... .............. A Lung transplant with 50.90 NA 34.97 7.73 NA 93.60 090
bypass.
32900............... .............. A Removal of rib(s).... 20.24 NA 9.95 2.92 NA 33.11 090
32905............... .............. A Revise & repair chest 20.72 NA 10.19 3.06 NA 33.97 090
wall.
32906............... .............. A Revise & repair chest 26.73 NA 12.14 3.98 NA 42.85 090
wall.
[[Page 1148]]
32940............... .............. A Revision of lung..... 19.40 NA 9.53 2.98 NA 31.91 090
32960............... .............. A Therapeutic 1.84 1.76 0.57 0.14 3.74 2.55 000
pneumothorax.
32997............... .............. A Total lung lavage.... 5.99 NA 1.91 0.66 NA 8.56 000
32999............... .............. C Chest surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
33010............... .............. A Drainage of heart sac 2.24 NA 0.96 0.16 NA 3.36 000
33011............... .............. A Repeat drainage of 2.24 NA 1.00 0.16 NA 3.40 000
heart sac.
33015............... .............. A Incision of heart sac 6.79 NA 4.98 0.77 NA 12.54 090
33020............... .............. A Incision of heart sac 12.59 NA 6.84 1.81 NA 21.24 090
33025............... .............. A Incision of heart sac 12.07 NA 6.39 1.81 NA 20.27 090
33030............... .............. A Partial removal of 18.68 NA 9.59 2.89 NA 31.16 090
heart sac.
33031............... .............. A Partial removal of 21.76 NA 10.10 3.35 NA 35.21 090
heart sac.
33050............... .............. A Removal of heart sac 14.34 NA 7.90 2.09 NA 24.33 090
lesion.
33120............... .............. A Removal of heart 24.52 NA 11.68 3.69 NA 39.89 090
lesion.
33130............... .............. A Removal of heart 21.36 NA 10.18 3.03 NA 34.57 090
lesion.
33140............... .............. A Heart revascularize 19.97 NA 10.94 2.74 NA 33.65 090
(tmr).
33141............... .............. A Heart tmr w/other 4.83 NA 1.59 0.66 NA 7.08 ZZZ
procedure.
33200............... .............. A Insertion of heart 12.46 NA 6.98 1.41 NA 20.85 090
pacemaker.
33201............... .............. A Insertion of heart 10.16 NA 6.73 1.46 NA 18.35 090
pacemaker.
33206............... .............. A Insertion of heart 6.66 NA 4.57 0.60 NA 11.83 090
pacemaker.
33207............... .............. A Insertion of heart 8.03 NA 4.76 0.69 NA 13.48 090
pacemaker.
33208............... .............. A Insertion of heart 8.12 NA 4.86 0.65 NA 13.63 090
pacemaker.
33210............... .............. A Insertion of heart 3.30 NA 1.25 0.21 NA 4.76 000
electrode.
33211............... .............. A Insertion of heart 3.39 NA 1.32 0.21 NA 4.92 000
electrode.
33212............... .............. A Insertion of pulse 5.51 NA 3.42 0.53 NA 9.46 090
generator.
33213............... .............. A Insertion of pulse 6.36 NA 3.78 0.55 NA 10.69 090
generator.
33214............... .............. A Upgrade of pacemaker 7.74 NA 4.99 0.63 NA 13.36 090
system.
33215............... .............. A Reposition pacing- 4.75 NA 3.18 0.43 NA 8.36 090
defib lead.
33216............... .............. A Insert lead pace- 5.77 NA 4.30 0.43 NA 10.50 090
defib, one.
33217............... .............. A Insert lead pace- 5.74 NA 4.33 0.43 NA 10.50 090
defib, dual.
33218............... .............. A Repair lead pace- 5.43 NA 4.37 0.48 NA 10.28 090
defib, one.
33220............... .............. A Repair lead pace- 5.51 NA 4.34 0.47 NA 10.32 090
defib, dual.
33222............... .............. A Revise pocket, 4.95 NA 4.36 0.47 NA 9.78 090
pacemaker.
33223............... .............. A Revise pocket, pacing- 6.45 NA 4.64 0.53 NA 11.62 090
defib.
33224............... .............. A Insert pacing lead & 9.04 NA 4.02 0.43 NA 13.49 000
connect.
33225............... .............. A L ventric pacing lead 8.33 NA 3.23 0.43 NA 11.99 ZZZ
add-on.
33226............... .............. A Reposition l ventric 8.68 NA 3.88 0.43 NA 12.99 000
lead.
33233............... .............. A Removal of pacemaker 3.29 NA 3.31 0.27 NA 6.87 090
system.
33234............... .............. A Removal of pacemaker 7.81 NA 4.95 0.68 NA 13.44 090
system.
33235............... .............. A Removal pacemaker 9.39 NA 6.86 0.82 NA 17.07 090
electrode.
33236............... .............. A Remove electrode/ 12.58 NA 7.48 1.80 NA 21.86 090
thoracotomy.
33237............... .............. A Remove electrode/ 13.69 NA 7.84 1.89 NA 23.42 090
thoracotomy.
33238............... .............. A Remove electrode/ 15.20 NA 8.26 1.88 NA 25.34 090
thoracotomy.
33240............... .............. A Insert pulse 7.59 NA 4.66 0.64 NA 12.89 090
generator.
33241............... .............. A Remove pulse 3.24 NA 2.99 0.25 NA 6.48 090
generator.
33243............... .............. A Remove eltrd/ 22.61 NA 11.50 3.05 NA 37.16 090
thoracotomy.
33244............... .............. A Remove eltrd, 13.74 NA 8.96 1.27 NA 23.97 090
transven.
33245............... .............. A Insert epic eltrd 14.28 NA 8.03 1.54 NA 23.85 090
pace-defib.
33246............... .............. A Insert epic eltrd/ 20.68 NA 10.41 2.68 NA 33.77 090
generator.
33249............... .............. A Eltrd/insert pace- 14.21 NA 8.49 0.96 NA 23.66 090
defib.
33250............... .............. A Ablate heart 21.82 NA 11.13 1.22 NA 34.17 090
dysrhythm focus.
33251............... .............. A Ablate heart 24.84 NA 11.74 2.91 NA 39.49 090
dysrhythm focus.
33253............... .............. A Reconstruct atria.... 31.01 NA 13.91 4.44 NA 49.36 090
33261............... .............. A Ablate heart 24.84 NA 11.85 3.40 NA 40.09 090
dysrhythm focus.
33282............... .............. A Implant pat-active ht 4.16 NA 4.11 0.47 NA 8.74 090
record.
33284............... .............. A Remove pat-active ht 2.50 NA 3.58 0.28 NA 6.36 090
record.
33300............... .............. A Repair of heart wound 17.89 NA 9.31 2.30 NA 29.50 090
33305............... .............. A Repair of heart wound 21.41 NA 10.70 3.23 NA 35.34 090
33310............... .............. A Exploratory heart 18.48 NA 9.65 2.73 NA 30.86 090
surgery.
33315............... .............. A Exploratory heart 22.34 NA 10.95 3.50 NA 36.79 090
surgery.
33320............... .............. A Repair major blood 16.76 NA 8.30 2.00 NA 27.06 090
vessel(s).
33321............... .............. A Repair major vessel.. 20.17 NA 9.86 3.26 NA 33.29 090
33322............... .............. A Repair major blood 20.59 NA 10.44 3.03 NA 34.06 090
vessel(s).
33330............... .............. A Insert major vessel 21.40 NA 10.35 3.00 NA 34.75 090
graft.
33332............... .............. A Insert major vessel 23.92 NA 10.59 2.95 NA 37.46 090
graft.
33335............... .............. A Insert major vessel 29.96 NA 13.42 4.57 NA 47.95 090
graft.
33400............... .............. A Repair of aortic 28.46 NA 15.73 3.73 NA 47.92 090
valve.
33401............... .............. A Valvuloplasty, open.. 23.87 NA 13.57 3.27 NA 40.71 090
33403............... .............. A Valvuloplasty, w/cp 24.85 NA 14.37 2.99 NA 42.21 090
bypass.
33404............... .............. A Prepare heart-aorta 28.50 NA 14.58 3.99 NA 47.07 090
conduit.
33405............... .............. A Replacement of aortic 34.95 NA 18.36 4.66 NA 57.97 090
valve.
33406............... .............. A Replacement of aortic 37.44 NA 19.20 4.91 NA 61.55 090
valve.
33410............... .............. A Replacement of aortic 32.41 NA 16.66 4.96 NA 54.03 090
valve.
33411............... .............. A Replacement of aortic 36.20 NA 18.83 5.02 NA 60.05 090
valve.
33412............... .............. A Replacement of aortic 41.94 NA 20.50 5.62 NA 68.06 090
valve.
33413............... .............. A Replacement of aortic 43.43 NA 20.91 5.14 NA 69.48 090
valve.
[[Page 1149]]
33414............... .............. A Repair of aortic 30.30 NA 14.23 4.57 NA 49.10 090
valve.
33415............... .............. A Revision, subvalvular 27.11 NA 12.11 3.92 NA 43.14 090
tissue.
33416............... .............. A Revise ventricle 30.30 NA 13.59 4.64 NA 48.53 090
muscle.
33417............... .............. A Repair of aortic 28.49 NA 13.71 4.32 NA 46.52 090
valve.
33420............... .............. A Revision of mitral 22.67 NA 9.66 1.79 NA 34.12 090
valve.
33422............... .............. A Revision of mitral 25.90 NA 13.71 3.98 NA 43.59 090
valve.
33425............... .............. A Repair of mitral 26.96 NA 13.10 3.62 NA 43.68 090
valve.
33426............... .............. A Repair of mitral 32.95 NA 17.21 4.67 NA 54.83 090
valve.
33427............... .............. A Repair of mitral 39.94 NA 19.44 5.19 NA 64.57 090
valve.
33430............... .............. A Replacement of mitral 33.45 NA 17.37 4.76 NA 55.58 090
valve.
33460............... .............. A Revision of tricuspid 23.56 NA 11.38 3.64 NA 38.58 090
valve.
33463............... .............. A Valvuloplasty, 25.58 NA 12.99 3.82 NA 42.39 090
tricuspid.
33464............... .............. A Valvuloplasty, 27.29 NA 13.60 4.19 NA 45.08 090
tricuspid.
33465............... .............. A Replace tricuspid 28.75 NA 13.05 4.35 NA 46.15 090
valve.
33468............... .............. A Revision of tricuspid 30.07 NA 13.76 4.82 NA 48.65 090
valve.
33470............... .............. A Revision of pulmonary 20.78 NA 10.78 3.39 NA 34.95 090
valve.
33471............... .............. A Valvotomy, pulmonary 22.22 NA 9.82 3.62 NA 35.66 090
valve.
33472............... .............. A Revision of pulmonary 22.22 NA 11.97 3.52 NA 37.71 090
valve.
33474............... .............. A Revision of pulmonary 23.01 NA 10.95 3.43 NA 37.39 090
valve.
33475............... .............. A Replacement, 32.95 NA 15.48 3.18 NA 51.61 090
pulmonary valve.
33476............... .............. A Revision of heart 25.73 NA 12.03 2.89 NA 40.65 090
chamber.
33478............... .............. A Revision of heart 26.70 NA 13.13 4.29 NA 44.12 090
chamber.
33496............... .............. A Repair, prosth valve 27.21 NA 12.83 4.15 NA 44.19 090
clot.
33500............... .............. A Repair heart vessel 25.51 NA 11.54 3.38 NA 40.43 090
fistula.
33501............... .............. A Repair heart vessel 17.75 NA 8.34 2.47 NA 28.56 090
fistula.
33502............... .............. A Coronary artery 21.01 NA 11.15 3.03 NA 35.19 090
correction.
33503............... .............. A Coronary artery graft 21.75 NA 9.83 1.71 NA 33.29 090
33504............... .............. A Coronary artery graft 24.62 NA 11.91 3.67 NA 40.20 090
33505............... .............. A Repair artery w/ 26.80 NA 13.02 1.83 NA 41.65 090
tunnel.
33506............... .............. A Repair artery, 35.45 NA 14.66 3.85 NA 53.96 090
translocation.
33508............... .............. A Endoscopic vein 0.31 NA 0.10 0.04 NA 0.45 ZZZ
harvest.
33510............... .............. A CABG, vein, single... 28.96 NA 16.41 3.78 NA 49.15 090
33511............... .............. A CABG, vein, two...... 29.96 NA 17.15 4.03 NA 51.14 090
33512............... .............. A CABG, vein, three.... 31.75 NA 17.68 4.46 NA 53.89 090
33513............... .............. A CABG, vein, four..... 31.95 NA 17.86 4.81 NA 54.62 090
33514............... .............. A CABG, vein, five..... 32.70 NA 18.14 5.27 NA 56.11 090
33516............... .............. A Cabg, vein, six or 34.95 NA 18.88 5.57 NA 59.40 090
more.
33517............... .............. A CABG, artery-vein, 2.57 NA 0.84 0.39 NA 3.80 ZZZ
single.
33518............... .............. A CABG, artery-vein, 4.84 NA 1.59 0.74 NA 7.17 ZZZ
two.
33519............... .............. A CABG, artery-vein, 7.11 NA 2.33 1.07 NA 10.51 ZZZ
three.
33521............... .............. A CABG, artery-vein, 9.39 NA 3.08 1.42 NA 13.89 ZZZ
four.
33522............... .............. A CABG, artery-vein, 11.65 NA 3.82 1.79 NA 17.26 ZZZ
five.
33523............... .............. A Cabg, art-vein, six 13.93 NA 4.55 2.15 NA 20.63 ZZZ
or more.
33530............... .............. A Coronary artery, 5.85 NA 1.91 0.88 NA 8.64 ZZZ
bypass/reop.
33533............... .............. A CABG, arterial, 29.96 NA 16.54 3.91 NA 50.41 090
single.
33534............... .............. A CABG, arterial, two.. 32.15 NA 17.79 4.38 NA 54.32 090
33535............... .............. A CABG, arterial, three 34.45 NA 18.22 4.79 NA 57.46 090
33536............... .............. A Cabg, arterial, four 37.44 NA 18.38 3.97 NA 59.79 090
or more.
33542............... .............. A Removal of heart 28.81 NA 13.08 4.35 NA 46.24 090
lesion.
33545............... .............. A Repair of heart 36.72 NA 15.73 5.31 NA 57.76 090
damage.
33572............... .............. A Open coronary 4.44 NA 1.46 0.66 NA 6.56 ZZZ
endarterectomy.
33600............... .............. A Closure of valve..... 29.47 NA 12.62 2.77 NA 44.86 090
33602............... .............. A Closure of valve..... 28.50 NA 12.54 3.50 NA 44.54 090
33606............... .............. A Anastomosis/artery- 30.69 NA 13.75 4.33 NA 48.77 090
aorta.
33608............... .............. A Repair anomaly w/ 31.04 NA 14.19 5.03 NA 50.26 090
conduit.
33610............... .............. A Repair by enlargement 30.56 NA 14.20 4.85 NA 49.61 090
33611............... .............. A Repair double 33.95 NA 14.23 3.96 NA 52.14 090
ventricle.
33612............... .............. A Repair double 34.95 NA 15.25 5.36 NA 55.56 090
ventricle.
33615............... .............. A Repair, modified 33.95 NA 15.14 3.80 NA 52.89 090
fontan.
33617............... .............. A Repair single 36.94 NA 16.11 4.93 NA 57.98 090
ventricle.
33619............... .............. A Repair single 44.93 NA 20.94 5.68 NA 71.55 090
ventricle.
33641............... .............. A Repair heart septum 21.36 NA 9.64 3.22 NA 34.22 090
defect.
33645............... .............. A Revision of heart 24.78 NA 11.84 3.94 NA 40.56 090
veins.
33647............... .............. A Repair heart septum 28.69 NA 13.86 4.06 NA 46.61 090
defects.
33660............... .............. A Repair of heart 29.96 NA 13.58 3.40 NA 46.94 090
defects.
33665............... .............. A Repair of heart 28.56 NA 13.91 4.60 NA 47.07 090
defects.
33670............... .............. A Repair of heart 34.95 NA 13.39 2.63 NA 50.97 090
chambers.
33681............... .............. A Repair heart septum 30.56 NA 14.77 4.26 NA 49.59 090
defect.
33684............... .............. A Repair heart septum 29.61 NA 13.71 4.55 NA 47.87 090
defect.
33688............... .............. A Repair heart septum 30.57 NA 10.58 4.69 NA 45.84 090
defect.
33690............... .............. A Reinforce pulmonary 19.52 NA 10.32 3.09 NA 32.93 090
artery.
33692............... .............. A Repair of heart 30.70 NA 14.02 4.55 NA 49.27 090
defects.
33694............... .............. A Repair of heart 33.95 NA 14.32 5.15 NA 53.42 090
defects.
33697............... .............. A Repair of heart 35.95 NA 14.95 5.48 NA 56.38 090
defects.
33702............... .............. A Repair of heart 26.50 NA 12.65 4.16 NA 43.31 090
defects.
[[Page 1150]]
33710............... .............. A Repair of heart 29.67 NA 14.08 4.64 NA 48.39 090
defects.
33720............... .............. A Repair of heart 26.52 NA 12.36 3.87 NA 42.75 090
defect.
33722............... .............. A Repair of heart 28.37 NA 13.94 4.58 NA 46.89 090
defect.
33730............... .............. A Repair heart-vein 34.20 NA 14.23 3.44 NA 51.87 090
defect(s).
33732............... .............. A Repair heart-vein 28.12 NA 13.50 3.35 NA 44.97 090
defect.
33735............... .............. A Revision of heart 21.36 NA 10.08 1.35 NA 32.79 090
chamber.
33736............... .............. A Revision of heart 23.48 NA 11.95 3.26 NA 38.69 090
chamber.
33737............... .............. A Revision of heart 21.73 NA 11.02 3.53 NA 36.28 090
chamber.
33750............... .............. A Major vessel shunt... 21.38 NA 10.31 2.10 NA 33.79 090
33755............... .............. A Major vessel shunt... 21.76 NA 8.86 3.53 NA 34.15 090
33762............... .............. A Major vessel shunt... 21.76 NA 10.24 1.92 NA 33.92 090
33764............... .............. A Major vessel shunt & 21.76 NA 10.31 2.33 NA 34.40 090
graft.
33766............... .............. A Major vessel shunt... 22.73 NA 11.73 3.67 NA 38.13 090
33767............... .............. A Major vessel shunt... 24.46 NA 11.81 3.79 NA 40.06 090
33770............... .............. A Repair great vessels 36.94 NA 14.77 5.42 NA 57.13 090
defect.
33771............... .............. A Repair great vessels 34.60 NA 12.48 5.63 NA 52.71 090
defect.
33774............... .............. A Repair great vessels 30.93 NA 14.23 5.04 NA 50.20 090
defect.
33775............... .............. A Repair great vessels 32.15 NA 14.28 5.23 NA 51.66 090
defect.
33776............... .............. A Repair great vessels 33.99 NA 15.88 5.52 NA 55.39 090
defect.
33777............... .............. A Repair great vessels 33.41 NA 14.95 5.44 NA 53.80 090
defect.
33778............... .............. A Repair great vessels 39.94 NA 16.98 5.83 NA 62.75 090
defect.
33779............... .............. A Repair great vessels 36.16 NA 15.49 2.89 NA 54.54 090
defect.
33780............... .............. A Repair great vessels 41.69 NA 19.13 6.28 NA 67.10 090
defect.
33781............... .............. A Repair great vessels 36.40 NA 13.56 5.92 NA 55.88 090
defect.
33786............... .............. A Repair arterial trunk 38.94 NA 16.79 5.66 NA 61.39 090
33788............... .............. A Revision of pulmonary 26.58 NA 12.03 4.00 NA 42.61 090
artery.
33800............... .............. A Aortic suspension.... 16.22 NA 8.21 1.34 NA 25.77 090
33802............... .............. A Repair vessel defect. 17.63 NA 9.30 1.88 NA 28.81 090
33803............... .............. A Repair vessel defect. 19.57 NA 9.84 3.17 NA 32.58 090
33813............... .............. A Repair septal defect. 20.62 NA 10.99 3.35 NA 34.96 090
33814............... .............. A Repair septal defect. 25.73 NA 12.73 3.04 NA 41.50 090
33820............... .............. A Revise major vessel.. 16.27 NA 8.39 2.53 NA 27.19 090
33822............... .............. A Revise major vessel.. 17.29 NA 9.03 2.81 NA 29.13 090
33824............... .............. A Revise major vessel.. 19.49 NA 10.06 3.15 NA 32.70 090
33840............... .............. A Remove aorta 20.60 NA 10.36 2.85 NA 33.81 090
constriction.
33845............... .............. A Remove aorta 22.09 NA 11.42 3.50 NA 37.01 090
constriction.
33851............... .............. A Remove aorta 21.24 NA 10.78 3.45 NA 35.47 090
constriction.
33852............... .............. A Repair septal defect. 23.67 NA 11.45 3.85 NA 38.97 090
33853............... .............. A Repair septal defect. 31.67 NA 14.92 5.10 NA 51.69 090
33860............... .............. A Ascending aortic 37.94 NA 16.55 5.19 NA 59.68 090
graft.
33861............... .............. A Ascending aortic 41.94 NA 17.81 5.11 NA 64.86 090
graft.
33863............... .............. A Ascending aortic 44.93 NA 18.80 5.55 NA 69.28 090
graft.
33870............... .............. A Transverse aortic 43.93 NA 18.49 6.14 NA 68.56 090
arch graft.
33875............... .............. A Thoracic aortic graft 33.01 NA 14.18 4.92 NA 52.11 090
33877............... .............. A Thoracoabdominal 42.54 NA 16.43 6.11 NA 65.08 090
graft.
33910............... .............. A Remove lung artery 24.55 NA 11.52 3.69 NA 39.76 090
emboli.
33915............... .............. A Remove lung artery 20.99 NA 9.68 1.45 NA 32.12 090
emboli.
33916............... .............. A Surgery of great 25.79 NA 11.43 3.67 NA 40.89 090
vessel.
33917............... .............. A Repair pulmonary 24.46 NA 12.27 3.82 NA 40.55 090
artery.
33918............... .............. A Repair pulmonary 26.41 NA 12.19 4.12 NA 42.72 090
atresia.
33919............... .............. A Repair pulmonary 39.94 NA 17.62 4.20 NA 61.76 090
atresia.
33920............... .............. A Repair pulmonary 31.90 NA 13.92 4.35 NA 50.17 090
atresia.
33922............... .............. A Transect pulmonary 23.48 NA 10.98 2.77 NA 37.23 090
artery.
33924............... .............. A Remove pulmonary 5.49 NA 1.85 0.89 NA 8.23 ZZZ
shunt.
33930............... .............. X Removal of donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
heart/lung.
33935............... .............. R Transplantation, 60.87 NA 29.07 9.83 NA 99.77 090
heart/lung.
33940............... .............. X Removal of donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
heart.
33945............... .............. R Transplantation of 42.04 NA 21.66 6.54 NA 70.24 090
heart.
33960............... .............. A External circulation 19.33 NA 4.93 2.58 NA 26.84 000
assist.
33961............... .............. A External circulation 10.91 NA 3.63 1.77 NA 16.31 ZZZ
assist.
33967............... .............. A Insert ia percut 4.84 NA 1.85 0.34 NA 7.03 000
device.
33968............... .............. A Remove aortic assist 0.64 NA 0.23 0.08 NA 0.95 000
device.
33970............... .............. A Aortic circulation 6.74 NA 2.29 0.84 NA 9.87 000
assist.
33971............... .............. A Aortic circulation 9.68 NA 6.07 1.17 NA 16.92 090
assist.
33973............... .............. A Insert balloon device 9.75 NA 3.32 1.22 NA 14.29 000
33974............... .............. A Remove intra-aortic 14.39 NA 7.95 1.79 NA 24.13 090
balloon.
33975............... .............. A Implant ventricular 20.97 NA 6.31 2.07 NA 29.35 XXX
device.
33976............... .............. A Implant ventricular 22.97 NA 7.58 3.40 NA 33.95 XXX
device.
33977............... .............. A Remove ventricular 19.26 NA 11.13 2.94 NA 33.33 090
device.
33978............... .............. A Remove ventricular 21.70 NA 11.80 3.21 NA 36.71 090
device.
33979............... .............. A Insert intracorporeal 45.93 NA 14.97 4.80 NA 65.70 XXX
device.
33980............... .............. A Remove intracorporeal 56.17 NA 25.52 5.55 NA 87.24 090
device.
33999............... .............. C Cardiac surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
34001............... .............. A Removal of artery 12.89 NA 6.75 1.76 NA 21.40 090
clot.
34051............... .............. A Removal of artery 15.19 NA 7.82 2.29 NA 25.30 090
clot.
[[Page 1151]]
34101............... .............. A Removal of artery 9.99 NA 5.38 1.34 NA 16.71 090
clot.
34111............... .............. A Removal of arm artery 9.99 NA 5.38 1.03 NA 16.40 090
clot.
34151............... .............. A Removal of artery 24.96 NA 10.45 2.22 NA 37.63 090
clot.
34201............... .............. A Removal of artery 10.01 NA 5.45 1.23 NA 16.69 090
clot.
34203............... .............. A Removal of leg artery 16.48 NA 8.09 1.65 NA 26.22 090
clot.
34401............... .............. A Removal of vein clot. 24.96 NA 10.72 1.45 NA 37.13 090
34421............... .............. A Removal of vein clot. 11.98 NA 6.33 1.15 NA 19.46 090
34451............... .............. A Removal of vein clot. 26.96 NA 11.49 1.92 NA 40.37 090
34471............... .............. A Removal of vein clot. 10.16 NA 5.35 1.09 NA 16.60 090
34490............... .............. A Removal of vein clot. 9.85 NA 5.46 0.88 NA 16.19 090
34501............... .............. A Repair valve, femoral 15.98 NA 8.55 1.65 NA 26.18 090
vein.
34502............... .............. A Reconstruct vena cava 26.91 NA 12.34 3.61 NA 42.86 090
34510............... .............. A Transposition of vein 18.92 NA 9.48 1.93 NA 30.33 090
valve.
34520............... .............. A Cross-over vein graft 17.92 NA 8.72 1.70 NA 28.34 090
34530............... .............. A Leg vein fusion...... 16.62 NA 8.65 2.48 NA 27.75 090
34800............... .............. A Endovasc abdo repair 20.72 NA 9.21 1.80 NA 31.73 090
w/tube.
34802............... .............. A Endovasc abdo repr w/ 22.97 NA 9.83 1.99 NA 34.79 090
device.
34804............... .............. A Endovasc abdo repr w/ 22.97 NA 9.84 1.99 NA 34.80 090
device.
34805............... .............. A Endovasc abdo repair 21.85 NA 9.46 1.99 NA 33.30 090
w/pros.
34808............... .............. A Endovasc abdo occlud 4.12 NA 1.38 0.35 NA 5.85 ZZZ
device.
34812............... .............. A Xpose for endoprosth, 6.74 NA 2.24 0.59 NA 9.57 000
femorl.
34813............... .............. A Femoral endovas graft 4.79 NA 1.58 0.41 NA 6.78 ZZZ
add-on.
34820............... .............. A Xpose for endoprosth, 9.74 NA 3.25 0.84 NA 13.83 000
iliac.
34825............... .............. A Endovasc extend 11.98 NA 6.17 1.04 NA 19.19 090
prosth, init.
34826............... .............. A Endovasc exten 4.12 NA 1.38 0.35 NA 5.85 ZZZ
prosth, add'l.
34830............... .............. A Open aortic tube 32.54 NA 13.76 2.82 NA 49.12 090
prosth repr.
34831............... .............. A Open aortoiliac 35.29 NA 11.80 3.05 NA 50.14 090
prosth repr.
34832............... .............. A Open aortofemor 35.29 NA 14.68 3.05 NA 53.02 090
prosth repr.
34833............... .............. A Xpose for endoprosth, 11.98 NA 4.51 0.84 NA 17.33 000
iliac.
34834............... .............. A Xpose, endoprosth, 5.34 NA 2.23 0.59 NA 8.16 000
brachial.
34900............... .............. A Endovasc iliac repr w/ 16.36 NA 7.82 1.80 NA 25.98 090
graft.
35001............... .............. A Repair defect of 19.61 NA 9.59 2.94 NA 32.14 090
artery.
35002............... .............. A Repair artery 20.97 NA 9.74 2.20 NA 32.91 090
rupture, neck.
35005............... .............. A Repair defect of 18.09 NA 8.89 1.63 NA 28.61 090
artery.
35011............... .............. A Repair defect of 17.97 NA 8.02 1.57 NA 27.56 090
artery.
35013............... .............. A Repair artery 21.97 NA 9.73 2.30 NA 34.00 090
rupture, arm.
35021............... .............. A Repair defect of 19.62 NA 9.50 2.33 NA 31.45 090
artery.
35022............... .............. A Repair artery 23.15 NA 10.10 2.40 NA 35.65 090
rupture, chest.
35045............... .............. A Repair defect of arm 17.54 NA 7.58 1.51 NA 26.63 090
artery.
35081............... .............. A Repair defect of 27.97 NA 11.51 3.86 NA 43.34 090
artery.
35082............... .............. A Repair artery 38.44 NA 15.35 4.91 NA 58.70 090
rupture, aorta.
35091............... .............. A Repair defect of 35.35 NA 13.63 4.93 NA 53.91 090
artery.
35092............... .............. A Repair artery 44.93 NA 17.70 5.20 NA 67.83 090
rupture, aorta.
35102............... .............. A Repair defect of 30.71 NA 12.41 4.15 NA 47.27 090
artery.
35103............... .............. A Repair artery 40.44 NA 15.92 4.57 NA 60.93 090
rupture, groin.
35111............... .............. A Repair defect of 24.96 NA 10.51 2.18 NA 37.65 090
artery.
35112............... .............. A Repair artery 29.96 NA 12.01 2.35 NA 44.32 090
rupture,spleen.
35121............... .............. A Repair defect of 29.96 NA 12.42 3.53 NA 45.91 090
artery.
35122............... .............. A Repair artery 34.95 NA 13.86 4.27 NA 53.08 090
rupture, belly.
35131............... .............. A Repair defect of 24.96 NA 10.80 2.54 NA 38.30 090
artery.
35132............... .............. A Repair artery 29.96 NA 12.42 2.99 NA 45.37 090
rupture, groin.
35141............... .............. A Repair defect of 19.97 NA 8.95 1.99 NA 30.91 090
artery.
35142............... .............. A Repair artery 23.27 NA 10.40 2.11 NA 35.78 090
rupture, thigh.
35151............... .............. A Repair defect of 22.61 NA 10.04 2.33 NA 34.98 090
artery.
35152............... .............. A Repair artery 25.58 NA 11.43 2.33 NA 39.34 090
rupture, knee.
35161............... .............. A Repair defect of 18.73 NA 9.19 2.67 NA 30.59 090
artery.
35162............... .............. A Repair artery rupture 19.75 NA 9.61 2.67 NA 32.03 090
35180............... .............. A Repair blood vessel 13.60 NA 6.98 1.74 NA 22.32 090
lesion.
35182............... .............. A Repair blood vessel 29.96 NA 12.85 2.27 NA 45.08 090
lesion.
35184............... .............. A Repair blood vessel 17.97 NA 8.34 1.62 NA 27.93 090
lesion.
35188............... .............. A Repair blood vessel 14.26 NA 7.67 1.85 NA 23.78 090
lesion.
35189............... .............. A Repair blood vessel 27.96 NA 12.00 2.56 NA 42.52 090
lesion.
35190............... .............. A Repair blood vessel 12.73 NA 6.50 1.60 NA 20.83 090
lesion.
35201............... .............. A Repair blood vessel 16.12 NA 8.02 1.41 NA 25.55 090
lesion.
35206............... .............. A Repair blood vessel 13.23 NA 6.61 1.25 NA 21.09 090
lesion.
35207............... .............. A Repair blood vessel 10.13 NA 7.51 1.39 NA 19.03 090
lesion.
35211............... .............. A Repair blood vessel 22.09 NA 10.70 3.41 NA 36.20 090
lesion.
35216............... .............. A Repair blood vessel 18.72 NA 9.04 2.62 NA 30.38 090
lesion.
35221............... .............. A Repair blood vessel 24.35 NA 9.98 2.16 NA 36.49 090
lesion.
35226............... .............. A Repair blood vessel 14.48 NA 7.52 1.01 NA 23.01 090
lesion.
35231............... .............. A Repair blood vessel 19.97 NA 9.81 1.59 NA 31.37 090
lesion.
35236............... .............. A Repair blood vessel 17.08 NA 7.95 1.44 NA 26.47 090
lesion.
35241............... .............. A Repair blood vessel 23.09 NA 11.20 3.50 NA 37.79 090
lesion.
35246............... .............. A Repair blood vessel 26.41 NA 11.51 2.68 NA 40.60 090
lesion.
35251............... .............. A Repair blood vessel 30.15 NA 11.84 2.26 NA 44.25 090
lesion.
[[Page 1152]]
35256............... .............. A Repair blood vessel 18.33 NA 8.43 1.59 NA 28.35 090
lesion.
35261............... .............. A Repair blood vessel 17.77 NA 8.05 1.62 NA 27.44 090
lesion.
35266............... .............. A Repair blood vessel 14.89 NA 7.06 1.40 NA 23.35 090
lesion.
35271............... .............. A Repair blood vessel 22.09 NA 10.59 3.34 NA 36.02 090
lesion.
35276............... .............. A Repair blood vessel 24.21 NA 11.28 2.86 NA 38.35 090
lesion.
35281............... .............. A Repair blood vessel 27.96 NA 11.75 2.20 NA 41.91 090
lesion.
35286............... .............. A Repair blood vessel 16.14 NA 8.12 1.64 NA 25.90 090
lesion.
35301............... .............. A Rechanneling of 18.67 NA 8.50 2.69 NA 29.86 090
artery.
35311............... .............. A Rechanneling of 26.96 NA 11.79 3.32 NA 42.07 090
artery.
35321............... .............. A Rechanneling of 15.98 NA 7.41 1.64 NA 25.03 090
artery.
35331............... .............. A Rechanneling of 26.16 NA 11.28 3.27 NA 40.71 090
artery.
35341............... .............. A Rechanneling of 25.07 NA 10.91 3.46 NA 39.44 090
artery.
35351............... .............. A Rechanneling of 22.97 NA 9.64 2.76 NA 35.37 090
artery.
35355............... .............. A Rechanneling of 18.47 NA 8.12 2.17 NA 28.76 090
artery.
35361............... .............. A Rechanneling of 28.16 NA 11.75 3.21 NA 43.12 090
artery.
35363............... .............. A Rechanneling of 30.15 NA 12.63 3.34 NA 46.12 090
artery.
35371............... .............. A Rechanneling of 14.70 NA 6.99 1.59 NA 23.28 090
artery.
35372............... .............. A Rechanneling of 17.97 NA 8.08 1.85 NA 27.90 090
artery.
35381............... .............. A Rechanneling of 15.79 NA 7.85 2.17 NA 25.81 090
artery.
35390............... .............. A Reoperation, carotid 3.19 NA 1.07 0.46 NA 4.72 ZZZ
add-on.
35400............... .............. A Angioscopy........... 3.00 NA 1.12 0.41 NA 4.53 ZZZ
35450............... .............. A Repair arterial 10.05 NA 4.04 1.01 NA 15.10 000
blockage.
35452............... .............. A Repair arterial 6.90 NA 3.17 0.92 NA 10.99 000
blockage.
35454............... .............. A Repair arterial 6.03 NA 2.84 0.81 NA 9.68 000
blockage.
35456............... .............. A Repair arterial 7.34 NA 3.29 0.99 NA 11.62 000
blockage.
35458............... .............. A Repair arterial 9.48 NA 4.01 1.31 NA 14.80 000
blockage.
35459............... .............. A Repair arterial 8.62 NA 3.64 1.16 NA 13.42 000
blockage.
35460............... .............. A Repair venous 6.03 NA 2.68 0.80 NA 9.51 000
blockage.
35470............... .............. A Repair arterial 8.62 NA 3.85 0.60 NA 13.07 000
blockage.
35471............... .............. A Repair arterial 10.05 NA 4.45 0.60 NA 15.10 000
blockage.
35472............... .............. A Repair arterial 6.90 NA 3.24 0.47 NA 10.61 000
blockage.
35473............... .............. A Repair arterial 6.03 NA 2.92 0.41 NA 9.36 000
blockage.
35474............... .............. A Repair arterial 7.35 NA 2.88 0.48 NA 10.71 000
blockage.
35475............... .............. R Repair arterial 9.48 NA 4.06 0.57 NA 14.11 000
blockage.
35476............... .............. A Repair venous 6.03 NA 2.85 0.33 NA 9.21 000
blockage.
35480............... .............. A Atherectomy, open.... 11.06 NA 4.51 1.36 NA 16.93 000
35481............... .............. A Atherectomy, open.... 7.60 NA 3.48 1.01 NA 12.09 000
35482............... .............. A Atherectomy, open.... 6.64 NA 3.09 0.90 NA 10.63 000
35483............... .............. A Atherectomy, open.... 8.09 NA 3.54 0.98 NA 12.61 000
35484............... .............. A Atherectomy, open.... 10.42 NA 4.23 1.36 NA 16.01 000
35485............... .............. A Atherectomy, open.... 9.48 NA 4.06 1.28 NA 14.82 000
35490............... .............. A Atherectomy, 11.06 NA 4.71 0.66 NA 16.43 000
percutaneous.
35491............... .............. A Atherectomy, 7.60 NA 3.30 0.59 NA 11.49 000
percutaneous.
35492............... .............. A Atherectomy, 6.64 NA 3.19 0.52 NA 10.35 000
percutaneous.
35493............... .............. A Atherectomy, 8.09 NA 3.81 0.57 NA 12.47 000
percutaneous.
35494............... .............. A Atherectomy, 10.42 NA 4.40 0.58 NA 15.40 000
percutaneous.
35495............... .............. A Atherectomy, 9.48 NA 4.39 0.62 NA 14.49 000
percutaneous.
35500............... .............. A Harvest vein for 6.44 NA 2.03 0.76 NA 9.23 ZZZ
bypass.
35501............... .............. A Artery bypass graft.. 19.16 NA 8.51 2.81 NA 30.48 090
35506............... .............. A Artery bypass graft.. 19.64 NA 9.51 2.81 NA 31.96 090
35507............... .............. A Artery bypass graft.. 19.64 NA 9.46 2.74 NA 31.84 090
35508............... .............. A Artery bypass graft.. 18.62 NA 9.48 2.82 NA 30.92 090
35509............... .............. A Artery bypass graft.. 18.04 NA 8.80 2.56 NA 29.40 090
35510............... .............. A Artery bypass graft.. 22.97 NA 10.17 2.10 NA 35.24 090
35511............... .............. A Artery bypass graft.. 21.17 NA 9.39 2.10 NA 32.66 090
35512............... .............. A Artery bypass graft.. 22.47 NA 10.00 2.10 NA 34.57 090
35515............... .............. A Artery bypass graft.. 18.62 NA 9.33 2.73 NA 30.68 090
35516............... .............. A Artery bypass graft.. 16.30 NA 6.84 2.27 NA 25.41 090
35518............... .............. A Artery bypass graft.. 21.17 NA 9.02 2.15 NA 32.34 090
35521............... .............. A Artery bypass graft.. 22.17 NA 9.87 2.20 NA 34.24 090
35522............... .............. A Artery bypass graft.. 21.73 NA 9.74 2.10 NA 33.57 090
35525............... .............. A Artery bypass graft.. 20.60 NA 9.35 2.10 NA 32.05 090
35526............... .............. A Artery bypass graft.. 29.91 NA 12.56 2.63 NA 45.10 090
35531............... .............. A Artery bypass graft.. 36.15 NA 14.54 3.51 NA 54.20 090
35533............... .............. A Artery bypass graft.. 27.96 NA 11.77 2.83 NA 42.56 090
35536............... .............. A Artery bypass graft.. 31.65 NA 13.00 3.16 NA 47.81 090
35541............... .............. A Artery bypass graft.. 25.76 NA 11.25 3.30 NA 40.31 090
35546............... .............. A Artery bypass graft.. 25.50 NA 10.91 3.43 NA 39.84 090
35548............... .............. A Artery bypass graft.. 21.54 NA 9.46 2.95 NA 33.95 090
35549............... .............. A Artery bypass graft.. 23.31 NA 10.42 3.34 NA 37.07 090
35551............... .............. A Artery bypass graft.. 26.63 NA 11.56 3.85 NA 42.04 090
35556............... .............. A Artery bypass graft.. 21.73 NA 9.77 2.99 NA 34.49 090
35558............... .............. A Artery bypass graft.. 21.17 NA 9.59 1.91 NA 32.67 090
35560............... .............. A Artery bypass graft.. 31.95 NA 13.37 3.29 NA 48.61 090
35563............... .............. A Artery bypass graft.. 24.16 NA 10.57 2.03 NA 36.76 090
[[Page 1153]]
35565............... .............. A Artery bypass graft.. 23.17 NA 10.17 2.06 NA 35.40 090
35566............... .............. A Artery bypass graft.. 26.88 NA 11.45 3.64 NA 41.97 090
35571............... .............. A Artery bypass graft.. 24.02 NA 10.91 2.58 NA 37.51 090
35572............... .............. A Harvest 6.81 NA 2.34 0.76 NA 9.91 ZZZ
femoropopliteal vein.
35582............... .............. A Vein bypass graft.... 27.09 NA 11.62 3.75 NA 42.46 090
35583............... .............. A Vein bypass graft.... 22.34 NA 10.21 3.05 NA 35.60 090
35585............... .............. A Vein bypass graft.... 28.35 NA 12.32 3.87 NA 44.54 090
35587............... .............. A Vein bypass graft.... 24.71 NA 11.54 2.62 NA 38.87 090
35600............... .............. A Harvest artery for 4.94 NA 1.63 0.72 NA 7.29 ZZZ
cabg.
35601............... .............. A Artery bypass graft.. 17.47 NA 8.66 2.51 NA 28.64 090
35606............... .............. A Artery bypass graft.. 18.68 NA 9.06 2.62 NA 30.36 090
35612............... .............. A Artery bypass graft.. 15.74 NA 7.92 2.07 NA 25.73 090
35616............... .............. A Artery bypass graft.. 15.68 NA 8.14 2.22 NA 26.04 090
35621............... .............. A Artery bypass graft.. 19.97 NA 8.71 2.03 NA 30.71 090
35623............... .............. A Bypass graft, not 23.96 NA 10.54 2.30 NA 36.80 090
vein.
35626............... .............. A Artery bypass graft.. 27.71 NA 12.03 3.49 NA 43.23 090
35631............... .............. A Artery bypass graft.. 33.95 NA 13.88 3.41 NA 51.24 090
35636............... .............. A Artery bypass graft.. 29.46 NA 12.35 2.86 NA 44.67 090
35641............... .............. A Artery bypass graft.. 24.53 NA 11.11 3.41 NA 39.05 090
35642............... .............. A Artery bypass graft.. 17.95 NA 8.72 2.22 NA 28.89 090
35645............... .............. A Artery bypass graft.. 17.44 NA 8.31 2.30 NA 28.05 090
35646............... .............. A Artery bypass graft.. 30.95 NA 13.15 4.38 NA 48.48 090
35647............... .............. A Artery bypass graft.. 27.96 NA 11.82 3.96 NA 43.74 090
35650............... .............. A Artery bypass graft.. 18.97 NA 8.40 1.98 NA 29.35 090
35651............... .............. A Artery bypass graft.. 25.00 NA 10.89 3.05 NA 38.94 090
35654............... .............. A Artery bypass graft.. 24.96 NA 10.70 2.53 NA 38.19 090
35656............... .............. A Artery bypass graft.. 19.50 NA 8.64 2.67 NA 30.81 090
35661............... .............. A Artery bypass graft.. 18.97 NA 8.96 1.81 NA 29.74 090
35663............... .............. A Artery bypass graft.. 21.97 NA 10.02 1.87 NA 33.86 090
35665............... .............. A Artery bypass graft.. 20.97 NA 9.48 2.12 NA 32.57 090
35666............... .............. A Artery bypass graft.. 22.16 NA 10.72 2.64 NA 35.52 090
35671............... .............. A Artery bypass graft.. 19.30 NA 9.43 2.03 NA 30.76 090
35681............... .............. A Composite bypass 1.60 NA 0.53 0.22 NA 2.35 ZZZ
graft.
35682............... .............. A Composite bypass 7.19 NA 2.40 1.00 NA 10.59 ZZZ
graft.
35683............... .............. A Composite bypass 8.49 NA 2.83 1.18 NA 12.50 ZZZ
graft.
35685............... .............. A Bypass graft patency/ 4.04 NA 1.35 0.30 NA 5.69 ZZZ
patch.
35686............... .............. A Bypass graft/av fist 3.34 NA 1.13 0.25 NA 4.72 ZZZ
patency.
35691............... .............. A Arterial 18.02 NA 8.45 2.48 NA 28.95 090
transposition.
35693............... .............. A Arterial 15.34 NA 7.76 2.17 NA 25.27 090
transposition.
35694............... .............. A Arterial 19.13 NA 8.64 2.57 NA 30.34 090
transposition.
35695............... .............. A Arterial 19.13 NA 8.60 2.64 NA 30.37 090
transposition.
35697............... .............. A Reimplant artery each 3.00 NA 1.03 0.41 NA 4.44 ZZZ
35700............... .............. A Reoperation, bypass 3.08 NA 1.03 0.43 NA 4.54 ZZZ
graft.
35701............... .............. A Exploration, carotid 8.49 NA 5.18 0.77 NA 14.44 090
artery.
35721............... .............. A Exploration, femoral 7.17 NA 4.48 0.71 NA 12.36 090
artery.
35741............... .............. A Exploration popliteal 7.99 NA 4.71 0.72 NA 13.42 090
artery.
35761............... .............. A Exploration of artery/ 5.36 NA 4.07 0.72 NA 10.15 090
vein.
35800............... .............. A Explore neck vessels. 7.01 NA 4.68 0.95 NA 12.64 090
35820............... .............. A Explore chest vessels 12.86 NA 7.20 1.94 NA 22.00 090
35840............... .............. A Explore abdominal 9.76 NA 5.31 1.28 NA 16.35 090
vessels.
35860............... .............. A Explore limb vessels. 5.54 NA 4.06 0.76 NA 10.36 090
35870............... .............. A Repair vessel graft 22.14 NA 9.81 2.98 NA 34.93 090
defect.
35875............... .............. A Removal of clot in 10.11 NA 5.24 1.17 NA 16.52 090
graft.
35876............... .............. A Removal of clot in 16.97 NA 7.59 2.27 NA 26.83 090
graft.
35879............... .............. A Revise graft w/vein.. 15.98 NA 7.75 1.63 NA 25.36 090
35881............... .............. A Revise graft w/vein.. 17.97 NA 8.75 1.74 NA 28.46 090
35901............... .............. A Excision, graft, neck 8.18 NA 5.36 1.09 NA 14.63 090
35903............... .............. A Excision, graft, 9.38 NA 6.01 1.24 NA 16.63 090
extremity.
35905............... .............. A Excision, graft, 31.20 NA 13.26 2.59 NA 47.05 090
thorax.
35907............... .............. A Excision, graft, 34.95 NA 14.11 2.62 NA 51.68 090
abdomen.
36000............... .............. A Place needle in vein. 0.18 0.60 0.05 0.01 0.79 0.24 XXX
36002............... .............. A Pseudoaneurysm 1.96 2.91 0.99 0.12 4.99 3.07 000
injection trt.
36005............... .............. A Injection ext 0.95 8.47 0.32 0.05 9.47 1.32 000
venography.
36010............... .............. A Place catheter in 2.43 NA 0.79 0.19 NA 3.41 XXX
vein.
36011............... .............. A Place catheter in 3.14 NA 1.03 0.21 NA 4.38 XXX
vein.
36012............... .............. A Place catheter in 3.51 NA 1.15 0.21 NA 4.87 XXX
vein.
36013............... .............. A Place catheter in 2.52 NA 0.66 0.21 NA 3.39 XXX
artery.
36014............... .............. A Place catheter in 3.02 NA 0.99 0.17 NA 4.18 XXX
artery.
36015............... .............. A Place catheter in 3.51 NA 1.15 0.19 NA 4.85 XXX
artery.
36100............... .............. A Establish access to 3.02 NA 1.10 0.22 NA 4.34 XXX
artery.
36120............... .............. A Establish access to 2.01 NA 0.65 0.13 NA 2.79 XXX
artery.
36140............... .............. A Establish access to 2.01 NA 0.64 0.14 NA 2.79 XXX
artery.
36145............... .............. A Artery to vein shunt. 2.01 NA 0.66 0.12 NA 2.79 XXX
36160............... .............. A Establish access to 2.52 NA 0.85 0.24 NA 3.61 XXX
aorta.
36200............... .............. A Place catheter in 3.02 NA 1.02 0.18 NA 4.22 XXX
aorta.
[[Page 1154]]
36215............... .............. A Place catheter in 4.67 NA 1.58 0.27 NA 6.52 XXX
artery.
36216............... .............. A Place catheter in 5.27 NA 1.76 0.29 NA 7.32 XXX
artery.
36217............... .............. A Place catheter in 6.29 NA 2.14 0.39 NA 8.82 XXX
artery.
36218............... .............. A Place catheter in 1.01 NA 0.35 0.06 NA 1.42 ZZZ
artery.
36245............... .............. A Place catheter in 4.67 NA 1.65 0.28 NA 6.60 XXX
artery.
36246............... .............. A Place catheter in 5.27 NA 1.79 0.31 NA 7.37 XXX
artery.
36247............... .............. A Place catheter in 6.29 NA 2.10 0.39 NA 8.78 XXX
artery.
36248............... .............. A Place catheter in 1.01 NA 0.35 0.07 NA 1.43 ZZZ
artery.
36260............... .............. A Insertion of infusion 9.70 NA 4.90 1.21 NA 15.81 090
pump.
36261............... .............. A Revision of infusion 5.44 NA 3.66 0.60 NA 9.70 090
pump.
36262............... .............. A Removal of infusion 4.01 NA 2.77 0.52 NA 7.30 090
pump.
36299............... .............. C Vessel injection 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
36400............... .............. A Bl draw < 3 yrs fem/ 0.38 0.29 0.09 0.01 0.68 0.48 XXX
jugular.
36405............... .............. A Bl draw < 3 yrs scalp 0.31 0.27 0.08 0.01 0.59 0.40 XXX
vein.
36406............... .............. A Bl draw < 3 yrs other 0.18 0.30 0.05 0.01 0.49 0.24 XXX
vein.
36410............... .............. A Non-routine bl draw 0.18 0.30 0.05 0.01 0.49 0.24 XXX
3 yrs.
36415............... .............. I Routine venipuncture. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
36416............... .............. I Capillary blood draw. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
36420............... .............. A Vein access cutdown < 1.01 3.06 0.28 0.11 4.18 1.40 XXX
1 yr.
36425............... .............. A Vein access cutdown 0.76 NA 0.22 0.06 NA 1.04 XXX
1 yr.
36430............... .............. A Blood transfusion 0.00 1.01 NA 0.06 1.07 NA XXX
service.
36440............... .............. A Bl push transfuse, 2 1.03 NA 0.30 0.10 NA 1.43 XXX
yr or <.
36450............... .............. A Bl exchange/ 2.23 NA 0.71 0.19 NA 3.13 XXX
transfuse, nb.
36455............... .............. A Bl exchange/transfuse 2.43 NA 1.02 0.12 NA 3.57 XXX
non-nb.
36460............... .............. A Transfusion service, 6.58 NA 2.25 0.68 NA 9.51 XXX
fetal.
36468............... .............. R Injection(s), spider 0.00 0.00 0.00 0.00 0.00 0.00 000
veins.
36469............... .............. R Injection(s), spider 0.00 0.00 0.00 0.00 0.00 0.00 000
veins.
36470............... .............. A Injection therapy of 1.09 2.72 0.44 0.12 3.93 1.65 010
vein.
36471............... .............. A Injection therapy of 1.57 3.07 0.60 0.18 4.82 2.35 010
veins.
36481............... .............. A Insertion of 6.98 7.51 2.73 0.48 14.97 10.19 000
catheter, vein.
36488............... .............. D Insertion of 0.00 0.00 0.00 0.00 0.00 0.00 000
catheter, vein.
36489............... .............. D Insertion of 0.00 0.00 0.00 0.00 0.00 0.00 000
catheter, vein.
36490............... .............. D Insertion of 0.00 0.00 0.00 0.00 0.00 0.00 000
catheter, vein.
36491............... .............. D Insertion of 0.00 0.00 0.00 0.00 0.00 0.00 000
catheter, vein.
36493............... .............. D Repositioning of cvc. 0.00 0.00 0.00 0.00 0.00 0.00 000
36500............... .............. A Insertion of 3.51 NA 1.37 0.17 NA 5.05 000
catheter, vein.
36510............... .............. A Insertion of 1.09 3.74 0.61 0.07 4.90 1.77 000
catheter, vein.
36511............... .............. A Apheresis wbc........ 1.74 NA 0.71 0.07 NA 2.52 000
36512............... .............. A Apheresis rbc........ 1.74 NA 0.71 0.07 NA 2.52 000
36513............... .............. A Apheresis platelets.. 1.74 NA 0.71 0.07 NA 2.52 000
36514............... .............. A Apheresis plasma..... 1.74 NA 0.71 0.07 NA 2.52 000
36515............... .............. A Apheresis, adsorp/ 1.74 NA 0.73 0.07 NA 2.54 000
reinfuse.
36516............... .............. A Apheresis, selective. 1.22 NA 0.51 0.07 NA 1.80 000
36522............... .............. A Photopheresis........ 1.67 30.33 1.13 0.08 32.08 2.88 000
36530............... .............. D Insertion of infusion 0.00 0.00 0.00 0.00 0.00 0.00 010
pump.
36531............... .............. D Revision of infusion 0.00 0.00 0.00 0.00 0.00 0.00 010
pump.
36532............... .............. D Removal of infusion 0.00 0.00 0.00 0.00 0.00 0.00 010
pump.
36533............... .............. D Insertion of access 0.00 0.00 0.00 0.00 0.00 0.00 010
device.
36534............... .............. D Revision of access 0.00 0.00 0.00 0.00 0.00 0.00 010
device.
36535............... .............. D Removal of access 0.00 0.00 0.00 0.00 0.00 0.00 010
device.
36536............... .............. D Remove cva device 0.00 0.00 0.00 0.00 0.00 0.00 000
obstruct.
36537............... .............. D Remove cva lumen 0.00 0.00 0.00 0.00 0.00 0.00 000
obstruct.
36540............... .............. B Collect blood venous 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
36550............... .............. A Declot vascular 0.00 0.39 NA 0.37 0.76 NA XXX
device.
36555............... .............. A Insert non-tunnel cv 2.68 6.00 0.82 0.21 8.89 3.71 000
cath.
36556............... .............. A Insert non-tunnel cv 2.50 5.85 0.74 0.10 8.45 3.34 000
cath.
36557............... .............. A Insert tunneled cv 5.09 13.56 2.58 0.59 19.24 8.26 010
cath.
36558............... .............. A Insert tunneled cv 4.79 13.45 2.47 0.59 18.83 7.85 010
cath.
36560............... .............. A Insert tunneled cv 6.24 29.19 2.96 0.59 36.02 9.79 010
cath.
36561............... .............. A Insert tunneled cv 5.99 29.11 2.87 0.59 35.69 9.45 010
cath.
36563............... .............. A Insert tunneled cv 6.19 38.09 2.98 0.68 44.96 9.85 010
cath.
36565............... .............. A Insert tunneled cv 5.99 22.15 2.87 0.59 28.73 9.45 010
cath.
36566............... .............. A Insert tunneled cv 6.49 22.95 3.04 0.59 30.03 10.12 010
cath.
36568............... .............. A Insert tunneled cv 1.92 8.19 0.59 0.21 10.32 2.72 000
cath.
36569............... .............. A Insert tunneled cv 1.82 7.39 0.57 0.16 9.37 2.55 000
cath.
36570............... .............. A Insert tunneled cv 5.31 40.27 2.64 0.59 46.17 8.54 010
cath.
36571............... .............. A Insert tunneled cv 5.29 35.64 2.63 0.59 41.52 8.51 010
cath.
36575............... .............. A Repair tunneled cv 0.67 3.35 0.26 0.59 4.61 1.52 000
cath.
36576............... .............. A Repair tunneled cv 3.19 7.71 1.76 0.59 11.49 5.54 010
cath.
36578............... .............. A Replace tunneled cv 3.49 10.54 2.20 0.59 14.62 6.28 010
cath.
36580............... .............. A Replace tunneled cv 1.31 6.76 0.41 0.16 8.23 1.88 000
cath.
36581............... .............. A Replace tunneled cv 3.43 13.27 1.84 0.59 17.29 5.86 010
cath.
36582............... .............. A Replace tunneled cv 5.19 26.63 2.76 0.59 32.41 8.54 010
cath.
36583............... .............. A Replace tunneled cv 5.24 13.13 2.77 0.59 18.96 8.60 010
cath.
36584............... .............. A Replace tunneled cv 1.20 7.23 0.54 0.16 8.59 1.90 000
cath.
[[Page 1155]]
36585............... .............. A Replace tunneled cv 4.79 35.46 2.62 0.59 40.84 8.00 010
cath.
36589............... .............. A Removal tunneled cv 2.27 2.20 1.41 0.25 4.72 3.93 010
cath.
36590............... .............. A Removal tunneled cv 3.30 6.41 1.64 0.41 10.12 5.35 010
cath.
36595............... .............. A Mech remov tunneled 3.59 19.71 1.46 0.28 23.58 5.33 000
cv cath.
36596............... .............. A Mech remov tunneled 0.75 4.39 0.49 0.05 5.19 1.29 000
cv cath.
36597............... .............. A Reposition venous 1.21 3.18 0.43 0.07 4.46 1.71 000
catheter.
36600............... .............. A Withdrawal of 0.32 0.48 0.09 0.02 0.82 0.43 XXX
arterial blood.
36620............... .............. A Insertion catheter, 1.15 NA 0.24 0.07 NA 1.46 000
artery.
36625............... .............. A Insertion catheter, 2.11 NA 0.52 0.19 NA 2.82 000
artery.
36640............... .............. A Insertion catheter, 2.10 NA 1.05 0.22 NA 3.37 000
artery.
36660............... .............. A Insertion catheter, 1.40 NA 0.44 0.10 NA 1.94 000
artery.
36680............... .............. A Insert needle, bone 1.20 NA 0.49 0.10 NA 1.79 000
cavity.
36800............... .............. A Insertion of cannula. 2.43 NA 1.81 0.21 NA 4.45 000
36810............... .............. A Insertion of cannula. 3.96 NA 1.69 0.48 NA 6.13 000
36815............... .............. A Insertion of cannula. 2.62 NA 1.17 0.31 NA 4.10 000
36819............... .............. A Av fusion/uppr arm 13.98 NA 6.40 1.88 NA 22.26 090
vein.
36820............... .............. A Av fusion/forearm 13.98 NA 6.40 1.88 NA 22.26 090
vein.
36821............... .............. A Av fusion direct any 8.92 NA 4.71 1.17 NA 14.80 090
site.
36822............... .............. A Insertion of 5.41 NA 4.49 0.76 NA 10.66 090
cannula(s).
36823............... .............. A Insertion of 20.97 NA 9.48 2.63 NA 33.08 090
cannula(s).
36825............... .............. A Artery-vein autograft 9.83 NA 5.14 1.31 NA 16.28 090
36830............... .............. A Artery-vein 11.98 NA 5.30 1.59 NA 18.87 090
nonautograft.
36831............... .............. A Open thrombect av 7.99 NA 3.97 0.95 NA 12.91 090
fistula.
36832............... .............. A Av fistula revision, 10.48 NA 4.79 1.36 NA 16.63 090
open.
36833............... .............. A Av fistula revision.. 11.93 NA 5.25 1.56 NA 18.74 090
36834............... .............. A Repair A-V aneurysm.. 9.92 NA 4.81 1.28 NA 16.01 090
36835............... .............. A Artery to vein shunt. 7.14 NA 4.39 0.96 NA 12.49 090
36838............... .............. A Dist revas ligation, 20.60 NA 9.36 2.99 NA 32.95 090
hemo.
36860............... .............. A External cannula 2.01 2.49 1.35 0.12 4.62 3.48 000
declotting.
36861............... .............. A Cannula declotting... 2.52 NA 1.48 0.17 NA 4.17 000
36870............... .............. A Percut thrombect av 5.15 46.98 3.14 0.28 52.41 8.57 090
fistula.
37140............... .............. A Revision of 23.56 NA 10.50 1.46 NA 35.52 090
circulation.
37145............... .............. A Revision of 24.57 NA 10.93 2.99 NA 38.49 090
circulation.
37160............... .............. A Revision of 21.57 NA 9.30 2.61 NA 33.48 090
circulation.
37180............... .............. A Revision of 24.57 NA 10.35 3.17 NA 38.09 090
circulation.
37181............... .............. A Splice spleen/kidney 26.64 NA 11.06 3.22 NA 40.92 090
veins.
37182............... .............. A Insert hepatic shunt 16.97 NA 6.27 1.80 NA 25.04 000
(tips).
37183............... .............. A Remove hepatic shunt 7.99 NA 3.08 0.52 NA 11.59 000
(tips).
37195............... .............. A Thrombolytic therapy, 0.00 8.08 NA 0.46 8.54 NA XXX
stroke.
37200............... .............. A Transcatheter biopsy. 4.55 NA 1.50 0.23 NA 6.28 000
37201............... .............. A Transcatheter therapy 4.99 NA 2.52 0.29 NA 7.80 000
infuse.
37202............... .............. A Transcatheter therapy 5.67 NA 3.03 0.46 NA 9.16 000
infuse.
37203............... .............. A Transcatheter 5.02 NA 2.53 0.28 NA 7.83 000
retrieval.
37204............... .............. A Transcatheter 18.11 NA 5.93 1.10 NA 25.14 000
occlusion.
37205............... .............. A Transcatheter stent.. 8.27 NA 3.74 0.52 NA 12.53 000
37206............... .............. A Transcatheter stent 4.12 NA 1.44 0.27 NA 5.83 ZZZ
add-on.
37207............... .............. A Transcatheter stent.. 8.27 NA 3.17 1.07 NA 12.51 000
37208............... .............. A Transcatheter stent 4.12 NA 1.39 0.53 NA 6.04 ZZZ
add-on.
37209............... .............. A Exchange arterial 2.27 NA 0.75 0.13 NA 3.15 000
catheter.
37250............... .............. A Iv us first vessel 2.10 NA 0.75 0.21 NA 3.06 ZZZ
add-on.
37251............... .............. A Iv us each add vessel 1.60 NA 0.55 0.17 NA 2.32 ZZZ
add-on.
37500............... .............. A Endoscopy ligate perf 10.98 NA 7.12 0.48 NA 18.58 090
veins.
37501............... .............. C Vascular endoscopy 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
37565............... .............. A Ligation of neck vein 10.86 NA 5.65 0.54 NA 17.05 090
37600............... .............. A Ligation of neck 11.23 NA 6.67 0.48 NA 18.38 090
artery.
37605............... .............. A Ligation of neck 13.09 NA 6.94 0.93 NA 20.96 090
artery.
37606............... .............. A Ligation of neck 6.27 NA 4.59 0.95 NA 11.81 090
artery.
37607............... .............. A Ligation of a-v 6.15 NA 3.59 0.81 NA 10.55 090
fistula.
37609............... .............. A Temporal artery 3.00 4.70 1.98 0.25 7.95 5.23 010
procedure.
37615............... .............. A Ligation of neck 5.72 NA 4.12 0.69 NA 10.53 090
artery.
37616............... .............. A Ligation of chest 16.47 NA 8.15 2.33 NA 26.95 090
artery.
37617............... .............. A Ligation of abdomen 22.03 NA 9.22 2.04 NA 33.29 090
artery.
37618............... .............. A Ligation of extremity 4.83 NA 3.59 0.65 NA 9.07 090
artery.
37620............... .............. A Revision of major 10.54 NA 5.72 0.90 NA 17.16 090
vein.
37650............... .............. A Revision of major 7.79 NA 4.72 0.68 NA 13.19 090
vein.
37660............... .............. A Revision of major 20.97 NA 9.10 1.41 NA 31.48 090
vein.
37700............... .............. A Revise leg vein...... 3.72 NA 2.81 0.48 NA 7.01 090
37720............... .............. A Removal of leg vein.. 5.65 NA 3.73 0.74 NA 10.12 090
37730............... .............. A Removal of leg veins. 7.32 NA 4.28 0.93 NA 12.53 090
37735............... .............. A Removal of leg veins/ 10.51 NA 5.54 1.41 NA 17.46 090
lesion.
37760............... .............. A Ligation, leg veins, 10.45 NA 5.38 1.34 NA 17.17 090
open.
37765............... .............. A Phleb veins - extrem - 7.34 NA 4.55 0.48 NA 12.37 090
to 20.
37766............... .............. A Phleb veins - extrem 9.29 NA 5.26 0.48 NA 15.03 090
20+.
37780............... .............. A Revision of leg vein. 3.83 NA 2.88 0.49 NA 7.20 090
37785............... .............. A Ligate/divide/excise 3.83 5.14 2.64 0.49 9.46 6.96 090
vein.
[[Page 1156]]
37788............... .............. A Revascularization, 21.98 NA 9.29 1.63 NA 32.90 090
penis.
37790............... .............. A Penile venous 8.33 NA 4.53 0.76 NA 13.62 090
occlusion.
37799............... .............. C Vascular surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
38100............... .............. A Removal of spleen, 14.48 NA 6.23 1.57 NA 22.28 090
total.
38101............... .............. A Removal of spleen, 15.29 NA 6.58 1.66 NA 23.53 090
partial.
38102............... .............. A Removal of spleen, 4.79 NA 1.65 0.59 NA 7.03 ZZZ
total.
38115............... .............. A Repair of ruptured 15.80 NA 6.70 1.69 NA 24.19 090
spleen.
38120............... .............. A Laparoscopy, 16.97 NA 7.43 2.09 NA 26.49 090
splenectomy.
38129............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
spleen.
38200............... .............. A Injection for spleen 2.64 NA 0.89 0.14 NA 3.67 000
x-ray.
38204............... .............. B Bl donor search 0.00 0.00 0.00 0.00 0.00 0.00 XXX
management.
38205............... .............. R Harvest allogenic 1.50 NA 0.67 0.06 NA 2.23 000
stem cells.
38206............... .............. R Harvest auto stem 1.50 NA 0.67 0.06 NA 2.23 000
cells.
38207............... .............. I Cryopreserve stem 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cells.
38208............... .............. I Thaw preserved stem 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cells.
38209............... .............. I Wash harvest stem 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cells.
38210............... .............. I T-cell depletion of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
38211............... .............. I Tumor cell deplete of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvst.
38212............... .............. I Rbc depletion of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
38213............... .............. I Platelet deplete of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
38214............... .............. I Volume deplete of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
38215............... .............. I Harvest stem cell 0.00 0.00 0.00 0.00 0.00 0.00 XXX
concentrte.
38220............... .............. A Bone marrow 1.08 3.98 0.52 0.04 5.10 1.64 XXX
aspiration.
38221............... .............. A Bone marrow biopsy... 1.37 4.19 0.65 0.05 5.61 2.07 XXX
38230............... .............. R Bone marrow 4.53 NA 3.08 0.30 NA 7.91 010
collection.
38240............... .............. R Bone marrow/stem 2.24 NA 1.03 0.10 NA 3.37 XXX
transplant.
38241............... .............. R Bone marrow/stem 2.24 NA 1.04 0.10 NA 3.38 XXX
transplant.
38242............... .............. A Lymphocyte infuse 1.71 NA 0.77 0.06 NA 2.54 000
transplant.
38300............... .............. A Drainage, lymph node 1.99 4.42 2.07 0.18 6.59 4.24 010
lesion.
38305............... .............. A Drainage, lymph node 5.99 5.98 4.38 0.43 12.40 10.80 090
lesion.
38308............... .............. A Incision of lymph 6.44 5.71 3.75 0.62 12.77 10.81 090
channels.
38380............... .............. A Thoracic duct 7.45 NA 5.71 0.82 NA 13.98 090
procedure.
38381............... .............. A Thoracic duct 12.86 NA 6.94 1.91 NA 21.71 090
procedure.
38382............... .............. A Thoracic duct 10.06 NA 5.83 1.30 NA 17.19 090
procedure.
38500............... .............. A Biopsy/removal, lymph 3.74 3.78 2.10 0.34 7.86 6.18 010
nodes.
38505............... .............. A Needle biopsy, lymph 1.14 2.13 0.78 0.11 3.38 2.03 000
nodes.
38510............... .............. A Biopsy/removal, lymph 6.42 5.65 3.51 0.46 12.53 10.39 010
nodes.
38520............... .............. A Biopsy/removal, lymph 6.66 NA 4.11 0.63 NA 11.40 090
nodes.
38525............... .............. A Biopsy/removal, lymph 6.06 NA 3.36 0.58 NA 10.00 090
nodes.
38530............... .............. A Biopsy/removal, lymph 7.97 NA 4.46 0.76 NA 13.19 090
nodes.
38542............... .............. A Explore deep node(s), 5.90 NA 4.51 0.60 NA 11.01 090
neck.
38550............... .............. A Removal, neck/armpit 6.91 NA 3.99 0.83 NA 11.73 090
lesion.
38555............... .............. A Removal, neck/armpit 14.12 NA 8.62 1.76 NA 24.50 090
lesion.
38562............... .............. A Removal, pelvic lymph 10.47 NA 5.83 1.17 NA 17.47 090
nodes.
38564............... .............. A Removal, abdomen 10.81 NA 5.30 1.28 NA 17.39 090
lymph nodes.
38570............... .............. A Laparoscopy, lymph 9.24 NA 3.94 1.07 NA 14.25 010
node biop.
38571............... .............. A Laparoscopy, 14.66 NA 5.60 0.96 NA 21.22 010
lymphadenectomy.
38572............... .............. A Laparoscopy, 16.57 NA 7.04 1.59 NA 25.20 010
lymphadenectomy.
38589............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
lymphatic.
38700............... .............. A Removal of lymph 8.23 NA 8.09 0.72 NA 17.04 090
nodes, neck.
38720............... .............. A Removal of lymph 13.59 NA 11.07 1.24 NA 25.90 090
nodes, neck.
38724............... .............. A Removal of lymph 14.52 NA 11.57 1.33 NA 27.42 090
nodes, neck.
38740............... .............. A Remove armpit lymph 10.01 NA 5.01 0.83 NA 15.85 090
nodes.
38745............... .............. A Remove armpit lymph 13.08 NA 6.19 1.09 NA 20.36 090
nodes.
38746............... .............. A Remove thoracic lymph 4.88 NA 1.62 0.66 NA 7.16 ZZZ
nodes.
38747............... .............. A Remove abdominal 4.88 NA 1.68 0.60 NA 7.16 ZZZ
lymph nodes.
38760............... .............. A Remove groin lymph 12.93 NA 6.20 1.06 NA 20.19 090
nodes.
38765............... .............. A Remove groin lymph 19.95 NA 8.92 1.81 NA 30.68 090
nodes.
38770............... .............. A Remove pelvis lymph 13.21 NA 5.81 1.19 NA 20.21 090
nodes.
38780............... .............. A Remove abdomen lymph 16.57 NA 8.27 1.93 NA 26.77 090
nodes.
38790............... .............. A Inject for lymphatic 1.29 11.24 0.79 0.11 12.64 2.19 000
x-ray.
38792............... .............. A Identify sentinel 0.52 NA 0.44 0.05 NA 1.01 000
node.
38794............... .............. A Access thoracic lymph 4.44 NA 3.40 0.21 NA 8.05 090
duct.
38999............... .............. C Blood/lymph system 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
39000............... .............. A Exploration of chest. 6.09 NA 4.70 0.88 NA 11.67 090
39010............... .............. A Exploration of chest. 11.77 NA 6.67 1.76 NA 20.20 090
39200............... .............. A Removal chest lesion. 13.60 NA 6.82 1.99 NA 22.41 090
39220............... .............. A Removal chest lesion. 17.39 NA 8.55 2.53 NA 28.47 090
39400............... .............. A Visualization of 5.60 NA 4.87 0.83 NA 11.30 010
chest.
39499............... .............. C Chest procedure...... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
39501............... .............. A Repair diaphragm 13.17 NA 6.52 1.66 NA 21.35 090
laceration.
39502............... .............. A Repair paraesophageal 16.31 NA 7.20 2.03 NA 25.54 090
hernia.
39503............... .............. A Repair of diaphragm 94.86 NA 33.56 4.25 NA 132.67 090
hernia.
39520............... .............. A Repair of diaphragm 16.08 NA 8.11 2.21 NA 26.40 090
hernia.
39530............... .............. A Repair of diaphragm 15.39 NA 7.20 2.00 NA 24.59 090
hernia.
[[Page 1157]]
39531............... .............. A Repair of diaphragm 16.40 NA 7.45 2.21 NA 26.06 090
hernia.
39540............... .............. A Repair of diaphragm 13.30 NA 6.29 1.66 NA 21.25 090
hernia.
39541............... .............. A Repair of diaphragm 14.39 NA 6.65 1.83 NA 22.87 090
hernia.
39545............... .............. A Revision of diaphragm 13.35 NA 7.62 1.87 NA 22.84 090
39560............... .............. A Resect diaphragm, 11.98 NA 6.35 1.63 NA 19.96 090
simple.
39561............... .............. A Resect diaphragm, 17.47 NA 9.40 2.38 NA 29.25 090
complex.
39599............... .............. C Diaphragm surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
40490............... .............. A Biopsy of lip........ 1.22 1.85 0.61 0.07 3.14 1.90 000
40500............... .............. A Partial excision of 4.27 6.08 4.90 0.37 10.72 9.54 090
lip.
40510............... .............. A Partial excision of 4.69 6.82 4.79 0.46 11.97 9.94 090
lip.
40520............... .............. A Partial excision of 4.66 7.33 5.03 0.51 12.50 10.20 090
lip.
40525............... .............. A Reconstruct lip with 7.54 NA 6.90 0.82 NA 15.26 090
flap.
40527............... .............. A Reconstruct lip with 9.12 NA 7.85 0.99 NA 17.96 090
flap.
40530............... .............. A Partial removal of 5.39 6.57 5.19 0.57 12.53 11.15 090
lip.
40650............... .............. A Repair lip........... 3.63 5.55 3.80 0.37 9.55 7.80 090
40652............... .............. A Repair lip........... 4.25 6.50 5.23 0.47 11.22 9.95 090
40654............... .............. A Repair lip........... 5.30 7.16 5.96 0.58 13.04 11.84 090
40700............... .............. A Repair cleft lip/ 12.77 NA 9.51 1.12 NA 23.40 090
nasal.
40701............... .............. A Repair cleft lip/ 15.83 NA 11.79 1.64 NA 29.26 090
nasal.
40702............... .............. A Repair cleft lip/ 13.02 NA 8.47 1.22 NA 22.71 090
nasal.
40720............... .............. A Repair cleft lip/ 13.53 NA 10.50 1.58 NA 25.61 090
nasal.
40761............... .............. A Repair cleft lip/ 14.70 NA 10.82 1.70 NA 27.22 090
nasal.
40799............... .............. C Lip surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
40800............... .............. A Drainage of mouth 1.17 2.21 1.14 0.11 3.49 2.42 010
lesion.
40801............... .............. A Drainage of mouth 2.53 3.17 2.03 0.22 5.92 4.78 010
lesion.
40804............... .............. A Removal, foreign 1.24 2.55 1.12 0.11 3.90 2.47 010
body, mouth.
40805............... .............. A Removal, foreign 2.69 3.39 1.98 0.21 6.29 4.88 010
body, mouth.
40806............... .............. A Incision of lip fold. 0.31 1.37 0.95 0.02 1.70 1.28 000
40808............... .............. A Biopsy of mouth 0.96 2.29 1.08 0.08 3.33 2.12 010
lesion.
40810............... .............. A Excision of mouth 1.31 2.38 1.21 0.11 3.80 2.63 010
lesion.
40812............... .............. A Excise/repair mouth 2.31 3.24 1.78 0.21 5.76 4.30 010
lesion.
40814............... .............. A Excise/repair mouth 3.41 4.74 3.29 0.31 8.46 7.01 090
lesion.
40816............... .............. A Excision of mouth 3.66 4.91 3.39 0.33 8.90 7.38 090
lesion.
40818............... .............. A Excise oral mucosa 2.41 5.16 3.53 0.17 7.74 6.11 090
for graft.
40819............... .............. A Excise lip or cheek 2.41 4.38 2.92 0.21 7.00 5.54 090
fold.
40820............... .............. A Treatment of mouth 1.28 2.69 2.35 0.10 4.07 3.73 010
lesion.
40830............... .............. A Repair mouth 1.76 3.07 2.51 0.17 5.00 4.44 010
laceration.
40831............... .............. A Repair mouth 2.46 3.61 3.08 0.25 6.32 5.79 010
laceration.
40840............... .............. R Reconstruction of 8.72 8.58 7.36 0.95 18.25 17.03 090
mouth.
40842............... .............. R Reconstruction of 8.72 8.68 7.10 0.78 18.18 16.60 090
mouth.
40843............... .............. R Reconstruction of 12.08 10.87 8.61 1.01 23.96 21.70 090
mouth.
40844............... .............. R Reconstruction of 15.99 13.82 11.75 1.97 31.78 29.71 090
mouth.
40845............... .............. R Reconstruction of 18.55 15.82 13.55 1.77 36.14 33.87 090
mouth.
40899............... .............. C Mouth surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
41000............... .............. A Drainage of mouth 1.30 2.47 1.40 0.11 3.88 2.81 010
lesion.
41005............... .............. A Drainage of mouth 1.26 2.67 1.62 0.11 4.04 2.99 010
lesion.
41006............... .............. A Drainage of mouth 3.24 4.38 3.44 0.30 7.92 6.98 090
lesion.
41007............... .............. A Drainage of mouth 3.10 4.16 3.31 0.27 7.53 6.68 090
lesion.
41008............... .............. A Drainage of mouth 3.36 4.53 3.49 0.29 8.18 7.14 090
lesion.
41009............... .............. A Drainage of mouth 3.58 4.86 3.85 0.30 8.74 7.73 090
lesion.
41010............... .............. A Incision of tongue 1.06 3.46 3.46 0.07 4.59 4.59 010
fold.
41015............... .............. A Drainage of mouth 3.95 5.36 4.06 0.35 9.66 8.36 090
lesion.
41016............... .............. A Drainage of mouth 4.06 5.45 4.07 0.34 9.85 8.47 090
lesion.
41017............... .............. A Drainage of mouth 4.06 5.36 4.14 0.39 9.81 8.59 090
lesion.
41018............... .............. A Drainage of mouth 5.09 5.80 4.25 0.42 11.31 9.76 090
lesion.
41100............... .............. A Biopsy of tongue..... 1.63 2.56 1.42 0.14 4.33 3.19 010
41105............... .............. A Biopsy of tongue..... 1.42 2.46 1.31 0.12 4.00 2.85 010
41108............... .............. A Biopsy of floor of 1.05 2.20 1.12 0.10 3.35 2.27 010
mouth.
41110............... .............. A Excision of tongue 1.51 2.52 1.33 0.13 4.16 2.97 010
lesion.
41112............... .............. A Excision of tongue 2.73 4.25 2.71 0.24 7.22 5.68 090
lesion.
41113............... .............. A Excision of tongue 3.19 4.60 2.98 0.28 8.07 6.45 090
lesion.
41114............... .............. A Excision of tongue 8.46 8.75 6.31 0.77 17.98 15.54 090
lesion.
41115............... .............. A Excision of tongue 1.74 3.43 2.57 0.16 5.33 4.47 010
fold.
41116............... .............. A Excision of mouth 2.44 4.22 2.77 0.21 6.87 5.42 090
lesion.
41120............... .............. A Partial removal of 9.76 NA 7.58 0.84 NA 18.18 090
tongue.
41130............... .............. A Partial removal of 11.13 NA 8.36 0.98 NA 20.47 090
tongue.
41135............... .............. A Tongue and neck 23.06 NA 14.83 2.00 NA 39.89 090
surgery.
41140............... .............. A Removal of tongue.... 25.46 NA 16.06 2.23 NA 43.75 090
41145............... .............. A Tongue removal, neck 30.01 NA 19.18 2.54 NA 51.73 090
surgery.
41150............... .............. A Tongue, mouth, jaw 23.01 NA 15.49 2.01 NA 40.51 090
surgery.
41153............... .............. A Tongue, mouth, neck 23.73 NA 15.96 2.06 NA 41.75 090
surgery.
41155............... .............. A Tongue, jaw, & neck 27.68 NA 17.99 2.44 NA 48.11 090
surgery.
41250............... .............. A Repair tongue 1.91 3.07 1.62 0.18 5.16 3.71 010
laceration.
41251............... .............. A Repair tongue 2.27 3.58 1.93 0.22 6.07 4.42 010
laceration.
41252............... .............. A Repair tongue 2.97 4.16 2.28 0.28 7.41 5.53 010
laceration.
[[Page 1158]]
41500............... .............. A Fixation of tongue... 3.70 NA 3.63 0.31 NA 7.64 090
41510............... .............. A Tongue to lip surgery 3.41 NA 3.10 0.29 NA 6.80 090
41520............... .............. A Reconstruction, 2.73 4.07 3.22 0.23 7.03 6.18 090
tongue fold.
41599............... .............. C Tongue and mouth 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
41800............... .............. A Drainage of gum 1.17 2.66 1.44 0.11 3.94 2.72 010
lesion.
41805............... .............. A Removal foreign body, 1.24 2.73 2.33 0.11 4.08 3.68 010
gum.
41806............... .............. A Removal foreign 2.69 3.62 3.14 0.27 6.58 6.10 010
body,jawbone.
41820............... .............. R Excision, gum, each 0.00 0.00 0.00 0.00 0.00 0.00 000
quadrant.
41821............... .............. R Excision of gum flap. 0.00 0.00 0.00 0.00 0.00 0.00 000
41822............... .............. R Excision of gum 2.31 4.09 1.33 0.29 6.69 3.93 010
lesion.
41823............... .............. R Excision of gum 3.30 5.82 4.10 0.35 9.47 7.75 090
lesion.
41825............... .............. A Excision of gum 1.31 3.27 2.35 0.12 4.70 3.78 010
lesion.
41826............... .............. A Excision of gum 2.31 3.85 2.89 0.21 6.37 5.41 010
lesion.
41827............... .............. A Excision of gum 3.41 5.61 3.84 0.30 9.32 7.55 090
lesion.
41828............... .............. R Excision of gum 3.09 4.38 3.35 0.27 7.74 6.71 010
lesion.
41830............... .............. R Removal of gum tissue 3.34 4.91 3.57 0.28 8.53 7.19 010
41850............... .............. R Treatment of gum 0.00 0.00 0.00 0.00 0.00 0.00 000
lesion.
41870............... .............. R Gum graft............ 0.00 0.00 0.00 0.00 0.00 0.00 000
41872............... .............. R Repair gum........... 2.59 4.63 3.53 0.22 7.44 6.34 090
41874............... .............. R Repair tooth socket.. 3.09 4.68 3.29 0.28 8.05 6.66 090
41899............... .............. C Dental surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
42000............... .............. A Drainage mouth roof 1.23 2.72 1.25 0.12 4.07 2.60 010
lesion.
42100............... .............. A Biopsy roof of mouth. 1.31 2.27 1.36 0.12 3.70 2.79 010
42104............... .............. A Excision lesion, 1.64 2.76 1.55 0.14 4.54 3.33 010
mouth roof.
42106............... .............. A Excision lesion, 2.10 3.72 2.81 0.19 6.01 5.10 010
mouth roof.
42107............... .............. A Excision lesion, 4.43 6.07 4.18 0.39 10.89 9.00 090
mouth roof.
42120............... .............. A Remove palate/lesion. 6.16 NA 5.56 0.53 NA 12.25 090
42140............... .............. A Excision of uvula.... 1.62 2.48 2.37 0.14 4.24 4.13 090
42145............... .............. A Repair palate, 8.04 NA 6.61 0.68 NA 15.33 090
pharynx/uvula.
42160............... .............. A Treatment mouth roof 1.80 3.59 2.65 0.16 5.55 4.61 010
lesion.
42180............... .............. A Repair palate........ 2.50 3.38 2.12 0.23 6.11 4.85 010
42182............... .............. A Repair palate........ 3.82 4.23 3.06 0.33 8.38 7.21 010
42200............... .............. A Reconstruct cleft 11.98 NA 9.01 1.17 NA 22.16 090
palate.
42205............... .............. A Reconstruct cleft 13.27 NA 9.35 0.99 NA 23.61 090
palate.
42210............... .............. A Reconstruct cleft 14.48 NA 10.52 1.50 NA 26.50 090
palate.
42215............... .............. A Reconstruct cleft 8.81 NA 7.55 1.16 NA 17.52 090
palate.
42220............... .............. A Reconstruct cleft 7.01 NA 5.64 0.49 NA 13.14 090
palate.
42225............... .............. A Reconstruct cleft 9.53 NA 7.66 0.90 NA 18.09 090
palate.
42226............... .............. A Lengthening of palate 9.99 NA 7.88 0.88 NA 18.75 090
42227............... .............. A Lengthening of palate 9.51 NA 7.34 0.84 NA 17.69 090
42235............... .............. A Repair palate........ 7.86 NA 5.35 0.59 NA 13.80 090
42260............... .............. A Repair nose to lip 9.79 9.23 7.44 1.03 20.05 18.26 090
fistula.
42280............... .............. A Preparation, palate 1.54 2.00 0.88 0.14 3.68 2.56 010
mold.
42281............... .............. A Insertion, palate 1.93 2.92 1.88 0.17 5.02 3.98 010
prosthesis.
42299............... .............. C Palate/uvula surgery. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
42300............... .............. A Drainage of salivary 1.93 2.95 1.83 0.18 5.06 3.94 010
gland.
42305............... .............. A Drainage of salivary 6.06 NA 4.95 0.55 NA 11.56 090
gland.
42310............... .............. A Drainage of salivary 1.56 2.34 1.54 0.13 4.03 3.23 010
gland.
42320............... .............. A Drainage of salivary 2.35 3.52 2.11 0.21 6.08 4.67 010
gland.
42325............... .............. A Create salivary cyst 2.75 3.54 2.23 0.21 6.50 5.19 090
drain.
42326............... .............. A Create salivary cyst 3.77 4.54 3.10 0.41 8.72 7.28 090
drain.
42330............... .............. A Removal of salivary 2.21 3.30 1.86 0.19 5.70 4.26 010
stone.
42335............... .............. A Removal of salivary 3.31 3.90 3.36 0.28 7.49 6.95 090
stone.
42340............... .............. A Removal of salivary 4.59 5.14 4.27 0.41 10.14 9.27 090
stone.
42400............... .............. A Biopsy of salivary 0.78 1.75 0.72 0.07 2.60 1.57 000
gland.
42405............... .............. A Biopsy of salivary 3.29 4.17 2.48 0.29 7.75 6.06 010
gland.
42408............... .............. A Excision of salivary 4.53 5.05 4.06 0.41 9.99 9.00 090
cyst.
42409............... .............. A Drainage of salivary 2.81 3.55 3.09 0.24 6.60 6.14 090
cyst.
42410............... .............. A Excise parotid gland/ 9.33 NA 6.64 0.93 NA 16.90 090
lesion.
42415............... .............. A Excise parotid gland/ 16.86 NA 11.26 1.52 NA 29.64 090
lesion.
42420............... .............. A Excise parotid gland/ 19.56 NA 12.77 1.75 NA 34.08 090
lesion.
42425............... .............. A Excise parotid gland/ 13.00 NA 9.07 1.18 NA 23.25 090
lesion.
42426............... .............. A Excise parotid gland/ 21.23 NA 13.43 1.89 NA 36.55 090
lesion.
42440............... .............. A Excise submaxillary 6.96 NA 5.06 0.62 NA 12.64 090
gland.
42450............... .............. A Excise sublingual 4.61 5.66 4.24 0.41 10.68 9.26 090
gland.
42500............... .............. A Repair salivary duct. 4.29 5.46 4.18 0.36 10.11 8.83 090
42505............... .............. A Repair salivary duct. 6.17 6.90 5.36 0.53 13.60 12.06 090
42507............... .............. A Parotid duct 6.10 NA 5.20 0.80 NA 12.10 090
diversion.
42508............... .............. A Parotid duct 9.09 NA 7.02 0.77 NA 16.88 090
diversion.
42509............... .............. A Parotid duct 11.52 NA 8.42 1.50 NA 21.44 090
diversion.
42510............... .............. A Parotid duct 8.14 NA 6.11 0.69 NA 14.94 090
diversion.
42550............... .............. A Injection for 1.25 13.05 0.41 0.07 14.37 1.73 000
salivary x-ray.
42600............... .............. A Closure of salivary 4.81 5.83 4.52 0.41 11.05 9.74 090
fistula.
42650............... .............. A Dilation of salivary 0.77 1.17 0.71 0.07 2.01 1.55 000
duct.
42660............... .............. A Dilation of salivary 1.13 1.48 0.84 0.08 2.69 2.05 000
duct.
[[Page 1159]]
42665............... .............. A Ligation of salivary 2.53 3.56 2.96 0.21 6.30 5.70 090
duct.
42699............... .............. C Salivary surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
42700............... .............. A Drainage of tonsil 1.62 2.74 1.73 0.14 4.50 3.49 010
abscess.
42720............... .............. A Drainage of throat 5.41 5.04 3.82 0.47 10.92 9.70 010
abscess.
42725............... .............. A Drainage of throat 10.70 NA 8.00 0.96 NA 19.66 090
abscess.
42800............... .............. A Biopsy of throat..... 1.39 2.23 1.40 0.12 3.74 2.91 010
42802............... .............. A Biopsy of throat..... 1.54 4.38 1.94 0.13 6.05 3.61 010
42804............... .............. A Biopsy of upper nose/ 1.24 3.97 1.79 0.11 5.32 3.14 010
throat.
42806............... .............. A Biopsy of upper nose/ 1.58 4.11 1.92 0.14 5.83 3.64 010
throat.
42808............... .............. A Excise pharynx lesion 2.30 3.17 1.93 0.21 5.68 4.44 010
42809............... .............. A Remove pharynx 1.81 2.36 1.36 0.16 4.33 3.33 010
foreign body.
42810............... .............. A Excision of neck cyst 3.25 4.84 3.37 0.30 8.39 6.92 090
42815............... .............. A Excision of neck cyst 7.06 NA 5.42 0.64 NA 13.12 090
42820............... .............. A Remove tonsils and 3.90 NA 3.47 0.34 NA 7.71 090
adenoids.
42821............... .............. A Remove tonsils and 4.28 NA 3.68 0.36 NA 8.32 090
adenoids.
42825............... .............. A Removal of tonsils... 3.41 NA 3.32 0.29 NA 7.02 090
42826............... .............. A Removal of tonsils... 3.37 NA 3.21 0.28 NA 6.86 090
42830............... .............. A Removal of adenoids.. 2.57 NA 2.62 0.22 NA 5.41 090
42831............... .............. A Removal of adenoids.. 2.71 NA 2.86 0.23 NA 5.80 090
42835............... .............. A Removal of adenoids.. 2.30 NA 2.62 0.21 NA 5.13 090
42836............... .............. A Removal of adenoids.. 3.18 NA 3.14 0.27 NA 6.59 090
42842............... .............. A Extensive surgery of 8.75 NA 6.74 0.74 NA 16.23 090
throat.
42844............... .............. A Extensive surgery of 14.29 NA 10.03 1.25 NA 25.57 090
throat.
42845............... .............. A Extensive surgery of 24.25 NA 16.11 2.12 NA 42.48 090
throat.
42860............... .............. A Excision of tonsil 2.22 NA 2.58 0.19 NA 4.99 090
tags.
42870............... .............. A Excision of lingual 5.39 NA 4.79 0.46 NA 10.64 090
tonsil.
42890............... .............. A Partial removal of 12.92 NA 9.34 1.10 NA 23.36 090
pharynx.
42892............... .............. A Revision of 15.81 NA 10.89 1.37 NA 28.07 090
pharyngeal walls.
42894............... .............. A Revision of 22.85 NA 15.07 1.98 NA 39.90 090
pharyngeal walls.
42900............... .............. A Repair throat wound.. 5.24 NA 3.70 0.47 NA 9.41 010
42950............... .............. A Reconstruction of 8.09 NA 6.60 0.70 NA 15.39 090
throat.
42953............... .............. A Repair throat, 8.95 NA 7.53 0.88 NA 17.36 090
esophagus.
42955............... .............. A Surgical opening of 7.38 NA 5.58 0.76 NA 13.72 090
throat.
42960............... .............. A Control throat 2.33 NA 2.00 0.21 NA 4.54 010
bleeding.
42961............... .............. A Control throat 5.58 NA 4.85 0.48 NA 10.91 090
bleeding.
42962............... .............. A Control throat 7.13 NA 5.73 0.62 NA 13.48 090
bleeding.
42970............... .............. A Control nose/throat 5.42 NA 3.61 0.45 NA 9.48 090
bleeding.
42971............... .............. A Control nose/throat 6.20 NA 4.97 0.54 NA 11.71 090
bleeding.
42972............... .............. A Control nose/throat 7.19 NA 5.47 0.65 NA 13.31 090
bleeding.
42999............... .............. C Throat surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
43020............... .............. A Incision of esophagus 8.08 NA 5.70 0.84 NA 14.62 090
43030............... .............. A Throat muscle surgery 7.68 NA 5.82 0.72 NA 14.22 090
43045............... .............. A Incision of esophagus 20.09 NA 10.76 2.59 NA 33.44 090
43100............... .............. A Excision of esophagus 9.18 NA 6.27 0.95 NA 16.40 090
lesion.
43101............... .............. A Excision of esophagus 16.22 NA 7.94 2.18 NA 26.34 090
lesion.
43107............... .............. A Removal of esophagus. 39.94 NA 17.14 3.97 NA 61.05 090
43108............... .............. A Removal of esophagus. 34.14 NA 14.30 4.56 NA 53.00 090
43112............... .............. A Removal of esophagus. 43.43 NA 18.24 4.43 NA 66.10 090
43113............... .............. A Removal of esophagus. 35.22 NA 15.20 5.22 NA 55.64 090
43116............... .............. A Partial removal of 31.17 NA 16.81 3.16 NA 51.14 090
esophagus.
43117............... .............. A Partial removal of 39.94 NA 16.38 4.23 NA 60.55 090
esophagus.
43118............... .............. A Partial removal of 33.15 NA 13.87 4.29 NA 51.31 090
esophagus.
43121............... .............. A Partial removal of 29.15 NA 12.75 4.15 NA 46.05 090
esophagus.
43122............... .............. A Partial removal of 39.94 NA 16.49 3.94 NA 60.37 090
esophagus.
43123............... .............. A Partial removal of 33.15 NA 14.18 4.78 NA 52.11 090
esophagus.
43124............... .............. A Removal of esophagus. 27.28 NA 13.16 3.56 NA 44.00 090
43130............... .............. A Removal of esophagus 11.73 NA 7.62 1.28 NA 20.63 090
pouch.
43135............... .............. A Removal of esophagus 16.08 NA 8.16 2.23 NA 26.47 090
pouch.
43200............... .............. A Esophagus endoscopy.. 1.59 4.01 1.10 0.13 5.73 2.82 000
43201............... .............. A Esoph scope w/ 2.09 4.70 1.27 0.14 6.93 3.50 000
submucous inj.
43202............... .............. A Esophagus endoscopy, 1.89 5.38 0.96 0.14 7.41 2.99 000
biopsy.
43204............... .............. A Esoph scope w/ 3.76 NA 1.54 0.22 NA 5.52 000
sclerosis inj.
43205............... .............. A Esophagus endoscopy/ 3.78 NA 1.55 0.21 NA 5.54 000
ligation.
43215............... .............. A Esophagus endoscopy.. 2.60 NA 1.22 0.21 NA 4.03 000
43216............... .............. A Esophagus endoscopy/ 2.40 NA 1.18 0.18 NA 3.76 000
lesion.
43217............... .............. A Esophagus endoscopy.. 2.90 6.79 1.21 0.21 9.90 4.32 000
43219............... .............. A Esophagus endoscopy.. 2.80 NA 1.37 0.19 NA 4.36 000
43220............... .............. A Esoph endoscopy, 2.10 NA 0.99 0.14 NA 3.23 000
dilation.
43226............... .............. A Esoph endoscopy, 2.34 NA 1.06 0.14 NA 3.54 000
dilation.
43227............... .............. A Esoph endoscopy, 3.59 NA 1.47 0.22 NA 5.28 000
repair.
43228............... .............. A Esoph endoscopy, 3.76 NA 1.58 0.30 NA 5.64 000
ablation.
43231............... .............. A Esoph endoscopy w/us 3.19 NA 1.33 0.24 NA 4.76 000
exam.
43232............... .............. A Esoph endoscopy w/us 4.47 NA 1.84 0.31 NA 6.62 000
fn bx.
43234............... .............. A Upper GI endoscopy, 2.01 5.21 0.90 0.16 7.38 3.07 000
exam.
43235............... .............. A Uppr gi endoscopy, 2.39 5.04 1.07 0.16 7.59 3.62 000
diagnosis.
[[Page 1160]]
43236............... .............. A Uppr gi scope w/ 2.92 6.32 1.26 0.17 9.41 4.35 000
submuc inj.
43237............... .............. A Endoscopic us exam, 3.98 NA 1.61 0.27 NA 5.86 000
esoph.
43238............... .............. A Uppr gi endoscopy w/ 5.02 NA 1.97 0.27 NA 7.26 000
us fn bx.
43239............... .............. A Upper GI endoscopy, 2.87 5.58 1.23 0.17 8.62 4.27 000
biopsy.
43240............... .............. A Esoph endoscope w/ 6.85 NA 2.65 0.43 NA 9.93 000
drain cyst.
43241............... .............. A Upper GI endoscopy 2.59 NA 1.14 0.17 NA 3.90 000
with tube.
43242............... .............. A Uppr gi endoscopy w/ 7.30 NA 2.78 0.35 NA 10.43 000
us fn bx.
43243............... .............. A Upper gi endoscopy & 4.56 NA 1.84 0.25 NA 6.65 000
inject.
43244............... .............. A Upper GI endoscopy/ 5.04 NA 2.01 0.25 NA 7.30 000
ligation.
43245............... .............. A Uppr gi scope dilate 3.18 NA 1.34 0.22 NA 4.74 000
strictr.
43246............... .............. A Place gastrostomy 4.32 NA 1.74 0.29 NA 6.35 000
tube.
43247............... .............. A Operative upper GI 3.38 NA 1.42 0.21 NA 5.01 000
endoscopy.
43248............... .............. A Uppr gi endoscopy/ 3.15 NA 1.35 0.18 NA 4.68 000
guide wire.
43249............... .............. A Esoph endoscopy, 2.90 NA 1.25 0.18 NA 4.33 000
dilation.
43250............... .............. A Upper GI endoscopy/ 3.20 NA 1.35 0.21 NA 4.76 000
tumor.
43251............... .............. A Operative upper GI 3.69 NA 1.53 0.23 NA 5.45 000
endoscopy.
43255............... .............. A Operative upper GI 4.81 NA 1.92 0.24 NA 6.97 000
endoscopy.
43256............... .............. A Uppr gi endoscopy w 4.34 NA 1.77 0.28 NA 6.39 000
stent.
43258............... .............. A Operative upper GI 4.54 NA 1.84 0.27 NA 6.65 000
endoscopy.
43259............... .............. A Endoscopic ultrasound 5.19 NA 2.04 0.27 NA 7.50 000
exam.
43260............... .............. A Endo 5.95 NA 2.31 0.33 NA 8.59 000
cholangiopancreatogr
aph.
43261............... .............. A Endo 6.26 NA 2.42 0.35 NA 9.03 000
cholangiopancreatogr
aph.
43262............... .............. A Endo 7.38 NA 2.81 0.41 NA 10.60 000
cholangiopancreatogr
aph.
43263............... .............. A Endo 7.28 NA 2.78 0.34 NA 10.40 000
cholangiopancreatogr
aph.
43264............... .............. A Endo 8.89 NA 3.35 0.49 NA 12.73 000
cholangiopancreatogr
aph.
43265............... .............. A Endo 10.00 NA 3.73 0.51 NA 14.24 000
cholangiopancreatogr
aph.
43267............... .............. A Endo 7.38 NA 2.80 0.41 NA 10.59 000
cholangiopancreatogr
aph.
43268............... .............. A Endo 7.38 NA 2.90 0.41 NA 10.69 000
cholangiopancreatogr
aph.
43269............... .............. A Endo 8.20 NA 3.10 0.34 NA 11.64 000
cholangiopancreatogr
aph.
43271............... .............. A Endo 7.38 NA 2.80 0.41 NA 10.59 000
cholangiopancreatogr
aph.
43272............... .............. A Endo 7.38 NA 2.81 0.41 NA 10.60 000
cholangiopancreatogr
aph.
43280............... .............. A Laparoscopy, 17.22 NA 7.33 2.12 NA 26.67 090
fundoplasty.
43289............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
esoph.
43300............... .............. A Repair of esophagus.. 9.13 NA 6.51 1.03 NA 16.67 090
43305............... .............. A Repair esophagus and 17.36 NA 10.78 1.64 NA 29.78 090
fistula.
43310............... .............. A Repair of esophagus.. 25.35 NA 11.15 3.84 NA 40.34 090
43312............... .............. A Repair esophagus and 28.38 NA 12.00 4.08 NA 44.46 090
fistula.
43313............... .............. A Esophagoplasty 45.21 NA 20.15 6.55 NA 71.91 090
congenital.
43314............... .............. A Tracheo- 50.19 NA 22.05 6.67 NA 78.91 090
esophagoplasty cong.
43320............... .............. A Fuse esophagus & 19.90 NA 9.27 1.92 NA 31.09 090
stomach.
43324............... .............. A Revise esophagus & 20.54 NA 8.82 2.07 NA 31.43 090
stomach.
43325............... .............. A Revise esophagus & 20.03 NA 8.84 1.99 NA 30.86 090
stomach.
43326............... .............. A Revise esophagus & 19.71 NA 9.34 2.22 NA 31.27 090
stomach.
43330............... .............. A Repair of esophagus.. 19.74 NA 8.59 1.83 NA 30.16 090
43331............... .............. A Repair of esophagus.. 20.10 NA 9.83 2.33 NA 32.26 090
43340............... .............. A Fuse esophagus & 19.58 NA 9.03 1.85 NA 30.46 090
intestine.
43341............... .............. A Fuse esophagus & 20.82 NA 10.06 2.58 NA 33.46 090
intestine.
43350............... .............. A Surgical opening, 15.76 NA 8.50 1.39 NA 25.65 090
esophagus.
43351............... .............. A Surgical opening, 18.32 NA 9.85 1.82 NA 29.99 090
esophagus.
43352............... .............. A Surgical opening, 15.24 NA 8.45 1.54 NA 25.23 090
esophagus.
43360............... .............. A Gastrointestinal 35.65 NA 15.15 3.62 NA 54.42 090
repair.
43361............... .............. A Gastrointestinal 40.44 NA 16.98 4.25 NA 61.67 090
repair.
43400............... .............. A Ligate esophagus 21.17 NA 9.43 1.19 NA 31.79 090
veins.
43401............... .............. A Esophagus surgery for 22.06 NA 9.56 2.09 NA 33.71 090
veins.
43405............... .............. A Ligate/staple 19.98 NA 9.62 1.97 NA 31.57 090
esophagus.
43410............... .............. A Repair esophagus 13.45 NA 7.69 1.39 NA 22.53 090
wound.
43415............... .............. A Repair esophagus 24.96 NA 11.80 2.32 NA 39.08 090
wound.
43420............... .............. A Repair esophagus 14.33 NA 7.48 1.04 NA 22.85 090
opening.
43425............... .............. A Repair esophagus 21.00 NA 10.03 2.45 NA 33.48 090
opening.
43450............... .............. A Dilate esophagus..... 1.38 2.52 0.73 0.08 3.98 2.19 000
43453............... .............. A Dilate esophagus..... 1.51 5.95 0.78 0.10 7.56 2.39 000
43456............... .............. A Dilate esophagus..... 2.57 13.75 1.15 0.17 16.49 3.89 000
43458............... .............. A Dilate esophagus..... 3.06 6.55 1.33 0.21 9.82 4.60 000
43460............... .............. A Pressure treatment 3.79 NA 1.49 0.25 NA 5.53 000
esophagus.
43496............... .............. C Free jejunum flap, 0.00 0.00 0.00 0.00 0.00 0.00 090
microvasc.
43499............... .............. C Esophagus surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
43500............... .............. A Surgical opening of 11.03 NA 5.00 1.01 NA 17.04 090
stomach.
43501............... .............. A Surgical repair of 20.01 NA 8.36 1.87 NA 30.24 090
stomach.
43502............... .............. A Surgical repair of 23.10 NA 9.51 2.21 NA 34.82 090
stomach.
43510............... .............. A Surgical opening of 13.06 NA 6.59 1.09 NA 20.74 090
stomach.
43520............... .............. A Incision of pyloric 9.98 NA 5.30 1.01 NA 16.29 090
muscle.
43600............... .............. A Biopsy of stomach.... 1.91 NA 1.03 0.13 NA 3.07 000
43605............... .............. A Biopsy of stomach.... 11.96 NA 5.32 1.12 NA 18.40 090
43610............... .............. A Excision of stomach 14.58 NA 6.20 1.37 NA 22.15 090
lesion.
43611............... .............. A Excision of stomach 17.81 NA 7.61 1.66 NA 27.08 090
lesion.
[[Page 1161]]
43620............... .............. A Removal of stomach... 29.99 NA 11.87 2.76 NA 44.62 090
43621............... .............. A Removal of stomach... 30.68 NA 12.06 2.85 NA 45.59 090
43622............... .............. A Removal of stomach... 32.48 NA 12.66 2.99 NA 48.13 090
43631............... .............. A Removal of stomach, 22.56 NA 9.21 2.40 NA 34.17 090
partial.
43632............... .............. A Removal of stomach, 22.56 NA 9.21 2.41 NA 34.18 090
partial.
43633............... .............. A Removal of stomach, 23.07 NA 9.37 2.47 NA 34.91 090
partial.
43634............... .............. A Removal of stomach, 25.08 NA 10.14 2.63 NA 37.85 090
partial.
43635............... .............. A Removal of stomach, 2.06 NA 0.70 0.25 NA 3.01 ZZZ
partial.
43638............... .............. A Removal of stomach, 28.96 NA 11.94 2.70 NA 43.60 090
partial.
43639............... .............. A Removal of stomach, 29.61 NA 11.74 2.79 NA 44.14 090
partial.
43640............... .............. A Vagotomy & pylorus 16.99 NA 7.30 1.82 NA 26.11 090
repair.
43641............... .............. A Vagotomy & pylorus 17.24 NA 7.41 1.85 NA 26.50 090
repair.
43651............... .............. A Laparoscopy, vagus 10.13 NA 4.80 1.24 NA 16.17 090
nerve.
43652............... .............. A Laparoscopy, vagus 12.13 NA 5.40 1.51 NA 19.04 090
nerve.
43653............... .............. A Laparoscopy, 7.72 NA 4.22 0.94 NA 12.88 090
gastrostomy.
43659............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
stom.
43750............... .............. A Place gastrostomy 4.48 NA 2.72 0.40 NA 7.60 010
tube.
43752............... .............. A Nasal/orogastric w/ 0.68 0.26 0.26 0.02 0.96 0.96 000
stent.
43760............... .............. A Change gastrostomy 1.10 1.65 0.45 0.08 2.83 1.63 000
tube.
43761............... .............. A Reposition 2.01 NA 0.79 0.12 NA 2.92 000
gastrostomy tube.
43800............... .............. A Reconstruction of 13.67 NA 5.94 1.29 NA 20.90 090
pylorus.
43810............... .............. A Fusion of stomach and 14.63 NA 6.23 1.33 NA 22.19 090
bowel.
43820............... .............. A Fusion of stomach and 15.35 NA 6.45 1.42 NA 23.22 090
bowel.
43825............... .............. A Fusion of stomach and 19.19 NA 8.06 1.81 NA 29.06 090
bowel.
43830............... .............. A Place gastrostomy 9.52 NA 4.88 0.83 NA 15.23 090
tube.
43831............... .............. A Place gastrostomy 7.83 NA 4.54 0.98 NA 13.35 090
tube.
43832............... .............. A Place gastrostomy 15.58 NA 6.90 1.36 NA 23.84 090
tube.
43840............... .............. A Repair of stomach 15.54 NA 6.81 1.45 NA 23.80 090
lesion.
43842............... .............. A Gastroplasty for 18.44 NA 8.15 1.82 NA 28.41 090
obesity.
43843............... .............. A Gastroplasty for 18.62 NA 8.12 1.85 NA 28.59 090
obesity.
43846............... .............. A Gastric bypass for 24.01 NA 10.37 2.36 NA 36.74 090
obesity.
43847............... .............. A Gastric bypass for 26.88 NA 11.32 2.58 NA 40.78 090
obesity.
43848............... .............. A Revision gastroplasty 29.35 NA 12.25 2.88 NA 44.48 090
43850............... .............. A Revise stomach-bowel 24.68 NA 9.87 2.38 NA 36.93 090
fusion.
43855............... .............. A Revise stomach-bowel 26.12 NA 10.38 2.42 NA 38.92 090
fusion.
43860............... .............. A Revise stomach-bowel 24.96 NA 10.03 2.45 NA 37.44 090
fusion.
43865............... .............. A Revise stomach-bowel 26.48 NA 10.56 2.59 NA 39.63 090
fusion.
43870............... .............. A Repair stomach 9.68 NA 4.55 0.86 NA 15.09 090
opening.
43880............... .............. A Repair stomach-bowel 24.61 NA 9.97 2.34 NA 36.92 090
fistula.
43999............... .............. C Stomach surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
44005............... .............. A Freeing of bowel 16.21 NA 6.77 1.68 NA 24.66 090
adhesion.
44010............... .............. A Incision of small 12.50 NA 5.50 1.27 NA 19.27 090
bowel.
44015............... .............. A Insert needle cath 2.62 NA 0.89 0.30 NA 3.81 ZZZ
bowel.
44020............... .............. A Explore small 13.97 NA 5.98 1.45 NA 21.40 090
intestine.
44021............... .............. A Decompress small 14.06 NA 6.02 1.42 NA 21.50 090
bowel.
44025............... .............. A Incision of large 14.26 NA 6.07 1.46 NA 21.79 090
bowel.
44050............... .............. A Reduce bowel 14.01 NA 6.00 1.39 NA 21.40 090
obstruction.
44055............... .............. A Correct malrotation 21.97 NA 8.78 1.59 NA 32.34 090
of bowel.
44100............... .............. A Biopsy of bowel...... 2.01 NA 1.10 0.14 NA 3.25 000
44110............... .............. A Excise intestine 11.79 NA 5.27 1.21 NA 18.27 090
lesion(s).
44111............... .............. A Excision of bowel 14.27 NA 6.17 1.47 NA 21.91 090
lesion(s).
44120............... .............. A Removal of small 16.97 NA 7.12 1.76 NA 25.85 090
intestine.
44121............... .............. A Removal of small 4.44 NA 1.53 0.55 NA 6.52 ZZZ
intestine.
44125............... .............. A Removal of small 17.51 NA 7.31 1.80 NA 26.62 090
intestine.
44126............... .............. A Enterectomy w/o 35.45 NA 14.16 0.43 NA 50.04 090
taper, cong.
44127............... .............. A Enterectomy w/taper, 40.94 NA 15.79 0.49 NA 57.22 090
cong.
44128............... .............. A Enterectomy cong, add- 4.44 NA 1.54 0.54 NA 6.52 ZZZ
on.
44130............... .............. A Bowel to bowel fusion 14.47 NA 6.26 1.48 NA 22.21 090
44132............... .............. R Enterectomy, cadaver 0.00 0.00 0.00 0.00 0.00 0.00 XXX
donor.
44133............... .............. R Enterectomy, live 0.00 0.00 0.00 0.00 0.00 0.00 XXX
donor.
44135............... .............. R Intestine transplnt, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cadaver.
44136............... .............. R Intestine transplant, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
live.
44139............... .............. A Mobilization of colon 2.23 NA 0.76 0.25 NA 3.24 ZZZ
44140............... .............. A Partial removal of 20.97 NA 8.69 2.58 NA 32.24 090
colon.
44141............... .............. A Partial removal of 19.48 NA 10.15 2.35 NA 31.98 090
colon.
44143............... .............. A Partial removal of 22.96 NA 10.80 2.44 NA 36.20 090
colon.
44144............... .............. A Partial removal of 21.50 NA 9.69 2.28 NA 33.47 090
colon.
44145............... .............. A Partial removal of 26.38 NA 10.87 2.68 NA 39.93 090
colon.
44146............... .............. A Partial removal of 27.50 NA 12.98 2.65 NA 43.13 090
colon.
44147............... .............. A Partial removal of 20.68 NA 8.74 2.10 NA 31.52 090
colon.
44150............... .............. A Removal of colon..... 23.91 NA 12.16 2.47 NA 38.54 090
44151............... .............. A Removal of colon/ 26.84 NA 13.54 2.38 NA 42.76 090
ileostomy.
44152............... .............. A Removal of colon/ 27.79 NA 11.68 2.85 NA 42.32 090
ileostomy.
44153............... .............. A Removal of colon/ 30.54 NA 14.56 2.81 NA 47.91 090
ileostomy.
44155............... .............. A Removal of colon/ 27.82 NA 13.44 2.73 NA 43.99 090
ileostomy.
[[Page 1162]]
44156............... .............. A Removal of colon/ 30.74 NA 15.20 2.64 NA 48.58 090
ileostomy.
44160............... .............. A Removal of colon..... 18.59 NA 7.80 2.24 NA 28.63 090
44200............... .............. A Laparoscopy, 14.42 NA 6.23 1.76 NA 22.41 090
enterolysis.
44201............... .............. A Laparoscopy, 9.77 NA 4.70 1.17 NA 15.64 090
jejunostomy.
44202............... .............. A Lap resect s/ 22.01 NA 8.98 2.61 NA 33.60 090
intestine singl.
44203............... .............. A Lap resect s/ 4.44 NA 1.50 0.55 NA 6.49 ZZZ
intestine, addl.
44204............... .............. A Laparo partial 25.04 NA 10.00 3.08 NA 38.12 090
colectomy.
44205............... .............. A Lap colectomy part w/ 22.20 NA 8.88 2.69 NA 33.77 090
ileum.
44206............... .............. A Lap part colectomy w/ 26.96 NA 11.37 2.44 NA 40.77 090
stoma.
44207............... .............. A L colectomy/ 29.96 NA 11.59 2.68 NA 44.23 090
coloproctostomy.
44208............... .............. A L colectomy/ 31.95 NA 13.27 2.65 NA 47.87 090
coloproctostomy.
44210............... .............. A Laparo total 27.96 NA 12.03 2.47 NA 42.46 090
proctocolectomy.
44211............... .............. A Laparo total 34.95 NA 14.74 2.81 NA 52.50 090
proctocolectomy.
44212............... .............. A Laparo total 32.45 NA 13.88 2.73 NA 49.06 090
proctocolectomy.
44238............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
intestine.
44239............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
rectum.
44300............... .............. A Open bowel to skin... 12.09 NA 5.53 1.06 NA 18.68 090
44310............... .............. A Ileostomy/jejunostomy 15.93 NA 6.73 1.36 NA 24.02 090
44312............... .............. A Revision of ileostomy 8.01 NA 4.03 0.65 NA 12.69 090
44314............... .............. A Revision of ileostomy 15.03 NA 6.60 1.19 NA 22.82 090
44316............... .............. A Devise bowel pouch... 21.06 NA 8.60 1.70 NA 31.36 090
44320............... .............. A Colostomy............ 17.61 NA 7.71 1.54 NA 26.86 090
44322............... .............. A Colostomy with 11.96 NA 8.70 1.42 NA 22.08 090
biopsies.
44340............... .............. A Revision of colostomy 7.71 NA 4.31 0.68 NA 12.70 090
44345............... .............. A Revision of colostomy 15.41 NA 6.93 1.34 NA 23.68 090
44346............... .............. A Revision of colostomy 16.96 NA 7.43 1.45 NA 25.84 090
44360............... .............. A Small bowel endoscopy 2.59 NA 1.12 0.17 NA 3.88 000
44361............... .............. A Small bowel endoscopy/ 2.87 NA 1.21 0.18 NA 4.26 000
biopsy.
44363............... .............. A Small bowel endoscopy 3.49 NA 1.40 0.23 NA 5.12 000
44364............... .............. A Small bowel endoscopy 3.73 NA 1.52 0.25 NA 5.50 000
44365............... .............. A Small bowel endoscopy 3.31 NA 1.38 0.22 NA 4.91 000
44366............... .............. A Small bowel endoscopy 4.40 NA 1.76 0.27 NA 6.43 000
44369............... .............. A Small bowel endoscopy 4.51 NA 1.76 0.28 NA 6.55 000
44370............... .............. A Small bowel endoscopy/ 4.79 NA 1.99 0.25 NA 7.03 000
stent.
44372............... .............. A Small bowel endoscopy 4.40 NA 1.75 0.33 NA 6.48 000
44373............... .............. A Small bowel endoscopy 3.49 NA 1.45 0.23 NA 5.17 000
44376............... .............. A Small bowel endoscopy 5.25 NA 2.04 0.35 NA 7.64 000
44377............... .............. A Small bowel endoscopy/ 5.52 NA 2.15 0.34 NA 8.01 000
biopsy.
44378............... .............. A Small bowel endoscopy 7.12 NA 2.71 0.45 NA 10.28 000
44379............... .............. A S bowel endoscope w/ 7.46 NA 2.93 0.46 NA 10.85 000
stent.
44380............... .............. A Small bowel endoscopy 1.05 NA 0.56 0.10 NA 1.71 000
44382............... .............. A Small bowel endoscopy 1.27 NA 0.65 0.11 NA 2.03 000
44383............... .............. A Ileoscopy w/stent.... 2.94 NA 1.28 0.16 NA 4.38 000
44385............... .............. A Endoscopy of bowel 1.82 4.98 0.96 0.14 6.94 2.92 000
pouch.
44386............... .............. A Endoscopy, bowel 2.12 6.51 1.12 0.18 8.81 3.42 000
pouch/biop.
44388............... .............. A Colonoscopy.......... 2.82 5.14 1.16 0.22 8.18 4.20 000
44389............... .............. A Colonoscopy with 3.13 6.49 1.28 0.22 9.84 4.63 000
biopsy.
44390............... .............. A Colonoscopy for 3.82 6.76 1.51 0.27 10.85 5.60 000
foreign body.
44391............... .............. A Colonoscopy for 4.31 8.61 1.72 0.28 13.20 6.31 000
bleeding.
44392............... .............. A Colonoscopy & 3.81 6.53 1.52 0.28 10.62 5.61 000
polypectomy.
44393............... .............. A Colonoscopy, lesion 4.83 6.90 1.88 0.33 12.06 7.04 000
removal.
44394............... .............. A Colonoscopy w/snare.. 4.42 7.75 1.75 0.31 12.48 6.48 000
44397............... .............. A Colonoscopy w/stent.. 4.70 NA 2.06 0.34 NA 7.10 000
44500............... .............. A Intro, 0.49 NA 0.36 0.02 NA 0.87 000
gastrointestinal
tube.
44602............... .............. A Suture, small 16.01 NA 6.42 1.29 NA 23.72 090
intestine.
44603............... .............. A Suture, small 18.63 NA 7.31 1.68 NA 27.62 090
intestine.
44604............... .............. A Suture, large 16.01 NA 6.49 1.71 NA 24.21 090
intestine.
44605............... .............. A Repair of bowel 19.50 NA 8.46 1.86 NA 29.82 090
lesion.
44615............... .............. A Intestinal 15.91 NA 6.72 1.68 NA 24.31 090
stricturoplasty.
44620............... .............. A Repair bowel opening. 12.18 NA 5.36 1.27 NA 18.81 090
44625............... .............. A Repair bowel opening. 15.03 NA 6.35 1.57 NA 22.95 090
44626............... .............. A Repair bowel opening. 25.32 NA 9.87 3.05 NA 38.24 090
44640............... .............. A Repair bowel-skin 21.62 NA 8.62 1.76 NA 32.00 090
fistula.
44650............... .............. A Repair bowel fistula. 22.54 NA 8.93 1.80 NA 33.27 090
44660............... .............. A Repair bowel-bladder 21.33 NA 8.40 1.37 NA 31.10 090
fistula.
44661............... .............. A Repair bowel-bladder 24.77 NA 9.60 1.85 NA 36.22 090
fistula.
44680............... .............. A Surgical revision, 15.38 NA 6.48 1.65 NA 23.51 090
intestine.
44700............... .............. A Suspend bowel w/ 16.09 NA 6.69 1.46 NA 24.24 090
prosthesis.
44701............... .............. A Intraop colon lavage 3.10 NA 1.06 0.25 NA 4.41 ZZZ
add-on.
44799............... .............. C Unlisted procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
intestine.
44800............... .............. A Excision of bowel 11.21 NA 5.43 1.34 NA 17.98 090
pouch.
44820............... .............. A Excision of mesentery 12.07 NA 5.53 1.24 NA 18.84 090
lesion.
44850............... .............. A Repair of mesentery.. 10.72 NA 5.04 1.19 NA 16.95 090
44899............... .............. C Bowel surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
44900............... .............. A Drain app abscess, 10.12 NA 4.74 1.01 NA 15.87 090
open.
[[Page 1163]]
44901............... .............. A Drain app abscess, 3.37 NA 1.12 0.21 NA 4.70 000
percut.
44950............... .............. A Appendectomy......... 9.99 NA 4.35 1.06 NA 15.40 090
44955............... .............. A Appendectomy add-on.. 1.53 NA 0.53 0.19 NA 2.25 ZZZ
44960............... .............. A Appendectomy......... 12.32 NA 5.38 1.31 NA 19.01 090
44970............... .............. A Laparoscopy, 8.69 NA 4.23 1.06 NA 13.98 090
appendectomy.
44979............... .............. C Laparoscope proc, app 0.00 0.00 0.00 0.00 0.00 0.00 YYY
45000............... .............. A Drainage of pelvic 4.51 NA 2.98 0.45 NA 7.94 090
abscess.
45005............... .............. A Drainage of rectal 1.99 4.84 1.69 0.22 7.05 3.90 010
abscess.
45020............... .............. A Drainage of rectal 4.71 NA 3.31 0.49 NA 8.51 090
abscess.
45100............... .............. A Biopsy of rectum..... 3.67 NA 2.39 0.40 NA 6.46 090
45108............... .............. A Removal of anorectal 4.75 NA 2.91 0.55 NA 8.21 090
lesion.
45110............... .............. A Removal of rectum.... 27.96 NA 12.50 2.73 NA 43.19 090
45111............... .............. A Partial removal of 16.46 NA 7.21 1.93 NA 25.60 090
rectum.
45112............... .............. A Removal of rectum.... 30.49 NA 11.82 2.83 NA 45.14 090
45113............... .............. A Partial proctectomy.. 30.53 NA 12.69 2.57 NA 45.79 090
45114............... .............. A Partial removal of 27.28 NA 11.01 2.75 NA 41.04 090
rectum.
45116............... .............. A Partial removal of 24.54 NA 10.08 2.41 NA 37.03 090
rectum.
45119............... .............. A Remove rectum w/ 30.79 NA 12.54 2.57 NA 45.90 090
reservoir.
45120............... .............. A Removal of rectum.... 24.56 NA 10.19 2.75 NA 37.50 090
45121............... .............. A Removal of rectum and 27.00 NA 11.18 3.21 NA 41.39 090
colon.
45123............... .............. A Partial proctectomy.. 16.68 NA 6.90 1.25 NA 24.83 090
45126............... .............. A Pelvic exenteration.. 45.09 NA 19.38 3.90 NA 68.37 090
45130............... .............. A Excision of rectal 16.42 NA 6.80 1.35 NA 24.57 090
prolapse.
45135............... .............. A Excision of rectal 19.25 NA 8.48 1.83 NA 29.56 090
prolapse.
45136............... .............. A Excise ileoanal 27.26 NA 12.52 3.28 NA 43.06 090
reservior.
45150............... .............. A Excision of rectal 5.66 NA 2.98 0.55 NA 9.19 090
stricture.
45160............... .............. A Excision of rectal 15.30 NA 6.68 1.29 NA 23.27 090
lesion.
45170............... .............. A Excision of rectal 11.47 NA 5.27 1.07 NA 17.81 090
lesion.
45190............... .............. A Destruction, rectal 9.73 NA 4.68 0.92 NA 15.33 090
tumor.
45300............... .............. A Proctosigmoidoscopy 0.38 1.47 0.31 0.06 1.91 0.75 000
dx.
45303............... .............. A Proctosigmoidoscopy 0.44 19.04 0.35 0.07 19.55 0.86 000
dilate.
45305............... .............. A Proctosigmoidoscopy w/ 1.01 2.58 0.52 0.11 3.70 1.64 000
bx.
45307............... .............. A Proctosigmoidoscopy 0.94 3.00 0.50 0.18 4.12 1.62 000
fb.
45308............... .............. A Proctosigmoidoscopy 0.83 1.94 0.46 0.16 2.93 1.45 000
removal.
45309............... .............. A Proctosigmoidoscopy 2.01 2.77 0.86 0.21 4.99 3.08 000
removal.
45315............... .............. A Proctosigmoidoscopy 1.40 2.80 0.65 0.24 4.44 2.29 000
removal.
45317............... .............. A Proctosigmoidoscopy 1.50 2.38 0.68 0.24 4.12 2.42 000
bleed.
45320............... .............. A Proctosigmoidoscopy 1.58 2.84 0.73 0.24 4.66 2.55 000
ablate.
45321............... .............. A Proctosigmoidoscopy 1.17 NA 0.58 0.21 NA 1.96 000
volvul.
45327............... .............. A Proctosigmoidoscopy w/ 1.65 NA 0.70 0.12 NA 2.47 000
stent.
45330............... .............. A Diagnostic 0.96 2.20 0.52 0.06 3.22 1.54 000
sigmoidoscopy.
45331............... .............. A Sigmoidoscopy and 1.15 2.91 0.63 0.08 4.14 1.86 000
biopsy.
45332............... .............. A Sigmoidoscopy w/fb 1.79 4.86 0.85 0.13 6.78 2.77 000
removal.
45333............... .............. A Sigmoidoscopy & 1.79 4.72 0.85 0.14 6.65 2.78 000
polypectomy.
45334............... .............. A Sigmoidoscopy for 2.73 NA 1.18 0.19 NA 4.10 000
bleeding.
45335............... .............. A Sigmoidoscopy w/ 1.46 3.44 0.68 0.08 4.98 2.22 000
submuc inj.
45337............... .............. A Sigmoidoscopy & 2.36 NA 1.05 0.18 NA 3.59 000
decompress.
45338............... .............. A Sigmoidoscopy w/tumr 2.34 5.03 1.05 0.18 7.55 3.57 000
remove.
45339............... .............. A Sigmoidoscopy w/ 3.14 3.34 1.32 0.21 6.69 4.67 000
ablate tumr.
45340............... .............. A Sig w/balloon 1.89 6.72 0.83 0.08 8.69 2.80 000
dilation.
45341............... .............. A Sigmoidoscopy w/ 2.60 NA 1.12 0.24 NA 3.96 000
ultrasound.
45342............... .............. A Sigmoidoscopy w/us 4.05 NA 1.60 0.28 NA 5.93 000
guide bx.
45345............... .............. A Sigmoidoscopy w/stent 2.92 NA 1.20 0.18 NA 4.30 000
45355............... .............. A Surgical colonoscopy. 3.51 NA 1.40 0.31 NA 5.22 000
45378............... .............. A Diagnostic 3.69 6.04 1.58 0.24 9.97 5.51 000
colonoscopy.
45378............... 53............ A Diagnostic 0.96 2.20 0.52 0.06 3.22 1.54 000
colonoscopy.
45379............... .............. A Colonoscopy w/fb 4.68 7.56 1.86 0.30 12.54 6.84 000
removal.
45380............... .............. A Colonoscopy and 4.43 7.07 1.78 0.25 11.75 6.46 000
biopsy.
45381............... .............. A Colonoscopy, 4.19 8.14 1.69 0.25 12.58 6.13 000
submucous inj.
45382............... .............. A Colonoscopy/control 5.68 9.72 2.23 0.33 15.73 8.24 000
bleeding.
45383............... .............. A Lesion removal 5.86 7.85 2.27 0.39 14.10 8.52 000
colonoscopy.
45384............... .............. A Lesion remove 4.69 6.69 1.87 0.29 11.67 6.85 000
colonoscopy.
45385............... .............. A Lesion removal 5.30 7.69 2.08 0.34 13.33 7.72 000
colonoscopy.
45386............... .............. A Colonoscopy dilate 4.57 13.65 1.83 0.25 18.47 6.65 000
stricture.
45387............... .............. A Colonoscopy w/stent.. 5.90 NA 2.35 0.40 NA 8.65 000
45500............... .............. A Repair of rectum..... 7.28 NA 3.59 0.68 NA 11.55 090
45505............... .............. A Repair of rectum..... 7.57 NA 3.87 0.60 NA 12.04 090
45520............... .............. A Treatment of rectal 0.55 0.85 0.19 0.05 1.45 0.79 000
prolapse.
45540............... .............. A Correct rectal 16.25 NA 6.86 1.41 NA 24.52 090
prolapse.
45541............... .............. A Correct rectal 13.38 NA 6.00 1.06 NA 20.44 090
prolapse.
45550............... .............. A Repair rectum/remove 22.97 NA 9.29 1.91 NA 34.17 090
sigmoid.
45560............... .............. A Repair of rectocele.. 10.56 NA 5.12 0.88 NA 16.56 090
45562............... .............. A Exploration/repair of 15.36 NA 7.05 1.39 NA 23.80 090
rectum.
45563............... .............. A Exploration/repair of 23.43 NA 10.61 2.22 NA 36.26 090
rectum.
45800............... .............. A Repair rect/bladder 17.74 NA 7.50 1.37 NA 26.61 090
fistula.
[[Page 1164]]
45805............... .............. A Repair fistula w/ 20.75 NA 9.60 1.77 NA 32.12 090
colostomy.
45820............... .............. A Repair rectourethral 18.45 NA 7.70 1.41 NA 27.56 090
fistula.
45825............... .............. A Repair fistula w/ 21.22 NA 9.91 1.17 NA 32.30 090
colostomy.
45900............... .............. A Reduction of rectal 2.61 NA 1.52 0.21 NA 4.34 010
prolapse.
45905............... .............. A Dilation of anal 2.30 NA 1.43 0.17 NA 3.90 010
sphincter.
45910............... .............. A Dilation of rectal 2.80 NA 1.66 0.17 NA 4.63 010
narrowing.
45915............... .............. A Remove rectal 3.14 4.73 1.17 0.21 8.08 4.52 010
obstruction.
45999............... .............. C Rectum surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
46020............... .............. A Placement of seton... 2.90 2.28 1.86 0.27 5.45 5.03 010
46030............... .............. A Removal of rectal 1.23 1.35 0.71 0.13 2.71 2.07 010
marker.
46040............... .............. A Incision of rectal 4.95 5.30 3.17 0.58 10.83 8.70 090
abscess.
46045............... .............. A Incision of rectal 4.31 NA 2.92 0.48 NA 7.71 090
abscess.
46050............... .............. A Incision of anal 1.19 2.57 0.86 0.13 3.89 2.18 010
abscess.
46060............... .............. A Incision of rectal 5.68 NA 3.30 0.63 NA 9.61 090
abscess.
46070............... .............. A Incision of anal 2.71 NA 1.88 0.33 NA 4.92 090
septum.
46080............... .............. A Incision of anal 2.49 2.39 1.13 0.28 5.16 3.90 010
sphincter.
46083............... .............. A Incise external 1.40 2.50 0.95 0.14 4.04 2.49 010
hemorrhoid.
46200............... .............. A Removal of anal 3.41 3.64 2.43 0.36 7.41 6.20 090
fissure.
46210............... .............. A Removal of anal crypt 2.67 4.81 2.14 0.31 7.79 5.12 090
46211............... .............. A Removal of anal 4.24 5.08 2.95 0.45 9.77 7.64 090
crypts.
46220............... .............. A Removal of anal tag.. 1.56 2.27 0.94 0.17 4.00 2.67 010
46221............... .............. A Ligation of 2.04 1.62 1.12 0.14 3.80 3.30 010
hemorrhoid(s).
46230............... .............. A Removal of anal tags. 2.57 3.04 1.28 0.27 5.88 4.12 010
46250............... .............. A Hemorrhoidectomy..... 3.88 4.86 2.46 0.52 9.26 6.86 090
46255............... .............. A Hemorrhoidectomy..... 4.59 5.40 2.67 0.62 10.61 7.88 090
46257............... .............. A Remove hemorrhoids & 5.39 NA 2.91 0.71 NA 9.01 090
fissure.
46258............... .............. A Remove hemorrhoids & 5.72 NA 3.31 0.77 NA 9.80 090
fistula.
46260............... .............. A Hemorrhoidectomy..... 6.36 NA 3.26 0.82 NA 10.44 090
46261............... .............. A Remove hemorrhoids & 7.07 NA 3.66 0.84 NA 11.57 090
fissure.
46262............... .............. A Remove hemorrhoids & 7.49 NA 3.79 0.92 NA 12.20 090
fistula.
46270............... .............. A Removal of anal 3.71 4.66 2.38 0.43 8.80 6.52 090
fistula.
46275............... .............. A Removal of anal 4.55 4.36 2.57 0.48 9.39 7.60 090
fistula.
46280............... .............. A Removal of anal 5.97 NA 3.31 0.60 NA 9.88 090
fistula.
46285............... .............. A Removal of anal 4.08 3.59 2.35 0.41 8.08 6.84 090
fistula.
46288............... .............. A Repair anal fistula.. 7.12 NA 3.72 0.72 NA 11.56 090
46320............... .............. A Removal of hemorrhoid 1.61 2.12 0.85 0.17 3.90 2.63 010
clot.
46500............... .............. A Injection into 1.61 2.79 0.62 0.14 4.54 2.37 010
hemorrhoid(s).
46600............... .............. A Diagnostic anoscopy.. 0.50 1.58 0.38 0.05 2.13 0.93 000
46604............... .............. A Anoscopy and dilation 1.31 9.30 0.64 0.11 10.72 2.06 000
46606............... .............. A Anoscopy and biopsy.. 0.81 3.83 0.44 0.08 4.72 1.33 000
46608............... .............. A Anoscopy, remove for 1.51 4.42 0.68 0.16 6.09 2.35 000
body.
46610............... .............. A Anoscopy, remove 1.32 4.08 0.63 0.14 5.54 2.09 000
lesion.
46611............... .............. A Anoscopy............. 1.81 3.35 0.80 0.18 5.34 2.79 000
46612............... .............. A Anoscopy, remove 2.34 5.19 1.00 0.22 7.75 3.56 000
lesions.
46614............... .............. A Anoscopy, control 2.01 2.28 0.87 0.17 4.46 3.05 000
bleeding.
46615............... .............. A Anoscopy............. 2.68 2.52 1.10 0.28 5.48 4.06 000
46700............... .............. A Repair of anal 9.12 NA 4.24 0.68 NA 14.04 090
stricture.
46705............... .............. A Repair of anal 6.89 NA 3.75 0.88 NA 11.52 090
stricture.
46706............... .............. A Repr of anal fistula 2.39 NA 1.24 0.21 NA 3.84 010
w/glue.
46715............... .............. A Repair of anovaginal 7.19 NA 3.64 0.92 NA 11.75 090
fistula.
46716............... .............. A Repair of anovaginal 15.05 NA 7.98 1.57 NA 24.60 090
fistula.
46730............... .............. A Construction of 26.71 NA 12.04 2.45 NA 41.20 090
absent anus.
46735............... .............. A Construction of 32.12 NA 13.58 3.18 NA 48.88 090
absent anus.
46740............... .............. A Construction of 29.96 NA 13.21 2.40 NA 45.57 090
absent anus.
46742............... .............. A Repair of 35.75 NA 17.54 3.17 NA 56.46 090
imperforated anus.
46744............... .............. A Repair of cloacal 52.55 NA 21.17 2.74 NA 76.46 090
anomaly.
46746............... .............. A Repair of cloacal 58.13 NA 25.20 3.03 NA 86.36 090
anomaly.
46748............... .............. A Repair of cloacal 64.11 NA 23.81 3.34 NA 91.26 090
anomaly.
46750............... .............. A Repair of anal 10.23 NA 5.10 0.83 NA 16.16 090
sphincter.
46751............... .............. A Repair of anal 8.76 NA 5.51 0.94 NA 15.21 090
sphincter.
46753............... .............. A Reconstruction of 8.28 NA 3.88 0.70 NA 12.86 090
anus.
46754............... .............. A Removal of suture 2.20 3.59 1.70 0.14 5.93 4.04 010
from anus.
46760............... .............. A Repair of anal 14.41 NA 7.11 1.04 NA 22.56 090
sphincter.
46761............... .............. A Repair of anal 13.82 NA 6.06 1.01 NA 20.89 090
sphincter.
46762............... .............. A Implant artificial 12.69 NA 5.56 0.86 NA 19.11 090
sphincter.
46900............... .............. A Destruction, anal 1.91 3.54 0.79 0.16 5.61 2.86 010
lesion(s).
46910............... .............. A Destruction, anal 1.86 2.68 1.10 0.17 4.71 3.13 010
lesion(s).
46916............... .............. A Cryosurgery, anal 1.86 3.12 1.40 0.11 5.09 3.37 010
lesion(s).
46917............... .............. A Laser surgery, anal 1.86 9.17 1.12 0.19 11.22 3.17 010
lesions.
46922............... .............. A Excision of anal 1.86 3.32 1.09 0.21 5.39 3.16 010
lesion(s).
46924............... .............. A Destruction, anal 2.76 8.69 1.36 0.24 11.69 4.36 010
lesion(s).
46934............... .............. A Destruction of 3.50 5.01 2.70 0.31 8.82 6.51 090
hemorrhoids.
46935............... .............. A Destruction of 2.43 3.45 1.21 0.21 6.09 3.85 010
hemorrhoids.
46936............... .............. A Destruction of 3.68 4.45 2.26 0.36 8.49 6.30 090
hemorrhoids.
46937............... .............. A Cryotherapy of rectal 2.69 2.73 1.22 0.14 5.56 4.05 010
lesion.
[[Page 1165]]
46938............... .............. A Cryotherapy of rectal 4.65 4.22 2.70 0.48 9.35 7.83 090
lesion.
46940............... .............. A Treatment of anal 2.32 1.99 1.09 0.21 4.52 3.62 010
fissure.
46942............... .............. A Treatment of anal 2.04 1.84 1.02 0.17 4.05 3.23 010
fissure.
46945............... .............. A Ligation of 1.84 3.54 1.88 0.21 5.59 3.93 090
hemorrhoids.
46946............... .............. A Ligation of 2.58 4.17 1.85 0.27 7.02 4.70 090
hemorrhoids.
46999............... .............. C Anus surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
47000............... .............. A Needle biopsy of 1.90 3.26 0.63 0.11 5.27 2.64 000
liver.
47001............... .............. A Needle biopsy, liver 1.90 NA 0.65 0.22 NA 2.77 ZZZ
add-on.
47010............... .............. A Open drainage, liver 15.99 NA 8.55 0.78 NA 25.32 090
lesion.
47011............... .............. A Percut drain, liver 3.69 NA 1.21 0.21 NA 5.11 000
lesion.
47015............... .............. A Inject/aspirate liver 15.09 NA 7.56 1.04 NA 23.69 090
cyst.
47100............... .............. A Wedge biopsy of liver 11.65 NA 6.10 0.90 NA 18.65 090
47120............... .............. A Partial removal of 35.45 NA 15.28 2.76 NA 53.49 090
liver.
47122............... .............. A Extensive removal of 55.05 NA 21.62 4.34 NA 81.01 090
liver.
47125............... .............. A Partial removal of 49.12 NA 19.67 3.84 NA 72.63 090
liver.
47130............... .............. A Partial removal of 53.27 NA 21.14 4.19 NA 78.60 090
liver.
47133............... .............. C Removal of donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
liver.
47134............... .............. D Partial removal, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
donor liver.
47135............... .............. R Transplantation of 81.40 NA 32.07 9.81 NA 123.28 090
liver.
47136............... .............. R Transplantation of 68.50 NA 27.50 8.36 NA 104.36 090
liver.
47140............... .............. A Partial removal, 54.92 NA 22.74 4.80 NA 82.46 090
donor liver.
47141............... .............. A Partial removal, 67.40 NA 27.39 4.80 NA 99.59 090
donor liver.
47142............... .............. A Partial removal, 74.89 NA 29.97 4.80 NA 109.66 090
donor liver.
47300............... .............. A Surgery for liver 15.06 NA 7.29 1.17 NA 23.52 090
lesion.
47350............... .............. A Repair liver wound... 19.53 NA 8.93 1.51 NA 29.97 090
47360............... .............. A Repair liver wound... 26.88 NA 11.67 2.06 NA 40.61 090
47361............... .............. A Repair liver wound... 47.05 NA 18.64 3.75 NA 69.44 090
47362............... .............. A Repair liver wound... 18.48 NA 8.80 1.47 NA 28.75 090
47370............... .............. A Laparo ablate liver 19.66 NA 8.18 1.03 NA 28.87 090
tumor rf.
47371............... .............. A Laparo ablate liver 19.66 NA 8.19 1.03 NA 28.88 090
cryosurg.
47379............... .............. C Laparoscope 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure, liver.
47380............... .............. A Open ablate liver 22.97 NA 9.39 1.03 NA 33.39 090
tumor rf.
47381............... .............. A Open ablate liver 23.24 NA 9.65 1.03 NA 33.92 090
tumor cryo.
47382............... .............. A Percut ablate liver 15.17 NA 6.10 1.37 NA 22.64 010
rf.
47399............... .............. C Liver surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
47400............... .............. A Incision of liver 32.44 NA 13.55 2.20 NA 48.19 090
duct.
47420............... .............. A Incision of bile duct 19.85 NA 8.82 2.05 NA 30.72 090
47425............... .............. A Incision of bile duct 19.80 NA 8.87 1.93 NA 30.60 090
47460............... .............. A Incise bile duct 18.01 NA 8.42 1.50 NA 27.93 090
sphincter.
47480............... .............. A Incision of 10.80 NA 5.97 1.03 NA 17.80 090
gallbladder.
47490............... .............. A Incision of 7.22 NA 5.83 0.40 NA 13.45 090
gallbladder.
47500............... .............. A Injection for liver x- 1.96 NA 0.64 0.11 NA 2.71 000
rays.
47505............... .............. A Injection for liver x- 0.76 2.60 0.25 0.04 3.40 1.05 000
rays.
47510............... .............. A Insert catheter, bile 7.82 NA 5.01 0.43 NA 13.26 090
duct.
47511............... .............. A Insert bile duct 10.48 NA 5.09 0.57 NA 16.14 090
drain.
47525............... .............. A Change bile duct 5.54 NA 3.26 0.29 NA 9.09 010
catheter.
47530............... .............. A Revise/reinsert bile 5.84 NA 4.32 0.35 NA 10.51 090
tube.
47550............... .............. A Bile duct endoscopy 3.02 NA 1.03 0.36 NA 4.41 ZZZ
add-on.
47552............... .............. A Biliary endoscopy 6.03 NA 2.40 0.51 NA 8.94 000
thru skin.
47553............... .............. A Biliary endoscopy 6.34 NA 2.60 0.36 NA 9.30 000
thru skin.
47554............... .............. A Biliary endoscopy 9.05 NA 3.38 0.89 NA 13.32 000
thru skin.
47555............... .............. A Biliary endoscopy 7.55 NA 3.01 0.42 NA 10.98 000
thru skin.
47556............... .............. A Biliary endoscopy 8.55 NA 3.33 0.46 NA 12.34 000
thru skin.
47560............... .............. A Laparoscopy w/ 4.88 NA 1.83 0.59 NA 7.30 000
cholangio.
47561............... .............. A Laparo w/cholangio/ 5.17 NA 2.13 0.59 NA 7.89 000
biopsy.
47562............... .............. A Laparoscopic 11.07 NA 5.00 1.36 NA 17.43 090
cholecystectomy.
47563............... .............. A Laparo 11.92 NA 5.32 1.46 NA 18.70 090
cholecystectomy/
graph.
47564............... .............. A Laparo 14.21 NA 5.97 1.74 NA 21.92 090
cholecystectomy/
explr.
47570............... .............. A Laparo 12.56 NA 5.39 1.54 NA 19.49 090
cholecystoenterostom
y.
47579............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
biliary.
47600............... .............. A Removal of 13.56 NA 6.20 1.40 NA 21.16 090
gallbladder.
47605............... .............. A Removal of 14.67 NA 6.55 1.51 NA 22.73 090
gallbladder.
47610............... .............. A Removal of 18.79 NA 7.99 1.94 NA 28.72 090
gallbladder.
47612............... .............. A Removal of 18.75 NA 7.94 1.93 NA 28.62 090
gallbladder.
47620............... .............. A Removal of 20.61 NA 8.59 2.13 NA 31.33 090
gallbladder.
47630............... .............. A Remove bile duct 9.10 NA 4.80 0.55 NA 14.45 090
stone.
47700............... .............. A Exploration of bile 15.60 NA 7.48 1.69 NA 24.77 090
ducts.
47701............... .............. A Bile duct revision... 27.77 NA 11.58 3.62 NA 42.97 090
47711............... .............. A Excision of bile duct 23.00 NA 10.01 2.39 NA 35.40 090
tumor.
47712............... .............. A Excision of bile duct 30.19 NA 12.50 3.22 NA 45.91 090
tumor.
47715............... .............. A Excision of bile duct 18.77 NA 8.49 1.92 NA 29.18 090
cyst.
47716............... .............. A Fusion of bile duct 16.42 NA 7.88 1.70 NA 26.00 090
cyst.
47720............... .............. A Fuse gallbladder & 15.89 NA 7.54 1.65 NA 25.08 090
bowel.
47721............... .............. A Fuse upper gi 19.09 NA 8.63 1.97 NA 29.69 090
structures.
47740............... .............. A Fuse gallbladder & 18.45 NA 8.45 1.92 NA 28.82 090
bowel.
[[Page 1166]]
47741............... .............. A Fuse gallbladder & 21.31 NA 9.35 2.20 NA 32.86 090
bowel.
47760............... .............. A Fuse bile ducts and 25.81 NA 10.92 2.67 NA 39.40 090
bowel.
47765............... .............. A Fuse liver ducts & 24.84 NA 10.89 2.63 NA 38.36 090
bowel.
47780............... .............. A Fuse bile ducts and 26.46 NA 11.28 2.74 NA 40.48 090
bowel.
47785............... .............. A Fuse bile ducts and 31.13 NA 13.01 3.24 NA 47.38 090
bowel.
47800............... .............. A Reconstruction of 23.27 NA 10.13 2.35 NA 35.75 090
bile ducts.
47801............... .............. A Placement, bile duct 15.15 NA 8.33 0.83 NA 24.31 090
support.
47802............... .............. A Fuse liver duct & 21.52 NA 9.76 2.22 NA 33.50 090
intestine.
47900............... .............. A Suture bile duct 19.87 NA 8.93 1.99 NA 30.79 090
injury.
47999............... .............. C Bile tract surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
48000............... .............. A Drainage of abdomen.. 28.03 NA 11.58 1.59 NA 41.20 090
48001............... .............. A Placement of drain, 35.40 NA 13.95 2.29 NA 51.64 090
pancreas.
48005............... .............. A Resect/debride 42.11 NA 16.63 2.73 NA 61.47 090
pancreas.
48020............... .............. A Removal of pancreatic 15.68 NA 7.35 1.64 NA 24.67 090
stone.
48100............... .............. A Biopsy of pancreas, 12.21 NA 5.65 1.30 NA 19.16 090
open.
48102............... .............. A Needle biopsy, 4.67 9.04 2.45 0.24 13.95 7.36 010
pancreas.
48120............... .............. A Removal of pancreas 15.83 NA 6.90 1.63 NA 24.36 090
lesion.
48140............... .............. A Partial removal of 22.91 NA 9.60 2.56 NA 35.07 090
pancreas.
48145............... .............. A Partial removal of 23.98 NA 9.91 2.71 NA 36.60 090
pancreas.
48146............... .............. A Pancreatectomy....... 26.36 NA 12.09 2.93 NA 41.38 090
48148............... .............. A Removal of pancreatic 17.31 NA 7.68 1.94 NA 26.93 090
duct.
48150............... .............. A Partial removal of 47.93 NA 19.65 5.34 NA 72.92 090
pancreas.
48152............... .............. A Pancreatectomy....... 43.68 NA 18.35 4.91 NA 66.94 090
48153............... .............. A Pancreatectomy....... 47.82 NA 19.74 5.31 NA 72.87 090
48154............... .............. A Pancreatectomy....... 44.03 NA 18.38 4.95 NA 67.36 090
48155............... .............. A Removal of pancreas.. 24.60 NA 11.82 2.77 NA 39.19 090
48160............... .............. N Pancreas removal/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transplant.
48180............... .............. A Fuse pancreas and 24.68 NA 10.22 2.70 NA 37.60 090
bowel.
48400............... .............. A Injection, intraop 1.95 NA 0.64 0.12 NA 2.71 ZZZ
add-on.
48500............... .............. A Surgery of pancreatic 15.26 NA 7.40 1.63 NA 24.29 090
cyst.
48510............... .............. A Drain pancreatic 14.29 NA 7.54 1.29 NA 23.12 090
pseudocyst.
48511............... .............. A Drain pancreatic 3.99 NA 1.31 0.21 NA 5.51 000
pseudocyst.
48520............... .............. A Fuse pancreas cyst 15.57 NA 6.75 1.70 NA 24.02 090
and bowel.
48540............... .............. A Fuse pancreas cyst 19.69 NA 8.16 2.20 NA 30.05 090
and bowel.
48545............... .............. A Pancreatorrhaphy..... 18.15 NA 8.05 1.94 NA 28.14 090
48547............... .............. A Duodenal exclusion... 25.79 NA 10.55 2.77 NA 39.11 090
48550............... .............. X Donor pancreatectomy. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
48554............... .............. R Transpl allograft 34.12 NA 17.32 3.98 NA 55.42 090
pancreas.
48556............... .............. A Removal, allograft 15.69 NA 8.29 1.83 NA 25.81 090
pancreas.
48999............... .............. C Pancreas surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
49000............... .............. A Exploration of 11.66 NA 5.42 1.41 NA 18.49 090
abdomen.
49002............... .............. A Reopening of abdomen. 10.47 NA 5.07 1.28 NA 16.82 090
49010............... .............. A Exploration behind 12.26 NA 5.95 1.47 NA 19.68 090
abdomen.
49020............... .............. A Drain abdominal 22.81 NA 10.24 1.58 NA 34.63 090
abscess.
49021............... .............. A Drain abdominal 3.37 NA 1.12 0.19 NA 4.68 000
abscess.
49040............... .............. A Drain, open, abdom 13.50 NA 6.47 1.01 NA 20.98 090
abscess.
49041............... .............. A Drain, percut, abdom 3.99 NA 1.31 0.22 NA 5.52 000
abscess.
49060............... .............. A Drain, open, retrop 15.84 NA 7.48 0.93 NA 24.25 090
abscess.
49061............... .............. A Drain, percut, 3.69 NA 1.21 0.21 NA 5.11 000
retroper absc.
49062............... .............. A Drain to peritoneal 11.34 NA 5.50 1.30 NA 18.14 090
cavity.
49080............... .............. A Puncture, peritoneal 1.35 4.20 0.45 0.08 5.63 1.88 000
cavity.
49081............... .............. A Removal of abdominal 1.26 2.62 0.57 0.07 3.95 1.90 000
fluid.
49085............... .............. A Remove abdomen 12.12 NA 5.56 1.06 NA 18.74 090
foreign body.
49180............... .............. A Biopsy, abdominal 1.73 3.32 0.56 0.10 5.15 2.39 000
mass.
49200............... .............. A Removal of abdominal 10.23 NA 5.08 1.11 NA 16.42 090
lesion.
49201............... .............. A Remove abdom lesion, 14.82 NA 7.10 1.77 NA 23.69 090
complex.
49215............... .............. A Excise sacral spine 33.45 NA 14.09 2.99 NA 50.53 090
tumor.
49220............... .............. A Multiple surgery, 14.86 NA 6.69 1.82 NA 23.37 090
abdomen.
49250............... .............. A Excision of umbilicus 8.34 NA 4.33 1.01 NA 13.68 090
49255............... .............. A Removal of omentum... 11.12 NA 5.66 1.35 NA 18.13 090
49320............... .............. A Diag laparo separate 5.09 NA 2.64 0.60 NA 8.33 010
proc.
49321............... .............. A Laparoscopy, biopsy.. 5.39 NA 2.65 0.64 NA 8.68 010
49322............... .............. A Laparoscopy, 5.69 NA 2.99 0.69 NA 9.37 010
aspiration.
49323............... .............. A Laparo drain 9.47 NA 4.52 1.06 NA 15.05 090
lymphocele.
49329............... .............. C Laparo proc, abdm/per/ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
oment.
49400............... .............. A Air injection into 1.88 NA 0.79 0.13 NA 2.80 000
abdomen.
49419............... .............. A Insrt abdom cath for 6.64 NA 3.56 0.66 NA 10.86 090
chemotx.
49420............... .............. A Insert abdom drain, 2.22 NA 1.12 0.16 NA 3.50 000
temp.
49421............... .............. A Insert abdom drain, 5.53 NA 3.20 0.66 NA 9.39 090
perm.
49422............... .............. A Remove perm cannula/ 6.24 NA 2.91 0.76 NA 9.91 010
catheter.
49423............... .............. A Exchange drainage 1.46 NA 0.67 0.08 NA 2.21 000
catheter.
49424............... .............. A Assess cyst, contrast 0.76 NA 0.44 0.04 NA 1.24 000
inject.
49425............... .............. A Insert abdomen-venous 11.35 NA 5.65 1.46 NA 18.46 090
drain.
49426............... .............. A Revise abdomen-venous 9.62 NA 4.82 1.12 NA 15.56 090
shunt.
49427............... .............. A Injection, abdominal 0.89 NA 0.48 0.06 NA 1.43 000
shunt.
[[Page 1167]]
49428............... .............. A Ligation of shunt.... 6.05 NA 3.29 0.37 NA 9.71 010
49429............... .............. A Removal of shunt..... 7.39 NA 3.44 0.98 NA 11.81 010
49491............... .............. A Rpr hern preemie 11.11 NA 5.07 1.33 NA 17.51 090
reduc.
49492............... .............. A Rpr ing hern premie, 14.01 NA 6.14 1.77 NA 21.92 090
blocked.
49495............... .............. A Rpr ing hernia baby, 5.88 NA 3.00 0.70 NA 9.58 090
reduc.
49496............... .............. A Rpr ing hernia baby, 8.78 NA 4.37 1.11 NA 14.26 090
blocked.
49500............... .............. A Rpr ing hernia, init, 5.47 NA 3.15 0.55 NA 9.17 090
reduce.
49501............... .............. A Rpr ing hernia, init 8.87 NA 4.24 0.92 NA 14.03 090
blocked.
49505............... .............. A Prp i/hern init 7.59 4.10 3.87 0.78 12.47 12.24 090
reduc5 yr.
49507............... .............. A Prp i/hern init 9.56 NA 4.54 1.00 NA 15.10 090
block5 yr.
49520............... .............. A Rerepair ing hernia, 9.62 NA 4.49 1.01 NA 15.12 090
reduce.
49521............... .............. A Rerepair ing hernia, 11.95 NA 5.28 1.25 NA 18.48 090
blocked.
49525............... .............. A Repair ing hernia, 8.56 NA 4.13 0.89 NA 13.58 090
sliding.
49540............... .............. A Repair lumbar hernia. 10.37 NA 4.81 1.09 NA 16.27 090
49550............... .............. A Rpr rem hernia, init, 8.62 NA 4.16 0.90 NA 13.68 090
reduce.
49553............... .............. A Rpr fem hernia, init 9.43 NA 4.46 1.00 NA 14.89 090
blocked.
49555............... .............. A Rerepair fem hernia, 9.02 NA 4.32 0.95 NA 14.29 090
reduce.
49557............... .............. A Rerepair fem hernia, 11.13 NA 5.03 1.17 NA 17.33 090
blocked.
49560............... .............. A Rpr ventral hern 11.55 NA 5.21 1.21 NA 17.97 090
init, reduc.
49561............... .............. A Rpr ventral hern 14.23 NA 6.11 1.48 NA 21.82 090
init, block.
49565............... .............. A Rerepair ventrl hern, 11.55 NA 5.28 1.21 NA 18.04 090
reduce.
49566............... .............. A Rerepair ventrl hern, 14.38 NA 6.18 1.50 NA 22.06 090
block.
49568............... .............. A Hernia repair w/mesh. 4.88 NA 1.68 0.60 NA 7.16 ZZZ
49570............... .............. A Rpr epigastric hern, 5.68 NA 3.20 0.60 NA 9.48 090
reduce.
49572............... .............. A Rpr epigastric hern, 6.72 NA 3.50 0.70 NA 10.92 090
blocked.
49580............... .............. A Rpr umbil hern, reduc 4.10 NA 2.64 0.41 NA 7.15 090
< 5 yr.
49582............... .............. A Rpr umbil hern, block 6.64 NA 3.53 0.69 NA 10.86 090
< 5 yr.
49585............... .............. A Rpr umbil hern, reduc 6.22 NA 3.35 0.64 NA 10.21 090
5 yr.
49587............... .............. A Rpr umbil hern, block 7.55 NA 3.78 0.78 NA 12.11 090
5 yr.
49590............... .............. A Repair spigilian 8.53 NA 4.13 0.89 NA 13.55 090
hernia.
49600............... .............. A Repair umbilical 10.94 NA 5.39 1.36 NA 17.69 090
lesion.
49605............... .............. A Repair umbilical 75.89 NA 28.65 3.10 NA 107.64 090
lesion.
49606............... .............. A Repair umbilical 18.57 NA 7.77 2.68 NA 29.02 090
lesion.
49610............... .............. A Repair umbilical 10.48 NA 5.26 0.93 NA 16.67 090
lesion.
49611............... .............. A Repair umbilical 8.91 NA 7.25 0.78 NA 16.94 090
lesion.
49650............... .............. A Laparo hernia repair 6.26 NA 3.23 0.77 NA 10.26 090
initial.
49651............... .............. A Laparo hernia repair 8.23 NA 4.09 1.01 NA 13.33 090
recur.
49659............... .............. C Laparo proc, hernia 0.00 0.00 0.00 0.00 0.00 0.00 YYY
repair.
49900............... .............. A Repair of abdominal 12.26 NA 6.28 1.48 NA 20.02 090
wall.
49904............... .............. A Omental flap, extra- 19.97 NA 15.52 2.30 NA 37.79 090
abdom.
49905............... .............. A Omental flap, intra- 6.54 NA 2.30 0.74 NA 9.58 ZZZ
abdom.
49906............... .............. C Free omental flap, 0.00 0.00 0.00 0.00 0.00 0.00 090
microvasc.
49999............... .............. C Abdomen surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
50010............... .............. A Exploration of kidney 10.96 NA 5.42 0.95 NA 17.33 090
50020............... .............. A Renal abscess, open 14.64 NA 8.81 0.96 NA 24.41 090
drain.
50021............... .............. A Renal abscess, percut 3.37 NA 1.11 0.18 NA 4.66 000
drain.
50040............... .............. A Drainage of kidney... 14.92 NA 8.42 0.99 NA 24.33 090
50045............... .............. A Exploration of kidney 15.44 NA 6.80 1.28 NA 23.52 090
50060............... .............. A Removal of kidney 19.27 NA 8.03 1.37 NA 28.67 090
stone.
50065............... .............. A Incision of kidney... 20.76 NA 6.24 1.36 NA 28.36 090
50070............... .............. A Incision of kidney... 20.29 NA 8.42 1.45 NA 30.16 090
50075............... .............. A Removal of kidney 25.30 NA 10.19 1.82 NA 37.31 090
stone.
50080............... .............. A Removal of kidney 14.69 NA 7.85 1.04 NA 23.58 090
stone.
50081............... .............. A Removal of kidney 21.77 NA 10.35 1.57 NA 33.69 090
stone.
50100............... .............. A Revise kidney blood 16.07 NA 7.99 1.98 NA 26.04 090
vessels.
50120............... .............. A Exploration of kidney 15.89 NA 6.97 1.25 NA 24.11 090
50125............... .............. A Explore and drain 16.50 NA 7.12 1.29 NA 24.91 090
kidney.
50130............... .............. A Removal of kidney 17.26 NA 7.38 1.25 NA 25.89 090
stone.
50135............... .............. A Exploration of kidney 19.15 NA 7.98 1.42 NA 28.55 090
50200............... .............. A Biopsy of kidney..... 2.63 NA 0.90 0.14 NA 3.67 000
50205............... .............. A Biopsy of kidney..... 11.29 NA 5.24 1.13 NA 17.66 090
50220............... .............. A Remove kidney, open.. 17.12 NA 7.44 1.40 NA 25.96 090
50225............... .............. A Removal kidney open, 20.20 NA 8.36 1.52 NA 30.08 090
complex.
50230............... .............. A Removal kidney open, 22.04 NA 8.83 1.63 NA 32.50 090
radical.
50234............... .............. A Removal of kidney & 22.37 NA 9.04 1.65 NA 33.06 090
ureter.
50236............... .............. A Removal of kidney & 24.82 NA 11.41 1.81 NA 38.04 090
ureter.
50240............... .............. A Partial removal of 21.97 NA 10.50 1.64 NA 34.11 090
kidney.
50280............... .............. A Removal of kidney 15.65 NA 6.89 1.19 NA 23.73 090
lesion.
50290............... .............. A Removal of kidney 14.71 NA 6.65 1.34 NA 22.70 090
lesion.
50300............... .............. X Removal of donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
kidney.
50320............... .............. A Removal of donor 22.18 NA 9.96 2.15 NA 34.29 090
kidney.
50340............... .............. A Removal of kidney.... 12.13 NA 6.93 1.39 NA 20.45 090
50360............... .............. A Transplantation of 31.48 NA 15.76 3.58 NA 50.82 090
kidney.
50365............... .............. A Transplantation of 36.75 NA 18.55 4.23 NA 59.53 090
kidney.
50370............... .............. A Remove transplanted 13.70 NA 7.52 1.52 NA 22.74 090
kidney.
[[Page 1168]]
50380............... .............. A Reimplantation of 20.73 NA 13.26 2.17 NA 36.16 090
kidney.
50390............... .............. A Drainage of kidney 1.96 NA 0.64 0.11 NA 2.71 000
lesion.
50392............... .............. A Insert kidney drain.. 3.37 NA 1.11 0.18 NA 4.66 000
50393............... .............. A Insert ureteral tube. 4.15 NA 1.35 0.22 NA 5.72 000
50394............... .............. A Injection for kidney 0.76 2.54 0.25 0.05 3.35 1.06 000
x-ray.
50395............... .............. A Create passage to 3.37 NA 1.10 0.19 NA 4.66 000
kidney.
50396............... .............. A Measure kidney 2.09 NA 0.86 0.12 NA 3.07 000
pressure.
50398............... .............. A Change kidney tube... 1.46 1.19 0.47 0.08 2.73 2.01 000
50400............... .............. A Revision of kidney/ 19.47 NA 7.72 1.46 NA 28.65 090
ureter.
50405............... .............. A Revision of kidney/ 23.89 NA 10.41 1.75 NA 36.05 090
ureter.
50500............... .............. A Repair of kidney 19.54 NA 8.77 1.75 NA 30.06 090
wound.
50520............... .............. A Close kidney-skin 17.20 NA 8.75 1.52 NA 27.47 090
fistula.
50525............... .............. A Repair renal-abdomen 22.24 NA 10.16 1.82 NA 34.22 090
fistula.
50526............... .............. A Repair renal-abdomen 23.98 NA 10.88 1.95 NA 36.81 090
fistula.
50540............... .............. A Revision of horseshoe 19.90 NA 8.55 1.54 NA 29.99 090
kidney.
50541............... .............. A Laparo ablate renal 15.98 NA 6.41 1.19 NA 23.58 090
cyst.
50542............... .............. A Laparo ablate renal 19.97 NA 8.13 1.64 NA 29.74 090
mass.
50543............... .............. A Laparo partial 25.46 NA 10.27 1.64 NA 37.37 090
nephrectomy.
50544............... .............. A Laparoscopy, 22.37 NA 8.47 1.70 NA 32.54 090
pyeloplasty.
50545............... .............. A Laparo radical 23.96 NA 9.12 1.85 NA 34.93 090
nephrectomy.
50546............... .............. A Laparoscopic 20.45 NA 8.30 1.65 NA 30.40 090
nephrectomy.
50547............... .............. A Laparo removal donor 25.46 NA 10.44 2.46 NA 38.36 090
kidney.
50548............... .............. A Laparo remove w/ 24.36 NA 9.11 1.80 NA 35.27 090
ureter.
50549............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
renal.
50551............... .............. A Kidney endoscopy..... 5.59 4.92 1.80 0.40 10.91 7.79 000
50553............... .............. A Kidney endoscopy..... 5.98 18.59 1.95 0.42 24.99 8.35 000
50555............... .............. A Kidney endoscopy & 6.52 19.17 2.11 0.46 26.15 9.09 000
biopsy.
50557............... .............. A Kidney endoscopy & 6.61 20.04 2.12 0.47 27.12 9.20 000
treatment.
50559............... .............. A Renal endoscopy/ 6.77 NA 2.19 0.33 NA 9.29 000
radiotracer.
50561............... .............. A Kidney endoscopy & 7.58 17.69 2.44 0.53 25.80 10.55 000
treatment.
50562............... .............. A Renal scope w/tumor 10.90 NA 3.84 1.01 NA 15.75 090
resect.
50570............... .............. A Kidney endoscopy..... 9.53 NA 3.06 0.68 NA 13.27 000
50572............... .............. A Kidney endoscopy..... 10.33 NA 3.33 0.77 NA 14.43 000
50574............... .............. A Kidney endoscopy & 11.00 NA 3.57 0.78 NA 15.35 000
biopsy.
50575............... .............. A Kidney endoscopy..... 13.96 NA 4.48 1.01 NA 19.45 000
50576............... .............. A Kidney endoscopy & 10.97 NA 3.51 0.80 NA 15.28 000
treatment.
50578............... .............. A Renal endoscopy/ 11.33 NA 3.64 0.81 NA 15.78 000
radiotracer.
50580............... .............. A Kidney endoscopy & 11.84 NA 3.80 0.84 NA 16.48 000
treatment.
50590............... .............. A Fragmenting of kidney 9.08 10.77 5.03 0.65 20.50 14.76 090
stone.
50600............... .............. A Exploration of ureter 15.82 NA 6.99 1.19 NA 24.00 090
50605............... .............. A Insert ureteral 15.44 NA 7.00 1.36 NA 23.80 090
support.
50610............... .............. A Removal of ureter 15.90 NA 7.24 1.30 NA 24.44 090
stone.
50620............... .............. A Removal of ureter 15.14 NA 6.62 1.10 NA 22.86 090
stone.
50630............... .............. A Removal of ureter 14.92 NA 6.56 1.09 NA 22.57 090
stone.
50650............... .............. A Removal of ureter.... 17.38 NA 7.50 1.29 NA 26.17 090
50660............... .............. A Removal of ureter.... 19.52 NA 8.24 1.44 NA 29.20 090
50684............... .............. A Injection for ureter 0.76 15.38 0.25 0.05 16.19 1.06 000
x-ray.
50686............... .............. A Measure ureter 1.51 4.56 0.65 0.11 6.18 2.27 000
pressure.
50688............... .............. A Change of ureter tube 1.17 NA 1.75 0.07 NA 2.99 010
50690............... .............. A Injection for ureter 1.16 15.84 0.37 0.07 17.07 1.60 000
x-ray.
50700............... .............. A Revision of ureter... 15.19 NA 7.30 1.04 NA 23.53 090
50715............... .............. A Release of ureter.... 18.87 NA 9.03 2.03 NA 29.93 090
50722............... .............. A Release of ureter.... 16.33 NA 8.03 1.70 NA 26.06 090
50725............... .............. A Release/revise ureter 18.46 NA 8.31 1.74 NA 28.51 090
50727............... .............. A Revise ureter........ 8.17 NA 5.20 0.62 NA 13.99 090
50728............... .............. A Revise ureter........ 12.00 NA 6.72 1.06 NA 19.78 090
50740............... .............. A Fusion of ureter & 18.39 NA 7.96 1.80 NA 28.15 090
kidney.
50750............... .............. A Fusion of ureter & 19.48 NA 8.27 1.50 NA 29.25 090
kidney.
50760............... .............. A Fusion of ureters.... 18.39 NA 7.95 1.51 NA 27.85 090
50770............... .............. A Splicing of ureters.. 19.48 NA 8.25 1.51 NA 29.24 090
50780............... .............. A Reimplant ureter in 18.33 NA 7.86 1.45 NA 27.64 090
bladder.
50782............... .............. A Reimplant ureter in 19.51 NA 9.83 1.36 NA 30.70 090
bladder.
50783............... .............. A Reimplant ureter in 20.52 NA 9.35 1.63 NA 31.50 090
bladder.
50785............... .............. A Reimplant ureter in 20.49 NA 8.58 1.57 NA 30.64 090
bladder.
50800............... .............. A Implant ureter in 14.50 NA 6.99 1.11 NA 22.60 090
bowel.
50810............... .............. A Fusion of ureter & 20.02 NA 9.57 2.15 NA 31.74 090
bowel.
50815............... .............. A Urine shunt to 19.90 NA 8.93 1.58 NA 30.41 090
intestine.
50820............... .............. A Construct bowel 21.86 NA 9.14 1.66 NA 32.66 090
bladder.
50825............... .............. A Construct bowel 28.14 NA 11.65 2.18 NA 41.97 090
bladder.
50830............... .............. A Revise urine flow.... 31.23 NA 12.66 2.65 NA 46.54 090
50840............... .............. A Replace ureter by 19.97 NA 8.93 1.52 NA 30.42 090
bowel.
50845............... .............. A Appendico-vesicostomy 20.86 NA 8.87 1.52 NA 31.25 090
50860............... .............. A Transplant ureter to 15.34 NA 6.89 1.22 NA 23.45 090
skin.
50900............... .............. A Repair of ureter..... 13.60 NA 6.36 1.18 NA 21.14 090
50920............... .............. A Closure ureter/skin 14.31 NA 6.79 1.01 NA 22.11 090
fistula.
[[Page 1169]]
50930............... .............. A Closure ureter/bowel 18.69 NA 8.19 1.89 NA 28.77 090
fistula.
50940............... .............. A Release of ureter.... 14.49 NA 6.63 1.25 NA 22.37 090
50945............... .............. A Laparoscopy 16.97 NA 6.96 1.39 NA 25.32 090
ureterolithotomy.
50947............... .............. A Laparo new ureter/ 24.46 NA 9.66 2.40 NA 36.52 090
bladder.
50948............... .............. A Laparo new ureter/ 22.47 NA 8.62 2.21 NA 33.30 090
bladder.
50949............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
ureter.
50951............... .............. A Endoscopy of ureter.. 5.83 5.34 1.87 0.42 11.59 8.12 000
50953............... .............. A Endoscopy of ureter.. 6.23 18.61 2.00 0.45 25.29 8.68 000
50955............... .............. A Ureter endoscopy & 6.74 20.51 2.22 0.46 27.71 9.42 000
biopsy.
50957............... .............. A Ureter endoscopy & 6.78 18.26 2.18 0.48 25.52 9.44 000
treatment.
50959............... .............. A Ureter endoscopy & 4.39 NA 1.37 0.22 NA 5.98 000
tracer.
50961............... .............. A Ureter endoscopy & 6.04 25.47 1.94 0.42 31.93 8.40 000
treatment.
50970............... .............. A Ureter endoscopy..... 7.13 NA 2.30 0.52 NA 9.95 000
50972............... .............. A Ureter endoscopy & 6.88 NA 2.27 0.47 NA 9.62 000
catheter.
50974............... .............. A Ureter endoscopy & 9.16 NA 2.93 0.64 NA 12.73 000
biopsy.
50976............... .............. A Ureter endoscopy & 9.03 NA 2.91 0.64 NA 12.58 000
treatment.
50978............... .............. A Ureter endoscopy & 5.09 NA 1.67 0.36 NA 7.12 000
tracer.
50980............... .............. A Ureter endoscopy & 6.84 NA 2.20 0.49 NA 9.53 000
treatment.
51000............... .............. A Drainage of bladder.. 0.78 1.98 0.24 0.06 2.82 1.08 000
51005............... .............. A Drainage of bladder.. 1.02 4.80 0.34 0.10 5.92 1.46 000
51010............... .............. A Drainage of bladder.. 3.52 5.74 1.89 0.28 9.54 5.69 010
51020............... .............. A Incise & treat 6.70 NA 3.98 0.51 NA 11.19 090
bladder.
51030............... .............. A Incise & treat 6.76 NA 4.09 0.51 NA 11.36 090
bladder.
51040............... .............. A Incise & drain 4.39 NA 2.87 0.33 NA 7.59 090
bladder.
51045............... .............. A Incise bladder/drain 6.76 NA 4.06 0.57 NA 11.39 090
ureter.
51050............... .............. A Removal of bladder 6.91 NA 3.75 0.51 NA 11.17 090
stone.
51060............... .............. A Removal of ureter 8.84 NA 4.62 0.65 NA 14.11 090
stone.
51065............... .............. A Remove ureter 8.84 NA 4.47 0.64 NA 13.95 090
calculus.
51080............... .............. A Drainage of bladder 5.95 NA 3.66 0.42 NA 10.03 090
abscess.
51500............... .............. A Removal of bladder 10.12 NA 5.08 1.06 NA 16.26 090
cyst.
51520............... .............. A Removal of bladder 9.28 NA 4.79 0.70 NA 14.77 090
lesion.
51525............... .............. A Removal of bladder 13.95 NA 6.25 1.03 NA 21.23 090
lesion.
51530............... .............. A Removal of bladder 12.36 NA 5.87 0.99 NA 19.22 090
lesion.
51535............... .............. A Repair of ureter 12.55 NA 6.23 1.09 NA 19.87 090
lesion.
51550............... .............. A Partial removal of 15.64 NA 6.86 1.27 NA 23.77 090
bladder.
51555............... .............. A Partial removal of 21.20 NA 8.81 1.65 NA 31.66 090
bladder.
51565............... .............. A Revise bladder & 21.59 NA 9.12 1.69 NA 32.40 090
ureter(s).
51570............... .............. A Removal of bladder... 24.20 NA 9.94 1.92 NA 36.06 090
51575............... .............. A Removal of bladder & 30.40 NA 12.26 2.27 NA 44.93 090
nodes.
51580............... .............. A Remove bladder/revise 31.03 NA 12.73 2.34 NA 46.10 090
tract.
51585............... .............. A Removal of bladder & 35.18 NA 13.93 2.63 NA 51.74 090
nodes.
51590............... .............. A Remove bladder/revise 32.61 NA 12.84 2.42 NA 47.87 090
tract.
51595............... .............. A Remove bladder/revise 37.08 NA 14.36 2.69 NA 54.13 090
tract.
51596............... .............. A Remove bladder/create 39.46 NA 15.47 2.88 NA 57.81 090
pouch.
51597............... .............. A Removal of pelvic 38.29 NA 15.07 3.00 NA 56.36 090
structures.
51600............... .............. A Injection for bladder 0.88 5.85 0.29 0.05 6.78 1.22 000
x-ray.
51605............... .............. A Preparation for 0.64 10.80 0.35 0.05 11.49 1.04 000
bladder xray.
51610............... .............. A Injection for bladder 1.05 1.72 0.60 0.06 2.83 1.71 000
x-ray.
51700............... .............. A Irrigation of bladder 0.88 1.65 0.28 0.06 2.59 1.22 000
51701............... .............. A Insert bladder 0.50 1.64 0.19 0.04 2.18 0.73 000
catheter.
51702............... .............. A Insert temp bladder 0.50 2.34 0.26 0.04 2.88 0.80 000
cath.
51703............... .............. A Insert bladder cath, 1.47 3.05 0.57 0.11 4.63 2.15 000
complex.
51705............... .............. A Change of bladder 1.02 2.34 0.61 0.07 3.43 1.70 010
tube.
51710............... .............. A Change of bladder 1.49 3.43 0.77 0.11 5.03 2.37 010
tube.
51715............... .............. A Endoscopic injection/ 3.73 4.01 1.35 0.29 8.03 5.37 000
implant.
51720............... .............. A Treatment of bladder 1.96 1.79 0.71 0.14 3.89 2.81 000
lesion.
51725............... .............. A Simple cystometrogram 1.51 5.77 NA 0.16 7.44 NA 000
51725............... 26............ A Simple cystometrogram 1.51 0.49 0.49 0.12 2.12 2.12 000
51725............... TC............ A Simple cystometrogram 0.00 5.28 NA 0.04 5.32 NA 000
51726............... .............. A Complex 1.71 7.84 NA 0.18 9.73 NA 000
cystometrogram.
51726............... 26............ A Complex 1.71 0.56 0.56 0.13 2.40 2.40 000
cystometrogram.
51726............... TC............ A Complex 0.00 7.28 NA 0.05 7.33 NA 000
cystometrogram.
51736............... .............. A Urine flow 0.61 0.58 NA 0.06 1.25 NA 000
measurement.
51736............... 26............ A Urine flow 0.61 0.20 0.20 0.05 0.86 0.86 000
measurement.
51736............... TC............ A Urine flow 0.00 0.38 NA 0.01 0.39 NA 000
measurement.
51741............... .............. A Electro-uroflowmetry, 1.14 0.80 NA 0.10 2.04 NA 000
first.
51741............... 26............ A Electro-uroflowmetry, 1.14 0.37 0.37 0.08 1.59 1.59 000
first.
51741............... TC............ A Electro-uroflowmetry, 0.00 0.43 NA 0.02 0.45 NA 000
first.
51772............... .............. A Urethra pressure 1.61 5.78 NA 0.19 7.58 NA 000
profile.
51772............... 26............ A Urethra pressure 1.61 0.55 0.55 0.14 2.30 2.30 000
profile.
51772............... TC............ A Urethra pressure 0.00 5.23 NA 0.05 5.28 NA 000
profile.
51784............... .............. A Anal/urinary muscle 1.53 4.11 NA 0.16 5.80 NA 000
study.
51784............... 26............ A Anal/urinary muscle 1.53 0.50 0.50 0.12 2.15 2.15 000
study.
51784............... TC............ A Anal/urinary muscle 0.00 3.61 NA 0.04 3.65 NA 000
study.
51785............... .............. A Anal/urinary muscle 1.53 4.62 NA 0.15 6.30 NA 000
study.
[[Page 1170]]
51785............... 26............ A Anal/urinary muscle 1.53 0.50 0.50 0.11 2.14 2.14 000
study.
51785............... TC............ A Anal/urinary muscle 0.00 4.12 NA 0.04 4.16 NA 000
study.
51792............... .............. A Urinary reflex study. 1.10 5.98 NA 0.24 7.32 NA 000
51792............... 26............ A Urinary reflex study. 1.10 0.41 0.41 0.11 1.62 1.62 000
51792............... TC............ A Urinary reflex study. 0.00 5.57 NA 0.13 5.70 NA 000
51795............... .............. A Urine voiding 1.53 7.62 NA 0.22 9.37 NA 000
pressure study.
51795............... 26............ A Urine voiding 1.53 0.50 0.50 0.12 2.15 2.15 000
pressure study.
51795............... TC............ A Urine voiding 0.00 7.12 NA 0.10 7.22 NA 000
pressure study.
51797............... .............. A Intraabdominal 1.60 5.95 NA 0.17 7.72 NA 000
pressure test.
51797............... 26............ A Intraabdominal 1.60 0.52 0.52 0.12 2.24 2.24 000
pressure test.
51797............... TC............ A Intraabdominal 0.00 5.43 NA 0.05 5.48 NA 000
pressure test.
51798............... .............. A Us urine capacity 0.00 0.36 NA 0.08 0.44 NA XXX
measure.
51800............... .............. A Revision of bladder/ 17.39 NA 7.69 1.41 NA 26.49 090
urethra.
51820............... .............. A Revision of urinary 17.86 NA 8.46 1.75 NA 28.07 090
tract.
51840............... .............. A Attach bladder/ 10.69 NA 5.57 1.05 NA 17.31 090
urethra.
51841............... .............. A Attach bladder/ 13.01 NA 6.37 1.25 NA 20.63 090
urethra.
51845............... .............. A Repair bladder neck.. 9.72 NA 4.87 0.75 NA 15.34 090
51860............... .............. A Repair of bladder 12.00 NA 5.90 1.07 NA 18.97 090
wound.
51865............... .............. A Repair of bladder 15.02 NA 6.83 1.22 NA 23.07 090
wound.
51880............... .............. A Repair of bladder 7.65 NA 4.07 0.65 NA 12.37 090
opening.
51900............... .............. A Repair bladder/vagina 12.95 NA 6.22 1.05 NA 20.22 090
lesion.
51920............... .............. A Close bladder-uterus 11.79 NA 5.75 1.04 NA 18.58 090
fistula.
51925............... .............. A Hysterectomy/bladder 15.56 NA 8.62 1.79 NA 25.97 090
repair.
51940............... .............. A Correction of bladder 28.39 NA 12.36 2.38 NA 43.13 090
defect.
51960............... .............. A Revision of bladder & 22.98 NA 9.87 1.70 NA 34.55 090
bowel.
51980............... .............. A Construct bladder 11.34 NA 5.49 0.89 NA 17.72 090
opening.
51990............... .............. A Laparo urethral 12.48 NA 6.18 1.23 NA 19.89 090
suspension.
51992............... .............. A Laparo sling 13.99 NA 6.24 1.12 NA 21.35 090
operation.
52000............... .............. A Cystoscopy........... 2.01 3.38 0.76 0.14 5.53 2.91 000
52001............... .............. A Cystoscopy, removal 5.44 5.18 1.87 0.39 11.01 7.70 000
of clots.
52005............... .............. A Cystoscopy & ureter 2.37 5.98 0.90 0.18 8.53 3.45 000
catheter.
52007............... .............. A Cystoscopy and biopsy 3.02 NA 1.15 0.22 NA 4.39 000
52010............... .............. A Cystoscopy & duct 3.02 NA 1.13 0.22 NA 4.37 000
catheter.
52204............... .............. A Cystoscopy........... 2.37 3.63 0.91 0.18 6.18 3.46 000
52214............... .............. A Cystoscopy and 3.70 NA 1.33 0.27 NA 5.30 000
treatment.
52224............... .............. A Cystoscopy and 3.14 NA 1.15 0.22 NA 4.51 000
treatment.
52234............... .............. A Cystoscopy and 4.62 NA 1.63 0.33 NA 6.58 000
treatment.
52235............... .............. A Cystoscopy and 5.44 NA 1.90 0.39 NA 7.73 000
treatment.
52240............... .............. A Cystoscopy and 9.71 NA 3.30 0.70 NA 13.71 000
treatment.
52250............... .............. A Cystoscopy and 4.49 NA 1.66 0.33 NA 6.48 000
radiotracer.
52260............... .............. A Cystoscopy and 3.91 NA 1.43 0.28 NA 5.62 000
treatment.
52265............... .............. A Cystoscopy and 2.94 3.75 1.12 0.22 6.91 4.28 000
treatment.
52270............... .............. A Cystoscopy & revise 3.36 NA 1.25 0.24 NA 4.85 000
urethra.
52275............... .............. A Cystoscopy & revise 4.69 NA 1.67 0.34 NA 6.70 000
urethra.
52276............... .............. A Cystoscopy and 4.99 NA 1.79 0.36 NA 7.14 000
treatment.
52277............... .............. A Cystoscopy and 6.16 NA 2.26 0.46 NA 8.88 000
treatment.
52281............... .............. A Cystoscopy and 2.80 7.43 1.08 0.21 10.44 4.09 000
treatment.
52282............... .............. A Cystoscopy, implant 6.39 NA 2.24 0.46 NA 9.09 000
stent.
52283............... .............. A Cystoscopy and 3.73 4.03 1.39 0.27 8.03 5.39 000
treatment.
52285............... .............. A Cystoscopy and 3.60 4.10 1.34 0.27 7.97 5.21 000
treatment.
52290............... .............. A Cystoscopy and 4.58 NA 1.66 0.33 NA 6.57 000
treatment.
52300............... .............. A Cystoscopy and 5.30 NA 1.91 0.39 NA 7.60 000
treatment.
52301............... .............. A Cystoscopy and 5.50 NA 2.00 0.47 NA 7.97 000
treatment.
52305............... .............. A Cystoscopy and 5.30 NA 1.86 0.37 NA 7.53 000
treatment.
52310............... .............. A Cystoscopy and 2.81 3.53 1.04 0.21 6.55 4.06 000
treatment.
52315............... .............. A Cystoscopy and 5.20 NA 1.84 0.37 NA 7.41 000
treatment.
52317............... .............. A Remove bladder stone. 6.71 NA 2.28 0.48 NA 9.47 000
52318............... .............. A Remove bladder stone. 9.18 NA 3.10 0.65 NA 12.93 000
52320............... .............. A Cystoscopy and 4.69 NA 1.64 0.34 NA 6.67 000
treatment.
52325............... .............. A Cystoscopy, stone 6.15 NA 2.11 0.45 NA 8.71 000
removal.
52327............... .............. A Cystoscopy, inject 5.18 NA 1.83 0.39 NA 7.40 000
material.
52330............... .............. A Cystoscopy and 5.03 NA 1.76 0.36 NA 7.15 000
treatment.
52332............... .............. A Cystoscopy and 2.83 NA 1.06 0.21 NA 4.10 000
treatment.
52334............... .............. A Create passage to 4.82 NA 1.76 0.34 NA 6.92 000
kidney.
52341............... .............. A Cysto w/ureter 5.99 NA 2.22 0.45 NA 8.66 000
stricture tx.
52342............... .............. A Cysto w/up stricture 6.49 NA 2.35 0.48 NA 9.32 000
tx.
52343............... .............. A Cysto w/renal 7.19 NA 2.59 0.53 NA 10.31 000
stricture tx.
52344............... .............. A Cysto/uretero, stone 7.69 NA 2.80 0.57 NA 11.06 000
remove.
52345............... .............. A Cysto/uretero w/up 8.19 NA 2.96 0.60 NA 11.75 000
stricture.
52346............... .............. A Cystouretero w/renal 9.22 NA 3.29 0.69 NA 13.20 000
strict.
52347............... .............. A Cystoscopy, resect 5.27 NA 1.71 0.40 NA 7.38 000
ducts.
52351............... .............. A Cystouretero & or 5.85 NA 2.14 0.43 NA 8.42 000
pyeloscope.
52352............... .............. A Cystouretero w/stone 6.87 NA 2.51 0.51 NA 9.89 000
remove.
52353............... .............. A Cystouretero w/ 7.96 NA 2.86 0.59 NA 11.41 000
lithotripsy.
52354............... .............. A Cystouretero w/biopsy 7.33 NA 2.67 0.54 NA 10.54 000
[[Page 1171]]
52355............... .............. A Cystouretero w/excise 8.81 NA 3.15 0.66 NA 12.62 000
tumor.
52400............... .............. A Cystouretero w/congen 9.67 NA 3.78 0.72 NA 14.17 090
repr.
52450............... .............. A Incision of prostate. 7.63 NA 3.71 0.55 NA 11.89 090
52500............... .............. A Revision of bladder 8.46 NA 3.96 0.60 NA 13.02 090
neck.
52510............... .............. A Dilation prostatic 6.71 NA 3.14 0.48 NA 10.33 090
urethra.
52601............... .............. A Prostatectomy (TURP). 12.35 NA 5.15 0.89 NA 18.39 090
52606............... .............. A Control postop 8.12 NA 3.58 0.59 NA 12.29 090
bleeding.
52612............... .............. A Prostatectomy, first 7.97 NA 3.77 0.58 NA 12.32 090
stage.
52614............... .............. A Prostatectomy, second 6.83 NA 3.38 0.49 NA 10.70 090
stage.
52620............... .............. A Remove residual 6.60 NA 3.01 0.47 NA 10.08 090
prostate.
52630............... .............. A Remove prostate 7.25 NA 3.22 0.52 NA 10.99 090
regrowth.
52640............... .............. A Relieve bladder 6.61 NA 2.98 0.47 NA 10.06 090
contracture.
52647............... .............. A Laser surgery of 10.34 76.71 4.57 0.74 87.79 15.65 090
prostate.
52648............... .............. A Laser surgery of 11.19 NA 4.84 0.80 NA 16.83 090
prostate.
52700............... .............. A Drainage of prostate 6.79 NA 3.21 0.49 NA 10.49 090
abscess.
53000............... .............. A Incision of urethra.. 2.28 NA 1.57 0.16 NA 4.01 010
53010............... .............. A Incision of urethra.. 3.63 NA 3.02 0.24 NA 6.89 090
53020............... .............. A Incision of urethra.. 1.77 3.10 0.67 0.13 5.00 2.57 000
53025............... .............. A Incision of urethra.. 1.13 3.87 0.51 0.08 5.08 1.72 000
53040............... .............. A Drainage of urethra 6.39 11.28 6.33 0.49 18.16 13.21 090
abscess.
53060............... .............. A Drainage of urethra 2.63 NA 1.45 0.28 NA 4.36 010
abscess.
53080............... .............. A Drainage of urinary 6.28 NA 6.17 0.51 NA 12.96 090
leakage.
53085............... .............. A Drainage of urinary 10.25 NA 7.63 0.81 NA 18.69 090
leakage.
53200............... .............. A Biopsy of urethra.... 2.59 4.29 0.98 0.21 7.09 3.78 000
53210............... .............. A Removal of urethra... 12.55 NA 5.98 0.98 NA 19.51 090
53215............... .............. A Removal of urethra... 15.56 NA 6.77 1.12 NA 23.45 090
53220............... .............. A Treatment of urethra 6.99 NA 3.84 0.53 NA 11.36 090
lesion.
53230............... .............. A Removal of urethra 9.57 NA 4.84 0.72 NA 15.13 090
lesion.
53235............... .............. A Removal of urethra 10.12 NA 5.02 0.72 NA 15.86 090
lesion.
53240............... .............. A Surgery for urethra 6.44 NA 3.64 0.51 NA 10.59 090
pouch.
53250............... .............. A Removal of urethra 5.88 NA 3.38 0.42 NA 9.68 090
gland.
53260............... .............. A Treatment of urethra 2.98 3.28 1.80 0.28 6.54 5.06 010
lesion.
53265............... .............. A Treatment of urethra 3.12 NA 1.84 0.24 NA 5.20 010
lesion.
53270............... .............. A Removal of urethra 3.09 NA 1.87 0.25 NA 5.21 010
gland.
53275............... .............. A Repair of urethra 4.52 NA 2.28 0.34 NA 7.14 010
defect.
53400............... .............. A Revise urethra, stage 12.75 NA 6.10 1.03 NA 19.88 090
1.
53405............... .............. A Revise urethra, stage 14.46 NA 6.45 1.10 NA 22.01 090
2.
53410............... .............. A Reconstruction of 16.42 NA 7.20 1.19 NA 24.81 090
urethra.
53415............... .............. A Reconstruction of 19.38 NA 7.47 1.40 NA 28.25 090
urethra.
53420............... .............. A Reconstruct urethra, 14.06 NA 6.45 1.09 NA 21.60 090
stage 1.
53425............... .............. A Reconstruct urethra, 15.96 NA 7.05 1.17 NA 24.18 090
stage 2.
53430............... .............. A Reconstruction of 16.32 NA 7.13 1.22 NA 24.67 090
urethra.
53431............... .............. A Reconstruct urethra/ 19.86 NA 8.17 1.57 NA 29.60 090
bladder.
53440............... .............. A Male sling procedure. 13.60 NA 6.04 0.88 NA 20.52 090
53442............... .............. A Remove/revise male 11.55 NA 5.51 0.66 NA 17.72 090
sling.
53444............... .............. A Insert tandem cuff... 13.38 NA 5.91 1.06 NA 20.35 090
53445............... .............. A Insert uro/ves nck 14.04 NA 7.26 1.01 NA 22.31 090
sphincter.
53446............... .............. A Remove uro sphincter. 10.21 NA 5.27 0.81 NA 16.29 090
53447............... .............. A Remove/replace ur 13.47 NA 6.48 0.95 NA 20.90 090
sphincter.
53448............... .............. A Remov/replc ur 21.12 NA 9.13 1.68 NA 31.93 090
sphinctr comp.
53449............... .............. A Repair uro sphincter. 9.69 NA 4.85 0.69 NA 15.23 090
53450............... .............. A Revision of urethra.. 6.13 NA 3.40 0.45 NA 9.98 090
53460............... .............. A Revision of urethra.. 7.11 NA 3.82 0.52 NA 11.45 090
53500............... .............. A Urethrlys, transvag w/ 12.19 NA 6.19 0.89 NA 19.27 090
scope.
53502............... .............. A Repair of urethra 7.62 NA 4.11 0.60 NA 12.33 090
injury.
53505............... .............. A Repair of urethra 7.62 NA 3.99 0.55 NA 12.16 090
injury.
53510............... .............. A Repair of urethra 10.09 NA 5.29 0.72 NA 16.10 090
injury.
53515............... .............. A Repair of urethra 13.29 NA 6.05 1.00 NA 20.34 090
injury.
53520............... .............. A Repair of urethra 8.67 NA 4.60 0.64 NA 13.91 090
defect.
53600............... .............. A Dilate urethra 1.21 1.17 0.43 0.08 2.46 1.72 000
stricture.
53601............... .............. A Dilate urethra 0.98 1.30 0.38 0.07 2.35 1.43 000
stricture.
53605............... .............. A Dilate urethra 1.28 NA 0.41 0.10 NA 1.79 000
stricture.
53620............... .............. A Dilate urethra 1.62 2.04 0.60 0.12 3.78 2.34 000
stricture.
53621............... .............. A Dilate urethra 1.35 2.13 0.50 0.10 3.58 1.95 000
stricture.
53660............... .............. A Dilation of urethra.. 0.71 1.34 0.33 0.05 2.10 1.09 000
53661............... .............. A Dilation of urethra.. 0.72 1.34 0.30 0.05 2.11 1.07 000
53665............... .............. A Dilation of urethra.. 0.76 NA 0.26 0.06 NA 1.08 000
53850............... .............. A Prostatic microwave 9.44 97.84 4.30 0.68 107.96 14.42 090
thermotx.
53852............... .............. A Prostatic rf thermotx 9.87 93.04 4.69 0.70 103.61 15.26 090
53853............... .............. A Prostatic water 5.23 57.88 3.18 0.33 63.44 8.74 090
thermother.
53899............... .............. C Urology surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
54000............... .............. A Slitting of prepuce.. 1.54 NA 1.33 0.12 NA 2.99 010
54001............... .............. A Slitting of prepuce.. 2.19 4.30 1.51 0.17 6.66 3.87 010
54015............... .............. A Drain penis lesion... 5.31 NA 2.59 0.40 NA 8.30 010
54050............... .............. A Destruction, penis 1.24 1.69 1.05 0.08 3.01 2.37 010
lesion(s).
[[Page 1172]]
54055............... .............. A Destruction, penis 1.22 1.60 0.80 0.08 2.90 2.10 010
lesion(s).
54056............... .............. A Cryosurgery, penis 1.24 2.48 1.35 0.07 3.79 2.66 010
lesion(s).
54057............... .............. A Laser surg, penis 1.24 NA 0.87 0.10 NA 2.21 010
lesion(s).
54060............... .............. A Excision of penis 1.93 3.88 1.45 0.14 5.95 3.52 010
lesion(s).
54065............... .............. A Destruction, penis 2.42 NA 1.72 0.16 NA 4.30 010
lesion(s).
54100............... .............. A Biopsy of penis...... 1.90 2.87 0.82 0.12 4.89 2.84 000
54105............... .............. A Biopsy of penis...... 3.49 NA 1.96 0.25 NA 5.70 010
54110............... .............. A Treatment of penis 10.11 NA 5.64 0.72 NA 16.47 090
lesion.
54111............... .............. A Treat penis lesion, 13.55 NA 6.69 0.95 NA 21.19 090
graft.
54112............... .............. A Treat penis lesion, 15.84 NA 7.69 1.13 NA 24.66 090
graft.
54115............... .............. A Treatment of penis 6.14 8.53 4.47 0.47 15.14 11.08 090
lesion.
54120............... .............. A Partial removal of 9.96 NA 5.60 0.72 NA 16.28 090
penis.
54125............... .............. A Removal of penis..... 13.51 NA 6.75 0.98 NA 21.24 090
54130............... .............. A Remove penis & nodes. 20.11 NA 9.10 1.44 NA 30.65 090
54135............... .............. A Remove penis & nodes. 26.32 NA 11.10 1.91 NA 39.33 090
54150............... .............. A Circumcision......... 1.81 NA 0.97 0.21 NA 2.99 010
54152............... .............. A Circumcision......... 2.31 NA 1.20 0.19 NA 3.70 010
54160............... .............. A Circumcision......... 2.48 NA 1.11 0.19 NA 3.78 010
54161............... .............. A Circumcision......... 3.27 NA 1.57 0.24 NA 5.08 010
54162............... .............. A Lysis penil circumic 3.00 NA 2.00 0.24 NA 5.24 010
lesion.
54163............... .............. A Repair of 3.00 NA 2.01 0.24 NA 5.25 010
circumcision.
54164............... .............. A Frenulotomy of penis. 2.50 NA 1.85 0.19 NA 4.54 010
54200............... .............. A Treatment of penis 1.06 1.85 0.99 0.07 2.98 2.12 010
lesion.
54205............... .............. A Treatment of penis 7.92 NA 4.83 0.57 NA 13.32 090
lesion.
54220............... .............. A Treatment of penis 2.42 3.94 0.96 0.18 6.54 3.56 000
lesion.
54230............... .............. A Prepare penis study.. 1.34 1.12 0.62 0.10 2.56 2.06 000
54231............... .............. A Dynamic 2.04 1.40 0.87 0.17 3.61 3.08 000
cavernosometry.
54235............... .............. A Penile injection..... 1.19 0.98 0.58 0.08 2.25 1.85 000
54240............... .............. A Penis study.......... 1.31 1.01 NA 0.16 2.48 NA 000
54240............... 26............ A Penis study.......... 1.31 0.42 0.42 0.10 1.83 1.83 000
54240............... TC............ A Penis study.......... 0.00 0.59 NA 0.06 0.65 NA 000
54250............... .............. A Penis study.......... 2.22 0.93 NA 0.19 3.34 NA 000
54250............... 26............ A Penis study.......... 2.22 0.71 0.71 0.17 3.10 3.10 000
54250............... TC............ A Penis study.......... 0.00 0.22 NA 0.02 0.24 NA 000
54300............... .............. A Revision of penis.... 10.39 NA 5.75 0.77 NA 16.91 090
54304............... .............. A Revision of penis.... 12.47 NA 6.54 0.89 NA 19.90 090
54308............... .............. A Reconstruction of 11.81 NA 6.17 0.84 NA 18.82 090
urethra.
54312............... .............. A Reconstruction of 13.55 NA 7.20 0.98 NA 21.73 090
urethra.
54316............... .............. A Reconstruction of 16.79 NA 8.15 1.21 NA 26.15 090
urethra.
54318............... .............. A Reconstruction of 11.23 NA 6.00 1.39 NA 18.62 090
urethra.
54322............... .............. A Reconstruction of 12.99 NA 6.63 0.93 NA 20.55 090
urethra.
54324............... .............. A Reconstruction of 16.29 NA 8.22 1.24 NA 25.75 090
urethra.
54326............... .............. A Reconstruction of 15.70 NA 8.00 1.12 NA 24.82 090
urethra.
54328............... .............. A Revise penis/urethra. 15.63 NA 7.45 1.11 NA 24.19 090
54332............... .............. A Revise penis/urethra. 17.05 NA 7.93 1.22 NA 26.20 090
54336............... .............. A Revise penis/urethra. 20.01 NA 10.71 2.29 NA 33.01 090
54340............... .............. A Secondary urethral 8.90 NA 5.25 0.87 NA 15.02 090
surgery.
54344............... .............. A Secondary urethral 15.92 NA 7.97 1.33 NA 25.22 090
surgery.
54348............... .............. A Secondary urethral 17.12 NA 8.60 1.23 NA 26.95 090
surgery.
54352............... .............. A Reconstruct urethra/ 24.70 NA 11.50 1.95 NA 38.15 090
penis.
54360............... .............. A Penis plastic surgery 11.91 NA 6.19 0.87 NA 18.97 090
54380............... .............. A Repair penis......... 13.16 NA 6.83 1.40 NA 21.39 090
54385............... .............. A Repair penis......... 15.37 NA 8.49 0.86 NA 24.72 090
54390............... .............. A Repair penis and 21.58 NA 9.61 1.54 NA 32.73 090
bladder.
54400............... .............. A Insert semi-rigid 8.98 NA 4.47 0.64 NA 14.09 090
prosthesis.
54401............... .............. A Insert self-contd 10.26 NA 5.83 0.74 NA 16.83 090
prosthesis.
54405............... .............. A Insert multi-comp 13.41 NA 6.06 0.96 NA 20.43 090
penis pros.
54406............... .............. A Remove muti-comp 12.08 NA 5.46 0.90 NA 18.44 090
penis pros.
54408............... .............. A Repair multi-comp 12.73 NA 5.77 0.95 NA 19.45 090
penis pros.
54410............... .............. A Remove/replace penis 15.48 NA 6.66 1.16 NA 23.30 090
prosth.
54411............... .............. A Remov/replc penis 15.98 NA 7.09 0.96 NA 24.03 090
pros, comp.
54415............... .............. A Remove self-contd 8.19 NA 4.22 0.65 NA 13.06 090
penis pros.
54416............... .............. A Remv/repl penis 10.85 NA 5.41 0.66 NA 16.92 090
contain pros.
54417............... .............. A Remv/replc penis 14.17 NA 6.21 0.66 NA 21.04 090
pros, compl.
54420............... .............. A Revision of penis.... 11.40 NA 5.71 0.87 NA 17.98 090
54430............... .............. A Revision of penis.... 10.13 NA 5.25 0.72 NA 16.10 090
54435............... .............. A Revision of penis.... 6.11 NA 3.73 0.43 NA 10.27 090
54440............... .............. C Repair of penis...... 0.00 0.00 0.00 0.00 0.00 0.00 090
54450............... .............. A Preputial stretching. 1.12 1.11 0.47 0.08 2.31 1.67 000
54500............... .............. A Biopsy of testis..... 1.31 0.61 0.56 0.10 2.02 1.97 000
54505............... .............. A Biopsy of testis..... 3.45 NA 1.93 0.25 NA 5.63 010
54512............... .............. A Excise lesion testis. 8.57 NA 4.15 0.68 NA 13.40 090
54520............... .............. A Removal of testis.... 5.22 NA 2.85 0.40 NA 8.47 090
54522............... .............. A Orchiectomy, partial. 9.49 NA 4.91 0.75 NA 15.15 090
54530............... .............. A Removal of testis.... 8.57 NA 4.31 0.64 NA 13.52 090
[[Page 1173]]
54535............... .............. A Extensive testis 12.14 NA 5.66 1.00 NA 18.80 090
surgery.
54550............... .............. A Exploration for 7.77 NA 3.90 0.59 NA 12.26 090
testis.
54560............... .............. A Exploration for 11.11 NA 5.28 0.95 NA 17.34 090
testis.
54600............... .............. A Reduce testis torsion 7.00 NA 3.61 0.54 NA 11.15 090
54620............... .............. A Suspension of testis. 4.89 NA 2.47 0.37 NA 7.73 010
54640............... .............. A Suspension of testis. 6.89 NA 3.80 0.59 NA 11.28 090
54650............... .............. A Orchiopexy (Fowler- 11.43 NA 5.52 0.98 NA 17.93 090
Stephens).
54660............... .............. A Revision of testis... 5.10 NA 3.05 0.42 NA 8.57 090
54670............... .............. A Repair testis injury. 6.40 NA 3.61 0.49 NA 10.50 090
54680............... .............. A Relocation of 12.63 NA 6.29 1.13 NA 20.05 090
testis(es).
54690............... .............. A Laparoscopy, 10.94 NA 5.06 1.19 NA 17.19 090
orchiectomy.
54692............... .............. A Laparoscopy, 12.86 NA 5.45 1.05 NA 19.36 090
orchiopexy.
54699............... .............. C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
testis.
54700............... .............. A Drainage of scrotum.. 3.42 NA 1.95 0.28 NA 5.65 010
54800............... .............. A Biopsy of epididymis. 2.33 0.95 0.90 0.17 3.45 3.40 000
54820............... .............. A Exploration of 5.13 NA 3.00 0.40 NA 8.53 090
epididymis.
54830............... .............. A Remove epididymis 5.37 NA 3.08 0.41 NA 8.86 090
lesion.
54840............... .............. A Remove epididymis 5.19 NA 2.84 0.37 NA 8.40 090
lesion.
54860............... .............. A Removal of epididymis 6.31 NA 3.37 0.46 NA 10.14 090
54861............... .............. A Removal of epididymis 8.89 NA 4.38 0.63 NA 13.90 090
54900............... .............. A Fusion of spermatic 13.18 NA 5.86 1.62 NA 20.66 090
ducts.
54901............... .............. A Fusion of spermatic 17.91 NA 7.56 2.21 NA 27.68 090
ducts.
55000............... .............. A Drainage of hydrocele 1.43 2.11 0.65 0.12 3.66 2.20 000
55040............... .............. A Removal of hydrocele. 5.35 NA 2.96 0.42 NA 8.73 090
55041............... .............. A Removal of hydroceles 7.73 NA 4.04 0.60 NA 12.37 090
55060............... .............. A Repair of hydrocele.. 5.51 NA 3.13 0.45 NA 9.09 090
55100............... .............. A Drainage of scrotum 2.13 3.77 1.59 0.18 6.08 3.90 010
abscess.
55110............... .............. A Explore scrotum...... 5.69 NA 3.18 0.43 NA 9.30 090
55120............... .............. A Removal of scrotum 5.08 5.76 2.98 0.40 11.24 8.46 090
lesion.
55150............... .............. A Removal of scrotum... 7.21 NA 3.96 0.57 NA 11.74 090
55175............... .............. A Revision of scrotum.. 5.23 NA 3.06 0.40 NA 8.69 090
55180............... .............. A Revision of scrotum.. 10.70 NA 5.46 0.87 NA 17.03 090
55200............... .............. A Incision of sperm 4.23 5.53 2.41 0.30 10.06 6.94 090
duct.
55250............... .............. A Removal of sperm 3.29 9.07 2.78 0.25 12.61 6.32 090
duct(s).
55300............... .............. A Prepare, sperm duct x- 3.50 NA 1.31 0.24 NA 5.05 000
ray.
55400............... .............. A Repair of sperm duct. 8.48 NA 4.17 0.60 NA 13.25 090
55450............... .............. A Ligation of sperm 4.11 7.21 1.87 0.29 11.61 6.27 010
duct.
55500............... .............. A Removal of hydrocele. 5.58 NA 3.15 0.52 NA 9.25 090
55520............... .............. A Removal of sperm cord 6.02 NA 3.31 0.68 NA 10.01 090
lesion.
55530............... .............. A Revise spermatic cord 5.65 NA 3.07 0.43 NA 9.15 090
veins.
55535............... .............. A Revise spermatic cord 6.55 NA 3.45 0.51 NA 10.51 090
veins.
55540............... .............. A Revise hernia & sperm 7.66 NA 3.86 0.89 NA 12.41 090
veins.
55550............... .............. A Laparo ligate 6.56 NA 3.32 0.57 NA 10.45 090
spermatic vein.
55559............... .............. C Laparo proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
spermatic cord.
55600............... .............. A Incise sperm duct 6.37 NA 3.39 0.46 NA 10.22 090
pouch.
55605............... .............. A Incise sperm duct 7.95 NA 4.36 0.65 NA 12.96 090
pouch.
55650............... .............. A Remove sperm duct 11.78 NA 5.35 0.87 NA 18.00 090
pouch.
55680............... .............. A Remove sperm pouch 5.18 NA 3.03 0.37 NA 8.58 090
lesion.
55700............... .............. A Biopsy of prostate... 1.57 4.33 0.71 0.12 6.02 2.40 000
55705............... .............. A Biopsy of prostate... 4.56 NA 2.32 0.31 NA 7.19 010
55720............... .............. A Drainage of prostate 7.63 NA 3.95 0.53 NA 12.11 090
abscess.
55725............... .............. A Drainage of prostate 8.67 NA 4.62 0.62 NA 13.91 090
abscess.
55801............... .............. A Removal of prostate.. 17.77 NA 7.38 1.30 NA 26.45 090
55810............... .............. A Extensive prostate 22.55 NA 8.71 1.63 NA 32.89 090
surgery.
55812............... .............. A Extensive prostate 27.47 NA 11.14 2.04 NA 40.65 090
surgery.
55815............... .............. A Extensive prostate 30.41 NA 12.07 2.22 NA 44.70 090
surgery.
55821............... .............. A Removal of prostate.. 14.23 NA 6.32 1.03 NA 21.58 090
55831............... .............. A Removal of prostate.. 15.60 NA 6.77 1.13 NA 23.50 090
55840............... .............. A Extensive prostate 22.66 NA 9.44 1.65 NA 33.75 090
surgery.
55842............... .............. A Extensive prostate 24.34 NA 10.01 1.79 NA 36.14 090
surgery.
55845............... .............. A Extensive prostate 28.51 NA 11.11 2.06 NA 41.68 090
surgery.
55859............... .............. A Percut/needle insert, 12.50 NA 5.91 0.89 NA 19.30 090
pros.
55860............... .............. A Surgical exposure, 14.43 NA 6.44 0.99 NA 21.86 090
prostate.
55862............... .............. A Extensive prostate 18.36 NA 7.96 1.37 NA 27.69 090
surgery.
55865............... .............. A Extensive prostate 22.84 NA 9.38 1.65 NA 33.87 090
surgery.
55866............... .............. A Laparo radical 30.69 NA 11.81 1.65 NA 44.15 090
prostatectomy.
55870............... .............. A Electroejaculation... 2.58 1.54 1.09 0.17 4.29 3.84 000
55873............... .............. A Cryoablate prostate.. 19.44 NA 9.02 1.23 NA 29.69 090
55899............... .............. C Genital surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
55970............... .............. N Sex transformation, M 0.00 0.00 0.00 0.00 0.00 0.00 XXX
to F.
55980............... .............. N Sex transformation, F 0.00 0.00 0.00 0.00 0.00 0.00 XXX
to M.
56405............... .............. A I & D of vulva/ 1.44 1.33 1.15 0.17 2.94 2.76 010
perineum.
56420............... .............. A Drainage of gland 1.39 2.29 1.09 0.16 3.84 2.64 010
abscess.
56440............... .............. A Surgery for vulva 2.84 NA 1.71 0.34 NA 4.89 010
lesion.
56441............... .............. A Lysis of labial 1.97 1.83 1.42 0.21 4.01 3.60 010
lesion(s).
[[Page 1174]]
56501............... .............. A Destroy, vulva 1.53 1.79 1.25 0.18 3.50 2.96 010
lesions, sim.
56515............... .............. A Destroy vulva lesion/ 2.76 2.55 1.81 0.22 5.53 4.79 010
s compl.
56605............... .............. A Biopsy of vulva/ 1.10 1.09 0.46 0.13 2.32 1.69 000
perineum.
56606............... .............. A Biopsy of vulva/ 0.55 0.49 0.22 0.07 1.11 0.84 ZZZ
perineum.
56620............... .............. A Partial removal of 7.46 NA 4.84 0.92 NA 13.22 090
vulva.
56625............... .............. A Complete removal of 8.39 NA 5.39 1.01 NA 14.79 090
vulva.
56630............... .............. A Extensive vulva 12.34 NA 6.96 1.48 NA 20.78 090
surgery.
56631............... .............. A Extensive vulva 16.18 NA 8.96 1.97 NA 27.11 090
surgery.
56632............... .............. A Extensive vulva 20.26 NA 9.62 2.45 NA 32.33 090
surgery.
56633............... .............. A Extensive vulva 16.45 NA 8.70 2.00 NA 27.15 090
surgery.
56634............... .............. A Extensive vulva 17.85 NA 9.59 2.15 NA 29.59 090
surgery.
56637............... .............. A Extensive vulva 21.94 NA 11.23 2.63 NA 35.80 090
surgery.
56640............... .............. A Extensive vulva 22.14 NA 10.80 2.73 NA 35.67 090
surgery.
56700............... .............. A Partial removal of 2.52 NA 1.73 0.29 NA 4.54 010
hymen.
56720............... .............. A Incision of hymen.... 0.68 NA 0.39 0.08 NA 1.15 000
56740............... .............. A Remove vagina gland 4.56 NA 2.47 0.45 NA 7.48 010
lesion.
56800............... .............. A Repair of vagina..... 3.88 NA 2.19 0.45 NA 6.52 010
56805............... .............. A Repair clitoris...... 18.83 NA 9.43 2.20 NA 30.46 090
56810............... .............. A Repair of perineum... 4.12 NA 2.30 0.49 NA 6.91 010
56820............... .............. A Exam of vulva w/scope 1.50 1.34 0.63 0.12 2.96 2.25 000
56821............... .............. A Exam/biopsy of vulva 2.05 1.78 0.90 0.16 3.99 3.11 000
w/scope.
57000............... .............. A Exploration of vagina 2.97 NA 1.73 0.34 NA 5.04 010
57010............... .............. A Drainage of pelvic 6.02 NA 3.85 0.69 NA 10.56 090
abscess.
57020............... .............. A Drainage of pelvic 1.50 0.95 0.59 0.18 2.63 2.27 000
fluid.
57022............... .............. A I & d vaginal 2.56 NA 1.50 0.29 NA 4.35 010
hematoma, pp.
57023............... .............. A I & d vag hematoma, 4.74 NA 2.59 0.29 NA 7.62 010
non-ob.
57061............... .............. A Destroy vag lesions, 1.25 1.66 1.12 0.16 3.07 2.53 010
simple.
57065............... .............. A Destroy vag lesions, 2.61 2.30 1.68 0.31 5.22 4.60 010
complex.
57100............... .............. A Biopsy of vagina..... 1.20 1.10 0.48 0.12 2.42 1.80 000
57105............... .............. A Biopsy of vagina..... 1.69 1.93 1.32 0.21 3.83 3.22 010
57106............... .............. A Remove vagina wall, 6.35 NA 4.20 0.70 NA 11.25 090
partial.
57107............... .............. A Remove vagina tissue, 22.97 NA 10.50 2.62 NA 36.09 090
part.
57109............... .............. A Vaginectomy partial w/ 26.96 NA 11.34 2.38 NA 40.68 090
nodes.
57110............... .............. A Remove vagina wall, 14.27 NA 7.31 1.72 NA 23.30 090
complete.
57111............... .............. A Remove vagina tissue, 26.96 NA 12.64 3.27 NA 42.87 090
compl.
57112............... .............. A Vaginectomy w/nodes, 28.96 NA 12.19 2.64 NA 43.79 090
compl.
57120............... .............. A Closure of vagina.... 7.40 NA 4.64 0.90 NA 12.94 090
57130............... .............. A Remove vagina lesion. 2.43 2.17 1.55 0.28 4.88 4.26 010
57135............... .............. A Remove vagina lesion. 2.67 2.27 1.66 0.31 5.25 4.64 010
57150............... .............. A Treat vagina 0.55 1.11 0.22 0.07 1.73 0.84 000
infection.
57155............... .............. A Insert uteri tandems/ 6.26 NA 4.17 0.71 NA 11.14 090
ovoids.
57160............... .............. A Insert pessary/other 0.89 1.09 0.38 0.11 2.09 1.38 000
device.
57170............... .............. A Fitting of diaphragm/ 0.91 1.49 0.34 0.11 2.51 1.36 000
cap.
57180............... .............. A Treat vaginal 1.58 2.18 1.29 0.19 3.95 3.06 010
bleeding.
57200............... .............. A Repair of vagina..... 3.93 NA 2.91 0.46 NA 7.30 090
57210............... .............. A Repair vagina/ 5.16 NA 3.44 0.60 NA 9.20 090
perineum.
57220............... .............. A Revision of urethra.. 4.30 NA 3.12 0.51 NA 7.93 090
57230............... .............. A Repair of urethral 5.63 NA 3.42 0.60 NA 9.65 090
lesion.
57240............... .............. A Repair bladder & 6.06 NA 3.84 0.64 NA 10.54 090
vagina.
57250............... .............. A Repair rectum & 5.52 NA 3.59 0.65 NA 9.76 090
vagina.
57260............... .............. A Repair of vagina..... 8.26 NA 4.86 1.00 NA 14.12 090
57265............... .............. A Extensive repair of 11.32 NA 6.06 1.37 NA 18.75 090
vagina.
57268............... .............. A Repair of bowel bulge 6.75 NA 4.21 0.80 NA 11.76 090
57270............... .............. A Repair of bowel pouch 12.09 NA 6.28 1.41 NA 19.78 090
57280............... .............. A Suspension of vagina. 15.02 NA 7.39 1.74 NA 24.15 090
57282............... .............. A Repair of vaginal 8.85 NA 5.32 1.04 NA 15.21 090
prolapse.
57284............... .............. A Repair paravaginal 12.68 NA 7.17 1.41 NA 21.26 090
defect.
57287............... .............. A Revise/remove sling 10.69 NA 5.52 0.89 NA 17.10 090
repair.
57288............... .............. A Repair bladder defect 13.00 NA 5.95 1.04 NA 19.99 090
57289............... .............. A Repair bladder & 11.56 NA 6.07 1.15 NA 18.78 090
vagina.
57291............... .............. A Construction of 7.94 NA 4.96 0.94 NA 13.84 090
vagina.
57292............... .............. A Construct vagina with 13.07 NA 6.98 1.56 NA 21.61 090
graft.
57300............... .............. A Repair rectum-vagina 7.60 NA 4.30 0.84 NA 12.74 090
fistula.
57305............... .............. A Repair rectum-vagina 13.75 NA 6.30 1.60 NA 21.65 090
fistula.
57307............... .............. A Fistula repair & 15.91 NA 7.07 1.92 NA 24.90 090
colostomy.
57308............... .............. A Fistula repair, 9.93 NA 5.15 1.10 NA 16.18 090
transperine.
57310............... .............. A Repair urethrovaginal 6.77 NA 3.90 0.54 NA 11.21 090
lesion.
57311............... .............. A Repair urethrovaginal 7.97 NA 4.18 0.62 NA 12.77 090
lesion.
57320............... .............. A Repair bladder-vagina 8.00 NA 4.43 0.72 NA 13.15 090
lesion.
57330............... .............. A Repair bladder-vagina 12.33 NA 5.78 1.04 NA 19.15 090
lesion.
57335............... .............. A Repair vagina........ 18.70 NA 9.10 2.00 NA 29.80 090
57400............... .............. A Dilation of vagina... 2.27 NA 1.13 0.27 NA 3.67 000
57410............... .............. A Pelvic examination... 1.75 2.02 0.89 0.17 3.94 2.81 000
57415............... .............. A Remove vaginal 2.17 NA 1.43 0.23 NA 3.83 010
foreign body.
57420............... .............. A Exam of vagina w/ 1.60 1.38 0.67 0.12 3.10 2.39 000
scope.
[[Page 1175]]
57421............... .............. A Exam/biopsy of vag w/ 2.20 1.87 0.96 0.16 4.23 3.32 000
scope.
57425............... .............. A Laparoscopy, surg, 15.73 NA 6.69 1.74 NA 24.16 090
colpopexy.
57452............... .............. A Exam of cervix w/ 1.50 1.40 0.63 0.12 3.02 2.25 000
scope.
57454............... .............. A Bx/curett of cervix w/ 2.33 1.76 1.00 0.16 4.25 3.49 000
scope.
57455............... .............. A Biopsy of cervix w/ 1.99 1.75 0.87 0.16 3.90 3.02 000
scope.
57456............... .............. A Endocerv curettage w/ 1.85 1.68 0.82 0.16 3.69 2.83 000
scope.
57460............... .............. A Bx of cervix w/scope, 2.83 6.03 1.22 0.34 9.20 4.39 000
leep.
57461............... .............. A Conz of cervix w/ 3.43 6.30 1.41 0.34 10.07 5.18 000
scope, leep.
57500............... .............. A Biopsy of cervix..... 0.97 2.66 0.47 0.12 3.75 1.56 000
57505............... .............. A Endocervical 1.14 1.47 1.10 0.14 2.75 2.38 010
curettage.
57510............... .............. A Cauterization of 1.90 1.57 1.05 0.22 3.69 3.17 010
cervix.
57511............... .............. A Cryocautery of cervix 1.90 1.84 1.38 0.22 3.96 3.50 010
57513............... .............. A Laser surgery of 1.90 1.87 1.41 0.23 4.00 3.54 010
cervix.
57520............... .............. A Conization of cervix. 4.03 4.88 2.77 0.49 9.40 7.29 090
57522............... .............. A Conization of cervix. 3.35 4.35 2.67 0.41 8.11 6.43 090
57530............... .............. A Removal of cervix.... 4.78 NA 3.43 0.58 NA 8.79 090
57531............... .............. A Removal of cervix, 27.96 NA 13.23 2.97 NA 44.16 090
radical.
57540............... .............. A Removal of residual 12.20 NA 6.27 1.46 NA 19.93 090
cervix.
57545............... .............. A Remove cervix/repair 13.01 NA 6.70 1.57 NA 21.28 090
pelvis.
57550............... .............. A Removal of residual 5.52 NA 3.86 0.66 NA 10.04 090
cervix.
57555............... .............. A Remove cervix/repair 8.94 NA 5.14 1.07 NA 15.15 090
vagina.
57556............... .............. A Remove cervix, repair 8.36 NA 4.88 0.96 NA 14.20 090
bowel.
57700............... .............. A Revision of cervix... 3.54 NA 3.10 0.40 NA 7.04 090
57720............... .............. A Revision of cervix... 4.12 NA 3.15 0.49 NA 7.76 090
57800............... .............. A Dilation of cervical 0.77 0.76 0.47 0.10 1.63 1.34 000
canal.
57820............... .............. A D & c of residual 1.67 1.49 1.14 0.21 3.37 3.02 010
cervix.
58100............... .............. A Biopsy of uterus 1.53 1.33 0.72 0.08 2.94 2.33 000
lining.
58120............... .............. A Dilation and 3.27 2.31 1.87 0.40 5.98 5.54 010
curettage.
58140............... .............. A Myomectomy abdom 14.58 NA 7.13 1.76 NA 23.47 090
method.
58145............... .............. A Myomectomy vag method 8.03 NA 4.84 0.96 NA 13.83 090
58146............... .............. A Myomectomy abdom 18.97 NA 8.79 1.76 NA 29.52 090
complex.
58150............... .............. A Total hysterectomy... 15.22 NA 7.52 1.89 NA 24.63 090
58152............... .............. A Total hysterectomy... 20.57 NA 9.89 1.83 NA 32.29 090
58180............... .............. A Partial hysterectomy. 15.27 NA 7.49 1.86 NA 24.62 090
58200............... .............. A Extensive 21.56 NA 10.05 2.59 NA 34.20 090
hysterectomy.
58210............... .............. A Extensive 28.81 NA 13.27 3.51 NA 45.59 090
hysterectomy.
58240............... .............. A Removal of pelvis 38.33 NA 17.72 4.53 NA 60.58 090
contents.
58260............... .............. A Vaginal hysterectomy. 12.96 NA 6.72 1.48 NA 21.16 090
58262............... .............. A Vag hyst including t/ 14.75 NA 7.40 1.71 NA 23.86 090
o.
58263............... .............. A Vag hyst w/t/o & vag 16.04 NA 7.90 1.87 NA 25.81 090
repair.
58267............... .............. A Vag hyst w/urinary 17.01 NA 8.42 1.82 NA 27.25 090
repair.
58270............... .............. A Vag hyst w/enterocele 14.24 NA 7.10 1.65 NA 22.99 090
repair.
58275............... .............. A Hysterectomy/revise 15.74 NA 7.80 1.82 NA 25.36 090
vagina.
58280............... .............. A Hysterectomy/revise 16.98 NA 8.28 1.86 NA 27.12 090
vagina.
58285............... .............. A Extensive 22.23 NA 10.02 2.27 NA 34.52 090
hysterectomy.
58290............... .............. A Vag hyst complex..... 18.97 NA 8.92 1.48 NA 29.37 090
58291............... .............. A Vag hyst incl t/o, 20.76 NA 9.89 1.71 NA 32.36 090
complex.
58292............... .............. A Vag hyst t/o & 22.05 NA 10.40 1.87 NA 34.32 090
repair, compl.
58293............... .............. A Vag hyst w/uro 23.03 NA 10.91 1.82 NA 35.76 090
repair, compl.
58294............... .............. A Vag hyst w/ 20.25 NA 9.68 1.65 NA 31.58 090
enterocele, compl.
58300............... .............. N Insert intrauterine +1.01 1.42 0.38 0.12 2.55 1.51 XXX
device.
58301............... .............. A Remove intrauterine 1.27 1.33 0.48 0.16 2.76 1.91 000
device.
58321............... .............. A Artificial 0.92 1.15 0.37 0.12 2.19 1.41 000
insemination.
58322............... .............. A Artificial 1.10 1.21 0.41 0.13 2.44 1.64 000
insemination.
58323............... .............. A Sperm washing........ 0.23 0.24 0.09 0.02 0.49 0.34 000
58340............... .............. A Catheter for 0.88 6.08 0.65 0.10 7.06 1.63 000
hysterography.
58345............... .............. A Reopen fallopian tube 4.65 NA 2.44 0.43 NA 7.52 010
58346............... .............. A Insert heyman uteri 6.74 NA 3.93 0.77 NA 11.44 090
capsule.
58350............... .............. A Reopen fallopian tube 1.01 1.50 0.93 0.12 2.63 2.06 010
58353............... .............. A Endometr ablate, 3.55 36.26 2.05 0.45 40.26 6.05 010
thermal.
58400............... .............. A Suspension of uterus. 6.35 NA 3.97 0.75 NA 11.07 090
58410............... .............. A Suspension of uterus. 12.71 NA 6.48 1.31 NA 20.50 090
58520............... .............. A Repair of ruptured 11.90 NA 6.07 1.41 NA 19.38 090
uterus.
58540............... .............. A Revision of uterus... 14.62 NA 6.98 1.54 NA 23.14 090
58545............... .............. A Laparoscopic 14.58 NA 7.19 1.75 NA 23.52 090
myomectomy.
58546............... .............. A Laparo-myomectomy, 18.97 NA 8.98 1.75 NA 29.70 090
complex.
58550............... .............. A Laparo-asst vag 14.17 NA 7.31 1.74 NA 23.22 090
hysterectomy.
58552............... .............. A Laparo-vag hyst incl 15.98 NA 8.02 1.74 NA 25.74 090
t/o.
58553............... .............. A Laparo-vag hyst, 18.97 NA 8.97 1.48 NA 29.42 090
complex.
58554............... .............. A Laparo-vag hyst w/t/ 21.97 NA 10.46 1.48 NA 33.91 090
o, compl.
58555............... .............. A Hysteroscopy, dx, sep 3.33 2.10 1.46 0.41 5.84 5.20 000
proc.
58558............... .............. A Hysteroscopy, biopsy. 4.74 NA 2.06 0.59 NA 7.39 000
58559............... .............. A Hysteroscopy, lysis.. 6.16 NA 2.62 0.75 NA 9.53 000
58560............... .............. A Hysteroscopy, resect 6.99 NA 2.97 0.86 NA 10.82 000
septum.
58561............... .............. A Hysteroscopy, remove 9.99 NA 4.18 1.23 NA 15.40 000
myoma.
[[Page 1176]]
58562............... .............. A Hysteroscopy, remove 5.20 NA 2.21 0.63 NA 8.04 000
fb.
58563............... .............. A Hysteroscopy, 6.16 NA 2.63 0.75 NA 9.54 000
ablation.
58578............... .............. C Laparo proc, uterus.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
58579............... .............. C Hysteroscope 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
58600............... .............. A Division of fallopian 5.59 NA 3.36 0.47 NA 9.42 090
tube.
58605............... .............. A Division of fallopian 4.99 NA 3.15 0.40 NA 8.54 090
tube.
58611............... .............. A Ligate oviduct(s) add- 1.45 NA 0.57 0.08 NA 2.10 ZZZ
on.
58615............... .............. A Occlude fallopian 3.89 NA 2.72 0.48 NA 7.09 010
tube(s).
58660............... .............. A Laparoscopy, lysis... 11.27 NA 5.28 1.37 NA 17.92 090
58661............... .............. A Laparoscopy, remove 11.03 NA 5.14 1.35 NA 17.52 010
adnexa.
58662............... .............. A Laparoscopy, excise 11.77 NA 5.80 1.42 NA 18.99 090
lesions.
58670............... .............. A Laparoscopy, tubal 5.59 NA 3.28 0.66 NA 9.53 090
cautery.
58671............... .............. A Laparoscopy, tubal 5.59 NA 3.30 0.68 NA 9.57 090
block.
58672............... .............. A Laparoscopy, 12.86 NA 6.23 1.47 NA 20.56 090
fimbrioplasty.
58673............... .............. A Laparoscopy, 13.72 NA 6.63 1.69 NA 22.04 090
salpingostomy.
58679............... .............. C Laparo proc, oviduct- 0.00 0.00 0.00 0.00 0.00 0.00 YYY
ovary.
58700............... .............. A Removal of fallopian 12.03 NA 6.01 0.77 NA 18.81 090
tube.
58720............... .............. A Removal of ovary/ 11.34 NA 5.81 1.37 NA 18.52 090
tube(s).
58740............... .............. A Revise fallopian 13.98 NA 7.16 0.71 NA 21.85 090
tube(s).
58750............... .............. A Repair oviduct....... 14.82 NA 7.41 1.83 NA 24.06 090
58752............... .............. A Revise ovarian 14.82 NA 6.99 1.82 NA 23.63 090
tube(s).
58760............... .............. A Remove tubal 13.11 NA 6.75 1.62 NA 21.48 090
obstruction.
58770............... .............. A Create new tubal 13.95 NA 6.95 1.71 NA 22.61 090
opening.
58800............... .............. A Drainage of ovarian 4.13 4.49 2.99 0.43 9.05 7.55 090
cyst(s).
58805............... .............. A Drainage of ovarian 5.87 NA 3.55 0.68 NA 10.10 090
cyst(s).
58820............... .............. A Drain ovary abscess, 4.21 NA 3.34 0.35 NA 7.90 090
open.
58822............... .............. A Drain ovary abscess, 10.11 NA 5.24 1.11 NA 16.46 090
percut.
58823............... .............. A Drain pelvic abscess, 3.37 NA 1.12 0.22 NA 4.71 000
percut.
58825............... .............. A Transposition, 10.96 NA 5.82 0.75 NA 17.53 090
ovary(s).
58900............... .............. A Biopsy of ovary(s)... 5.98 NA 3.61 0.68 NA 10.27 090
58920............... .............. A Partial removal of 11.34 NA 5.62 0.82 NA 17.78 090
ovary(s).
58925............... .............. A Removal of ovarian 11.34 NA 5.71 1.37 NA 18.42 090
cyst(s).
58940............... .............. A Removal of ovary(s).. 7.28 NA 4.13 0.88 NA 12.29 090
58943............... .............. A Removal of ovary(s).. 18.40 NA 8.75 2.24 NA 29.39 090
58950............... .............. A Resect ovarian 16.90 NA 8.50 1.87 NA 27.27 090
malignancy.
58951............... .............. A Resect ovarian 22.35 NA 10.55 2.65 NA 35.55 090
malignancy.
58952............... .............. A Resect ovarian 24.97 NA 11.85 3.10 NA 39.92 090
malignancy.
58953............... .............. A Tah, rad dissect for 31.95 NA 14.61 3.98 NA 50.54 090
debulk.
58954............... .............. A Tah rad debulk/lymph 34.95 NA 15.77 4.29 NA 55.01 090
remove.
58960............... .............. A Exploration of 14.63 NA 7.45 1.77 NA 23.85 090
abdomen.
58970............... .............. A Retrieval of oocyte.. 3.52 2.32 1.50 0.43 6.27 5.45 000
58974............... .............. C Transfer of embryo... 0.00 0.00 0.00 0.00 0.00 0.00 000
58976............... .............. A Transfer of embryo... 3.82 2.64 1.83 0.47 6.93 6.12 000
58999............... .............. C Genital surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
59000............... .............. A Amniocentesis, 1.30 2.10 0.69 0.28 3.68 2.27 000
diagnostic.
59001............... .............. A Amniocentesis, 3.00 NA 1.41 0.28 NA 4.69 000
therapeutic.
59012............... .............. A Fetal cord 3.44 NA 1.56 0.75 NA 5.75 000
puncture,prenatal.
59015............... .............. A Chorion biopsy....... 2.20 1.57 1.06 0.48 4.25 3.74 000
59020............... .............. A Fetal contract stress 0.66 0.79 NA 0.24 1.69 NA 000
test.
59020............... 26............ A Fetal contract stress 0.66 0.27 0.27 0.14 1.07 1.07 000
test.
59020............... TC............ A Fetal contract stress 0.00 0.52 NA 0.10 0.62 NA 000
test.
59025............... .............. A Fetal non-stress test 0.53 0.45 NA 0.14 1.12 NA 000
59025............... 26............ A Fetal non-stress test 0.53 0.21 0.21 0.12 0.86 0.86 000
59025............... TC............ A Fetal non-stress test 0.00 0.24 NA 0.02 0.26 NA 000
59030............... .............. A Fetal scalp blood 1.99 NA 1.05 0.43 NA 3.47 000
sample.
59050............... .............. A Fetal monitor w/ 0.89 NA 0.36 0.19 NA 1.44 XXX
report.
59051............... .............. A Fetal monitor/ 0.74 NA 0.30 0.17 NA 1.21 XXX
interpret only.
59070............... .............. A Transabdom amnioinfus 5.24 5.12 2.41 0.28 10.64 7.93 000
w/ us.
59072............... .............. A Umbilical cord occlud 8.99 NA 3.13 0.68 NA 12.80 000
w/ us.
59074............... .............. A Fetal fluid drainage 5.24 4.61 2.41 0.28 10.13 7.93 000
w/ us.
59076............... .............. A Fetal shunt 8.99 NA 3.13 0.68 NA 12.80 000
placement, w/ us.
59100............... .............. A Remove uterus lesion. 12.33 NA 6.48 2.67 NA 21.48 090
59120............... .............. A Treat ectopic 11.47 NA 6.27 2.48 NA 20.22 090
pregnancy.
59121............... .............. A Treat ectopic 11.65 NA 6.35 2.52 NA 20.52 090
pregnancy.
59130............... .............. A Treat ectopic 14.20 NA 4.99 3.06 NA 22.25 090
pregnancy.
59135............... .............. A Treat ectopic 13.86 NA 7.25 3.00 NA 24.11 090
pregnancy.
59136............... .............. A Treat ectopic 13.16 NA 6.64 2.85 NA 22.65 090
pregnancy.
59140............... .............. A Treat ectopic 5.45 5.20 3.59 1.18 11.83 10.22 090
pregnancy.
59150............... .............. A Treat ectopic 11.65 NA 6.05 1.48 NA 19.18 090
pregnancy.
59151............... .............. A Treat ectopic 11.47 NA 6.09 1.70 NA 19.26 090
pregnancy.
59160............... .............. A D & c after delivery. 2.71 3.27 2.11 0.59 6.57 5.41 010
59200............... .............. A Insert cervical 0.79 1.20 0.31 0.18 2.17 1.28 000
dilator.
59300............... .............. A Episiotomy or vaginal 2.41 2.16 0.96 0.52 5.09 3.89 000
repair.
59320............... .............. A Revision of cervix... 2.48 NA 1.26 0.54 NA 4.28 000
59325............... .............. A Revision of cervix... 4.06 NA 1.92 0.88 NA 6.86 000
[[Page 1177]]
59350............... .............. A Repair of uterus..... 4.94 NA 1.95 1.06 NA 7.95 000
59400............... .............. A Obstetrical care..... 23.03 NA 15.48 4.99 NA 43.50 MMM
59409............... .............. A Obstetrical care..... 13.48 NA 5.32 2.92 NA 21.72 MMM
59410............... .............. A Obstetrical care..... 14.76 NA 6.33 3.20 NA 24.29 MMM
59412............... .............. A Antepartum 1.71 NA 0.81 0.37 NA 2.89 MMM
manipulation.
59414............... .............. A Deliver placenta..... 1.61 NA 0.63 0.35 NA 2.59 MMM
59425............... .............. A Antepartum care only. 4.80 4.26 1.87 1.04 10.10 7.71 MMM
59426............... .............. A Antepartum care only. 8.27 7.65 3.23 1.80 17.72 13.30 MMM
59430............... .............. A Care after delivery.. 2.13 1.24 0.94 0.46 3.83 3.53 MMM
59510............... .............. A Cesarean delivery.... 26.18 NA 17.43 5.67 NA 49.28 MMM
59514............... .............. A Cesarean delivery 15.95 NA 6.23 3.45 NA 25.63 MMM
only.
59515............... .............. A Cesarean delivery.... 17.34 NA 7.87 3.76 NA 28.97 MMM
59525............... .............. A Remove uterus after 8.53 NA 3.32 1.85 NA 13.70 ZZZ
cesarean.
59610............... .............. A Vbac delivery........ 24.58 NA 16.03 5.32 NA 45.93 MMM
59612............... .............. A Vbac delivery only... 15.04 NA 6.07 3.26 NA 24.37 MMM
59614............... .............. A Vbac care after 16.32 NA 6.96 3.53 NA 26.81 MMM
delivery.
59618............... .............. A Attempted vbac 27.74 NA 18.43 6.01 NA 52.18 MMM
delivery.
59620............... .............. A Attempted vbac 17.50 NA 6.78 3.80 NA 28.08 MMM
delivery only.
59622............... .............. A Attempted vbac after 18.90 NA 8.67 4.09 NA 31.66 MMM
care.
59812............... .............. A Treatment of 4.00 NA 2.56 0.70 NA 7.26 090
miscarriage.
59820............... .............. A Care of miscarriage.. 4.00 NA 3.52 0.87 NA 8.39 090
59821............... .............. A Treatment of 4.46 NA 3.45 0.96 NA 8.87 090
miscarriage.
59830............... .............. A Treat uterus 6.10 NA 4.01 1.33 NA 11.44 090
infection.
59840............... .............. R Abortion............. 3.01 NA 2.13 0.65 NA 5.79 010
59841............... .............. R Abortion............. 5.23 2.58 2.58 1.13 8.94 8.94 010
59850............... .............. R Abortion............. 5.90 NA 3.27 1.28 NA 10.45 090
59851............... .............. R Abortion............. 5.92 NA 3.74 1.28 NA 10.94 090
59852............... .............. R Abortion............. 8.23 NA 5.06 1.79 NA 15.08 090
59855............... .............. R Abortion............. 6.11 NA 3.56 1.33 NA 11.00 090
59856............... .............. R Abortion............. 7.47 NA 4.07 1.62 NA 13.16 090
59857............... .............. R Abortion............. 9.28 NA 4.59 2.00 NA 15.87 090
59866............... .............. R Abortion (mpr)....... 3.99 NA 1.83 0.87 NA 6.69 000
59870............... .............. A Evacuate mole of 6.00 NA 4.43 0.93 NA 11.36 090
uterus.
59871............... .............. A Remove cerclage 2.13 1.76 1.13 0.46 4.35 3.72 000
suture.
59897............... .............. C Fetal invas px w/ us. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
59898............... .............. C Laparo proc, ob care/ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
deliver.
59899............... .............. C Maternity care 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
60000............... .............. A Drain thyroid/tongue 1.76 2.16 2.04 0.17 4.09 3.97 010
cyst.
60001............... .............. A Aspirate/inject 0.97 1.49 0.34 0.07 2.53 1.38 000
thyriod cyst.
60100............... .............. A Biopsy of thyroid.... 1.56 1.42 0.53 0.06 3.04 2.15 000
60200............... .............. A Remove thyroid lesion 9.54 NA 6.14 1.01 NA 16.69 090
60210............... .............. A Partial thyroid 10.86 NA 5.78 1.22 NA 17.86 090
excision.
60212............... .............. A Partial thyroid 16.01 NA 7.82 1.82 NA 25.65 090
excision.
60220............... .............. A Partial removal of 11.88 NA 6.30 1.17 NA 19.35 090
thyroid.
60225............... .............. A Partial removal of 14.17 NA 7.55 1.58 NA 23.30 090
thyroid.
60240............... .............. A Removal of thyroid... 16.04 NA 7.75 1.81 NA 25.60 090
60252............... .............. A Removal of thyroid... 20.54 NA 10.29 1.97 NA 32.80 090
60254............... .............. A Extensive thyroid 26.95 NA 14.38 2.36 NA 43.69 090
surgery.
60260............... .............. A Repeat thyroid 17.44 NA 8.85 1.68 NA 27.97 090
surgery.
60270............... .............. A Removal of thyroid... 20.24 NA 10.66 2.15 NA 33.05 090
60271............... .............. A Removal of thyroid... 16.80 NA 8.78 1.63 NA 27.21 090
60280............... .............. A Remove thyroid duct 5.86 NA 4.83 0.54 NA 11.23 090
lesion.
60281............... .............. A Remove thyroid duct 8.52 NA 5.99 0.81 NA 15.32 090
lesion.
60500............... .............. A Explore parathyroid 16.21 NA 7.53 1.94 NA 25.68 090
glands.
60502............... .............. A Re-explore 20.32 NA 9.49 2.41 NA 32.22 090
parathyroids.
60505............... .............. A Explore parathyroid 21.46 NA 11.12 2.58 NA 35.16 090
glands.
60512............... .............. A Autotransplant 4.44 NA 1.63 0.53 NA 6.60 ZZZ
parathyroid.
60520............... .............. A Removal of thymus 16.78 NA 8.38 2.22 NA 27.38 090
gland.
60521............... .............. A Removal of thymus 18.84 NA 9.63 2.82 NA 31.29 090
gland.
60522............... .............. A Removal of thymus 23.06 NA 11.35 3.41 NA 37.82 090
gland.
60540............... .............. A Explore adrenal gland 17.00 NA 7.65 1.71 NA 26.36 090
60545............... .............. A Explore adrenal gland 19.85 NA 8.61 2.11 NA 30.57 090
60600............... .............. A Remove carotid body 17.90 NA 10.90 2.26 NA 31.06 090
lesion.
60605............... .............. A Remove carotid body 20.21 NA 12.79 2.75 NA 35.75 090
lesion.
60650............... .............. A Laparoscopy 19.97 NA 7.99 2.39 NA 30.35 090
adrenalectomy.
60659............... .............. C Laparo proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
endocrine.
60699............... .............. C Endocrine surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
61000............... .............. A Remove cranial cavity 1.58 NA 0.96 0.16 NA 2.70 000
fluid.
61001............... .............. A Remove cranial cavity 1.49 NA 1.06 0.18 NA 2.73 000
fluid.
61020............... .............. A Remove brain cavity 1.51 NA 1.35 0.31 NA 3.17 000
fluid.
61026............... .............. A Injection into brain 1.69 NA 1.41 0.25 NA 3.35 000
canal.
61050............... .............. A Remove brain canal 1.51 NA 1.26 0.16 NA 2.93 000
fluid.
61055............... .............. A Injection into brain 2.10 NA 1.42 0.16 NA 3.68 000
canal.
61070............... .............. A Brain canal shunt 0.89 NA 1.03 0.11 NA 2.03 000
procedure.
61105............... .............. A Twist drill hole..... 5.13 NA 3.95 1.27 NA 10.35 090
[[Page 1178]]
61107............... .............. A Drill skull for 4.99 NA 3.32 1.23 NA 9.54 000
implantation.
61108............... .............. A Drill skull for 10.17 NA 7.14 2.46 NA 19.77 090
drainage.
61120............... .............. A Burr hole for 8.75 NA 6.00 2.18 NA 16.93 090
puncture.
61140............... .............. A Pierce skull for 15.88 NA 9.91 3.80 NA 29.59 090
biopsy.
61150............... .............. A Pierce skull for 17.54 NA 10.41 4.25 NA 32.20 090
drainage.
61151............... .............. A Pierce skull for 12.40 NA 7.85 2.95 NA 23.20 090
drainage.
61154............... .............. A Pierce skull & remove 14.97 NA 9.50 3.68 NA 28.15 090
clot.
61156............... .............. A Pierce skull for 16.30 NA 9.86 4.12 NA 30.28 090
drainage.
61210............... .............. A Pierce skull, implant 5.83 NA 3.71 1.40 NA 10.94 000
device.
61215............... .............. A Insert brain-fluid 4.88 NA 4.02 1.19 NA 10.09 090
device.
61250............... .............. A Pierce skull & 10.40 NA 6.87 2.44 NA 19.71 090
explore.
61253............... .............. A Pierce skull & 12.34 NA 7.74 2.73 NA 22.81 090
explore.
61304............... .............. A Open skull for 21.93 NA 12.88 5.22 NA 40.03 090
exploration.
61305............... .............. A Open skull for 26.57 NA 15.37 6.33 NA 48.27 090
exploration.
61312............... .............. A Open skull for 24.53 NA 15.08 6.02 NA 45.63 090
drainage.
61313............... .............. A Open skull for 24.89 NA 14.85 6.11 NA 45.85 090
drainage.
61314............... .............. A Open skull for 24.19 NA 13.08 4.82 NA 42.09 090
drainage.
61315............... .............. A Open skull for 27.64 NA 16.07 6.78 NA 50.49 090
drainage.
61316............... .............. A Implt cran bone flap 1.39 NA 0.57 0.52 NA 2.48 ZZZ
to abdo.
61320............... .............. A Open skull for 25.58 NA 14.80 6.27 NA 46.65 090
drainage.
61321............... .............. A Open skull for 28.46 NA 16.18 6.45 NA 51.09 090
drainage.
61322............... .............. A Decompressive 29.46 NA 14.45 6.02 NA 49.93 090
craniotomy.
61323............... .............. A Decompressive 30.95 NA 14.64 6.02 NA 51.61 090
lobectomy.
61330............... .............. A Decompress eye socket 23.29 NA 13.80 3.11 NA 40.20 090
61332............... .............. A Explore/biopsy eye 27.24 NA 15.66 5.01 NA 47.91 090
socket.
61333............... .............. A Explore orbit/remove 27.91 NA 15.66 2.70 NA 46.27 090
lesion.
61334............... .............. A Explore orbit/remove 18.24 NA 10.70 3.64 NA 32.58 090
object.
61340............... .............. A Subtemporal 18.63 NA 11.16 4.41 NA 34.20 090
decompression.
61343............... .............. A Incise skull (press 29.73 NA 16.88 7.28 NA 53.89 090
relief).
61345............... .............. A Relieve cranial 27.16 NA 15.47 6.31 NA 48.94 090
pressure.
61440............... .............. A Incise skull for 26.59 NA 14.28 6.72 NA 47.59 090
surgery.
61450............... .............. A Incise skull for 25.91 NA 14.35 6.16 NA 46.42 090
surgery.
61458............... .............. A Incise skull for 27.25 NA 15.58 6.37 NA 49.20 090
brain wound.
61460............... .............. A Incise skull for 28.35 NA 16.49 6.19 NA 51.03 090
surgery.
61470............... .............. A Incise skull for 26.02 NA 13.91 5.61 NA 45.54 090
surgery.
61480............... .............. A Incise skull for 26.45 NA 15.34 6.68 NA 48.47 090
surgery.
61490............... .............. A Incise skull for 25.62 NA 14.39 6.48 NA 46.49 090
surgery.
61500............... .............. A Removal of skull 17.89 NA 10.85 3.93 NA 32.67 090
lesion.
61501............... .............. A Remove infected skull 14.82 NA 9.25 3.17 NA 27.24 090
bone.
61510............... .............. A Removal of brain 28.41 NA 16.76 6.96 NA 52.13 090
lesion.
61512............... .............. A Remove brain lining 35.04 NA 19.76 8.61 NA 63.41 090
lesion.
61514............... .............. A Removal of brain 25.22 NA 14.50 6.18 NA 45.90 090
abscess.
61516............... .............. A Removal of brain 24.57 NA 14.33 5.96 NA 44.86 090
lesion.
61517............... .............. A Implt brain chemotx 1.38 NA 0.57 0.10 NA 2.05 ZZZ
add-on.
61518............... .............. A Removal of brain 37.26 NA 21.20 9.08 NA 67.54 090
lesion.
61519............... .............. A Remove brain lining 41.33 NA 22.75 9.83 NA 73.91 090
lesion.
61520............... .............. A Removal of brain 54.76 NA 30.46 12.18 NA 97.40 090
lesion.
61521............... .............. A Removal of brain 44.41 NA 24.33 10.67 NA 79.41 090
lesion.
61522............... .............. A Removal of brain 29.41 NA 16.49 6.39 NA 52.29 090
abscess.
61524............... .............. A Removal of brain 27.82 NA 15.74 6.04 NA 49.60 090
lesion.
61526............... .............. A Removal of brain 52.09 NA 29.62 8.10 NA 89.81 090
lesion.
61530............... .............. A Removal of brain 43.79 NA 25.19 7.44 NA 76.42 090
lesion.
61531............... .............. A Implant brain 14.61 NA 9.17 3.43 NA 27.21 090
electrodes.
61533............... .............. A Implant brain 19.68 NA 11.59 4.58 NA 35.85 090
electrodes.
61534............... .............. A Removal of brain 20.94 NA 12.15 5.01 NA 38.10 090
lesion.
61535............... .............. A Remove brain 11.61 NA 7.46 2.76 NA 21.83 090
electrodes.
61536............... .............. A Removal of brain 35.47 NA 19.87 8.06 NA 63.40 090
lesion.
61537............... .............. A Removal of brain 24.96 NA 14.45 6.49 NA 45.90 090
tissue.
61538............... .............. A Removal of brain 26.77 NA 15.38 6.49 NA 48.64 090
tissue.
61539............... .............. A Removal of brain 32.03 NA 17.85 7.98 NA 57.86 090
tissue.
61540............... .............. A Removal of brain 29.96 NA 17.48 7.98 NA 55.42 090
tissue.
61541............... .............. A Incision of brain 28.81 NA 16.28 6.63 NA 51.72 090
tissue.
61542............... .............. A Removal of brain 30.97 NA 17.91 7.83 NA 56.71 090
tissue.
61543............... .............. A Removal of brain 29.18 NA 16.46 7.37 NA 53.01 090
tissue.
61544............... .............. A Remove & treat brain 25.46 NA 13.90 5.92 NA 45.28 090
lesion.
61545............... .............. A Excision of brain 43.73 NA 24.33 10.71 NA 78.77 090
tumor.
61546............... .............. A Removal of pituitary 31.25 NA 17.58 7.31 NA 56.14 090
gland.
61548............... .............. A Removal of pituitary 21.50 NA 12.85 4.38 NA 38.73 090
gland.
61550............... .............. A Release of skull 14.63 NA 7.01 1.37 NA 23.01 090
seams.
61552............... .............. A Release of skull 19.53 NA 9.20 1.06 NA 29.79 090
seams.
61556............... .............. A Incise skull/sutures. 22.23 NA 11.42 4.31 NA 37.96 090
61557............... .............. A Incise skull/sutures. 22.35 NA 13.68 5.64 NA 41.67 090
61558............... .............. A Excision of skull/ 25.54 NA 14.25 3.15 NA 42.94 090
sutures.
61559............... .............. A Excision of skull/ 32.74 NA 19.39 8.27 NA 60.40 090
sutures.
61563............... .............. A Excision of skull 26.79 NA 15.33 5.38 NA 47.50 090
tumor.
[[Page 1179]]
61564............... .............. A Excision of skull 33.78 NA 18.37 8.54 NA 60.69 090
tumor.
61566............... .............. A Removal of brain 30.95 NA 17.42 6.49 NA 54.86 090
tissue.
61567............... .............. A Incision of brain 35.45 NA 20.73 6.49 NA 62.67 090
tissue.
61570............... .............. A Remove foreign body, 24.56 NA 13.97 5.55 NA 44.08 090
brain.
61571............... .............. A Incise skull for 26.35 NA 15.21 6.31 NA 47.87 090
brain wound.
61575............... .............. A Skull base/brainstem 34.31 NA 19.74 6.05 NA 60.10 090
surgery.
61576............... .............. A Skull base/brainstem 52.35 NA 29.68 5.64 NA 87.67 090
surgery.
61580............... .............. A Craniofacial 30.30 NA 25.49 3.32 NA 59.11 090
approach, skull.
61581............... .............. A Craniofacial 34.55 NA 23.05 4.06 NA 61.66 090
approach, skull.
61582............... .............. A Craniofacial 31.61 NA 26.99 7.60 NA 66.20 090
approach, skull.
61583............... .............. A Craniofacial 36.16 NA 25.01 8.37 NA 69.54 090
approach, skull.
61584............... .............. A Orbitocranial 34.60 NA 24.41 7.88 NA 66.89 090
approach/skull.
61585............... .............. A Orbitocranial 38.55 NA 26.46 7.47 NA 72.48 090
approach/skull.
61586............... .............. A Resect nasopharynx, 25.06 NA 22.35 4.25 NA 51.66 090
skull.
61590............... .............. A Infratemporal 41.72 NA 28.81 5.16 NA 75.69 090
approach/skull.
61591............... .............. A Infratemporal 43.61 NA 29.71 6.34 NA 79.66 090
approach/skull.
61592............... .............. A Orbitocranial 39.58 NA 26.60 9.11 NA 75.29 090
approach/skull.
61595............... .............. A Transtemporal 29.53 NA 22.51 3.68 NA 55.72 090
approach/skull.
61596............... .............. A Transcochlear 35.58 NA 24.59 5.13 NA 65.30 090
approach/skull.
61597............... .............. A Transcondylar 37.90 NA 23.05 8.02 NA 68.97 090
approach/skull.
61598............... .............. A Transpetrosal 33.36 NA 23.35 5.55 NA 62.26 090
approach/skull.
61600............... .............. A Resect/excise cranial 25.81 NA 19.88 3.76 NA 49.45 090
lesion.
61601............... .............. A Resect/excise cranial 27.85 NA 20.56 6.38 NA 54.79 090
lesion.
61605............... .............. A Resect/excise cranial 29.29 NA 22.16 3.03 NA 54.48 090
lesion.
61606............... .............. A Resect/excise cranial 38.77 NA 25.23 8.21 NA 72.21 090
lesion.
61607............... .............. A Resect/excise cranial 36.22 NA 23.88 6.86 NA 66.96 090
lesion.
61608............... .............. A Resect/excise cranial 42.04 NA 26.67 10.02 NA 78.73 090
lesion.
61609............... .............. A Transect artery, 9.88 NA 4.87 2.50 NA 17.25 ZZZ
sinus.
61610............... .............. A Transect artery, 29.63 NA 13.19 4.25 NA 47.07 ZZZ
sinus.
61611............... .............. A Transect artery, 7.41 NA 3.84 1.87 NA 13.12 ZZZ
sinus.
61612............... .............. A Transect artery, 27.84 NA 13.36 4.28 NA 45.48 ZZZ
sinus.
61613............... .............. A Remove aneurysm, 40.80 NA 26.34 10.03 NA 77.17 090
sinus.
61615............... .............. A Resect/excise lesion, 32.02 NA 22.82 5.60 NA 60.44 090
skull.
61616............... .............. A Resect/excise lesion, 43.27 NA 28.77 8.47 NA 80.51 090
skull.
61618............... .............. A Repair dura.......... 16.96 NA 10.51 3.52 NA 30.99 090
61619............... .............. A Repair dura.......... 20.68 NA 12.31 4.12 NA 37.11 090
61623............... .............. A Endovasc tempory 9.95 NA 4.23 0.60 NA 14.78 000
vessel occl.
61624............... .............. A Transcath occlusion, 20.12 NA 6.93 1.39 NA 28.44 000
cns.
61626............... .............. A Transcath occlusion, 16.60 NA 5.54 1.01 NA 23.15 000
non-cns.
61680............... .............. A Intracranial vessel 30.66 NA 17.52 7.28 NA 55.46 090
surgery.
61682............... .............. A Intracranial vessel 61.48 NA 32.37 15.31 NA 109.16 090
surgery.
61684............... .............. A Intracranial vessel 39.75 NA 22.10 9.49 NA 71.34 090
surgery.
61686............... .............. A Intracranial vessel 64.39 NA 34.88 15.92 NA 115.19 090
surgery.
61690............... .............. A Intracranial vessel 29.27 NA 16.80 6.65 NA 52.72 090
surgery.
61692............... .............. A Intracranial vessel 51.79 NA 27.61 12.27 NA 91.67 090
surgery.
61697............... .............. A Brain aneurysm repr, 50.44 NA 28.13 12.43 NA 91.00 090
complx.
61698............... .............. A Brain aneurysm repr, 48.34 NA 26.80 12.05 NA 87.19 090
complx.
61700............... .............. A Brain aneurysm repr, 50.44 NA 27.93 12.28 NA 90.65 090
simple.
61702............... .............. A Inner skull vessel 48.34 NA 26.15 11.76 NA 86.25 090
surgery.
61703............... .............. A Clamp neck artery.... 17.44 NA 10.52 4.37 NA 32.33 090
61705............... .............. A Revise circulation to 36.15 NA 19.34 8.04 NA 63.53 090
head.
61708............... .............. A Revise circulation to 35.25 NA 15.20 2.63 NA 53.08 090
head.
61710............... .............. A Revise circulation to 29.63 NA 13.66 2.92 NA 46.21 090
head.
61711............... .............. A Fusion of skull 36.28 NA 19.90 8.91 NA 65.09 090
arteries.
61720............... .............. A Incise skull/brain 16.74 NA 10.03 4.23 NA 31.00 090
surgery.
61735............... .............. A Incise skull/brain 20.40 NA 12.22 5.02 NA 37.64 090
surgery.
61750............... .............. A Incise skull/brain 18.17 NA 10.67 4.47 NA 33.31 090
biopsy.
61751............... .............. A Brain biopsy w/ct/mr 17.59 NA 10.86 4.31 NA 32.76 090
guide.
61760............... .............. A Implant brain 22.24 NA 8.77 5.54 NA 36.55 090
electrodes.
61770............... .............. A Incise skull for 21.41 NA 12.31 4.93 NA 38.65 090
treatment.
61790............... .............. A Treat trigeminal 10.84 NA 5.95 2.20 NA 18.99 090
nerve.
61791............... .............. A Treat trigeminal 14.59 NA 8.96 3.65 NA 27.20 090
tract.
61793............... .............. A Focus radiation beam. 17.21 NA 10.16 4.23 NA 31.60 090
61795............... .............. A Brain surgery using 4.03 NA 2.04 0.98 NA 7.05 ZZZ
computer.
61850............... .............. A Implant 12.37 NA 7.71 2.69 NA 22.77 090
neuroelectrodes.
61860............... .............. A Implant 20.84 NA 12.13 4.87 NA 37.84 090
neuroelectrodes.
61862............... .............. D Implant neurostimul, 0.00 0.00 0.00 0.00 0.00 0.00 090
subcort.
61863............... .............. A Implant 18.97 NA 9.21 4.79 NA 32.97 090
neuroelectrode.
61864............... .............. A Implant 4.49 NA 2.29 1.13 NA 7.91 ZZZ
neuroelectrde, add'l.
61867............... .............. A Implant 31.29 NA 13.81 4.79 NA 49.89 090
neuroelectrode.
61868............... .............. A Implant 7.91 NA 4.03 1.21 NA 13.15 ZZZ
neuroelectrde, add'l.
61870............... .............. A Implant 14.92 NA 9.82 2.05 NA 26.79 090
neuroelectrodes.
61875............... .............. A Implant 15.04 NA 8.61 2.92 NA 26.57 090
neuroelectrodes.
61880............... .............. A Revise/remove 6.28 NA 4.60 1.58 NA 12.46 090
neuroelectrode.
61885............... .............. A Implant neurostim one 5.84 NA 5.32 1.47 NA 12.63 090
array.
[[Page 1180]]
61886............... .............. A Implant neurostim 7.99 NA 6.36 1.98 NA 16.33 090
arrays.
61888............... .............. A Revise/remove 5.06 NA 3.88 1.25 NA 10.19 010
neuroreceiver.
62000............... .............. A Treat skull fracture. 12.51 NA 5.55 1.05 NA 19.11 090
62005............... .............. A Treat skull fracture. 16.15 NA 8.83 2.81 NA 27.79 090
62010............... .............. A Treatment of head 19.78 NA 11.75 4.88 NA 36.41 090
injury.
62100............... .............. A Repair brain fluid 22.00 NA 12.85 4.91 NA 39.76 090
leakage.
62115............... .............. A Reduction of skull 21.63 NA 11.69 5.46 NA 38.78 090
defect.
62116............... .............. A Reduction of skull 23.55 NA 13.42 5.85 NA 42.82 090
defect.
62117............... .............. A Reduction of skull 26.56 NA 15.44 6.71 NA 48.71 090
defect.
62120............... .............. A Repair skull cavity 23.31 NA 14.33 3.70 NA 41.34 090
lesion.
62121............... .............. A Incise skull repair.. 21.55 NA 12.75 2.98 NA 37.28 090
62140............... .............. A Repair of skull 13.49 NA 8.36 3.14 NA 24.99 090
defect.
62141............... .............. A Repair of skull 14.89 NA 9.10 3.44 NA 27.43 090
defect.
62142............... .............. A Remove skull plate/ 10.77 NA 7.03 2.53 NA 20.33 090
flap.
62143............... .............. A Replace skull plate/ 13.03 NA 8.08 3.08 NA 24.19 090
flap.
62145............... .............. A Repair of skull & 18.79 NA 10.95 4.60 NA 34.34 090
brain.
62146............... .............. A Repair of skull with 16.10 NA 9.68 3.55 NA 29.33 090
graft.
62147............... .............. A Repair of skull with 19.31 NA 11.38 4.39 NA 35.08 090
graft.
62148............... .............. A Retr bone flap to fix 2.00 NA 0.82 0.52 NA 3.34 ZZZ
skull.
62160............... .............. A Neuroendoscopy add-on 3.00 NA 1.14 0.63 NA 4.77 ZZZ
62161............... .............. A Dissect brain w/scope 19.97 NA 9.56 4.46 NA 33.99 090
62162............... .............. A Remove colloid cyst w/ 25.21 NA 11.69 6.96 NA 43.86 090
scope.
62163............... .............. A Neuroendoscopy w/fb 15.48 NA 7.85 4.46 NA 27.79 090
removal.
62164............... .............. A Remove brain tumor w/ 27.46 NA 12.90 6.96 NA 47.32 090
scope.
62165............... .............. A Remove pituit tumor w/ 21.97 NA 10.51 4.38 NA 36.86 090
scope.
62180............... .............. A Establish brain 21.03 NA 12.34 5.21 NA 38.58 090
cavity shunt.
62190............... .............. A Establish brain 11.05 NA 7.11 2.63 NA 20.79 090
cavity shunt.
62192............... .............. A Establish brain 12.23 NA 7.66 2.97 NA 22.86 090
cavity shunt.
62194............... .............. A Replace/irrigate 5.02 NA 2.79 0.60 NA 8.41 010
catheter.
62200............... .............. A Establish brain 18.29 NA 10.89 4.46 NA 33.64 090
cavity shunt.
62201............... .............. A Brain cavity shunt w/ 14.84 NA 9.49 3.04 NA 27.37 090
scope.
62220............... .............. A Establish brain 12.98 NA 8.02 3.05 NA 24.05 090
cavity shunt.
62223............... .............. A Establish brain 12.85 NA 8.28 3.11 NA 24.24 090
cavity shunt.
62225............... .............. A Replace/irrigate 5.40 NA 4.11 1.31 NA 10.82 090
catheter.
62230............... .............. A Replace/revise brain 10.52 NA 6.51 2.53 NA 19.56 090
shunt.
62252............... .............. A Csf shunt reprogram.. 0.74 1.48 NA 0.21 2.43 NA XXX
62252............... 26............ A Csf shunt reprogram.. 0.74 0.37 0.37 0.19 1.30 1.30 XXX
62252............... TC............ A Csf shunt reprogram.. 0.00 1.11 NA 0.02 1.13 NA XXX
62256............... .............. A Remove brain cavity 6.59 NA 4.72 1.62 NA 12.93 090
shunt.
62258............... .............. A Replace brain cavity 14.52 NA 8.74 3.51 NA 26.77 090
shunt.
62263............... .............. A Epidural lysis mult 6.13 11.87 2.39 0.51 18.51 9.03 010
sessions.
62264............... .............. A Epidural lysis on 4.42 7.66 1.40 0.36 12.44 6.18 010
single day.
62268............... .............. A Drain spinal cord 4.73 10.58 2.18 0.35 15.66 7.26 000
cyst.
62269............... .............. A Needle biopsy, spinal 5.01 12.80 2.01 0.35 18.16 7.37 000
cord.
62270............... .............. A Spinal fluid tap, 1.13 3.08 0.49 0.07 4.28 1.69 000
diagnostic.
62272............... .............. A Drain cerebro spinal 1.35 3.68 0.64 0.16 5.19 2.15 000
fluid.
62273............... .............. A Treat epidural spine 2.15 2.73 0.57 0.17 5.05 2.89 000
lesion.
62280............... .............. A Treat spinal cord 2.63 6.59 0.88 0.21 9.43 3.72 010
lesion.
62281............... .............. A Treat spinal cord 2.66 5.76 0.77 0.19 8.61 3.62 010
lesion.
62282............... .............. A Treat spinal canal 2.33 8.20 0.79 0.17 10.70 3.29 010
lesion.
62284............... .............. A Injection for 1.54 4.88 0.60 0.12 6.54 2.26 000
myelogram.
62287............... .............. A Percutaneous 8.07 NA 5.52 0.80 NA 14.39 090
diskectomy.
62290............... .............. A Inject for spine disk 3.00 6.81 1.28 0.24 10.05 4.52 000
x-ray.
62291............... .............. A Inject for spine disk 2.91 5.69 1.13 0.21 8.81 4.25 000
x-ray.
62292............... .............. A Injection into disk 7.85 NA 4.50 0.78 NA 13.13 090
lesion.
62294............... .............. A Injection into spinal 11.81 NA 5.62 1.03 NA 18.46 090
artery.
62310............... .............. A Inject spine c/t..... 1.91 4.83 0.50 0.13 6.87 2.54 000
62311............... .............. A Inject spine l/s (cd) 1.54 4.91 0.45 0.11 6.56 2.10 000
62318............... .............. A Inject spine w/cath, 2.04 5.51 0.51 0.14 7.69 2.69 000
c/t.
62319............... .............. A Inject spine w/cath l/ 1.87 4.82 0.47 0.13 6.82 2.47 000
s (cd).
62350............... .............. A Implant spinal canal 6.86 NA 3.99 0.77 NA 11.62 090
cath.
62351............... .............. A Implant spinal canal 9.99 NA 7.10 2.16 NA 19.25 090
cath.
62355............... .............. A Remove spinal canal 5.44 NA 3.20 0.57 NA 9.21 090
catheter.
62360............... .............. A Insert spine infusion 2.62 NA 2.71 0.25 NA 5.58 090
device.
62361............... .............. A Implant spine 5.41 NA 3.91 0.60 NA 9.92 090
infusion pump.
62362............... .............. A Implant spine 7.03 NA 4.38 1.04 NA 12.45 090
infusion pump.
62365............... .............. A Remove spine infusion 5.41 NA 3.60 0.70 NA 9.71 090
device.
62367............... .............. C Analyze spine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infusion pump.
62367............... 26............ A Analyze spine 0.48 0.13 0.13 0.04 0.65 0.65 XXX
infusion pump.
62367............... TC............ C Analyze spine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infusion pump.
62368............... .............. C Analyze spine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infusion pump.
62368............... 26............ A Analyze spine 0.75 0.19 0.19 0.06 1.00 1.00 XXX
infusion pump.
62368............... TC............ C Analyze spine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infusion pump.
63001............... .............. A Removal of spinal 15.80 NA 9.52 3.65 NA 28.97 090
lamina.
63003............... .............. A Removal of spinal 15.93 NA 9.86 3.59 NA 29.38 090
lamina.
[[Page 1181]]
63005............... .............. A Removal of spinal 14.90 NA 9.93 3.16 NA 27.99 090
lamina.
63011............... .............. A Removal of spinal 14.50 NA 8.26 1.72 NA 24.48 090
lamina.
63012............... .............. A Removal of spinal 15.38 NA 10.09 3.27 NA 28.74 090
lamina.
63015............... .............. A Removal of spinal 19.32 NA 11.89 4.63 NA 35.84 090
lamina.
63016............... .............. A Removal of spinal 19.17 NA 11.79 4.37 NA 35.33 090
lamina.
63017............... .............. A Removal of spinal 15.92 NA 10.36 3.51 NA 29.79 090
lamina.
63020............... .............. A Neck spine disk 14.79 NA 9.67 3.49 NA 27.95 090
surgery.
63030............... .............. A Low back disk surgery 11.98 NA 8.39 2.67 NA 23.04 090
63035............... .............. A Spinal disk surgery 3.15 NA 1.59 0.69 NA 5.43 ZZZ
add-on.
63040............... .............. A Laminotomy, single 18.78 NA 11.50 4.05 NA 34.33 090
cervical.
63042............... .............. A Laminotomy, single 17.44 NA 11.30 3.75 NA 32.49 090
lumbar.
63043............... .............. C Laminotomy, add'l 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
cervical.
63044............... .............. C Laminotomy, add'l 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
lumbar.
63045............... .............. A Removal of spinal 16.48 NA 10.35 3.85 NA 30.68 090
lamina.
63046............... .............. A Removal of spinal 15.78 NA 10.16 3.49 NA 29.43 090
lamina.
63047............... .............. A Removal of spinal 14.59 NA 9.85 3.15 NA 27.59 090
lamina.
63048............... .............. A Remove spinal lamina 3.26 NA 1.67 0.70 NA 5.63 ZZZ
add-on.
63055............... .............. A Decompress spinal 21.96 NA 13.14 4.93 NA 40.03 090
cord.
63056............... .............. A Decompress spinal 20.33 NA 12.54 4.03 NA 36.90 090
cord.
63057............... .............. A Decompress spine cord 5.25 NA 2.64 0.98 NA 8.87 ZZZ
add-on.
63064............... .............. A Decompress spinal 24.57 NA 14.45 5.69 NA 44.71 090
cord.
63066............... .............. A Decompress spine cord 3.26 NA 1.67 0.76 NA 5.69 ZZZ
add-on.
63075............... .............. A Neck spine disk 19.38 NA 12.08 4.50 NA 35.96 090
surgery.
63076............... .............. A Neck spine disk 4.04 NA 2.06 0.94 NA 7.04 ZZZ
surgery.
63077............... .............. A Spine disk surgery, 21.41 NA 12.76 4.15 NA 38.32 090
thorax.
63078............... .............. A Spine disk surgery, 3.28 NA 1.64 0.60 NA 5.52 ZZZ
thorax.
63081............... .............. A Removal of vertebral 23.69 NA 14.33 5.38 NA 43.40 090
body.
63082............... .............. A Remove vertebral body 4.36 NA 2.23 0.99 NA 7.58 ZZZ
add-on.
63085............... .............. A Removal of vertebral 26.88 NA 15.47 5.67 NA 48.02 090
body.
63086............... .............. A Remove vertebral body 3.19 NA 1.60 0.66 NA 5.45 ZZZ
add-on.
63087............... .............. A Removal of vertebral 35.52 NA 19.45 7.08 NA 62.05 090
body.
63088............... .............. A Remove vertebral body 4.32 NA 2.18 0.93 NA 7.43 ZZZ
add-on.
63090............... .............. A Removal of vertebral 28.12 NA 16.01 5.15 NA 49.28 090
body.
63091............... .............. A Remove vertebral body 3.03 NA 1.46 0.54 NA 5.03 ZZZ
add-on.
63101............... .............. A Removal of vertebral 31.95 NA 19.34 5.69 NA 56.98 090
body.
63102............... .............. A Removal of vertebral 31.95 NA 19.34 5.69 NA 56.98 090
body.
63103............... .............. A Remove vertebral body 3.89 NA 2.01 0.76 NA 6.66 ZZZ
add-on.
63170............... .............. A Incise spinal cord 19.80 NA 12.06 4.69 NA 36.55 090
tract(s).
63172............... .............. A Drainage of spinal 17.63 NA 10.85 4.17 NA 32.65 090
cyst.
63173............... .............. A Drainage of spinal 21.96 NA 13.03 4.99 NA 39.98 090
cyst.
63180............... .............. A Revise spinal cord 18.24 NA 11.21 4.62 NA 34.07 090
ligaments.
63182............... .............. A Revise spinal cord 20.47 NA 11.18 4.20 NA 35.85 090
ligaments.
63185............... .............. A Incise spinal column/ 15.02 NA 8.25 2.51 NA 25.78 090
nerves.
63190............... .............. A Incise spinal column/ 17.42 NA 10.31 3.47 NA 31.20 090
nerves.
63191............... .............. A Incise spinal column/ 17.51 NA 10.68 4.22 NA 32.41 090
nerves.
63194............... .............. A Incise spinal column 19.16 NA 11.89 4.84 NA 35.89 090
& cord.
63195............... .............. A Incise spinal column 18.81 NA 11.24 4.15 NA 34.20 090
& cord.
63196............... .............. A Incise spinal column 22.27 NA 13.58 5.62 NA 41.47 090
& cord.
63197............... .............. A Incise spinal column 21.08 NA 12.39 5.33 NA 38.80 090
& cord.
63198............... .............. A Incise spinal column 25.34 NA 8.63 6.40 NA 40.37 090
& cord.
63199............... .............. A Incise spinal column 26.85 NA 15.24 6.78 NA 48.87 090
& cord.
63200............... .............. A Release of spinal 19.15 NA 11.48 4.35 NA 34.98 090
cord.
63250............... .............. A Revise spinal cord 40.70 NA 20.03 9.23 NA 69.96 090
vessels.
63251............... .............. A Revise spinal cord 41.14 NA 22.69 9.62 NA 73.45 090
vessels.
63252............... .............. A Revise spinal cord 41.13 NA 22.33 9.35 NA 72.81 090
vessels.
63265............... .............. A Excise intraspinal 21.53 NA 12.81 5.17 NA 39.51 090
lesion.
63266............... .............. A Excise intraspinal 22.27 NA 13.22 5.39 NA 40.88 090
lesion.
63267............... .............. A Excise intraspinal 17.92 NA 11.09 4.22 NA 33.23 090
lesion.
63268............... .............. A Excise intraspinal 18.49 NA 10.42 3.84 NA 32.75 090
lesion.
63270............... .............. A Excise intraspinal 26.76 NA 15.52 6.53 NA 48.81 090
lesion.
63271............... .............. A Excise intraspinal 26.88 NA 15.63 6.71 NA 49.22 090
lesion.
63272............... .............. A Excise intraspinal 25.28 NA 14.73 6.11 NA 46.12 090
lesion.
63273............... .............. A Excise intraspinal 24.25 NA 14.39 6.13 NA 44.77 090
lesion.
63275............... .............. A Biopsy/excise spinal 23.64 NA 13.83 5.64 NA 43.11 090
tumor.
63276............... .............. A Biopsy/excise spinal 23.41 NA 13.72 5.58 NA 42.71 090
tumor.
63277............... .............. A Biopsy/excise spinal 20.80 NA 12.54 4.86 NA 38.20 090
tumor.
63278............... .............. A Biopsy/excise spinal 20.53 NA 12.39 4.85 NA 37.77 090
tumor.
63280............... .............. A Biopsy/excise spinal 28.31 NA 16.37 7.00 NA 51.68 090
tumor.
63281............... .............. A Biopsy/excise spinal 28.01 NA 16.22 6.84 NA 51.07 090
tumor.
63282............... .............. A Biopsy/excise spinal 26.35 NA 15.38 6.43 NA 48.16 090
tumor.
63283............... .............. A Biopsy/excise spinal 24.96 NA 14.71 6.18 NA 45.85 090
tumor.
63285............... .............. A Biopsy/excise spinal 35.95 NA 20.01 8.82 NA 64.78 090
tumor.
63286............... .............. A Biopsy/excise spinal 35.58 NA 19.97 8.53 NA 64.08 090
tumor.
63287............... .............. A Biopsy/excise spinal 36.64 NA 20.53 9.02 NA 66.19 090
tumor.
63290............... .............. A Biopsy/excise spinal 37.32 NA 20.66 9.23 NA 67.21 090
tumor.
[[Page 1182]]
63300............... .............. A Removal of vertebral 24.39 NA 14.34 5.77 NA 44.50 090
body.
63301............... .............. A Removal of vertebral 27.56 NA 15.58 6.07 NA 49.21 090
body.
63302............... .............. A Removal of vertebral 27.77 NA 15.88 6.33 NA 49.98 090
body.
63303............... .............. A Removal of vertebral 30.45 NA 16.92 6.28 NA 53.65 090
body.
63304............... .............. A Removal of vertebral 30.28 NA 17.34 5.69 NA 53.31 090
body.
63305............... .............. A Removal of vertebral 31.98 NA 18.06 6.50 NA 56.54 090
body.
63306............... .............. A Removal of vertebral 32.17 NA 17.84 2.88 NA 52.89 090
body.
63307............... .............. A Removal of vertebral 31.58 NA 16.82 5.10 NA 53.50 090
body.
63308............... .............. A Remove vertebral body 5.24 NA 2.62 1.22 NA 9.08 ZZZ
add-on.
63600............... .............. A Remove spinal cord 14.00 NA 5.44 1.47 NA 20.91 090
lesion.
63610............... .............. A Stimulation of spinal 8.72 55.66 2.30 0.52 64.90 11.54 000
cord.
63615............... .............. A Remove lesion of 16.26 NA 9.41 3.44 NA 29.11 090
spinal cord.
63650............... .............. A Implant 6.73 NA 3.22 0.58 NA 10.53 090
neuroelectrodes.
63655............... .............. A Implant 10.27 NA 6.90 2.23 NA 19.40 090
neuroelectrodes.
63660............... .............. A Revise/remove 6.15 NA 3.63 0.78 NA 10.56 090
neuroelectrode.
63685............... .............. A Implant neuroreceiver 7.03 NA 4.16 1.16 NA 12.35 090
63688............... .............. A Revise/remove 5.38 NA 3.57 0.84 NA 9.79 090
neuroreceiver.
63700............... .............. A Repair of spinal 16.51 NA 10.27 3.24 NA 30.02 090
herniation.
63702............... .............. A Repair of spinal 18.45 NA 10.84 1.64 NA 30.93 090
herniation.
63704............... .............. A Repair of spinal 21.15 NA 12.89 4.63 NA 38.67 090
herniation.
63706............... .............. A Repair of spinal 24.07 NA 13.61 5.70 NA 43.38 090
herniation.
63707............... .............. A Repair spinal fluid 11.24 NA 7.68 2.36 NA 21.28 090
leakage.
63709............... .............. A Repair spinal fluid 14.30 NA 9.36 3.00 NA 26.66 090
leakage.
63710............... .............. A Graft repair of spine 14.05 NA 9.05 3.15 NA 26.25 090
defect.
63740............... .............. A Install spinal shunt. 11.34 NA 7.38 2.59 NA 21.31 090
63741............... .............. A Install spinal shunt. 8.24 NA 4.78 1.27 NA 14.29 090
63744............... .............. A Revision of spinal 8.09 NA 5.28 1.82 NA 15.19 090
shunt.
63746............... .............. A Removal of spinal 6.42 NA 3.80 1.39 NA 11.61 090
shunt.
64400............... .............. A N block inj, 1.11 2.01 0.37 0.07 3.19 1.55 000
trigeminal.
64402............... .............. A N block inj, facial.. 1.25 1.74 0.53 0.08 3.07 1.86 000
64405............... .............. A N block inj, 1.32 1.52 0.39 0.10 2.94 1.81 000
occipital.
64408............... .............. A N block inj, vagus... 1.41 1.58 0.66 0.11 3.10 2.18 000
64410............... .............. A N block inj, phrenic. 1.43 2.56 0.39 0.10 4.09 1.92 000
64412............... .............. A N block inj, spinal 1.18 2.71 0.37 0.10 3.99 1.65 000
accessor.
64413............... .............. A N block inj, cervical 1.40 1.88 0.43 0.11 3.39 1.94 000
plexus.
64415............... .............. A N block inj, brachial 1.48 2.84 0.39 0.10 4.42 1.97 000
plexus.
64416............... .............. A N block cont infuse, 3.49 NA 0.72 0.10 NA 4.31 010
b plex.
64417............... .............. A N block inj, axillary 1.44 3.09 0.42 0.11 4.64 1.97 000
64418............... .............. A N block inj, 1.32 2.65 0.37 0.08 4.05 1.77 000
suprascapular.
64420............... .............. A N block inj, 1.18 3.53 0.36 0.08 4.79 1.62 000
intercost, sng.
64421............... .............. A N block inj, 1.68 5.39 0.45 0.12 7.19 2.25 000
intercost, mlt.
64425............... .............. A N block inj ilio-ing/ 1.75 1.70 0.47 0.13 3.58 2.35 000
hypogi.
64430............... .............. A N block inj, pudendal 1.46 2.59 0.49 0.13 4.18 2.08 000
64435............... .............. A N block inj, 1.45 2.58 0.63 0.18 4.21 2.26 000
paracervical.
64445............... .............. A N block inj, sciatic, 1.48 2.69 0.37 0.10 4.27 1.95 000
sng.
64446............... .............. A N blk inj, sciatic, 3.25 NA 1.18 0.10 NA 4.53 010
cont inf.
64447............... .............. A N block inj fem, 1.50 NA 0.51 0.10 NA 2.11 000
single.
64448............... .............. A N block inj fem, cont 3.00 NA 1.03 0.10 NA 4.13 010
inf.
64449............... .............. A N block inj, lumbar 3.00 NA 0.97 0.10 NA 4.07 010
plexus.
64450............... .............. A N block, other 1.27 1.26 0.41 0.10 2.63 1.78 000
peripheral.
64470............... .............. A Inj paravertebral c/t 1.85 4.86 0.56 0.14 6.85 2.55 000
64472............... .............. A Inj paravertebral c/t 1.29 1.94 0.31 0.11 3.34 1.71 ZZZ
add-on.
64475............... .............. A Inj paravertebral l/s 1.41 4.56 0.47 0.11 6.08 1.99 000
64476............... .............. A Inj paravertebral l/s 0.98 1.82 0.25 0.07 2.87 1.30 ZZZ
add-on.
64479............... .............. A Inj foramen epidural 2.20 7.05 0.72 0.17 9.42 3.09 000
c/t.
64480............... .............. A Inj foramen epidural 1.54 2.41 0.46 0.11 4.06 2.11 ZZZ
add-on.
64483............... .............. A Inj foramen epidural 1.90 7.53 0.66 0.14 9.57 2.70 000
l/s.
64484............... .............. A Inj foramen epidural 1.33 2.80 0.37 0.10 4.23 1.80 ZZZ
add-on.
64505............... .............. A N block, 1.36 1.22 0.47 0.10 2.68 1.93 000
spenopalatine gangl.
64508............... .............. A N block, carotid 1.12 2.96 0.51 0.07 4.15 1.70 000
sinus s/p.
64510............... .............. A N block, stellate 1.22 3.20 0.37 0.08 4.50 1.67 000
ganglion.
64517............... .............. A N block inj, hypogas 2.20 2.70 0.87 0.13 5.03 3.20 000
plxs.
64520............... .............. A N block, lumbar/ 1.35 4.56 0.41 0.10 6.01 1.86 000
thoracic.
64530............... .............. A N block inj, celiac 1.58 3.94 0.47 0.11 5.63 2.16 000
pelus.
64550............... .............. A Apply neurostimulator 0.18 0.30 0.05 0.01 0.49 0.24 000
64553............... .............. A Implant 2.31 2.70 1.86 0.21 5.22 4.38 010
neuroelectrodes.
64555............... .............. A Implant 2.27 3.09 1.20 0.13 5.49 3.60 010
neuroelectrodes.
64560............... .............. A Implant 2.36 2.64 1.30 0.21 5.21 3.87 010
neuroelectrodes.
64561............... .............. A Implant 6.73 NA 3.16 0.13 NA 10.02 010
neuroelectrodes.
64565............... .............. A Implant 1.76 3.35 1.26 0.10 5.21 3.12 010
neuroelectrodes.
64573............... .............. A Implant 7.49 NA 5.23 1.79 NA 14.51 090
neuroelectrodes.
64575............... .............. A Implant 4.34 NA 2.70 0.45 NA 7.49 090
neuroelectrodes.
64577............... .............. A Implant 4.61 NA 3.32 0.60 NA 8.53 090
neuroelectrodes.
64580............... .............. A Implant 4.11 NA 3.55 0.25 NA 7.91 090
neuroelectrodes.
64581............... .............. A Implant 13.48 NA 5.41 0.45 NA 19.34 090
neuroelectrodes.
[[Page 1183]]
64585............... .............. A Revise/remove 2.06 11.57 1.71 0.35 13.98 4.12 010
neuroelectrode.
64590............... .............. A Implant neuroreceiver 2.40 7.26 1.90 0.48 10.14 4.78 010
64595............... .............. A Revise/remove 1.73 10.69 1.49 0.27 12.69 3.49 010
neuroreceiver.
64600............... .............. A Injection treatment 3.44 8.45 1.57 0.34 12.23 5.35 010
of nerve.
64605............... .............. A Injection treatment 5.60 8.59 2.05 0.64 14.83 8.29 010
of nerve.
64610............... .............. A Injection treatment 7.15 7.89 3.58 1.35 16.39 12.08 010
of nerve.
64612............... .............. A Destroy nerve, face 1.96 2.62 1.08 0.11 4.69 3.15 010
muscle.
64613............... .............. A Destroy nerve, spine 1.96 2.97 0.99 0.12 5.05 3.07 010
muscle.
64614............... .............. A Destroy nerve, extrem 2.20 3.24 1.12 0.11 5.55 3.43 010
musc.
64620............... .............. A Injection treatment 2.84 4.60 1.18 0.21 7.65 4.23 010
of nerve.
64622............... .............. A Destr paravertebrl 3.00 7.62 1.23 0.21 10.83 4.44 010
nerve l/s.
64623............... .............. A Destr paravertebral n 0.99 2.42 0.23 0.07 3.48 1.29 ZZZ
add-on.
64626............... .............. A Destr paravertebrl 3.28 6.67 1.85 0.27 10.22 5.40 010
nerve c/t.
64627............... .............. A Destr paravertebral n 1.16 2.61 0.27 0.10 3.87 1.53 ZZZ
add-on.
64630............... .............. A Injection treatment 3.00 2.73 1.28 0.19 5.92 4.47 010
of nerve.
64640............... .............. A Injection treatment 2.76 4.24 1.67 0.13 7.13 4.56 010
of nerve.
64680............... .............. A Injection treatment 2.62 5.97 1.28 0.18 8.77 4.08 010
of nerve.
64681............... .............. A Injection treatment 3.54 8.71 2.10 0.18 12.43 5.82 010
of nerve.
64702............... .............. A Revise finger/toe 4.22 NA 3.82 0.62 NA 8.66 090
nerve.
64704............... .............. A Revise hand/foot 4.56 NA 3.28 0.71 NA 8.55 090
nerve.
64708............... .............. A Revise arm/leg nerve. 6.11 NA 4.83 0.99 NA 11.93 090
64712............... .............. A Revision of sciatic 7.74 NA 4.99 0.65 NA 13.38 090
nerve.
64713............... .............. A Revision of arm 10.98 NA 5.90 1.22 NA 18.10 090
nerve(s).
64714............... .............. A Revise low back 10.31 NA 4.24 0.77 NA 15.32 090
nerve(s).
64716............... .............. A Revision of cranial 6.30 NA 5.26 0.71 NA 12.27 090
nerve.
64718............... .............. A Revise ulnar nerve at 5.98 NA 5.87 1.05 NA 12.90 090
elbow.
64719............... .............. A Revise ulnar nerve at 4.84 NA 4.46 0.76 NA 10.06 090
wrist.
64721............... .............. A Carpal tunnel surgery 4.28 4.95 4.95 0.71 9.94 9.94 090
64722............... .............. A Relieve pressure on 4.69 NA 3.06 0.39 NA 8.14 090
nerve(s).
64726............... .............. A Release foot/toe 4.17 NA 2.76 0.69 NA 7.62 090
nerve.
64727............... .............. A Internal nerve 3.10 NA 1.51 0.48 NA 5.09 ZZZ
revision.
64732............... .............. A Incision of brow 4.40 NA 3.53 0.93 NA 8.86 090
nerve.
64734............... .............. A Incision of cheek 4.91 NA 4.06 1.00 NA 9.97 090
nerve.
64736............... .............. A Incision of chin 4.59 NA 4.03 0.86 NA 9.48 090
nerve.
64738............... .............. A Incision of jaw nerve 5.72 NA 4.62 1.01 NA 11.35 090
64740............... .............. A Incision of tongue 5.58 NA 4.39 0.52 NA 10.49 090
nerve.
64742............... .............. A Incision of facial 6.21 NA 4.74 0.83 NA 11.78 090
nerve.
64744............... .............. A Incise nerve, back of 5.23 NA 3.79 1.18 NA 10.20 090
head.
64746............... .............. A Incise diaphragm 5.92 NA 4.53 0.90 NA 11.35 090
nerve.
64752............... .............. A Incision of vagus 7.05 NA 4.31 1.00 NA 12.36 090
nerve.
64755............... .............. A Incision of stomach 13.50 NA 5.68 1.40 NA 20.58 090
nerves.
64760............... .............. A Incision of vagus 6.95 NA 3.52 0.62 NA 11.09 090
nerve.
64761............... .............. A Incision of pelvis 6.40 NA 3.56 0.31 NA 10.27 090
nerve.
64763............... .............. A Incise hip/thigh 6.92 NA 5.24 0.93 NA 13.09 090
nerve.
64766............... .............. A Incise hip/thigh 8.66 NA 5.26 1.19 NA 15.11 090
nerve.
64771............... .............. A Sever cranial nerve.. 7.34 NA 5.58 1.59 NA 14.51 090
64772............... .............. A Incision of spinal 7.20 NA 4.93 1.45 NA 13.58 090
nerve.
64774............... .............. A Remove skin nerve 5.16 NA 3.81 0.72 NA 9.69 090
lesion.
64776............... .............. A Remove digit nerve 5.11 NA 3.67 0.76 NA 9.54 090
lesion.
64778............... .............. A Digit nerve surgery 3.11 NA 1.50 0.46 NA 5.07 ZZZ
add-on.
64782............... .............. A Remove limb nerve 6.22 NA 3.75 0.95 NA 10.92 090
lesion.
64783............... .............. A Limb nerve surgery 3.71 NA 1.85 0.58 NA 6.14 ZZZ
add-on.
64784............... .............. A Remove nerve lesion.. 9.81 NA 6.57 1.41 NA 17.79 090
64786............... .............. A Remove sciatic nerve 15.44 NA 9.84 2.68 NA 27.96 090
lesion.
64787............... .............. A Implant nerve end.... 4.29 NA 2.13 0.68 NA 7.10 ZZZ
64788............... .............. A Remove skin nerve 4.60 NA 3.47 0.65 NA 8.72 090
lesion.
64790............... .............. A Removal of nerve 11.29 NA 7.19 2.03 NA 20.51 090
lesion.
64792............... .............. A Removal of nerve 14.90 NA 8.84 2.27 NA 26.01 090
lesion.
64795............... .............. A Biopsy of nerve...... 3.01 NA 1.59 0.48 NA 5.08 000
64802............... .............. A Remove sympathetic 9.14 NA 5.17 1.05 NA 15.36 090
nerves.
64804............... .............. A Remove sympathetic 14.62 NA 7.20 2.16 NA 23.98 090
nerves.
64809............... .............. A Remove sympathetic 13.65 NA 5.80 1.16 NA 20.61 090
nerves.
64818............... .............. A Remove sympathetic 10.28 NA 5.33 1.30 NA 16.91 090
nerves.
64820............... .............. A Remove sympathetic 10.35 NA 7.11 1.41 NA 18.87 090
nerves.
64821............... .............. A Remove sympathetic 8.74 NA 7.35 1.19 NA 17.28 090
nerves.
64822............... .............. A Remove sympathetic 8.74 NA 7.27 1.19 NA 17.20 090
nerves.
64823............... .............. A Remove sympathetic 10.35 NA 8.18 1.41 NA 19.94 090
nerves.
64831............... .............. A Repair of digit nerve 9.43 NA 7.05 1.37 NA 17.85 090
64832............... .............. A Repair nerve add-on.. 5.65 NA 2.95 0.82 NA 9.42 ZZZ
64834............... .............. A Repair of hand or 10.17 NA 7.08 1.48 NA 18.73 090
foot nerve.
64835............... .............. A Repair of hand or 10.92 NA 7.67 1.64 NA 20.23 090
foot nerve.
64836............... .............. A Repair of hand or 10.92 NA 7.65 1.59 NA 20.16 090
foot nerve.
64837............... .............. A Repair nerve add-on.. 6.25 NA 3.25 0.96 NA 10.46 ZZZ
64840............... .............. A Repair of leg nerve.. 13.00 NA 8.28 1.04 NA 22.32 090
64856............... .............. A Repair/transpose 13.78 NA 9.17 2.06 NA 25.01 090
nerve.
[[Page 1184]]
64857............... .............. A Repair arm/leg nerve. 14.47 NA 9.62 2.12 NA 26.21 090
64858............... .............. A Repair sciatic nerve. 16.47 NA 10.74 3.35 NA 30.56 090
64859............... .............. A Nerve surgery........ 4.25 NA 2.20 0.60 NA 7.05 ZZZ
64861............... .............. A Repair of arm nerves. 19.21 NA 11.83 2.95 NA 33.99 090
64862............... .............. A Repair of low back 19.41 NA 11.96 2.98 NA 34.35 090
nerves.
64864............... .............. A Repair of facial 12.53 NA 8.10 1.36 NA 21.99 090
nerve.
64865............... .............. A Repair of facial 15.22 NA 9.87 1.65 NA 26.74 090
nerve.
64866............... .............. A Fusion of facial/ 15.72 NA 9.71 1.28 NA 26.71 090
other nerve.
64868............... .............. A Fusion of facial/ 14.02 NA 8.87 1.69 NA 24.58 090
other nerve.
64870............... .............. A Fusion of facial/ 15.97 NA 8.75 1.30 NA 26.02 090
other nerve.
64872............... .............. A Subsequent repair of 1.99 NA 1.09 0.29 NA 3.37 ZZZ
nerve.
64874............... .............. A Repair & revise nerve 2.98 NA 1.54 0.41 NA 4.93 ZZZ
add-on.
64876............... .............. A Repair nerve/shorten 3.37 NA 1.28 0.47 NA 5.12 ZZZ
bone.
64885............... .............. A Nerve graft, head or 17.50 NA 10.91 1.82 NA 30.23 090
neck.
64886............... .............. A Nerve graft, head or 20.72 NA 12.75 2.09 NA 35.56 090
neck.
64890............... .............. A Nerve graft, hand or 15.13 NA 9.99 2.10 NA 27.22 090
foot.
64891............... .............. A Nerve graft, hand or 16.12 NA 7.63 1.66 NA 25.41 090
foot.
64892............... .............. A Nerve graft, arm or 14.63 NA 8.86 1.99 NA 25.48 090
leg.
64893............... .............. A Nerve graft, arm or 15.58 NA 9.89 2.13 NA 27.60 090
leg.
64895............... .............. A Nerve graft, hand or 19.22 NA 9.67 2.46 NA 31.35 090
foot.
64896............... .............. A Nerve graft, hand or 20.46 NA 11.01 2.23 NA 33.70 090
foot.
64897............... .............. A Nerve graft, arm or 18.21 NA 10.72 3.18 NA 32.11 090
leg.
64898............... .............. A Nerve graft, arm or 19.47 NA 11.81 3.27 NA 34.55 090
leg.
64901............... .............. A Nerve graft add-on... 10.20 NA 5.29 1.19 NA 16.68 ZZZ
64902............... .............. A Nerve graft add-on... 11.81 NA 5.99 1.33 NA 19.13 ZZZ
64905............... .............. A Nerve pedicle 14.00 NA 8.56 1.83 NA 24.39 090
transfer.
64907............... .............. A Nerve pedicle 18.80 NA 12.50 2.16 NA 33.46 090
transfer.
64999............... .............. C Nervous system 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
65091............... .............. A Revise eye........... 6.45 NA 9.73 0.31 NA 16.49 090
65093............... .............. A Revise eye with 6.86 NA 10.09 0.34 NA 17.29 090
implant.
65101............... .............. A Removal of eye....... 7.02 NA 10.68 0.34 NA 18.04 090
65103............... .............. A Remove eye/insert 7.56 NA 10.87 0.36 NA 18.79 090
implant.
65105............... .............. A Remove eye/attach 8.48 NA 11.52 0.41 NA 20.41 090
implant.
65110............... .............. A Removal of eye....... 13.93 NA 14.61 0.82 NA 29.36 090
65112............... .............. A Remove eye/revise 16.36 NA 16.88 1.16 NA 34.40 090
socket.
65114............... .............. A Remove eye/revise 17.50 NA 17.10 1.13 NA 35.73 090
socket.
65125............... .............. A Revise ocular implant 3.12 9.23 2.96 0.18 12.53 6.26 090
65130............... .............. A Insert ocular implant 7.14 NA 10.24 0.34 NA 17.72 090
65135............... .............. A Insert ocular implant 7.32 NA 10.42 0.35 NA 18.09 090
65140............... .............. A Attach ocular implant 8.01 NA 10.87 0.37 NA 19.25 090
65150............... .............. A Revise ocular implant 6.25 NA 9.29 0.30 NA 15.84 090
65155............... .............. A Reinsert ocular 8.65 NA 11.59 0.48 NA 20.72 090
implant.
65175............... .............. A Removal of ocular 6.27 NA 9.65 0.31 NA 16.23 090
implant.
65205............... .............. A Remove foreign body 0.71 0.60 0.19 0.04 1.35 0.94 000
from eye.
65210............... .............. A Remove foreign body 0.84 0.74 0.30 0.04 1.62 1.18 000
from eye.
65220............... .............. A Remove foreign body 0.71 0.60 0.18 0.06 1.37 0.95 000
from eye.
65222............... .............. A Remove foreign body 0.93 0.76 0.27 0.05 1.74 1.25 000
from eye.
65235............... .............. A Remove foreign body 7.56 NA 7.26 0.36 NA 15.18 090
from eye.
65260............... .............. A Remove foreign body 10.94 NA 11.43 0.52 NA 22.89 090
from eye.
65265............... .............. A Remove foreign body 12.57 NA 12.67 0.60 NA 25.84 090
from eye.
65270............... .............. A Repair of eye wound.. 1.90 3.83 2.24 0.10 5.83 4.24 010
65272............... .............. A Repair of eye wound.. 3.81 5.78 5.21 0.19 9.78 9.21 090
65273............... .............. A Repair of eye wound.. 4.35 NA 5.63 0.21 NA 10.19 090
65275............... .............. A Repair of eye wound.. 5.33 5.66 5.66 0.33 11.32 11.32 090
65280............... .............. A Repair of eye wound.. 7.65 NA 8.17 0.36 NA 16.18 090
65285............... .............. A Repair of eye wound.. 12.88 NA 12.38 0.62 NA 25.88 090
65286............... .............. A Repair of eye wound.. 5.50 8.42 7.52 0.25 14.17 13.27 090
65290............... .............. A Repair of eye socket 5.40 NA 6.47 0.31 NA 12.18 090
wound.
65400............... .............. A Removal of eye lesion 6.05 8.63 7.47 0.29 14.97 13.81 090
65410............... .............. A Biopsy of cornea..... 1.47 1.72 0.65 0.07 3.26 2.19 000
65420............... .............. A Removal of eye lesion 4.16 7.53 6.74 0.21 11.90 11.11 090
65426............... .............. A Removal of eye lesion 5.24 7.49 6.54 0.24 12.97 12.02 090
65430............... .............. A Corneal smear........ 1.47 4.95 0.66 0.07 6.49 2.20 000
65435............... .............. A Curette/treat cornea. 0.92 1.32 0.39 0.05 2.29 1.36 000
65436............... .............. A Curette/treat cornea. 4.18 5.85 5.22 0.21 10.24 9.61 090
65450............... .............. A Treatment of corneal 3.27 7.22 6.33 0.16 10.65 9.76 090
lesion.
65600............... .............. A Revision of cornea... 3.39 5.63 3.11 0.17 9.19 6.67 090
65710............... .............. A Corneal transplant... 12.33 NA 12.33 0.59 NA 25.25 090
65730............... .............. A Corneal transplant... 14.23 NA 11.86 0.68 NA 26.77 090
65750............... .............. A Corneal transplant... 14.98 NA 13.35 0.71 NA 29.04 090
65755............... .............. A Corneal transplant... 14.87 NA 13.26 0.70 NA 28.83 090
65760............... .............. N Revision of cornea... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
65765............... .............. N Revision of cornea... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
65767............... .............. N Corneal tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transplant.
65770............... .............. A Revise cornea with 17.53 NA 14.31 0.83 NA 32.67 090
implant.
[[Page 1185]]
65771............... .............. N Radial keratotomy.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
65772............... .............. A Correction of 4.28 7.15 6.46 0.21 11.64 10.95 090
astigmatism.
65775............... .............. A Correction of 5.78 NA 7.35 0.27 NA 13.40 090
astigmatism.
65780............... .............. A Ocular reconst, 10.23 NA 9.94 0.35 NA 20.52 090
transplant.
65781............... .............. A Ocular reconst, 17.64 NA 13.31 0.35 NA 31.30 090
transplant.
65782............... .............. A Ocular reconst, 14.98 NA 11.66 0.35 NA 26.99 090
transplant.
65800............... .............. A Drainage of eye...... 1.91 2.27 1.17 0.10 4.28 3.18 000
65805............... .............. A Drainage of eye...... 1.91 2.27 1.18 0.10 4.28 3.19 000
65810............... .............. A Drainage of eye...... 4.86 NA 8.05 0.23 NA 13.14 090
65815............... .............. A Drainage of eye...... 5.04 8.37 7.49 0.24 13.65 12.77 090
65820............... .............. A Relieve inner eye 8.12 NA 10.65 0.39 NA 19.16 090
pressure.
65850............... .............. A Incision of eye...... 10.50 NA 9.38 0.49 NA 20.37 090
65855............... .............. A Laser surgery of eye. 3.84 5.20 4.05 0.21 9.25 8.10 010
65860............... .............. A Incise inner eye 3.54 3.90 3.26 0.17 7.61 6.97 090
adhesions.
65865............... .............. A Incise inner eye 5.59 NA 6.48 0.27 NA 12.34 090
adhesions.
65870............... .............. A Incise inner eye 6.26 NA 7.14 0.29 NA 13.69 090
adhesions.
65875............... .............. A Incise inner eye 6.53 NA 7.44 0.30 NA 14.27 090
adhesions.
65880............... .............. A Incise inner eye 7.08 NA 7.69 0.34 NA 15.11 090
adhesions.
65900............... .............. A Remove eye lesion.... 10.91 NA 11.51 0.55 NA 22.97 090
65920............... .............. A Remove implant of eye 8.39 NA 8.70 0.40 NA 17.49 090
65930............... .............. A Remove blood clot 7.43 NA 7.74 0.35 NA 15.52 090
from eye.
66020............... .............. A Injection treatment 1.59 2.37 1.58 0.08 4.04 3.25 010
of eye.
66030............... .............. A Injection treatment 1.25 2.21 1.42 0.06 3.52 2.73 010
of eye.
66130............... .............. A Remove eye lesion.... 7.68 7.48 6.92 0.37 15.53 14.97 090
66150............... .............. A Glaucoma surgery..... 8.29 NA 9.86 0.40 NA 18.55 090
66155............... .............. A Glaucoma surgery..... 8.28 NA 9.80 0.39 NA 18.47 090
66160............... .............. A Glaucoma surgery..... 10.15 NA 10.65 0.49 NA 21.29 090
66165............... .............. A Glaucoma surgery..... 8.00 NA 9.69 0.37 NA 18.06 090
66170............... .............. A Glaucoma surgery..... 12.14 NA 12.45 0.58 NA 25.17 090
66172............... .............. A Incision of eye...... 15.02 NA 15.12 0.71 NA 30.85 090
66180............... .............. A Implant eye shunt.... 14.53 NA 11.56 0.69 NA 26.78 090
66185............... .............. A Revise eye shunt..... 8.13 NA 8.19 0.39 NA 16.71 090
66220............... .............. A Repair eye lesion.... 7.76 NA 8.73 0.39 NA 16.88 090
66225............... .............. A Repair/graft eye 11.03 NA 9.32 0.53 NA 20.88 090
lesion.
66250............... .............. A Follow-up surgery of 5.97 7.67 6.50 0.28 13.92 12.75 090
eye.
66500............... .............. A Incision of iris..... 3.70 NA 5.10 0.18 NA 8.98 090
66505............... .............. A Incision of iris..... 4.07 NA 5.38 0.21 NA 9.66 090
66600............... .............. A Remove iris and 8.67 NA 8.91 0.41 NA 17.99 090
lesion.
66605............... .............. A Removal of iris...... 12.77 NA 11.26 0.74 NA 24.77 090
66625............... .............. A Removal of iris...... 5.12 7.02 6.30 0.24 12.38 11.66 090
66630............... .............. A Removal of iris...... 6.15 NA 7.42 0.29 NA 13.86 090
66635............... .............. A Removal of iris...... 6.24 NA 6.64 0.29 NA 13.17 090
66680............... .............. A Repair iris & ciliary 5.43 NA 6.04 0.25 NA 11.72 090
body.
66682............... .............. A Repair iris & ciliary 6.20 NA 7.43 0.29 NA 13.92 090
body.
66700............... .............. A Destruction, ciliary 4.77 5.34 4.05 0.23 10.34 9.05 090
body.
66710............... .............. A Destruction, ciliary 4.77 5.22 3.85 0.22 10.21 8.84 090
body.
66720............... .............. A Destruction, ciliary 4.77 5.68 4.60 0.23 10.68 9.60 090
body.
66740............... .............. A Destruction, ciliary 4.77 5.38 4.21 0.22 10.37 9.20 090
body.
66761............... .............. A Revision of iris..... 4.06 5.55 4.23 0.19 9.80 8.48 090
66762............... .............. A Revision of iris..... 4.57 5.62 4.22 0.22 10.41 9.01 090
66770............... .............. A Removal of inner eye 5.17 6.05 4.73 0.24 11.46 10.14 090
lesion.
66820............... .............. A Incision, secondary 3.88 NA 7.10 0.19 NA 11.17 090
cataract.
66821............... .............. A After cataract laser 2.35 3.98 3.88 0.12 6.45 6.35 090
surgery.
66825............... .............. A Reposition 8.22 NA 10.08 0.39 NA 18.69 090
intraocular lens.
66830............... .............. A Removal of lens 8.19 NA 7.08 0.39 NA 15.66 090
lesion.
66840............... .............. A Removal of lens 7.90 NA 6.99 0.37 NA 15.26 090
material.
66850............... .............. A Removal of lens 9.10 NA 7.75 0.43 NA 17.28 090
material.
66852............... .............. A Removal of lens 9.96 NA 8.20 0.47 NA 18.63 090
material.
66920............... .............. A Extraction of lens... 8.85 NA 7.43 0.42 NA 16.70 090
66930............... .............. A Extraction of lens... 10.16 NA 8.57 0.49 NA 19.22 090
66940............... .............. A Extraction of lens... 8.92 NA 8.01 0.42 NA 17.35 090
66982............... .............. A Cataract surgery, 13.48 NA 9.92 0.68 NA 24.08 090
complex.
66983............... .............. A Cataract surg w/iol, 8.98 NA 6.20 0.45 NA 15.63 090
1 stage.
66984............... .............. A Cataract surg w/iol, 10.21 NA 7.63 0.49 NA 18.33 090
1 stage.
66985............... .............. A Insert lens 8.38 NA 7.47 0.40 NA 16.25 090
prosthesis.
66986............... .............. A Exchange lens 12.26 NA 9.22 0.59 NA 22.07 090
prosthesis.
66990............... .............. A Ophthalmic endoscope 1.51 NA 0.69 0.07 NA 2.27 ZZZ
add-on.
66999............... .............. C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
67005............... .............. A Partial removal of 5.69 NA 4.38 0.27 NA 10.34 090
eye fluid.
67010............... .............. A Partial removal of 6.86 NA 4.93 0.33 NA 12.12 090
eye fluid.
67015............... .............. A Release of eye fluid. 6.91 NA 7.73 0.33 NA 14.97 090
67025............... .............. A Replace eye fluid.... 6.83 14.23 7.51 0.33 21.39 14.67 090
67027............... .............. A Implant eye drug 10.83 12.78 8.79 0.55 24.16 20.17 090
system.
67028............... .............. A Injection eye drug... 2.52 6.50 1.13 0.13 9.15 3.78 000
67030............... .............. A Incise inner eye 4.83 NA 6.81 0.23 NA 11.87 090
strands.
[[Page 1186]]
67031............... .............. A Laser surgery, eye 3.66 4.74 4.09 0.18 8.58 7.93 090
strands.
67036............... .............. A Removal of inner eye 11.87 NA 9.35 0.57 NA 21.79 090
fluid.
67038............... .............. A Strip retinal 21.21 NA 15.83 1.01 NA 38.05 090
membrane.
67039............... .............. A Laser treatment of 14.50 NA 12.54 0.69 NA 27.73 090
retina.
67040............... .............. A Laser treatment of 17.20 NA 14.02 0.82 NA 32.04 090
retina.
67101............... .............. A Repair detached 7.52 9.85 8.11 0.35 17.72 15.98 090
retina.
67105............... .............. A Repair detached 7.40 7.99 6.23 0.35 15.74 13.98 090
retina.
67107............... .............. A Repair detached 14.82 NA 12.82 0.70 NA 28.34 090
retina.
67108............... .............. A Repair detached 20.79 NA 17.02 0.99 NA 38.80 090
retina.
67110............... .............. A Repair detached 8.80 15.37 9.23 0.42 24.59 18.45 090
retina.
67112............... .............. A Rerepair detached 16.83 NA 14.59 0.80 NA 32.22 090
retina.
67115............... .............. A Release encircling 4.98 NA 7.09 0.23 NA 12.30 090
material.
67120............... .............. A Remove eye implant 5.97 12.30 6.93 0.28 18.55 13.18 090
material.
67121............... .............. A Remove eye implant 10.65 NA 11.17 0.51 NA 22.33 090
material.
67141............... .............. A Treatment of retina.. 5.19 7.24 6.49 0.24 12.67 11.92 090
67145............... .............. A Treatment of retina.. 5.36 5.76 4.94 0.25 11.37 10.55 090
67208............... .............. A Treatment of retinal 6.69 5.95 5.38 0.31 12.95 12.38 090
lesion.
67210............... .............. A Treatment of retinal 8.81 6.25 5.79 0.42 15.48 15.02 090
lesion.
67218............... .............. A Treatment of retinal 18.50 NA 14.13 0.64 NA 33.27 090
lesion.
67220............... .............. A Treatment of choroid 13.11 9.84 8.83 0.62 23.57 22.56 090
lesion.
67221............... .............. R Ocular photodynamic 4.00 4.69 1.81 0.19 8.88 6.00 000
ther.
67225............... .............. A Eye photodynamic ther 0.47 0.26 0.22 0.01 0.74 0.70 ZZZ
add-on.
67227............... .............. A Treatment of retinal 6.57 6.38 5.39 0.31 13.26 12.27 090
lesion.
67228............... .............. A Treatment of retinal 12.72 10.83 8.42 0.60 24.15 21.74 090
lesion.
67250............... .............. A Reinforce eye wall... 8.65 NA 10.37 0.43 NA 19.45 090
67255............... .............. A Reinforce/graft eye 8.89 NA 10.95 0.42 NA 20.26 090
wall.
67299............... .............. C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
67311............... .............. A Revise eye muscle.... 6.64 NA 6.42 0.33 NA 13.39 090
67312............... .............. A Revise two eye 8.53 NA 7.55 0.42 NA 16.50 090
muscles.
67314............... .............. A Revise eye muscle.... 7.51 NA 7.26 0.36 NA 15.13 090
67316............... .............. A Revise two eye 9.65 NA 8.22 0.48 NA 18.35 090
muscles.
67318............... .............. A Revise eye muscle(s). 7.84 NA 7.64 0.37 NA 15.85 090
67320............... .............. A Revise eye muscle(s) 4.32 NA 1.96 0.21 NA 6.49 ZZZ
add-on.
67331............... .............. A Eye surgery follow-up 4.05 NA 1.91 0.21 NA 6.17 ZZZ
add-on.
67332............... .............. A Rerevise eye muscles 4.48 NA 2.03 0.22 NA 6.73 ZZZ
add-on.
67334............... .............. A Revise eye muscle w/ 3.97 NA 1.81 0.19 NA 5.97 ZZZ
suture.
67335............... .............. A Eye suture during 2.49 NA 1.12 0.12 NA 3.73 ZZZ
surgery.
67340............... .............. A Revise eye muscle add- 4.92 NA 2.23 0.23 NA 7.38 ZZZ
on.
67343............... .............. A Release eye tissue... 7.34 NA 7.34 0.36 NA 15.04 090
67345............... .............. A Destroy nerve of eye 2.96 4.36 1.37 0.16 7.48 4.49 010
muscle.
67350............... .............. A Biopsy eye muscle.... 2.87 NA 1.87 0.16 NA 4.90 000
67399............... .............. C Eye muscle surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
67400............... .............. A Explore/biopsy eye 9.75 NA 12.51 0.52 NA 22.78 090
socket.
67405............... .............. A Explore/drain eye 7.92 NA 11.09 0.43 NA 19.44 090
socket.
67412............... .............. A Explore/treat eye 9.49 NA 12.99 0.49 NA 22.97 090
socket.
67413............... .............. A Explore/treat eye 9.99 NA 12.14 0.52 NA 22.65 090
socket.
67414............... .............. A Explr/decompress eye 11.11 NA 14.01 0.58 NA 25.70 090
socket.
67415............... .............. A Aspiration, orbital 1.76 NA 0.77 0.11 NA 2.64 000
contents.
67420............... .............. A Explore/treat eye 20.03 NA 18.77 1.01 NA 39.81 090
socket.
67430............... .............. A Explore/treat eye 13.37 NA 15.83 1.17 NA 30.37 090
socket.
67440............... .............. A Explore/drain eye 13.07 NA 15.47 0.70 NA 29.24 090
socket.
67445............... .............. A Explr/decompress eye 14.40 NA 15.70 0.76 NA 30.86 090
socket.
67450............... .............. A Explore/biopsy eye 13.49 NA 15.82 0.68 NA 29.99 090
socket.
67500............... .............. A Inject/treat eye 0.79 0.82 0.19 0.05 1.66 1.03 000
socket.
67505............... .............. A Inject/treat eye 0.82 0.92 0.21 0.05 1.79 1.08 000
socket.
67515............... .............. A Inject/treat eye 0.61 0.82 0.28 0.02 1.45 0.91 000
socket.
67550............... .............. A Insert eye socket 10.17 NA 12.28 0.60 NA 23.05 090
implant.
67560............... .............. A Revise eye socket 10.58 NA 12.33 0.57 NA 23.48 090
implant.
67570............... .............. A Decompress optic 13.56 NA 15.33 0.83 NA 29.72 090
nerve.
67599............... .............. C Orbit surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
67700............... .............. A Drainage of eyelid 1.35 4.84 0.62 0.07 6.26 2.04 010
abscess.
67710............... .............. A Incision of eyelid... 1.02 4.99 0.53 0.05 6.06 1.60 010
67715............... .............. A Incision of eyelid 1.22 4.58 0.62 0.06 5.86 1.90 010
fold.
67800............... .............. A Remove eyelid lesion. 1.38 2.50 0.69 0.07 3.95 2.14 010
67801............... .............. A Remove eyelid lesions 1.88 5.34 0.92 0.10 7.32 2.90 010
67805............... .............. A Remove eyelid lesions 2.22 5.49 1.08 0.11 7.82 3.41 010
67808............... .............. A Remove eyelid 3.79 NA 5.23 0.21 NA 9.23 090
lesion(s).
67810............... .............. A Biopsy of eyelid..... 1.48 3.65 0.68 0.07 5.20 2.23 000
67820............... .............. A Revise eyelashes..... 0.89 1.11 0.37 0.05 2.05 1.31 000
67825............... .............. A Revise eyelashes..... 1.38 1.58 1.08 0.07 3.03 2.53 010
67830............... .............. A Revise eyelashes..... 1.70 7.48 1.95 0.08 9.26 3.73 010
67835............... .............. A Revise eyelashes..... 5.55 NA 5.00 0.27 NA 10.82 090
67840............... .............. A Remove eyelid lesion. 2.04 5.32 1.00 0.10 7.46 3.14 010
67850............... .............. A Treat eyelid lesion.. 1.69 6.06 1.89 0.08 7.83 3.66 010
67875............... .............. A Closure of eyelid by 1.35 7.05 0.62 0.07 8.47 2.04 000
suture.
[[Page 1187]]
67880............... .............. A Revision of eyelid... 3.79 9.66 4.29 0.19 13.64 8.27 090
67882............... .............. A Revision of eyelid... 5.06 11.01 5.50 0.25 16.32 10.81 090
67900............... .............. A Repair brow defect... 6.13 10.53 6.32 0.36 17.02 12.81 090
67901............... .............. A Repair eyelid defect. 6.96 NA 6.41 0.39 NA 13.76 090
67902............... .............. A Repair eyelid defect. 7.02 NA 6.47 0.41 NA 13.90 090
67903............... .............. A Repair eyelid defect. 6.36 11.28 6.70 0.47 18.11 13.53 090
67904............... .............. A Repair eyelid defect. 6.25 12.49 7.17 0.31 19.05 13.73 090
67906............... .............. A Repair eyelid defect. 6.78 9.11 6.01 0.51 16.40 13.30 090
67908............... .............. A Repair eyelid defect. 5.12 8.83 5.68 0.24 14.19 11.04 090
67909............... .............. A Revise eyelid defect. 5.39 9.36 6.09 0.30 15.05 11.78 090
67911............... .............. A Revise eyelid defect. 5.26 NA 6.04 0.28 NA 11.58 090
67912............... .............. A Correction eyelid w/ 5.67 20.38 5.27 0.28 26.33 11.22 090
implant.
67914............... .............. A Repair eyelid defect. 3.67 9.30 3.95 0.19 13.16 7.81 090
67915............... .............. A Repair eyelid defect. 3.18 7.90 2.58 0.16 11.24 5.92 090
67916............... .............. A Repair eyelid defect. 5.30 11.78 5.69 0.27 17.35 11.26 090
67917............... .............. A Repair eyelid defect. 6.01 9.71 6.15 0.30 16.02 12.46 090
67921............... .............. A Repair eyelid defect. 3.39 9.11 3.75 0.17 12.67 7.31 090
67922............... .............. A Repair eyelid defect. 3.06 7.86 3.49 0.16 11.08 6.71 090
67923............... .............. A Repair eyelid defect. 5.87 11.35 5.90 0.29 17.51 12.06 090
67924............... .............. A Repair eyelid defect. 5.78 9.10 5.65 0.28 15.16 11.71 090
67930............... .............. A Repair eyelid wound.. 3.60 8.42 2.95 0.21 12.23 6.76 010
67935............... .............. A Repair eyelid wound.. 6.21 11.36 5.95 0.35 17.92 12.51 090
67938............... .............. A Remove eyelid foreign 1.33 5.81 0.56 0.07 7.21 1.96 010
body.
67950............... .............. A Revision of eyelid... 5.81 8.25 6.57 0.36 14.42 12.74 090
67961............... .............. A Revision of eyelid... 5.68 10.20 5.70 0.31 16.19 11.69 090
67966............... .............. A Revision of eyelid... 6.56 8.33 5.66 0.40 15.29 12.62 090
67971............... .............. A Reconstruction of 9.78 NA 7.27 0.51 NA 17.56 090
eyelid.
67973............... .............. A Reconstruction of 12.85 NA 9.24 0.71 NA 22.80 090
eyelid.
67974............... .............. A Reconstruction of 12.82 NA 9.16 0.65 NA 22.63 090
eyelid.
67975............... .............. A Reconstruction of 9.12 NA 6.95 0.46 NA 16.53 090
eyelid.
67999............... .............. C Revision of eyelid... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
68020............... .............. A Incise/drain eyelid 1.37 5.69 0.68 0.07 7.13 2.12 010
lining.
68040............... .............. A Treatment of eyelid 0.85 4.82 0.37 0.04 5.71 1.26 000
lesions.
68100............... .............. A Biopsy of eyelid 1.35 5.01 0.61 0.07 6.43 2.03 000
lining.
68110............... .............. A Remove eyelid lining 1.77 6.06 1.40 0.08 7.91 3.25 010
lesion.
68115............... .............. A Remove eyelid lining 2.36 5.56 1.13 0.12 8.04 3.61 010
lesion.
68130............... .............. A Remove eyelid lining 4.92 8.14 4.28 0.23 13.29 9.43 090
lesion.
68135............... .............. A Remove eyelid lining 1.84 5.32 0.90 0.08 7.24 2.82 010
lesion.
68200............... .............. A Treat eyelid by 0.49 0.72 0.23 0.02 1.23 0.74 000
injection.
68320............... .............. A Revise/graft eyelid 5.36 6.56 5.41 0.25 12.17 11.02 090
lining.
68325............... .............. A Revise/graft eyelid 7.35 NA 6.39 0.36 NA 14.10 090
lining.
68326............... .............. A Revise/graft eyelid 7.14 NA 6.28 0.36 NA 13.78 090
lining.
68328............... .............. A Revise/graft eyelid 8.17 NA 7.03 0.48 NA 15.68 090
lining.
68330............... .............. A Revise eyelid lining. 4.82 7.24 6.05 0.23 12.29 11.10 090
68335............... .............. A Revise/graft eyelid 7.18 NA 6.79 0.35 NA 14.32 090
lining.
68340............... .............. A Separate eyelid 4.16 10.80 4.77 0.21 15.17 9.14 090
adhesions.
68360............... .............. A Revise eyelid lining. 4.36 6.60 5.58 0.21 11.17 10.15 090
68362............... .............. A Revise eyelid lining. 7.33 NA 7.72 0.35 NA 15.40 090
68371............... .............. A Harvest eye tissue, 4.89 NA 4.62 0.21 NA 9.72 010
alograft.
68399............... .............. C Eyelid lining surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
68400............... .............. A Incise/drain tear 1.69 7.61 2.04 0.08 9.38 3.81 010
gland.
68420............... .............. A Incise/drain tear sac 2.30 7.92 2.33 0.12 10.34 4.75 010
68440............... .............. A Incise tear duct 0.94 4.93 0.49 0.05 5.92 1.48 010
opening.
68500............... .............. A Removal of tear gland 11.00 NA 10.16 0.72 NA 21.88 090
68505............... .............. A Partial removal, tear 10.92 NA 11.17 0.69 NA 22.78 090
gland.
68510............... .............. A Biopsy of tear gland. 4.60 8.42 2.10 0.23 13.25 6.93 000
68520............... .............. A Removal of tear sac.. 7.50 NA 7.78 0.40 NA 15.68 090
68525............... .............. A Biopsy of tear sac... 4.42 NA 2.02 0.22 NA 6.66 000
68530............... .............. A Clearance of tear 3.65 9.45 2.85 0.19 13.29 6.69 010
duct.
68540............... .............. A Remove tear gland 10.58 NA 9.78 0.55 NA 20.91 090
lesion.
68550............... .............. A Remove tear gland 13.24 NA 11.75 0.80 NA 25.79 090
lesion.
68700............... .............. A Repair tear ducts.... 6.59 NA 7.29 0.33 NA 14.21 090
68705............... .............. A Revise tear duct 2.06 5.45 1.01 0.10 7.61 3.17 010
opening.
68720............... .............. A Create tear sac drain 8.95 NA 8.26 0.46 NA 17.67 090
68745............... .............. A Create tear duct 8.62 NA 8.22 0.46 NA 17.30 090
drain.
68750............... .............. A Create tear duct 8.65 NA 8.69 0.45 NA 17.79 090
drain.
68760............... .............. A Close tear duct 1.73 3.99 1.23 0.08 5.80 3.04 010
opening.
68761............... .............. A Close tear duct 1.36 3.42 0.98 0.07 4.85 2.41 010
opening.
68770............... .............. A Close tear system 7.01 12.75 6.78 0.34 20.10 14.13 090
fistula.
68801............... .............. A Dilate tear duct 0.94 0.94 0.60 0.05 1.93 1.59 010
opening.
68810............... .............. A Probe nasolacrimal 1.90 2.32 0.92 0.10 4.32 2.92 010
duct.
68811............... .............. A Probe nasolacrimal 2.35 NA 2.36 0.12 NA 4.83 010
duct.
68815............... .............. A Probe nasolacrimal 3.20 8.16 2.68 0.17 11.53 6.05 010
duct.
68840............... .............. A Explore/irrigate tear 1.25 1.64 0.96 0.06 2.95 2.27 010
ducts.
68850............... .............. A Injection for tear 0.80 16.32 0.30 0.04 17.16 1.14 000
sac x-ray.
[[Page 1188]]
68899............... .............. C Tear duct system 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
69000............... .............. A Drain external ear 1.45 2.95 1.39 0.12 4.52 2.96 010
lesion.
69005............... .............. A Drain external ear 2.11 2.96 1.85 0.19 5.26 4.15 010
lesion.
69020............... .............. A Drain outer ear canal 1.48 3.92 2.03 0.13 5.53 3.64 010
lesion.
69090............... .............. N Pierce earlobes...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
69100............... .............. A Biopsy of external 0.81 1.74 0.39 0.05 2.60 1.25 000
ear.
69105............... .............. A Biopsy of external 0.85 2.31 0.77 0.07 3.23 1.69 000
ear canal.
69110............... .............. A Remove external ear, 3.43 4.07 3.03 0.29 7.79 6.75 090
partial.
69120............... .............. A Removal of external 4.04 NA 3.96 0.37 NA 8.37 090
ear.
69140............... .............. A Remove ear canal 7.96 NA 6.69 0.68 NA 15.33 090
lesion(s).
69145............... .............. A Remove ear canal 2.62 3.57 2.60 0.22 6.41 5.44 090
lesion(s).
69150............... .............. A Extensive ear canal 13.41 NA 9.90 1.29 NA 24.60 090
surgery.
69155............... .............. A Extensive ear/neck 20.77 NA 14.47 1.82 NA 37.06 090
surgery.
69200............... .............. A Clear outer ear canal 0.77 2.33 0.58 0.06 3.16 1.41 000
69205............... .............. A Clear outer ear canal 1.20 NA 1.35 0.11 NA 2.66 010
69210............... .............. A Remove impacted ear 0.61 0.63 0.24 0.05 1.29 0.90 000
wax.
69220............... .............. A Clean out mastoid 0.83 2.31 0.74 0.07 3.21 1.64 000
cavity.
69222............... .............. A Clean out mastoid 1.40 3.78 2.02 0.12 5.30 3.54 010
cavity.
69300............... .............. R Revise external ear.. 6.35 NA 4.23 0.52 NA 11.10 YYY
69310............... .............. A Rebuild outer ear 10.77 NA 8.37 0.93 NA 20.07 090
canal.
69320............... .............. A Rebuild outer ear 16.93 NA 12.09 1.41 NA 30.43 090
canal.
69399............... .............. C Outer ear surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
69400............... .............. A Inflate middle ear 0.83 2.33 0.67 0.07 3.23 1.57 000
canal.
69401............... .............. A Inflate middle ear 0.63 1.30 0.65 0.05 1.98 1.33 000
canal.
69405............... .............. A Catheterize middle 2.63 3.48 2.29 0.22 6.33 5.14 010
ear canal.
69410............... .............. A Inset middle ear 0.33 2.05 0.48 0.02 2.40 0.83 000
(baffle).
69420............... .............. A Incision of eardrum.. 1.33 3.08 1.58 0.12 4.53 3.03 010
69421............... .............. A Incision of eardrum.. 1.73 NA 2.09 0.16 NA 3.98 010
69424............... .............. A Remove ventilating 0.85 2.14 0.68 0.07 3.06 1.60 000
tube.
69433............... .............. A Create eardrum 1.52 3.09 1.66 0.13 4.74 3.31 010
opening.
69436............... .............. A Create eardrum 1.96 NA 2.22 0.17 NA 4.35 010
opening.
69440............... .............. A Exploration of middle 7.56 NA 6.28 0.64 NA 14.48 090
ear.
69450............... .............. A Eardrum revision..... 5.56 NA 5.02 0.47 NA 11.05 090
69501............... .............. A Mastoidectomy........ 9.06 NA 7.06 0.78 NA 16.90 090
69502............... .............. A Mastoidectomy........ 12.36 NA 9.26 1.04 NA 22.66 090
69505............... .............. A Remove mastoid 12.97 NA 9.51 1.11 NA 23.59 090
structures.
69511............... .............. A Extensive mastoid 13.50 NA 9.85 1.16 NA 24.51 090
surgery.
69530............... .............. A Extensive mastoid 19.16 NA 13.01 1.59 NA 33.76 090
surgery.
69535............... .............. A Remove part of 36.09 NA 22.36 3.12 NA 61.57 090
temporal bone.
69540............... .............. A Remove ear lesion.... 1.20 3.68 1.93 0.11 4.99 3.24 010
69550............... .............. A Remove ear lesion.... 10.97 NA 8.31 0.96 NA 20.24 090
69552............... .............. A Remove ear lesion.... 19.43 NA 12.92 1.64 NA 33.99 090
69554............... .............. A Remove ear lesion.... 33.11 NA 20.88 2.80 NA 56.79 090
69601............... .............. A Mastoid surgery 13.22 NA 10.01 1.11 NA 24.34 090
revision.
69602............... .............. A Mastoid surgery 13.56 NA 9.95 1.13 NA 24.64 090
revision.
69603............... .............. A Mastoid surgery 14.00 NA 10.16 1.21 NA 25.37 090
revision.
69604............... .............. A Mastoid surgery 14.00 NA 10.14 1.18 NA 25.32 090
revision.
69605............... .............. A Mastoid surgery 18.46 NA 12.80 1.56 NA 32.82 090
revision.
69610............... .............. A Repair of eardrum.... 4.42 5.39 3.27 0.37 10.18 8.06 010
69620............... .............. A Repair of eardrum.... 5.88 6.13 4.51 0.48 12.49 10.87 090
69631............... .............. A Repair eardrum 9.85 NA 7.85 0.83 NA 18.53 090
structures.
69632............... .............. A Rebuild eardrum 12.73 NA 9.72 1.07 NA 23.52 090
structures.
69633............... .............. A Rebuild eardrum 12.08 NA 9.38 1.01 NA 22.47 090
structures.
69635............... .............. A Repair eardrum 13.31 NA 9.38 1.05 NA 23.74 090
structures.
69636............... .............. A Rebuild eardrum 15.20 NA 11.15 1.29 NA 27.64 090
structures.
69637............... .............. A Rebuild eardrum 15.09 NA 11.09 1.28 NA 27.46 090
structures.
69641............... .............. A Revise middle ear & 12.69 NA 9.47 1.07 NA 23.23 090
mastoid.
69642............... .............. A Revise middle ear & 16.81 NA 12.11 1.42 NA 30.34 090
mastoid.
69643............... .............. A Revise middle ear & 15.30 NA 11.15 1.30 NA 27.75 090
mastoid.
69644............... .............. A Revise middle ear & 16.94 NA 12.06 1.44 NA 30.44 090
mastoid.
69645............... .............. A Revise middle ear & 16.36 NA 11.70 1.40 NA 29.46 090
mastoid.
69646............... .............. A Revise middle ear & 17.96 NA 12.63 1.52 NA 32.11 090
mastoid.
69650............... .............. A Release middle ear 9.65 NA 7.40 0.82 NA 17.87 090
bone.
69660............... .............. A Revise middle ear 11.88 NA 8.60 1.01 NA 21.49 090
bone.
69661............... .............. A Revise middle ear 15.72 NA 11.07 1.33 NA 28.12 090
bone.
69662............... .............. A Revise middle ear 15.42 NA 10.79 1.30 NA 27.51 090
bone.
69666............... .............. A Repair middle ear 9.74 NA 7.48 0.82 NA 18.04 090
structures.
69667............... .............. A Repair middle ear 9.75 NA 7.46 0.87 NA 18.08 090
structures.
69670............... .............. A Remove mastoid air 11.49 NA 8.63 0.94 NA 21.06 090
cells.
69676............... .............. A Remove middle ear 9.51 NA 7.60 0.83 NA 17.94 090
nerve.
69700............... .............. A Close mastoid fistula 8.22 NA 5.87 0.66 NA 14.75 090
69710............... .............. N Implant/replace 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing aid.
69711............... .............. A Remove/repair hearing 10.42 NA 8.06 0.75 NA 19.23 090
aid.
69714............... .............. A Implant temple bone w/ 13.98 NA 9.89 1.22 NA 25.09 090
stimul.
69715............... .............. A Temple bne implnt w/ 18.22 NA 12.37 1.59 NA 32.18 090
stimulat.
[[Page 1189]]
69717............... .............. A Temple bone implant 14.96 NA 9.55 1.30 NA 25.81 090
revision.
69718............... .............. A Revise temple bone 18.47 NA 12.27 1.62 NA 32.36 090
implant.
69720............... .............. A Release facial nerve. 14.36 NA 10.74 1.24 NA 26.34 090
69725............... .............. A Release facial nerve. 25.34 NA 16.83 2.15 NA 44.32 090
69740............... .............. A Repair facial nerve.. 15.94 NA 10.35 1.36 NA 27.65 090
69745............... .............. A Repair facial nerve.. 16.66 NA 11.34 1.21 NA 29.21 090
69799............... .............. C Middle ear surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
69801............... .............. A Incise inner ear..... 8.55 NA 6.81 0.72 NA 16.08 090
69802............... .............. A Incise inner ear..... 13.08 NA 9.59 1.10 NA 23.77 090
69805............... .............. A Explore inner ear.... 13.80 NA 10.04 1.17 NA 25.01 090
69806............... .............. A Explore inner ear.... 12.33 NA 9.17 1.04 NA 22.54 090
69820............... .............. A Establish inner ear 10.32 NA 7.83 0.80 NA 18.95 090
window.
69840............... .............. A Revise inner ear 10.24 NA 6.91 0.77 NA 17.92 090
window.
69905............... .............. A Remove inner ear..... 11.08 NA 8.30 0.93 NA 20.31 090
69910............... .............. A Remove inner ear & 13.61 NA 9.70 1.13 NA 24.44 090
mastoid.
69915............... .............. A Incise inner ear 21.20 NA 14.15 1.86 NA 37.21 090
nerve.
69930............... .............. A Implant cochlear 16.78 NA 11.81 1.44 NA 30.03 090
device.
69949............... .............. C Inner ear surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
69950............... .............. A Incise inner ear 25.60 NA 16.04 3.50 NA 45.14 090
nerve.
69955............... .............. A Release facial nerve. 27.00 NA 17.57 2.28 NA 46.85 090
69960............... .............. A Release inner ear 27.00 NA 17.04 2.93 NA 46.97 090
canal.
69970............... .............. A Remove inner ear 29.99 NA 18.32 2.82 NA 51.13 090
lesion.
69979............... .............. C Temporal bone surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
69990............... .............. R Microsurgery add-on.. 3.46 NA 1.80 0.68 NA 5.94 ZZZ
70010............... .............. A Contrast x-ray of 1.19 4.73 NA 0.29 6.21 NA XXX
brain.
70010............... 26............ A Contrast x-ray of 1.19 0.39 0.39 0.07 1.65 1.65 XXX
brain.
70010............... TC............ A Contrast x-ray of 0.00 4.34 NA 0.22 4.56 NA XXX
brain.
70015............... .............. A Contrast x-ray of 1.19 1.75 NA 0.14 3.08 NA XXX
brain.
70015............... 26............ A Contrast x-ray of 1.19 0.39 0.39 0.06 1.64 1.64 XXX
brain.
70015............... TC............ A Contrast x-ray of 0.00 1.36 NA 0.08 1.44 NA XXX
brain.
70030............... .............. A X-ray eye for foreign 0.17 0.47 NA 0.03 0.67 NA XXX
body.
70030............... 26............ A X-ray eye for foreign 0.17 0.06 0.06 0.01 0.24 0.24 XXX
body.
70030............... TC............ A X-ray eye for foreign 0.00 0.41 NA 0.02 0.43 NA XXX
body.
70100............... .............. A X-ray exam of jaw.... 0.18 0.58 NA 0.03 0.79 NA XXX
70100............... 26............ A X-ray exam of jaw.... 0.18 0.06 0.06 0.01 0.25 0.25 XXX
70100............... TC............ A X-ray exam of jaw.... 0.00 0.52 NA 0.02 0.54 NA XXX
70110............... .............. A X-ray exam of jaw.... 0.25 0.70 NA 0.05 1.00 NA XXX
70110............... 26............ A X-ray exam of jaw.... 0.25 0.08 0.08 0.01 0.34 0.34 XXX
70110............... TC............ A X-ray exam of jaw.... 0.00 0.62 NA 0.04 0.66 NA XXX
70120............... .............. A X-ray exam of 0.18 0.68 NA 0.05 0.91 NA XXX
mastoids.
70120............... 26............ A X-ray exam of 0.18 0.06 0.06 0.01 0.25 0.25 XXX
mastoids.
70120............... TC............ A X-ray exam of 0.00 0.62 NA 0.04 0.66 NA XXX
mastoids.
70130............... .............. A X-ray exam of 0.34 0.90 NA 0.06 1.30 NA XXX
mastoids.
70130............... 26............ A X-ray exam of 0.34 0.11 0.11 0.01 0.46 0.46 XXX
mastoids.
70130............... TC............ A X-ray exam of 0.00 0.79 NA 0.05 0.84 NA XXX
mastoids.
70134............... .............. A X-ray exam of middle 0.34 0.85 NA 0.06 1.25 NA XXX
ear.
70134............... 26............ A X-ray exam of middle 0.34 0.11 0.11 0.01 0.46 0.46 XXX
ear.
70134............... TC............ A X-ray exam of middle 0.00 0.74 NA 0.05 0.79 NA XXX
ear.
70140............... .............. A X-ray exam of facial 0.19 0.68 NA 0.05 0.92 NA XXX
bones.
70140............... 26............ A X-ray exam of facial 0.19 0.06 0.06 0.01 0.26 0.26 XXX
bones.
70140............... TC............ A X-ray exam of facial 0.00 0.62 NA 0.04 0.66 NA XXX
bones.
70150............... .............. A X-ray exam of facial 0.26 0.88 NA 0.06 1.20 NA XXX
bones.
70150............... 26............ A X-ray exam of facial 0.26 0.09 0.09 0.01 0.36 0.36 XXX
bones.
70150............... TC............ A X-ray exam of facial 0.00 0.79 NA 0.05 0.84 NA XXX
bones.
70160............... .............. A X-ray exam of nasal 0.17 0.58 NA 0.03 0.78 NA XXX
bones.
70160............... 26............ A X-ray exam of nasal 0.17 0.06 0.06 0.01 0.24 0.24 XXX
bones.
70160............... TC............ A X-ray exam of nasal 0.00 0.52 NA 0.02 0.54 NA XXX
bones.
70170............... .............. A X-ray exam of tear 0.30 1.05 NA 0.07 1.42 NA XXX
duct.
70170............... 26............ A X-ray exam of tear 0.30 0.10 0.10 0.01 0.41 0.41 XXX
duct.
70170............... TC............ A X-ray exam of tear 0.00 0.95 NA 0.06 1.01 NA XXX
duct.
70190............... .............. A X-ray exam of eye 0.21 0.69 NA 0.05 0.95 NA XXX
sockets.
70190............... 26............ A X-ray exam of eye 0.21 0.07 0.07 0.01 0.29 0.29 XXX
sockets.
70190............... TC............ A X-ray exam of eye 0.00 0.62 NA 0.04 0.66 NA XXX
sockets.
70200............... .............. A X-ray exam of eye 0.28 0.88 NA 0.06 1.22 NA XXX
sockets.
70200............... 26............ A X-ray exam of eye 0.28 0.09 0.09 0.01 0.38 0.38 XXX
sockets.
70200............... TC............ A X-ray exam of eye 0.00 0.79 NA 0.05 0.84 NA XXX
sockets.
70210............... .............. A X-ray exam of sinuses 0.17 0.68 NA 0.05 0.90 NA XXX
70210............... 26............ A X-ray exam of sinuses 0.17 0.06 0.06 0.01 0.24 0.24 XXX
70210............... TC............ A X-ray exam of sinuses 0.00 0.62 NA 0.04 0.66 NA XXX
70220............... .............. A X-ray exam of sinuses 0.25 0.87 NA 0.06 1.18 NA XXX
70220............... 26............ A X-ray exam of sinuses 0.25 0.08 0.08 0.01 0.34 0.34 XXX
70220............... TC............ A X-ray exam of sinuses 0.00 0.79 NA 0.05 0.84 NA XXX
70240............... .............. A X-ray exam, pituitary 0.19 0.47 NA 0.03 0.69 NA XXX
saddle.
70240............... 26............ A X-ray exam, pituitary 0.19 0.06 0.06 0.01 0.26 0.26 XXX
saddle.
70240............... TC............ A X-ray exam, pituitary 0.00 0.41 NA 0.02 0.43 NA XXX
saddle.
[[Page 1190]]
70250............... .............. A X-ray exam of skull.. 0.24 0.70 NA 0.05 0.99 NA XXX
70250............... 26............ A X-ray exam of skull.. 0.24 0.08 0.08 0.01 0.33 0.33 XXX
70250............... TC............ A X-ray exam of skull.. 0.00 0.62 NA 0.04 0.66 NA XXX
70260............... .............. A X-ray exam of skull.. 0.34 1.00 NA 0.07 1.41 NA XXX
70260............... 26............ A X-ray exam of skull.. 0.34 0.11 0.11 0.01 0.46 0.46 XXX
70260............... TC............ A X-ray exam of skull.. 0.00 0.89 NA 0.06 0.95 NA XXX
70300............... .............. A X-ray exam of teeth.. 0.10 0.32 NA 0.03 0.45 NA XXX
70300............... 26............ A X-ray exam of teeth.. 0.10 0.05 0.05 0.01 0.16 0.16 XXX
70300............... TC............ A X-ray exam of teeth.. 0.00 0.27 NA 0.02 0.29 NA XXX
70310............... .............. A X-ray exam of teeth.. 0.16 0.49 NA 0.03 0.68 NA XXX
70310............... 26............ A X-ray exam of teeth.. 0.16 0.08 0.08 0.01 0.25 0.25 XXX
70310............... TC............ A X-ray exam of teeth.. 0.00 0.41 NA 0.02 0.43 NA XXX
70320............... .............. A Full mouth x-ray of 0.22 0.87 NA 0.06 1.15 NA XXX
teeth.
70320............... 26............ A Full mouth x-ray of 0.22 0.08 0.08 0.01 0.31 0.31 XXX
teeth.
70320............... TC............ A Full mouth x-ray of 0.00 0.79 NA 0.05 0.84 NA XXX
teeth.
70328............... .............. A X-ray exam of jaw 0.18 0.55 NA 0.03 0.76 NA XXX
joint.
70328............... 26............ A X-ray exam of jaw 0.18 0.06 0.06 0.01 0.25 0.25 XXX
joint.
70328............... TC............ A X-ray exam of jaw 0.00 0.49 NA 0.02 0.51 NA XXX
joint.
70330............... .............. A X-ray exam of jaw 0.24 0.93 NA 0.06 1.23 NA XXX
joints.
70330............... 26............ A X-ray exam of jaw 0.24 0.08 0.08 0.01 0.33 0.33 XXX
joints.
70330............... TC............ A X-ray exam of jaw 0.00 0.85 NA 0.05 0.90 NA XXX
joints.
70332............... .............. A X-ray exam of jaw 0.54 2.30 NA 0.14 2.98 NA XXX
joint.
70332............... 26............ A X-ray exam of jaw 0.54 0.20 0.20 0.02 0.76 0.76 XXX
joint.
70332............... TC............ A X-ray exam of jaw 0.00 2.10 NA 0.12 2.22 NA XXX
joint.
70336............... .............. A Magnetic image, jaw 1.48 11.72 NA 0.67 13.87 NA XXX
joint.
70336............... 26............ A Magnetic image, jaw 1.48 0.48 0.48 0.08 2.04 2.04 XXX
joint.
70336............... TC............ A Magnetic image, jaw 0.00 11.24 NA 0.59 11.83 NA XXX
joint.
70350............... .............. A X-ray head for 0.17 0.44 NA 0.03 0.64 NA XXX
orthodontia.
70350............... 26............ A X-ray head for 0.17 0.07 0.07 0.01 0.25 0.25 XXX
orthodontia.
70350............... TC............ A X-ray head for 0.00 0.37 NA 0.02 0.39 NA XXX
orthodontia.
70355............... .............. A Panoramic x-ray of 0.20 0.65 NA 0.05 0.90 NA XXX
jaws.
70355............... 26............ A Panoramic x-ray of 0.20 0.08 0.08 0.01 0.29 0.29 XXX
jaws.
70355............... TC............ A Panoramic x-ray of 0.00 0.57 NA 0.04 0.61 NA XXX
jaws.
70360............... .............. A X-ray exam of neck... 0.17 0.47 NA 0.03 0.67 NA XXX
70360............... 26............ A X-ray exam of neck... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
70360............... TC............ A X-ray exam of neck... 0.00 0.41 NA 0.02 0.43 NA XXX
70370............... .............. A Throat x-ray & 0.32 1.42 NA 0.08 1.82 NA XXX
fluoroscopy.
70370............... 26............ A Throat x-ray & 0.32 0.11 0.11 0.01 0.44 0.44 XXX
fluoroscopy.
70370............... TC............ A Throat x-ray & 0.00 1.31 NA 0.07 1.38 NA XXX
fluoroscopy.
70371............... .............. A Speech evaluation, 0.84 2.38 NA 0.17 3.39 NA XXX
complex.
70371............... 26............ A Speech evaluation, 0.84 0.28 0.28 0.05 1.17 1.17 XXX
complex.
70371............... TC............ A Speech evaluation, 0.00 2.10 NA 0.12 2.22 NA XXX
complex.
70373............... .............. A Contrast x-ray of 0.44 1.94 NA 0.13 2.51 NA XXX
larynx.
70373............... 26............ A Contrast x-ray of 0.44 0.15 0.15 0.02 0.61 0.61 XXX
larynx.
70373............... TC............ A Contrast x-ray of 0.00 1.79 NA 0.11 1.90 NA XXX
larynx.
70380............... .............. A X-ray exam of 0.17 0.73 NA 0.05 0.95 NA XXX
salivary gland.
70380............... 26............ A X-ray exam of 0.17 0.06 0.06 0.01 0.24 0.24 XXX
salivary gland.
70380............... TC............ A X-ray exam of 0.00 0.67 NA 0.04 0.71 NA XXX
salivary gland.
70390............... .............. A X-ray exam of 0.38 1.92 NA 0.13 2.43 NA XXX
salivary duct.
70390............... 26............ A X-ray exam of 0.38 0.13 0.13 0.02 0.53 0.53 XXX
salivary duct.
70390............... TC............ A X-ray exam of 0.00 1.79 NA 0.11 1.90 NA XXX
salivary duct.
70450............... .............. A Ct head/brain w/o dye 0.85 5.02 NA 0.30 6.17 NA XXX
70450............... 26............ A Ct head/brain w/o dye 0.85 0.28 0.28 0.05 1.18 1.18 XXX
70450............... TC............ A Ct head/brain w/o dye 0.00 4.74 NA 0.25 4.99 NA XXX
70460............... .............. A Ct head/brain w/dye.. 1.13 6.04 NA 0.36 7.53 NA XXX
70460............... 26............ A Ct head/brain w/dye.. 1.13 0.37 0.37 0.06 1.56 1.56 XXX
70460............... TC............ A Ct head/brain w/dye.. 0.00 5.67 NA 0.30 5.97 NA XXX
70470............... .............. A Ct head/brain w/o & w/ 1.27 7.51 NA 0.44 9.22 NA XXX
dye.
70470............... 26............ A Ct head/brain w/o & w/ 1.27 0.41 0.41 0.07 1.75 1.75 XXX
dye.
70470............... TC............ A Ct head/brain w/o & w/ 0.00 7.10 NA 0.37 7.47 NA XXX
dye.
70480............... .............. A Ct orbit/ear/fossa w/ 1.28 5.16 NA 0.32 6.76 NA XXX
o dye.
70480............... 26............ A Ct orbit/ear/fossa w/ 1.28 0.42 0.42 0.07 1.77 1.77 XXX
o dye.
70480............... TC............ A Ct orbit/ear/fossa w/ 0.00 4.74 NA 0.25 4.99 NA XXX
o dye.
70481............... .............. A Ct orbit/ear/fossa w/ 1.38 6.12 NA 0.37 7.87 NA XXX
dye.
70481............... 26............ A Ct orbit/ear/fossa w/ 1.38 0.45 0.45 0.07 1.90 1.90 XXX
dye.
70481............... TC............ A Ct orbit/ear/fossa w/ 0.00 5.67 NA 0.30 5.97 NA XXX
dye.
70482............... .............. A Ct orbit/ear/fossa w/ 1.45 7.57 NA 0.44 9.46 NA XXX
o&w dye.
70482............... 26............ A Ct orbit/ear/fossa w/ 1.45 0.47 0.47 0.07 1.99 1.99 XXX
o&w dye.
70482............... TC............ A Ct orbit/ear/fossa w/ 0.00 7.10 NA 0.37 7.47 NA XXX
o&w dye.
70486............... .............. A Ct maxillofacial w/o 1.14 5.11 NA 0.31 6.56 NA XXX
dye.
70486............... 26............ A Ct maxillofacial w/o 1.14 0.37 0.37 0.06 1.57 1.57 XXX
dye.
70486............... TC............ A Ct maxillofacial w/o 0.00 4.74 NA 0.25 4.99 NA XXX
dye.
70487............... .............. A Ct maxillofacial w/ 1.30 6.09 NA 0.37 7.76 NA XXX
dye.
70487............... 26............ A Ct maxillofacial w/ 1.30 0.42 0.42 0.07 1.79 1.79 XXX
dye.
70487............... TC............ A Ct maxillofacial w/ 0.00 5.67 NA 0.30 5.97 NA XXX
dye.
[[Page 1191]]
70488............... .............. A Ct maxillofacial w/o 1.42 7.56 NA 0.44 9.42 NA XXX
& w dye.
70488............... 26............ A Ct maxillofacial w/o 1.42 0.46 0.46 0.07 1.95 1.95 XXX
& w dye.
70488............... TC............ A Ct maxillofacial w/o 0.00 7.10 NA 0.37 7.47 NA XXX
& w dye.
70490............... .............. A Ct soft tissue neck w/ 1.28 5.16 NA 0.32 6.76 NA XXX
o dye.
70490............... 26............ A Ct soft tissue neck w/ 1.28 0.42 0.42 0.07 1.77 1.77 XXX
o dye.
70490............... TC............ A Ct soft tissue neck w/ 0.00 4.74 NA 0.25 4.99 NA XXX
o dye.
70491............... .............. A Ct soft tissue neck w/ 1.38 6.12 NA 0.37 7.87 NA XXX
dye.
70491............... 26............ A Ct soft tissue neck w/ 1.38 0.45 0.45 0.07 1.90 1.90 XXX
dye.
70491............... TC............ A Ct soft tissue neck w/ 0.00 5.67 NA 0.30 5.97 NA XXX
dye.
70492............... .............. A Ct sft tsue nck w/o & 1.45 7.57 NA 0.44 9.46 NA XXX
w/dye.
70492............... 26............ A Ct sft tsue nck w/o & 1.45 0.47 0.47 0.07 1.99 1.99 XXX
w/dye.
70492............... TC............ A Ct sft tsue nck w/o & 0.00 7.10 NA 0.37 7.47 NA XXX
w/dye.
70496............... .............. A Ct angiography, head. 1.75 11.22 NA 0.68 13.65 NA XXX
70496............... 26............ A Ct angiography, head. 1.75 0.57 0.57 0.10 2.42 2.42 XXX
70496............... TC............ A Ct angiography, head. 0.00 10.65 NA 0.58 11.23 NA XXX
70498............... .............. A Ct angiography, neck. 1.75 11.22 NA 0.68 13.65 NA XXX
70498............... 26............ A Ct angiography, neck. 1.75 0.57 0.57 0.10 2.42 2.42 XXX
70498............... TC............ A Ct angiography, neck. 0.00 10.65 NA 0.58 11.23 NA XXX
70540............... .............. A Mri orbit/face/neck w/ 1.35 11.68 NA 0.44 13.47 NA XXX
o dye.
70540............... 26............ A Mri orbit/face/neck w/ 1.35 0.44 0.44 0.05 1.84 1.84 XXX
o dye.
70540............... TC............ A Mri orbit/face/neck w/ 0.00 11.24 NA 0.39 11.63 NA XXX
o dye.
70542............... .............. A Mri orbit/face/neck w/ 1.62 14.02 NA 0.53 16.17 NA XXX
dye.
70542............... 26............ A Mri orbit/face/neck w/ 1.62 0.53 0.53 0.06 2.21 2.21 XXX
dye.
70542............... TC............ A Mri orbit/face/neck w/ 0.00 13.49 NA 0.47 13.96 NA XXX
dye.
70543............... .............. A Mri orbt/fac/nck w/o 2.15 25.69 NA 0.92 28.76 NA XXX
& w dye.
70543............... 26............ A Mri orbt/fac/nck w/o 2.15 0.71 0.71 0.08 2.94 2.94 XXX
& w dye.
70543............... TC............ A Mri orbt/fac/nck w/o 0.00 24.98 NA 0.84 25.82 NA XXX
& w dye.
70544............... .............. A Mr angiography head w/ 1.20 11.63 NA 0.65 13.48 NA XXX
o dye.
70544............... 26............ A Mr angiography head w/ 1.20 0.39 0.39 0.06 1.65 1.65 XXX
o dye.
70544............... TC............ A Mr angiography head w/ 0.00 11.24 NA 0.59 11.83 NA XXX
o dye.
70545............... .............. A Mr angiography head w/ 1.20 11.63 NA 0.65 13.48 NA XXX
dye.
70545............... 26............ A Mr angiography head w/ 1.20 0.39 0.39 0.06 1.65 1.65 XXX
dye.
70545............... TC............ A Mr angiography head w/ 0.00 11.24 NA 0.59 11.83 NA XXX
dye.
70546............... .............. A Mr angiograph head w/ 1.80 23.08 NA 0.69 25.57 NA XXX
o&w dye.
70546............... 26............ A Mr angiograph head w/ 1.80 0.59 0.59 0.10 2.49 2.49 XXX
o&w dye.
70546............... TC............ A Mr angiograph head w/ 0.00 22.49 NA 0.59 23.08 NA XXX
o&w dye.
70547............... .............. A Mr angiography neck w/ 1.20 11.63 NA 0.65 13.48 NA XXX
o dye.
70547............... 26............ A Mr angiography neck w/ 1.20 0.39 0.39 0.06 1.65 1.65 XXX
o dye.
70547............... TC............ A Mr angiography neck w/ 0.00 11.24 NA 0.59 11.83 NA XXX
o dye.
70548............... .............. A Mr angiography neck w/ 1.20 11.63 NA 0.65 13.48 NA XXX
dye.
70548............... 26............ A Mr angiography neck w/ 1.20 0.39 0.39 0.06 1.65 1.65 XXX
dye.
70548............... TC............ A Mr angiography neck w/ 0.00 11.24 NA 0.59 11.83 NA XXX
dye.
70549............... .............. A Mr angiograph neck w/ 1.80 23.08 NA 0.69 25.57 NA XXX
o&w dye.
70549............... 26............ A Mr angiograph neck w/ 1.80 0.59 0.59 0.10 2.49 2.49 XXX
o&w dye.
70549............... TC............ A Mr angiograph neck w/ 0.00 22.49 NA 0.59 23.08 NA XXX
o&w dye.
70551............... .............. A Mri brain w/o dye.... 1.48 11.73 NA 0.67 13.88 NA XXX
70551............... 26............ A Mri brain w/o dye.... 1.48 0.49 0.49 0.08 2.05 2.05 XXX
70551............... TC............ A Mri brain w/o dye.... 0.00 11.24 NA 0.59 11.83 NA XXX
70552............... .............. A Mri brain w/ dye..... 1.78 14.08 NA 0.80 16.66 NA XXX
70552............... 26............ A Mri brain w/ dye..... 1.78 0.59 0.59 0.10 2.47 2.47 XXX
70552............... TC............ A Mri brain w/ dye..... 0.00 13.49 NA 0.70 14.19 NA XXX
70553............... .............. A Mri brain w/o & w/ 2.36 25.76 NA 1.43 29.55 NA XXX
dye.
70553............... 26............ A Mri brain w/o & w/ 2.36 0.78 0.78 0.12 3.26 3.26 XXX
dye.
70553............... TC............ A Mri brain w/o & w/ 0.00 24.98 NA 1.31 26.29 NA XXX
dye.
70557............... .............. C Mri brain w/o dye.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
70557............... 26............ A Mri brain w/o dye.... 2.90 0.98 0.98 0.08 3.96 3.96 XXX
70557............... TC............ C Mri brain w/o dye.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
70558............... .............. C Mri brain w/ dye..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
70558............... 26............ A Mri brain w/ dye..... 3.20 1.08 1.08 0.10 4.38 4.38 XXX
70558............... TC............ C Mri brain w/ dye..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
70559............... .............. C Mri brain w/o & w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dye.
70559............... 26............ A Mri brain w/o & w/ 3.20 1.08 1.08 0.12 4.40 4.40 XXX
dye.
70559............... TC............ C Mri brain w/o & w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dye.
71010............... .............. A Chest x-ray.......... 0.18 0.53 NA 0.03 0.74 NA XXX
71010............... 26............ A Chest x-ray.......... 0.18 0.06 0.06 0.01 0.25 0.25 XXX
71010............... TC............ A Chest x-ray.......... 0.00 0.47 NA 0.02 0.49 NA XXX
71015............... .............. A Chest x-ray.......... 0.21 0.59 NA 0.03 0.83 NA XXX
71015............... 26............ A Chest x-ray.......... 0.21 0.07 0.07 0.01 0.29 0.29 XXX
71015............... TC............ A Chest x-ray.......... 0.00 0.52 NA 0.02 0.54 NA XXX
71020............... .............. A Chest x-ray.......... 0.22 0.69 NA 0.05 0.96 NA XXX
71020............... 26............ A Chest x-ray.......... 0.22 0.07 0.07 0.01 0.30 0.30 XXX
71020............... TC............ A Chest x-ray.......... 0.00 0.62 NA 0.04 0.66 NA XXX
71021............... .............. A Chest x-ray.......... 0.27 0.83 NA 0.06 1.16 NA XXX
71021............... 26............ A Chest x-ray.......... 0.27 0.09 0.09 0.01 0.37 0.37 XXX
71021............... TC............ A Chest x-ray.......... 0.00 0.74 NA 0.05 0.79 NA XXX
[[Page 1192]]
71022............... .............. A Chest x-ray.......... 0.31 0.84 NA 0.07 1.22 NA XXX
71022............... 26............ A Chest x-ray.......... 0.31 0.10 0.10 0.02 0.43 0.43 XXX
71022............... TC............ A Chest x-ray.......... 0.00 0.74 NA 0.05 0.79 NA XXX
71023............... .............. A Chest x-ray and 0.38 0.92 NA 0.07 1.37 NA XXX
fluoroscopy.
71023............... 26............ A Chest x-ray and 0.38 0.13 0.13 0.02 0.53 0.53 XXX
fluoroscopy.
71023............... TC............ A Chest x-ray and 0.00 0.79 NA 0.05 0.84 NA XXX
fluoroscopy.
71030............... .............. A Chest x-ray.......... 0.31 0.89 NA 0.06 1.26 NA XXX
71030............... 26............ A Chest x-ray.......... 0.31 0.10 0.10 0.01 0.42 0.42 XXX
71030............... TC............ A Chest x-ray.......... 0.00 0.79 NA 0.05 0.84 NA XXX
71034............... .............. A Chest x-ray and 0.46 1.60 NA 0.10 2.16 NA XXX
fluoroscopy.
71034............... 26............ A Chest x-ray and 0.46 0.16 0.16 0.02 0.64 0.64 XXX
fluoroscopy.
71034............... TC............ A Chest x-ray and 0.00 1.44 NA 0.08 1.52 NA XXX
fluoroscopy.
71035............... .............. A Chest x-ray.......... 0.18 0.58 NA 0.03 0.79 NA XXX
71035............... 26............ A Chest x-ray.......... 0.18 0.06 0.06 0.01 0.25 0.25 XXX
71035............... TC............ A Chest x-ray.......... 0.00 0.52 NA 0.02 0.54 NA XXX
71040............... .............. A Contrast x-ray of 0.58 1.65 NA 0.12 2.35 NA XXX
bronchi.
71040............... 26............ A Contrast x-ray of 0.58 0.19 0.19 0.04 0.81 0.81 XXX
bronchi.
71040............... TC............ A Contrast x-ray of 0.00 1.46 NA 0.08 1.54 NA XXX
bronchi.
71060............... .............. A Contrast x-ray of 0.74 2.46 NA 0.17 3.37 NA XXX
bronchi.
71060............... 26............ A Contrast x-ray of 0.74 0.25 0.25 0.04 1.03 1.03 XXX
bronchi.
71060............... TC............ A Contrast x-ray of 0.00 2.21 NA 0.13 2.34 NA XXX
bronchi.
71090............... .............. A X-ray & pacemaker 0.54 1.90 NA 0.13 2.57 NA XXX
insertion.
71090............... 26............ A X-ray & pacemaker 0.54 0.21 0.21 0.02 0.77 0.77 XXX
insertion.
71090............... TC............ A X-ray & pacemaker 0.00 1.69 NA 0.11 1.80 NA XXX
insertion.
71100............... .............. A X-ray exam of ribs... 0.22 0.64 NA 0.05 0.91 NA XXX
71100............... 26............ A X-ray exam of ribs... 0.22 0.07 0.07 0.01 0.30 0.30 XXX
71100............... TC............ A X-ray exam of ribs... 0.00 0.57 NA 0.04 0.61 NA XXX
71101............... .............. A X-ray exam of ribs/ 0.27 0.76 NA 0.05 1.08 NA XXX
chest.
71101............... 26............ A X-ray exam of ribs/ 0.27 0.09 0.09 0.01 0.37 0.37 XXX
chest.
71101............... TC............ A X-ray exam of ribs/ 0.00 0.67 NA 0.04 0.71 NA XXX
chest.
71110............... .............. A X-ray exam of ribs... 0.27 0.88 NA 0.06 1.21 NA XXX
71110............... 26............ A X-ray exam of ribs... 0.27 0.09 0.09 0.01 0.37 0.37 XXX
71110............... TC............ A X-ray exam of ribs... 0.00 0.79 NA 0.05 0.84 NA XXX
71111............... .............. A X-ray exam of ribs/ 0.32 1.00 NA 0.07 1.39 NA XXX
chest.
71111............... 26............ A X-ray exam of ribs/ 0.32 0.11 0.11 0.01 0.44 0.44 XXX
chest.
71111............... TC............ A X-ray exam of ribs/ 0.00 0.89 NA 0.06 0.95 NA XXX
chest.
71120............... .............. A X-ray exam of 0.20 0.72 NA 0.05 0.97 NA XXX
breastbone.
71120............... 26............ A X-ray exam of 0.20 0.07 0.07 0.01 0.28 0.28 XXX
breastbone.
71120............... TC............ A X-ray exam of 0.00 0.65 NA 0.04 0.69 NA XXX
breastbone.
71130............... .............. A X-ray exam of 0.22 0.78 NA 0.05 1.05 NA XXX
breastbone.
71130............... 26............ A X-ray exam of 0.22 0.07 0.07 0.01 0.30 0.30 XXX
breastbone.
71130............... TC............ A X-ray exam of 0.00 0.71 NA 0.04 0.75 NA XXX
breastbone.
71250............... .............. A Ct thorax w/o dye.... 1.16 6.31 NA 0.37 7.84 NA XXX
71250............... 26............ A Ct thorax w/o dye.... 1.16 0.38 0.38 0.06 1.60 1.60 XXX
71250............... TC............ A Ct thorax w/o dye.... 0.00 5.93 NA 0.31 6.24 NA XXX
71260............... .............. A Ct thorax w/dye...... 1.24 7.50 NA 0.43 9.17 NA XXX
71260............... 26............ A Ct thorax w/dye...... 1.24 0.40 0.40 0.06 1.70 1.70 XXX
71260............... TC............ A Ct thorax w/dye...... 0.00 7.10 NA 0.37 7.47 NA XXX
71270............... .............. A Ct thorax w/o & w/ 1.38 9.33 NA 0.53 11.24 NA XXX
dye.
71270............... 26............ A Ct thorax w/o & w/ 1.38 0.45 0.45 0.07 1.90 1.90 XXX
dye.
71270............... TC............ A Ct thorax w/o & w/ 0.00 8.88 NA 0.46 9.34 NA XXX
dye.
71275............... .............. A Ct angiography, chest 1.92 13.05 NA 0.46 15.43 NA XXX
71275............... 26............ A Ct angiography, chest 1.92 0.63 0.63 0.07 2.62 2.62 XXX
71275............... TC............ A Ct angiography, chest 0.00 12.42 NA 0.39 12.81 NA XXX
71550............... .............. A Mri chest w/o dye.... 1.46 11.72 NA 0.50 13.68 NA XXX
71550............... 26............ A Mri chest w/o dye.... 1.46 0.48 0.48 0.05 1.99 1.99 XXX
71550............... TC............ A Mri chest w/o dye.... 0.00 11.24 NA 0.45 11.69 NA XXX
71551............... .............. A Mri chest w/dye...... 1.73 14.06 NA 0.59 16.38 NA XXX
71551............... 26............ A Mri chest w/dye...... 1.73 0.57 0.57 0.07 2.37 2.37 XXX
71551............... TC............ A Mri chest w/dye...... 0.00 13.49 NA 0.52 14.01 NA XXX
71552............... .............. A Mri chest w/o & w/dye 2.26 25.72 NA 0.78 28.76 NA XXX
71552............... 26............ A Mri chest w/o & w/dye 2.26 0.74 0.74 0.10 3.10 3.10 XXX
71552............... TC............ A Mri chest w/o & w/dye 0.00 24.98 NA 0.68 25.66 NA XXX
71555............... .............. R Mri angio chest w or 1.81 11.84 NA 0.69 14.34 NA XXX
w/o dye.
71555............... 26............ R Mri angio chest w or 1.81 0.60 0.60 0.10 2.51 2.51 XXX
w/o dye.
71555............... TC............ R Mri angio chest w or 0.00 11.24 NA 0.59 11.83 NA XXX
w/o dye.
72010............... .............. A X-ray exam of spine.. 0.45 1.18 NA 0.10 1.73 NA XXX
72010............... 26............ A X-ray exam of spine.. 0.45 0.15 0.15 0.04 0.64 0.64 XXX
72010............... TC............ A X-ray exam of spine.. 0.00 1.03 NA 0.06 1.09 NA XXX
72020............... .............. A X-ray exam of spine.. 0.15 0.46 NA 0.03 0.64 NA XXX
72020............... 26............ A X-ray exam of spine.. 0.15 0.05 0.05 0.01 0.21 0.21 XXX
72020............... TC............ A X-ray exam of spine.. 0.00 0.41 NA 0.02 0.43 NA XXX
72040............... .............. A X-ray exam of neck 0.22 0.67 NA 0.05 0.94 NA XXX
spine.
72040............... 26............ A X-ray exam of neck 0.22 0.07 0.07 0.01 0.30 0.30 XXX
spine.
72040............... TC............ A X-ray exam of neck 0.00 0.60 NA 0.04 0.64 NA XXX
spine.
[[Page 1193]]
72050............... .............. A X-ray exam of neck 0.31 0.99 NA 0.08 1.38 NA XXX
spine.
72050............... 26............ A X-ray exam of neck 0.31 0.10 0.10 0.02 0.43 0.43 XXX
spine.
72050............... TC............ A X-ray exam of neck 0.00 0.89 NA 0.06 0.95 NA XXX
spine.
72052............... .............. A X-ray exam of neck 0.36 1.25 NA 0.08 1.69 NA XXX
spine.
72052............... 26............ A X-ray exam of neck 0.36 0.12 0.12 0.02 0.50 0.50 XXX
spine.
72052............... TC............ A X-ray exam of neck 0.00 1.13 NA 0.06 1.19 NA XXX
spine.
72069............... .............. A X-ray exam of trunk 0.22 0.57 NA 0.04 0.83 NA XXX
spine.
72069............... 26............ A X-ray exam of trunk 0.22 0.08 0.08 0.02 0.32 0.32 XXX
spine.
72069............... TC............ A X-ray exam of trunk 0.00 0.49 NA 0.02 0.51 NA XXX
spine.
72070............... .............. A X-ray exam of 0.22 0.72 NA 0.05 0.99 NA XXX
thoracic spine.
72070............... 26............ A X-ray exam of 0.22 0.07 0.07 0.01 0.30 0.30 XXX
thoracic spine.
72070............... TC............ A X-ray exam of 0.00 0.65 NA 0.04 0.69 NA XXX
thoracic spine.
72072............... .............. A X-ray exam of 0.22 0.81 NA 0.06 1.09 NA XXX
thoracic spine.
72072............... 26............ A X-ray exam of 0.22 0.07 0.07 0.01 0.30 0.30 XXX
thoracic spine.
72072............... TC............ A X-ray exam of 0.00 0.74 NA 0.05 0.79 NA XXX
thoracic spine.
72074............... .............. A X-ray exam of 0.22 0.98 NA 0.07 1.27 NA XXX
thoracic spine.
72074............... 26............ A X-ray exam of 0.22 0.07 0.07 0.01 0.30 0.30 XXX
thoracic spine.
72074............... TC............ A X-ray exam of 0.00 0.91 NA 0.06 0.97 NA XXX
thoracic spine.
72080............... .............. A X-ray exam of trunk 0.22 0.74 NA 0.06 1.02 NA XXX
spine.
72080............... 26............ A X-ray exam of trunk 0.22 0.07 0.07 0.02 0.31 0.31 XXX
spine.
72080............... TC............ A X-ray exam of trunk 0.00 0.67 NA 0.04 0.71 NA XXX
spine.
72090............... .............. A X-ray exam of trunk 0.28 0.76 NA 0.06 1.10 NA XXX
spine.
72090............... 26............ A X-ray exam of trunk 0.28 0.09 0.09 0.02 0.39 0.39 XXX
spine.
72090............... TC............ A X-ray exam of trunk 0.00 0.67 NA 0.04 0.71 NA XXX
spine.
72100............... .............. A X-ray exam of lower 0.22 0.74 NA 0.06 1.02 NA XXX
spine.
72100............... 26............ A X-ray exam of lower 0.22 0.07 0.07 0.02 0.31 0.31 XXX
spine.
72100............... TC............ A X-ray exam of lower 0.00 0.67 NA 0.04 0.71 NA XXX
spine.
72110............... .............. A X-ray exam of lower 0.31 1.01 NA 0.08 1.40 NA XXX
spine.
72110............... 26............ A X-ray exam of lower 0.31 0.10 0.10 0.02 0.43 0.43 XXX
spine.
72110............... TC............ A X-ray exam of lower 0.00 0.91 NA 0.06 0.97 NA XXX
spine.
72114............... .............. A X-ray exam of lower 0.36 1.31 NA 0.10 1.77 NA XXX
spine.
72114............... 26............ A X-ray exam of lower 0.36 0.12 0.12 0.04 0.52 0.52 XXX
spine.
72114............... TC............ A X-ray exam of lower 0.00 1.19 NA 0.06 1.25 NA XXX
spine.
72120............... .............. A X-ray exam of lower 0.22 0.96 NA 0.08 1.26 NA XXX
spine.
72120............... 26............ A X-ray exam of lower 0.22 0.07 0.07 0.02 0.31 0.31 XXX
spine.
72120............... TC............ A X-ray exam of lower 0.00 0.89 NA 0.06 0.95 NA XXX
spine.
72125............... .............. A Ct neck spine w/o dye 1.16 6.31 NA 0.37 7.84 NA XXX
72125............... 26............ A Ct neck spine w/o dye 1.16 0.38 0.38 0.06 1.60 1.60 XXX
72125............... TC............ A Ct neck spine w/o dye 0.00 5.93 NA 0.31 6.24 NA XXX
72126............... .............. A Ct neck spine w/dye.. 1.22 7.49 NA 0.43 9.14 NA XXX
72126............... 26............ A Ct neck spine w/dye.. 1.22 0.39 0.39 0.06 1.67 1.67 XXX
72126............... TC............ A Ct neck spine w/dye.. 0.00 7.10 NA 0.37 7.47 NA XXX
72127............... .............. A Ct neck spine w/o & w/ 1.27 9.29 NA 0.53 11.09 NA XXX
dye.
72127............... 26............ A Ct neck spine w/o & w/ 1.27 0.41 0.41 0.07 1.75 1.75 XXX
dye.
72127............... TC............ A Ct neck spine w/o & w/ 0.00 8.88 NA 0.46 9.34 NA XXX
dye.
72128............... .............. A Ct chest spine w/o 1.16 6.31 NA 0.37 7.84 NA XXX
dye.
72128............... 26............ A Ct chest spine w/o 1.16 0.38 0.38 0.06 1.60 1.60 XXX
dye.
72128............... TC............ A Ct chest spine w/o 0.00 5.93 NA 0.31 6.24 NA XXX
dye.
72129............... .............. A Ct chest spine w/dye. 1.22 7.49 NA 0.43 9.14 NA XXX
72129............... 26............ A Ct chest spine w/dye. 1.22 0.39 0.39 0.06 1.67 1.67 XXX
72129............... TC............ A Ct chest spine w/dye. 0.00 7.10 NA 0.37 7.47 NA XXX
72130............... .............. A Ct chest spine w/o & 1.27 9.29 NA 0.53 11.09 NA XXX
w/dye.
72130............... 26............ A Ct chest spine w/o & 1.27 0.41 0.41 0.07 1.75 1.75 XXX
w/dye.
72130............... TC............ A Ct chest spine w/o & 0.00 8.88 NA 0.46 9.34 NA XXX
w/dye.
72131............... .............. A Ct lumbar spine w/o 1.16 6.31 NA 0.37 7.84 NA XXX
dye.
72131............... 26............ A Ct lumbar spine w/o 1.16 0.38 0.38 0.06 1.60 1.60 XXX
dye.
72131............... TC............ A Ct lumbar spine w/o 0.00 5.93 NA 0.31 6.24 NA XXX
dye.
72132............... .............. A Ct lumbar spine w/dye 1.22 7.50 NA 0.44 9.16 NA XXX
72132............... 26............ A Ct lumbar spine w/dye 1.22 0.40 0.40 0.07 1.69 1.69 XXX
72132............... TC............ A Ct lumbar spine w/dye 0.00 7.10 NA 0.37 7.47 NA XXX
72133............... .............. A Ct lumbar spine w/o & 1.27 9.30 NA 0.53 11.10 NA XXX
w/dye.
72133............... 26............ A Ct lumbar spine w/o & 1.27 0.42 0.42 0.07 1.76 1.76 XXX
w/dye.
72133............... TC............ A Ct lumbar spine w/o & 0.00 8.88 NA 0.46 9.34 NA XXX
w/dye.
72141............... .............. A Mri neck spine w/o 1.60 11.77 NA 0.67 14.04 NA XXX
dye.
72141............... 26............ A Mri neck spine w/o 1.60 0.53 0.53 0.08 2.21 2.21 XXX
dye.
72141............... TC............ A Mri neck spine w/o 0.00 11.24 NA 0.59 11.83 NA XXX
dye.
72142............... .............. A Mri neck spine w/dye. 1.92 14.14 NA 0.81 16.87 NA XXX
72142............... 26............ A Mri neck spine w/dye. 1.92 0.65 0.65 0.11 2.68 2.68 XXX
72142............... TC............ A Mri neck spine w/dye. 0.00 13.49 NA 0.70 14.19 NA XXX
72146............... .............. A Mri chest spine w/o 1.60 13.00 NA 0.72 15.32 NA XXX
dye.
72146............... 26............ A Mri chest spine w/o 1.60 0.52 0.52 0.08 2.20 2.20 XXX
dye.
72146............... TC............ A Mri chest spine w/o 0.00 12.48 NA 0.64 13.12 NA XXX
dye.
72147............... .............. A Mri chest spine w/dye 1.92 14.13 NA 0.81 16.86 NA XXX
72147............... 26............ A Mri chest spine w/dye 1.92 0.64 0.64 0.11 2.67 2.67 XXX
72147............... TC............ A Mri chest spine w/dye 0.00 13.49 NA 0.70 14.19 NA XXX
[[Page 1194]]
72148............... .............. A Mri lumbar spine w/o 1.48 12.97 NA 0.72 15.17 NA XXX
dye.
72148............... 26............ A Mri lumbar spine w/o 1.48 0.49 0.49 0.08 2.05 2.05 XXX
dye.
72148............... TC............ A Mri lumbar spine w/o 0.00 12.48 NA 0.64 13.12 NA XXX
dye.
72149............... .............. A Mri lumbar spine w/ 1.78 14.09 NA 0.81 16.68 NA XXX
dye.
72149............... 26............ A Mri lumbar spine w/ 1.78 0.60 0.60 0.11 2.49 2.49 XXX
dye.
72149............... TC............ A Mri lumbar spine w/ 0.00 13.49 NA 0.70 14.19 NA XXX
dye.
72156............... .............. A Mri neck spine w/o & 2.57 25.83 NA 1.44 29.84 NA XXX
w/dye.
72156............... 26............ A Mri neck spine w/o & 2.57 0.85 0.85 0.13 3.55 3.55 XXX
w/dye.
72156............... TC............ A Mri neck spine w/o & 0.00 24.98 NA 1.31 26.29 NA XXX
w/dye.
72157............... .............. A Mri chest spine w/o & 2.57 25.83 NA 1.44 29.84 NA XXX
w/dye.
72157............... 26............ A Mri chest spine w/o & 2.57 0.85 0.85 0.13 3.55 3.55 XXX
w/dye.
72157............... TC............ A Mri chest spine w/o & 0.00 24.98 NA 1.31 26.29 NA XXX
w/dye.
72158............... .............. A Mri lumbar spine w/o 2.36 25.76 NA 1.44 29.56 NA XXX
& w/dye.
72158............... 26............ A Mri lumbar spine w/o 2.36 0.78 0.78 0.13 3.27 3.27 XXX
& w/dye.
72158............... TC............ A Mri lumbar spine w/o 0.00 24.98 NA 1.31 26.29 NA XXX
& w/dye.
72159............... .............. N Mr angio spine w/o&w/ +1.80 12.92 12.92 0.74 15.46 15.46 XXX
dye.
72159............... 26............ N Mr angio spine w/o&w/ +1.80 0.69 0.69 0.10 2.59 2.59 XXX
dye.
72159............... TC............ N Mr angio spine w/o&w/ +0.00 12.23 12.23 0.64 12.87 12.87 XXX
dye.
72170............... .............. A X-ray exam of pelvis. 0.17 0.58 NA 0.03 0.78 NA XXX
72170............... 26............ A X-ray exam of pelvis. 0.17 0.06 0.06 0.01 0.24 0.24 XXX
72170............... TC............ A X-ray exam of pelvis. 0.00 0.52 NA 0.02 0.54 NA XXX
72190............... .............. A X-ray exam of pelvis. 0.21 0.74 NA 0.05 1.00 NA XXX
72190............... 26............ A X-ray exam of pelvis. 0.21 0.07 0.07 0.01 0.29 0.29 XXX
72190............... TC............ A X-ray exam of pelvis. 0.00 0.67 NA 0.04 0.71 NA XXX
72191............... .............. A Ct angiograph pelv w/ 1.81 12.67 NA 0.46 14.94 NA XXX
o&w/dye.
72191............... 26............ A Ct angiograph pelv w/ 1.81 0.60 0.60 0.07 2.48 2.48 XXX
o&w/dye.
72191............... TC............ A Ct angiograph pelv w/ 0.00 12.07 NA 0.39 12.46 NA XXX
o&w/dye.
72192............... .............. A Ct pelvis w/o dye.... 1.09 6.29 NA 0.37 7.75 NA XXX
72192............... 26............ A Ct pelvis w/o dye.... 1.09 0.36 0.36 0.06 1.51 1.51 XXX
72192............... TC............ A Ct pelvis w/o dye.... 0.00 5.93 NA 0.31 6.24 NA XXX
72193............... .............. A Ct pelvis w/dye...... 1.16 7.25 NA 0.42 8.83 NA XXX
72193............... 26............ A Ct pelvis w/dye...... 1.16 0.38 0.38 0.06 1.60 1.60 XXX
72193............... TC............ A Ct pelvis w/dye...... 0.00 6.87 NA 0.36 7.23 NA XXX
72194............... .............. A Ct pelvis w/o & w/dye 1.22 8.92 NA 0.49 10.63 NA XXX
72194............... 26............ A Ct pelvis w/o & w/dye 1.22 0.40 0.40 0.06 1.68 1.68 XXX
72194............... TC............ A Ct pelvis w/o & w/dye 0.00 8.52 NA 0.43 8.95 NA XXX
72195............... .............. A Mri pelvis w/o dye... 1.46 11.72 NA 0.51 13.69 NA XXX
72195............... 26............ A Mri pelvis w/o dye... 1.46 0.48 0.48 0.06 2.00 2.00 XXX
72195............... TC............ A Mri pelvis w/o dye... 0.00 11.24 NA 0.45 11.69 NA XXX
72196............... .............. A Mri pelvis w/dye..... 1.73 14.06 NA 0.58 16.37 NA XXX
72196............... 26............ A Mri pelvis w/dye..... 1.73 0.57 0.57 0.06 2.36 2.36 XXX
72196............... TC............ A Mri pelvis w/dye..... 0.00 13.49 NA 0.52 14.01 NA XXX
72197............... .............. A Mri pelvis w/o & w/ 2.26 25.72 NA 1.02 29.00 NA XXX
dye.
72197............... 26............ A Mri pelvis w/o & w/ 2.26 0.74 0.74 0.10 3.10 3.10 XXX
dye.
72197............... TC............ A Mri pelvis w/o & w/ 0.00 24.98 NA 0.92 25.90 NA XXX
dye.
72198............... .............. A Mr angio pelvis w/o & 1.80 11.92 NA 0.69 14.41 NA XXX
w/dye.
72198............... 26............ A Mr angio pelvis w/o & 1.80 0.68 0.68 0.10 2.58 2.58 XXX
w/dye.
72198............... TC............ A Mr angio pelvis w/o & 0.00 11.24 NA 0.59 11.83 NA XXX
w/dye.
72200............... .............. A X-ray exam sacroiliac 0.17 0.58 NA 0.03 0.78 NA XXX
joints.
72200............... 26............ A X-ray exam sacroiliac 0.17 0.06 0.06 0.01 0.24 0.24 XXX
joints.
72200............... TC............ A X-ray exam sacroiliac 0.00 0.52 NA 0.02 0.54 NA XXX
joints.
72202............... .............. A X-ray exam sacroiliac 0.19 0.68 NA 0.05 0.92 NA XXX
joints.
72202............... 26............ A X-ray exam sacroiliac 0.19 0.06 0.06 0.01 0.26 0.26 XXX
joints.
72202............... TC............ A X-ray exam sacroiliac 0.00 0.62 NA 0.04 0.66 NA XXX
joints.
72220............... .............. A X-ray exam of 0.17 0.63 NA 0.05 0.85 NA XXX
tailbone.
72220............... 26............ A X-ray exam of 0.17 0.06 0.06 0.01 0.24 0.24 XXX
tailbone.
72220............... TC............ A X-ray exam of 0.00 0.57 NA 0.04 0.61 NA XXX
tailbone.
72240............... .............. A Contrast x-ray of 0.91 5.06 NA 0.30 6.27 NA XXX
neck spine.
72240............... 26............ A Contrast x-ray of 0.91 0.29 0.29 0.05 1.25 1.25 XXX
neck spine.
72240............... TC............ A Contrast x-ray of 0.00 4.77 NA 0.25 5.02 NA XXX
neck spine.
72255............... .............. A Contrast x-ray, 0.91 4.62 NA 0.27 5.80 NA XXX
thorax spine.
72255............... 26............ A Contrast x-ray, 0.91 0.28 0.28 0.05 1.24 1.24 XXX
thorax spine.
72255............... TC............ A Contrast x-ray, 0.00 4.34 NA 0.22 4.56 NA XXX
thorax spine.
72265............... .............. A Contrast x-ray, lower 0.83 4.35 NA 0.27 5.45 NA XXX
spine.
72265............... 26............ A Contrast x-ray, lower 0.83 0.26 0.26 0.05 1.14 1.14 XXX
spine.
72265............... TC............ A Contrast x-ray, lower 0.00 4.09 NA 0.22 4.31 NA XXX
spine.
72270............... .............. A Contrast x-ray, spine 1.33 6.53 NA 0.41 8.27 NA XXX
72270............... 26............ A Contrast x-ray, spine 1.33 0.41 0.41 0.08 1.82 1.82 XXX
72270............... TC............ A Contrast x-ray, spine 0.00 6.12 NA 0.33 6.45 NA XXX
72275............... .............. A Epidurography........ 0.76 2.30 NA 0.26 3.32 NA XXX
72275............... 26............ A Epidurography........ 0.76 0.20 0.20 0.04 1.00 1.00 XXX
72275............... TC............ A Epidurography........ 0.00 2.10 NA 0.22 2.32 NA XXX
72285............... .............. A X-ray c/t spine disk. 1.16 8.77 NA 0.50 10.43 NA XXX
72285............... 26............ A X-ray c/t spine disk. 1.16 0.36 0.36 0.07 1.59 1.59 XXX
72285............... TC............ A X-ray c/t spine disk. 0.00 8.41 NA 0.43 8.84 NA XXX
[[Page 1195]]
72295............... .............. A X-ray of lower spine 0.83 8.15 NA 0.45 9.43 NA XXX
disk.
72295............... 26............ A X-ray of lower spine 0.83 0.27 0.27 0.05 1.15 1.15 XXX
disk.
72295............... TC............ A X-ray of lower spine 0.00 7.88 NA 0.40 8.28 NA XXX
disk.
73000............... .............. A X-ray exam of collar 0.16 0.57 NA 0.03 0.76 NA XXX
bone.
73000............... 26............ A X-ray exam of collar 0.16 0.05 0.05 0.01 0.22 0.22 XXX
bone.
73000............... TC............ A X-ray exam of collar 0.00 0.52 NA 0.02 0.54 NA XXX
bone.
73010............... .............. A X-ray exam of 0.17 0.58 NA 0.03 0.78 NA XXX
shoulder blade.
73010............... 26............ A X-ray exam of 0.17 0.06 0.06 0.01 0.24 0.24 XXX
shoulder blade.
73010............... TC............ A X-ray exam of 0.00 0.52 NA 0.02 0.54 NA XXX
shoulder blade.
73020............... .............. A X-ray exam of 0.15 0.52 NA 0.03 0.70 NA XXX
shoulder.
73020............... 26............ A X-ray exam of 0.15 0.05 0.05 0.01 0.21 0.21 XXX
shoulder.
73020............... TC............ A X-ray exam of 0.00 0.47 NA 0.02 0.49 NA XXX
shoulder.
73030............... .............. A X-ray exam of 0.18 0.63 NA 0.05 0.86 NA XXX
shoulder.
73030............... 26............ A X-ray exam of 0.18 0.06 0.06 0.01 0.25 0.25 XXX
shoulder.
73030............... TC............ A X-ray exam of 0.00 0.57 NA 0.04 0.61 NA XXX
shoulder.
73040............... .............. A Contrast x-ray of 0.54 2.28 NA 0.16 2.98 NA XXX
shoulder.
73040............... 26............ A Contrast x-ray of 0.54 0.18 0.18 0.04 0.76 0.76 XXX
shoulder.
73040............... TC............ A Contrast x-ray of 0.00 2.10 NA 0.12 2.22 NA XXX
shoulder.
73050............... .............. A X-ray exam of 0.20 0.74 NA 0.06 1.00 NA XXX
shoulders.
73050............... 26............ A X-ray exam of 0.20 0.07 0.07 0.02 0.29 0.29 XXX
shoulders.
73050............... TC............ A X-ray exam of 0.00 0.67 NA 0.04 0.71 NA XXX
shoulders.
73060............... .............. A X-ray exam of humerus 0.17 0.63 NA 0.05 0.85 NA XXX
73060............... 26............ A X-ray exam of humerus 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73060............... TC............ A X-ray exam of humerus 0.00 0.57 NA 0.04 0.61 NA XXX
73070............... .............. A X-ray exam of elbow.. 0.15 0.57 NA 0.03 0.75 NA XXX
73070............... 26............ A X-ray exam of elbow.. 0.15 0.05 0.05 0.01 0.21 0.21 XXX
73070............... TC............ A X-ray exam of elbow.. 0.00 0.52 NA 0.02 0.54 NA XXX
73080............... .............. A X-ray exam of elbow.. 0.17 0.63 NA 0.05 0.85 NA XXX
73080............... 26............ A X-ray exam of elbow.. 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73080............... TC............ A X-ray exam of elbow.. 0.00 0.57 NA 0.04 0.61 NA XXX
73085............... .............. A Contrast x-ray of 0.54 2.29 NA 0.16 2.99 NA XXX
elbow.
73085............... 26............ A Contrast x-ray of 0.54 0.19 0.19 0.04 0.77 0.77 XXX
elbow.
73085............... TC............ A Contrast x-ray of 0.00 2.10 NA 0.12 2.22 NA XXX
elbow.
73090............... .............. A X-ray exam of forearm 0.16 0.57 NA 0.03 0.76 NA XXX
73090............... 26............ A X-ray exam of forearm 0.16 0.05 0.05 0.01 0.22 0.22 XXX
73090............... TC............ A X-ray exam of forearm 0.00 0.52 NA 0.02 0.54 NA XXX
73092............... .............. A X-ray exam of arm, 0.16 0.54 NA 0.03 0.73 NA XXX
infant.
73092............... 26............ A X-ray exam of arm, 0.16 0.05 0.05 0.01 0.22 0.22 XXX
infant.
73092............... TC............ A X-ray exam of arm, 0.00 0.49 NA 0.02 0.51 NA XXX
infant.
73100............... .............. A X-ray exam of wrist.. 0.16 0.55 NA 0.04 0.75 NA XXX
73100............... 26............ A X-ray exam of wrist.. 0.16 0.06 0.06 0.02 0.24 0.24 XXX
73100............... TC............ A X-ray exam of wrist.. 0.00 0.49 NA 0.02 0.51 NA XXX
73110............... .............. A X-ray exam of wrist.. 0.17 0.59 NA 0.03 0.79 NA XXX
73110............... 26............ A X-ray exam of wrist.. 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73110............... TC............ A X-ray exam of wrist.. 0.00 0.53 NA 0.02 0.55 NA XXX
73115............... .............. A Contrast x-ray of 0.54 1.77 NA 0.14 2.45 NA XXX
wrist.
73115............... 26............ A Contrast x-ray of 0.54 0.19 0.19 0.04 0.77 0.77 XXX
wrist.
73115............... TC............ A Contrast x-ray of 0.00 1.58 NA 0.10 1.68 NA XXX
wrist.
73120............... .............. A X-ray exam of hand... 0.16 0.54 NA 0.03 0.73 NA XXX
73120............... 26............ A X-ray exam of hand... 0.16 0.05 0.05 0.01 0.22 0.22 XXX
73120............... TC............ A X-ray exam of hand... 0.00 0.49 NA 0.02 0.51 NA XXX
73130............... .............. A X-ray exam of hand... 0.17 0.59 NA 0.03 0.79 NA XXX
73130............... 26............ A X-ray exam of hand... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73130............... TC............ A X-ray exam of hand... 0.00 0.53 NA 0.02 0.55 NA XXX
73140............... .............. A X-ray exam of 0.13 0.45 NA 0.03 0.61 NA XXX
finger(s).
73140............... 26............ A X-ray exam of 0.13 0.04 0.04 0.01 0.18 0.18 XXX
finger(s).
73140............... TC............ A X-ray exam of 0.00 0.41 NA 0.02 0.43 NA XXX
finger(s).
73200............... .............. A Ct upper extremity w/ 1.09 5.33 NA 0.31 6.73 NA XXX
o dye.
73200............... 26............ A Ct upper extremity w/ 1.09 0.36 0.36 0.06 1.51 1.51 XXX
o dye.
73200............... TC............ A Ct upper extremity w/ 0.00 4.97 NA 0.25 5.22 NA XXX
o dye.
73201............... .............. A Ct upper extremity w/ 1.16 6.31 NA 0.37 7.84 NA XXX
dye.
73201............... 26............ A Ct upper extremity w/ 1.16 0.38 0.38 0.06 1.60 1.60 XXX
dye.
73201............... TC............ A Ct upper extremity w/ 0.00 5.93 NA 0.31 6.24 NA XXX
dye.
73202............... .............. A Ct uppr extremity w/ 1.22 7.85 NA 0.46 9.53 NA XXX
o&w/dye.
73202............... 26............ A Ct uppr extremity w/ 1.22 0.40 0.40 0.07 1.69 1.69 XXX
o&w/dye.
73202............... TC............ A Ct uppr extremity w/ 0.00 7.45 NA 0.39 7.84 NA XXX
o&w/dye.
73206............... .............. A Ct angio upr extrm w/ 1.81 11.59 NA 0.46 13.86 NA XXX
o&w/dye.
73206............... 26............ A Ct angio upr extrm w/ 1.81 0.59 0.59 0.07 2.47 2.47 XXX
o&w/dye.
73206............... TC............ A Ct angio upr extrm w/ 0.00 11.00 NA 0.39 11.39 NA XXX
o&w/dye.
73218............... .............. A Mri upper extremity w/ 1.35 11.68 NA 0.44 13.47 NA XXX
o dye.
73218............... 26............ A Mri upper extremity w/ 1.35 0.44 0.44 0.05 1.84 1.84 XXX
o dye.
73218............... TC............ A Mri upper extremity w/ 0.00 11.24 NA 0.39 11.63 NA XXX
o dye.
73219............... .............. A Mri upper extremity w/ 1.62 14.02 NA 0.53 16.17 NA XXX
dye.
73219............... 26............ A Mri upper extremity w/ 1.62 0.53 0.53 0.06 2.21 2.21 XXX
dye.
73219............... TC............ A Mri upper extremity w/ 0.00 13.49 NA 0.47 13.96 NA XXX
dye.
[[Page 1196]]
73220............... .............. A Mri uppr extremity w/ 2.15 25.69 NA 0.94 28.78 NA XXX
o&w/dye.
73220............... 26............ A Mri uppr extremity w/ 2.15 0.71 0.71 0.10 2.96 2.96 XXX
o&w/dye.
73220............... TC............ A Mri uppr extremity w/ 0.00 24.98 NA 0.84 25.82 NA XXX
o&w/dye.
73221............... .............. A Mri joint upr extrem 1.35 11.68 NA 0.44 13.47 NA XXX
w/o dye.
73221............... 26............ A Mri joint upr extrem 1.35 0.44 0.44 0.05 1.84 1.84 XXX
w/o dye.
73221............... TC............ A Mri joint upr extrem 0.00 11.24 NA 0.39 11.63 NA XXX
w/o dye.
73222............... .............. A Mri joint upr extrem 1.62 14.02 NA 0.53 16.17 NA XXX
w/dye.
73222............... 26............ A Mri joint upr extrem 1.62 0.53 0.53 0.06 2.21 2.21 XXX
w/dye.
73222............... TC............ A Mri joint upr extrem 0.00 13.49 NA 0.47 13.96 NA XXX
w/dye.
73223............... .............. A Mri joint upr extr w/ 2.15 25.69 NA 0.92 28.76 NA XXX
o&w/dye.
73223............... 26............ A Mri joint upr extr w/ 2.15 0.71 0.71 0.08 2.94 2.94 XXX
o&w/dye.
73223............... TC............ A Mri joint upr extr w/ 0.00 24.98 NA 0.84 25.82 NA XXX
o&w/dye.
73225............... .............. N Mr angio upr extr w/ +1.73 11.68 11.68 0.69 14.10 14.10 XXX
o&w/dye.
73225............... 26............ N Mr angio upr extr w/ +1.73 0.67 0.67 0.10 2.50 2.50 XXX
o&w/dye.
73225............... TC............ N Mr angio upr extr w/ +0.00 11.01 11.01 0.59 11.60 11.60 XXX
o&w/dye.
73500............... .............. A X-ray exam of hip.... 0.17 0.53 NA 0.03 0.73 NA XXX
73500............... 26............ A X-ray exam of hip.... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73500............... TC............ A X-ray exam of hip.... 0.00 0.47 NA 0.02 0.49 NA XXX
73510............... .............. A X-ray exam of hip.... 0.21 0.64 NA 0.06 0.91 NA XXX
73510............... 26............ A X-ray exam of hip.... 0.21 0.07 0.07 0.02 0.30 0.30 XXX
73510............... TC............ A X-ray exam of hip.... 0.00 0.57 NA 0.04 0.61 NA XXX
73520............... .............. A X-ray exam of hips... 0.26 0.76 NA 0.06 1.08 NA XXX
73520............... 26............ A X-ray exam of hips... 0.26 0.09 0.09 0.02 0.37 0.37 XXX
73520............... TC............ A X-ray exam of hips... 0.00 0.67 NA 0.04 0.71 NA XXX
73525............... .............. A Contrast x-ray of hip 0.54 2.28 NA 0.16 2.98 NA XXX
73525............... 26............ A Contrast x-ray of hip 0.54 0.18 0.18 0.04 0.76 0.76 XXX
73525............... TC............ A Contrast x-ray of hip 0.00 2.10 NA 0.12 2.22 NA XXX
73530............... .............. A X-ray exam of hip.... 0.29 0.62 NA 0.03 0.94 NA XXX
73530............... 26............ A X-ray exam of hip.... 0.29 0.10 0.10 0.01 0.40 0.40 XXX
73530............... TC............ A X-ray exam of hip.... 0.00 0.52 NA 0.02 0.54 NA XXX
73540............... .............. A X-ray exam of pelvis 0.20 0.64 NA 0.06 0.90 NA XXX
& hips.
73540............... 26............ A X-ray exam of pelvis 0.20 0.07 0.07 0.02 0.29 0.29 XXX
& hips.
73540............... TC............ A X-ray exam of pelvis 0.00 0.57 NA 0.04 0.61 NA XXX
& hips.
73542............... .............. A X-ray exam, 0.59 2.26 NA 0.16 3.01 NA XXX
sacroiliac joint.
73542............... 26............ A X-ray exam, 0.59 0.16 0.16 0.04 0.79 0.79 XXX
sacroiliac joint.
73542............... TC............ A X-ray exam, 0.00 2.10 NA 0.12 2.22 NA XXX
sacroiliac joint.
73550............... .............. A X-ray exam of thigh.. 0.17 0.63 NA 0.05 0.85 NA XXX
73550............... 26............ A X-ray exam of thigh.. 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73550............... TC............ A X-ray exam of thigh.. 0.00 0.57 NA 0.04 0.61 NA XXX
73560............... .............. A X-ray exam of knee, 1 0.17 0.58 NA 0.04 0.79 NA XXX
or 2.
73560............... 26............ A X-ray exam of knee, 1 0.17 0.06 0.06 0.02 0.25 0.25 XXX
or 2.
73560............... TC............ A X-ray exam of knee, 1 0.00 0.52 NA 0.02 0.54 NA XXX
or 2.
73562............... .............. A X-ray exam of knee, 3 0.18 0.63 NA 0.06 0.87 NA XXX
73562............... 26............ A X-ray exam of knee, 3 0.18 0.06 0.06 0.02 0.26 0.26 XXX
73562............... TC............ A X-ray exam of knee, 3 0.00 0.57 NA 0.04 0.61 NA XXX
73564............... .............. A X-ray exam, knee, 4 0.22 0.70 NA 0.06 0.98 NA XXX
or more.
73564............... 26............ A X-ray exam, knee, 4 0.22 0.08 0.08 0.02 0.32 0.32 XXX
or more.
73564............... TC............ A X-ray exam, knee, 4 0.00 0.62 NA 0.04 0.66 NA XXX
or more.
73565............... .............. A X-ray exam of knees.. 0.17 0.55 NA 0.04 0.76 NA XXX
73565............... 26............ A X-ray exam of knees.. 0.17 0.06 0.06 0.02 0.25 0.25 XXX
73565............... TC............ A X-ray exam of knees.. 0.00 0.49 NA 0.02 0.51 NA XXX
73580............... .............. A Contrast x-ray of 0.54 2.80 NA 0.18 3.52 NA XXX
knee joint.
73580............... 26............ A Contrast x-ray of 0.54 0.18 0.18 0.04 0.76 0.76 XXX
knee joint.
73580............... TC............ A Contrast x-ray of 0.00 2.62 NA 0.14 2.76 NA XXX
knee joint.
73590............... .............. A X-ray exam of lower 0.17 0.58 NA 0.03 0.78 NA XXX
leg.
73590............... 26............ A X-ray exam of lower 0.17 0.06 0.06 0.01 0.24 0.24 XXX
leg.
73590............... TC............ A X-ray exam of lower 0.00 0.52 NA 0.02 0.54 NA XXX
leg.
73592............... .............. A X-ray exam of leg, 0.16 0.55 NA 0.03 0.74 NA XXX
infant.
73592............... 26............ A X-ray exam of leg, 0.16 0.06 0.06 0.01 0.23 0.23 XXX
infant.
73592............... TC............ A X-ray exam of leg, 0.00 0.49 NA 0.02 0.51 NA XXX
infant.
73600............... .............. A X-ray exam of ankle.. 0.16 0.54 NA 0.03 0.73 NA XXX
73600............... 26............ A X-ray exam of ankle.. 0.16 0.05 0.05 0.01 0.22 0.22 XXX
73600............... TC............ A X-ray exam of ankle.. 0.00 0.49 NA 0.02 0.51 NA XXX
73610............... .............. A X-ray exam of ankle.. 0.17 0.59 NA 0.03 0.79 NA XXX
73610............... 26............ A X-ray exam of ankle.. 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73610............... TC............ A X-ray exam of ankle.. 0.00 0.53 NA 0.02 0.55 NA XXX
73615............... .............. A Contrast x-ray of 0.54 2.29 NA 0.16 2.99 NA XXX
ankle.
73615............... 26............ A Contrast x-ray of 0.54 0.19 0.19 0.04 0.77 0.77 XXX
ankle.
73615............... TC............ A Contrast x-ray of 0.00 2.10 NA 0.12 2.22 NA XXX
ankle.
73620............... .............. A X-ray exam of foot... 0.16 0.54 NA 0.03 0.73 NA XXX
73620............... 26............ A X-ray exam of foot... 0.16 0.05 0.05 0.01 0.22 0.22 XXX
73620............... TC............ A X-ray exam of foot... 0.00 0.49 NA 0.02 0.51 NA XXX
73630............... .............. A X-ray exam of foot... 0.17 0.59 NA 0.03 0.79 NA XXX
73630............... 26............ A X-ray exam of foot... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73630............... TC............ A X-ray exam of foot... 0.00 0.53 NA 0.02 0.55 NA XXX
[[Page 1197]]
73650............... .............. A X-ray exam of heel... 0.16 0.52 NA 0.03 0.71 NA XXX
73650............... 26............ A X-ray exam of heel... 0.16 0.05 0.05 0.01 0.22 0.22 XXX
73650............... TC............ A X-ray exam of heel... 0.00 0.47 NA 0.02 0.49 NA XXX
73660............... .............. A X-ray exam of toe(s). 0.13 0.45 NA 0.03 0.61 NA XXX
73660............... 26............ A X-ray exam of toe(s). 0.13 0.04 0.04 0.01 0.18 0.18 XXX
73660............... TC............ A X-ray exam of toe(s). 0.00 0.41 NA 0.02 0.43 NA XXX
73700............... .............. A Ct lower extremity w/ 1.09 5.33 NA 0.31 6.73 NA XXX
o dye.
73700............... 26............ A Ct lower extremity w/ 1.09 0.36 0.36 0.06 1.51 1.51 XXX
o dye.
73700............... TC............ A Ct lower extremity w/ 0.00 4.97 NA 0.25 5.22 NA XXX
o dye.
73701............... .............. A Ct lower extremity w/ 1.16 6.31 NA 0.37 7.84 NA XXX
dye.
73701............... 26............ A Ct lower extremity w/ 1.16 0.38 0.38 0.06 1.60 1.60 XXX
dye.
73701............... TC............ A Ct lower extremity w/ 0.00 5.93 NA 0.31 6.24 NA XXX
dye.
73702............... .............. A Ct lwr extremity w/ 1.22 7.85 NA 0.45 9.52 NA XXX
o&w/dye.
73702............... 26............ A Ct lwr extremity w/ 1.22 0.40 0.40 0.06 1.68 1.68 XXX
o&w/dye.
73702............... TC............ A Ct lwr extremity w/ 0.00 7.45 NA 0.39 7.84 NA XXX
o&w/dye.
73706............... .............. A Ct angio lwr extr w/ 1.90 11.62 NA 0.46 13.98 NA XXX
o&w/dye.
73706............... 26............ A Ct angio lwr extr w/ 1.90 0.62 0.62 0.07 2.59 2.59 XXX
o&w/dye.
73706............... TC............ A Ct angio lwr extr w/ 0.00 11.00 NA 0.39 11.39 NA XXX
o&w/dye.
73718............... .............. A Mri lower extremity w/ 1.35 11.68 NA 0.44 13.47 NA XXX
o dye.
73718............... 26............ A Mri lower extremity w/ 1.35 0.44 0.44 0.05 1.84 1.84 XXX
o dye.
73718............... TC............ A Mri lower extremity w/ 0.00 11.24 NA 0.39 11.63 NA XXX
o dye.
73719............... .............. A Mri lower extremity w/ 1.62 14.02 NA 0.53 16.17 NA XXX
dye.
73719............... 26............ A Mri lower extremity w/ 1.62 0.53 0.53 0.06 2.21 2.21 XXX
dye.
73719............... TC............ A Mri lower extremity w/ 0.00 13.49 NA 0.47 13.96 NA XXX
dye.
73720............... .............. A Mri lwr extremity w/ 2.15 25.69 NA 0.94 28.78 NA XXX
o&w/dye.
73720............... 26............ A Mri lwr extremity w/ 2.15 0.71 0.71 0.10 2.96 2.96 XXX
o&w/dye.
73720............... TC............ A Mri lwr extremity w/ 0.00 24.98 NA 0.84 25.82 NA XXX
o&w/dye.
73721............... .............. A Mri jnt of lwr extre 1.35 11.68 NA 0.44 13.47 NA XXX
w/o dye.
73721............... 26............ A Mri jnt of lwr extre 1.35 0.44 0.44 0.05 1.84 1.84 XXX
w/o dye.
73721............... TC............ A Mri jnt of lwr extre 0.00 11.24 NA 0.39 11.63 NA XXX
w/o dye.
73722............... .............. A Mri joint of lwr extr 1.62 14.02 NA 0.54 16.18 NA XXX
w/dye.
73722............... 26............ A Mri joint of lwr extr 1.62 0.53 0.53 0.07 2.22 2.22 XXX
w/dye.
73722............... TC............ A Mri joint of lwr extr 0.00 13.49 NA 0.47 13.96 NA XXX
w/dye.
73723............... .............. A Mri joint lwr extr w/ 2.15 25.69 NA 0.92 28.76 NA XXX
o&w/dye.
73723............... 26............ A Mri joint lwr extr w/ 2.15 0.71 0.71 0.08 2.94 2.94 XXX
o&w/dye.
73723............... TC............ A Mri joint lwr extr w/ 0.00 24.98 NA 0.84 25.82 NA XXX
o&w/dye.
73725............... .............. R Mr ang lwr ext w or w/ 1.82 11.84 NA 0.69 14.35 NA XXX
o dye.
73725............... 26............ R Mr ang lwr ext w or w/ 1.82 0.60 0.60 0.10 2.52 2.52 XXX
o dye.
73725............... TC............ R Mr ang lwr ext w or w/ 0.00 11.24 NA 0.59 11.83 NA XXX
o dye.
74000............... .............. A X-ray exam of abdomen 0.18 0.58 NA 0.03 0.79 NA XXX
74000............... 26............ A X-ray exam of abdomen 0.18 0.06 0.06 0.01 0.25 0.25 XXX
74000............... TC............ A X-ray exam of abdomen 0.00 0.52 NA 0.02 0.54 NA XXX
74010............... .............. A X-ray exam of abdomen 0.23 0.65 NA 0.05 0.93 NA XXX
74010............... 26............ A X-ray exam of abdomen 0.23 0.08 0.08 0.01 0.32 0.32 XXX
74010............... TC............ A X-ray exam of abdomen 0.00 0.57 NA 0.04 0.61 NA XXX
74020............... .............. A X-ray exam of abdomen 0.27 0.71 NA 0.05 1.03 NA XXX
74020............... 26............ A X-ray exam of abdomen 0.27 0.09 0.09 0.01 0.37 0.37 XXX
74020............... TC............ A X-ray exam of abdomen 0.00 0.62 NA 0.04 0.66 NA XXX
74022............... .............. A X-ray exam series, 0.32 0.85 NA 0.06 1.23 NA XXX
abdomen.
74022............... 26............ A X-ray exam series, 0.32 0.11 0.11 0.01 0.44 0.44 XXX
abdomen.
74022............... TC............ A X-ray exam series, 0.00 0.74 NA 0.05 0.79 NA XXX
abdomen.
74150............... .............. A Ct abdomen w/o dye... 1.19 6.06 NA 0.36 7.61 NA XXX
74150............... 26............ A Ct abdomen w/o dye... 1.19 0.39 0.39 0.06 1.64 1.64 XXX
74150............... TC............ A Ct abdomen w/o dye... 0.00 5.67 NA 0.30 5.97 NA XXX
74160............... .............. A Ct abdomen w/dye..... 1.27 7.28 NA 0.43 8.98 NA XXX
74160............... 26............ A Ct abdomen w/dye..... 1.27 0.41 0.41 0.07 1.75 1.75 XXX
74160............... TC............ A Ct abdomen w/dye..... 0.00 6.87 NA 0.36 7.23 NA XXX
74170............... .............. A Ct abdomen w/o &w / 1.40 8.97 NA 0.50 10.87 NA XXX
dye.
74170............... 26............ A Ct abdomen w/o &w / 1.40 0.45 0.45 0.07 1.92 1.92 XXX
dye.
74170............... TC............ A Ct abdomen w/o &w / 0.00 8.52 NA 0.43 8.95 NA XXX
dye.
74175............... .............. A Ct angio abdom w/o & 1.90 12.69 NA 0.46 15.05 NA XXX
w/dye.
74175............... 26............ A Ct angio abdom w/o & 1.90 0.62 0.62 0.07 2.59 2.59 XXX
w/dye.
74175............... TC............ A Ct angio abdom w/o & 0.00 12.07 NA 0.39 12.46 NA XXX
w/dye.
74181............... .............. A Mri abdomen w/o dye.. 1.46 11.72 NA 0.52 13.70 NA XXX
74181............... 26............ A Mri abdomen w/o dye.. 1.46 0.48 0.48 0.07 2.01 2.01 XXX
74181............... TC............ A Mri abdomen w/o dye.. 0.00 11.24 NA 0.45 11.69 NA XXX
74182............... .............. A Mri abdomen w/dye.... 1.73 14.05 NA 0.59 16.37 NA XXX
74182............... 26............ A Mri abdomen w/dye.... 1.73 0.56 0.56 0.07 2.36 2.36 XXX
74182............... TC............ A Mri abdomen w/dye.... 0.00 13.49 NA 0.52 14.01 NA XXX
74183............... .............. A Mri abdomen w/o & w/ 2.26 25.72 NA 1.02 29.00 NA XXX
dye.
74183............... 26............ A Mri abdomen w/o & w/ 2.26 0.74 0.74 0.10 3.10 3.10 XXX
dye.
74183............... TC............ A Mri abdomen w/o & w/ 0.00 24.98 NA 0.92 25.90 NA XXX
dye.
74185............... .............. R Mri angio, abdom w 1.80 11.83 NA 0.69 14.32 NA XXX
orw/o dye.
74185............... 26............ R Mri angio, abdom w 1.80 0.59 0.59 0.10 2.49 2.49 XXX
orw/o dye.
74185............... TC............ R Mri angio, abdom w 0.00 11.24 NA 0.59 11.83 NA XXX
orw/o dye.
[[Page 1198]]
74190............... .............. A X-ray exam of 0.48 1.47 NA 0.09 2.04 NA XXX
peritoneum.
74190............... 26............ A X-ray exam of 0.48 0.16 0.16 0.02 0.66 0.66 XXX
peritoneum.
74190............... TC............ A X-ray exam of 0.00 1.31 NA 0.07 1.38 NA XXX
peritoneum.
74210............... .............. A Contrst x-ray exam of 0.36 1.31 NA 0.08 1.75 NA XXX
throat.
74210............... 26............ A Contrst x-ray exam of 0.36 0.12 0.12 0.02 0.50 0.50 XXX
throat.
74210............... TC............ A Contrst x-ray exam of 0.00 1.19 NA 0.06 1.25 NA XXX
throat.
74220............... .............. A Contrast x-ray, 0.46 1.34 NA 0.08 1.88 NA XXX
esophagus.
74220............... 26............ A Contrast x-ray, 0.46 0.15 0.15 0.02 0.63 0.63 XXX
esophagus.
74220............... TC............ A Contrast x-ray, 0.00 1.19 NA 0.06 1.25 NA XXX
esophagus.
74230............... .............. A Cine/vid x-ray, 0.53 1.49 NA 0.09 2.11 NA XXX
throat/esoph.
74230............... 26............ A Cine/vid x-ray, 0.53 0.18 0.18 0.02 0.73 0.73 XXX
throat/esoph.
74230............... TC............ A Cine/vid x-ray, 0.00 1.31 NA 0.07 1.38 NA XXX
throat/esoph.
74235............... .............. A Remove esophagus 1.19 3.01 NA 0.20 4.40 NA XXX
obstruction.
74235............... 26............ A Remove esophagus 1.19 0.39 0.39 0.06 1.64 1.64 XXX
obstruction.
74235............... TC............ A Remove esophagus 0.00 2.62 NA 0.14 2.76 NA XXX
obstruction.
74240............... .............. A X-ray exam, upper gi 0.69 1.69 NA 0.12 2.50 NA XXX
tract.
74240............... 26............ A X-ray exam, upper gi 0.69 0.23 0.23 0.04 0.96 0.96 XXX
tract.
74240............... TC............ A X-ray exam, upper gi 0.00 1.46 NA 0.08 1.54 NA XXX
tract.
74241............... .............. A X-ray exam, upper gi 0.69 1.72 NA 0.12 2.53 NA XXX
tract.
74241............... 26............ A X-ray exam, upper gi 0.69 0.23 0.23 0.04 0.96 0.96 XXX
tract.
74241............... TC............ A X-ray exam, upper gi 0.00 1.49 NA 0.08 1.57 NA XXX
tract.
74245............... .............. A X-ray exam, upper gi 0.91 2.69 NA 0.18 3.78 NA XXX
tract.
74245............... 26............ A X-ray exam, upper gi 0.91 0.30 0.30 0.05 1.26 1.26 XXX
tract.
74245............... TC............ A X-ray exam, upper gi 0.00 2.39 NA 0.13 2.52 NA XXX
tract.
74246............... .............. A Contrst x-ray uppr gi 0.69 1.88 NA 0.14 2.71 NA XXX
tract.
74246............... 26............ A Contrst x-ray uppr gi 0.69 0.23 0.23 0.04 0.96 0.96 XXX
tract.
74246............... TC............ A Contrst x-ray uppr gi 0.00 1.65 NA 0.10 1.75 NA XXX
tract.
74247............... .............. A Contrst x-ray uppr gi 0.69 1.92 NA 0.15 2.76 NA XXX
tract.
74247............... 26............ A Contrst x-ray uppr gi 0.69 0.23 0.23 0.04 0.96 0.96 XXX
tract.
74247............... TC............ A Contrst x-ray uppr gi 0.00 1.69 NA 0.11 1.80 NA XXX
tract.
74249............... .............. A Contrst x-ray uppr gi 0.91 2.89 NA 0.19 3.99 NA XXX
tract.
74249............... 26............ A Contrst x-ray uppr gi 0.91 0.30 0.30 0.05 1.26 1.26 XXX
tract.
74249............... TC............ A Contrst x-ray uppr gi 0.00 2.59 NA 0.14 2.73 NA XXX
tract.
74250............... .............. A X-ray exam of small 0.47 1.47 NA 0.09 2.03 NA XXX
bowel.
74250............... 26............ A X-ray exam of small 0.47 0.16 0.16 0.02 0.65 0.65 XXX
bowel.
74250............... TC............ A X-ray exam of small 0.00 1.31 NA 0.07 1.38 NA XXX
bowel.
74251............... .............. A X-ray exam of small 0.69 1.54 NA 0.11 2.34 NA XXX
bowel.
74251............... 26............ A X-ray exam of small 0.69 0.23 0.23 0.04 0.96 0.96 XXX
bowel.
74251............... TC............ A X-ray exam of small 0.00 1.31 NA 0.07 1.38 NA XXX
bowel.
74260............... .............. A X-ray exam of small 0.50 1.66 NA 0.10 2.26 NA XXX
bowel.
74260............... 26............ A X-ray exam of small 0.50 0.17 0.17 0.02 0.69 0.69 XXX
bowel.
74260............... TC............ A X-ray exam of small 0.00 1.49 NA 0.08 1.57 NA XXX
bowel.
74270............... .............. A Contrast x-ray exam 0.69 1.94 NA 0.15 2.78 NA XXX
of colon.
74270............... 26............ A Contrast x-ray exam 0.69 0.23 0.23 0.04 0.96 0.96 XXX
of colon.
74270............... TC............ A Contrast x-ray exam 0.00 1.71 NA 0.11 1.82 NA XXX
of colon.
74280............... .............. A Contrast x-ray exam 0.99 2.57 NA 0.18 3.74 NA XXX
of colon.
74280............... 26............ A Contrast x-ray exam 0.99 0.33 0.33 0.05 1.37 1.37 XXX
of colon.
74280............... TC............ A Contrast x-ray exam 0.00 2.24 NA 0.13 2.37 NA XXX
of colon.
74283............... .............. A Contrast x-ray exam 2.02 3.24 NA 0.25 5.51 NA XXX
of colon.
74283............... 26............ A Contrast x-ray exam 2.02 0.66 0.66 0.11 2.79 2.79 XXX
of colon.
74283............... TC............ A Contrast x-ray exam 0.00 2.58 NA 0.14 2.72 NA XXX
of colon.
74290............... .............. A Contrast x-ray, 0.32 0.85 NA 0.06 1.23 NA XXX
gallbladder.
74290............... 26............ A Contrast x-ray, 0.32 0.11 0.11 0.01 0.44 0.44 XXX
gallbladder.
74290............... TC............ A Contrast x-ray, 0.00 0.74 NA 0.05 0.79 NA XXX
gallbladder.
74291............... .............. A Contrast x-rays, 0.20 0.48 NA 0.03 0.71 NA XXX
gallbladder.
74291............... 26............ A Contrast x-rays, 0.20 0.07 0.07 0.01 0.28 0.28 XXX
gallbladder.
74291............... TC............ A Contrast x-rays, 0.00 0.41 NA 0.02 0.43 NA XXX
gallbladder.
74300............... .............. C X-ray bile ducts/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pancreas.
74300............... 26............ A X-ray bile ducts/ 0.36 0.12 0.12 0.02 0.50 0.50 XXX
pancreas.
74300............... TC............ C X-ray bile ducts/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pancreas.
74301............... .............. C X-rays at surgery add- 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
on.
74301............... 26............ A X-rays at surgery add- 0.21 0.07 0.07 0.01 0.29 0.29 ZZZ
on.
74301............... TC............ C X-rays at surgery add- 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
on.
74305............... .............. A X-ray bile ducts/ 0.42 0.93 NA 0.07 1.42 NA XXX
pancreas.
74305............... 26............ A X-ray bile ducts/ 0.42 0.14 0.14 0.02 0.58 0.58 XXX
pancreas.
74305............... TC............ A X-ray bile ducts/ 0.00 0.79 NA 0.05 0.84 NA XXX
pancreas.
74320............... .............. A Contrast x-ray of 0.54 3.35 NA 0.19 4.08 NA XXX
bile ducts.
74320............... 26............ A Contrast x-ray of 0.54 0.18 0.18 0.02 0.74 0.74 XXX
bile ducts.
74320............... TC............ A Contrast x-ray of 0.00 3.17 NA 0.17 3.34 NA XXX
bile ducts.
74327............... .............. A X-ray bile stone 0.70 2.00 NA 0.15 2.85 NA XXX
removal.
74327............... 26............ A X-ray bile stone 0.70 0.23 0.23 0.04 0.97 0.97 XXX
removal.
74327............... TC............ A X-ray bile stone 0.00 1.77 NA 0.11 1.88 NA XXX
removal.
74328............... .............. A X-ray bile duct 0.70 3.40 NA 0.21 4.31 NA XXX
endoscopy.
74328............... 26............ A X-ray bile duct 0.70 0.23 0.23 0.04 0.97 0.97 XXX
endoscopy.
74328............... TC............ A X-ray bile duct 0.00 3.17 NA 0.17 3.34 NA XXX
endoscopy.
[[Page 1199]]
74329............... .............. A X-ray for pancreas 0.70 3.40 NA 0.21 4.31 NA XXX
endoscopy.
74329............... 26............ A X-ray for pancreas 0.70 0.23 0.23 0.04 0.97 0.97 XXX
endoscopy.
74329............... TC............ A X-ray for pancreas 0.00 3.17 NA 0.17 3.34 NA XXX
endoscopy.
74330............... .............. A X-ray bile/panc 0.90 3.47 NA 0.22 4.59 NA XXX
endoscopy.
74330............... 26............ A X-ray bile/panc 0.90 0.30 0.30 0.05 1.25 1.25 XXX
endoscopy.
74330............... TC............ A X-ray bile/panc 0.00 3.17 NA 0.17 3.34 NA XXX
endoscopy.
74340............... .............. A X-ray guide for GI 0.54 2.80 NA 0.16 3.50 NA XXX
tube.
74340............... 26............ A X-ray guide for GI 0.54 0.18 0.18 0.02 0.74 0.74 XXX
tube.
74340............... TC............ A X-ray guide for GI 0.00 2.62 NA 0.14 2.76 NA XXX
tube.
74350............... .............. A X-ray guide, stomach 0.76 3.42 NA 0.21 4.39 NA XXX
tube.
74350............... 26............ A X-ray guide, stomach 0.76 0.25 0.25 0.04 1.05 1.05 XXX
tube.
74350............... TC............ A X-ray guide, stomach 0.00 3.17 NA 0.17 3.34 NA XXX
tube.
74355............... .............. A X-ray guide, 0.76 2.87 NA 0.18 3.81 NA XXX
intestinal tube.
74355............... 26............ A X-ray guide, 0.76 0.25 0.25 0.04 1.05 1.05 XXX
intestinal tube.
74355............... TC............ A X-ray guide, 0.00 2.62 NA 0.14 2.76 NA XXX
intestinal tube.
74360............... .............. A X-ray guide, GI 0.54 3.36 NA 0.19 4.09 NA XXX
dilation.
74360............... 26............ A X-ray guide, GI 0.54 0.19 0.19 0.02 0.75 0.75 XXX
dilation.
74360............... TC............ A X-ray guide, GI 0.00 3.17 NA 0.17 3.34 NA XXX
dilation.
74363............... .............. A X-ray, bile duct 0.88 6.41 NA 0.38 7.67 NA XXX
dilation.
74363............... 26............ A X-ray, bile duct 0.88 0.29 0.29 0.05 1.22 1.22 XXX
dilation.
74363............... TC............ A X-ray, bile duct 0.00 6.12 NA 0.33 6.45 NA XXX
dilation.
74400............... .............. A Contrst x-ray, 0.49 1.85 NA 0.13 2.47 NA XXX
urinary tract.
74400............... 26............ A Contrst x-ray, 0.49 0.16 0.16 0.02 0.67 0.67 XXX
urinary tract.
74400............... TC............ A Contrst x-ray, 0.00 1.69 NA 0.11 1.80 NA XXX
urinary tract.
74410............... .............. A Contrst x-ray, 0.49 2.12 NA 0.13 2.74 NA XXX
urinary tract.
74410............... 26............ A Contrst x-ray, 0.49 0.16 0.16 0.02 0.67 0.67 XXX
urinary tract.
74410............... TC............ A Contrst x-ray, 0.00 1.96 NA 0.11 2.07 NA XXX
urinary tract.
74415............... .............. A Contrst x-ray, 0.49 2.28 NA 0.14 2.91 NA XXX
urinary tract.
74415............... 26............ A Contrst x-ray, 0.49 0.16 0.16 0.02 0.67 0.67 XXX
urinary tract.
74415............... TC............ A Contrst x-ray, 0.00 2.12 NA 0.12 2.24 NA XXX
urinary tract.
74420............... .............. A Contrst x-ray, 0.36 2.74 NA 0.16 3.26 NA XXX
urinary tract.
74420............... 26............ A Contrst x-ray, 0.36 0.12 0.12 0.02 0.50 0.50 XXX
urinary tract.
74420............... TC............ A Contrst x-ray, 0.00 2.62 NA 0.14 2.76 NA XXX
urinary tract.
74425............... .............. A Contrst x-ray, 0.36 1.43 NA 0.09 1.88 NA XXX
urinary tract.
74425............... 26............ A Contrst x-ray, 0.36 0.12 0.12 0.02 0.50 0.50 XXX
urinary tract.
74425............... TC............ A Contrst x-ray, 0.00 1.31 NA 0.07 1.38 NA XXX
urinary tract.
74430............... .............. A Contrast x-ray, 0.32 1.17 NA 0.08 1.57 NA XXX
bladder.
74430............... 26............ A Contrast x-ray, 0.32 0.11 0.11 0.02 0.45 0.45 XXX
bladder.
74430............... TC............ A Contrast x-ray, 0.00 1.06 NA 0.06 1.12 NA XXX
bladder.
74440............... .............. A X-ray, male genital 0.38 1.25 NA 0.08 1.71 NA XXX
tract.
74440............... 26............ A X-ray, male genital 0.38 0.12 0.12 0.02 0.52 0.52 XXX
tract.
74440............... TC............ A X-ray, male genital 0.00 1.13 NA 0.06 1.19 NA XXX
tract.
74445............... .............. A X-ray exam of penis.. 1.14 1.50 NA 0.12 2.76 NA XXX
74445............... 26............ A X-ray exam of penis.. 1.14 0.37 0.37 0.06 1.57 1.57 XXX
74445............... TC............ A X-ray exam of penis.. 0.00 1.13 NA 0.06 1.19 NA XXX
74450............... .............. A X-ray, urethra/ 0.33 1.57 NA 0.10 2.00 NA XXX
bladder.
74450............... 26............ A X-ray, urethra/ 0.33 0.11 0.11 0.02 0.46 0.46 XXX
bladder.
74450............... TC............ A X-ray, urethra/ 0.00 1.46 NA 0.08 1.54 NA XXX
bladder.
74455............... .............. A X-ray, urethra/ 0.33 1.69 NA 0.12 2.14 NA XXX
bladder.
74455............... 26............ A X-ray, urethra/ 0.33 0.11 0.11 0.02 0.46 0.46 XXX
bladder.
74455............... TC............ A X-ray, urethra/ 0.00 1.58 NA 0.10 1.68 NA XXX
bladder.
74470............... .............. A X-ray exam of kidney 0.54 1.43 NA 0.09 2.06 NA XXX
lesion.
74470............... 26............ A X-ray exam of kidney 0.54 0.18 0.18 0.02 0.74 0.74 XXX
lesion.
74470............... TC............ A X-ray exam of kidney 0.00 1.25 NA 0.07 1.32 NA XXX
lesion.
74475............... .............. A X-ray control, cath 0.54 4.27 NA 0.24 5.05 NA XXX
insert.
74475............... 26............ A X-ray control, cath 0.54 0.18 0.18 0.02 0.74 0.74 XXX
insert.
74475............... TC............ A X-ray control, cath 0.00 4.09 NA 0.22 4.31 NA XXX
insert.
74480............... .............. A X-ray control, cath 0.54 4.27 NA 0.24 5.05 NA XXX
insert.
74480............... 26............ A X-ray control, cath 0.54 0.18 0.18 0.02 0.74 0.74 XXX
insert.
74480............... TC............ A X-ray control, cath 0.00 4.09 NA 0.22 4.31 NA XXX
insert.
74485............... .............. A X-ray guide, GU 0.54 3.35 NA 0.21 4.10 NA XXX
dilation.
74485............... 26............ A X-ray guide, GU 0.54 0.18 0.18 0.04 0.76 0.76 XXX
dilation.
74485............... TC............ A X-ray guide, GU 0.00 3.17 NA 0.17 3.34 NA XXX
dilation.
74710............... .............. A X-ray measurement of 0.34 1.17 NA 0.08 1.59 NA XXX
pelvis.
74710............... 26............ A X-ray measurement of 0.34 0.11 0.11 0.02 0.47 0.47 XXX
pelvis.
74710............... TC............ A X-ray measurement of 0.00 1.06 NA 0.06 1.12 NA XXX
pelvis.
74740............... .............. A X-ray, female genital 0.38 1.44 NA 0.09 1.91 NA XXX
tract.
74740............... 26............ A X-ray, female genital 0.38 0.13 0.13 0.02 0.53 0.53 XXX
tract.
74740............... TC............ A X-ray, female genital 0.00 1.31 NA 0.07 1.38 NA XXX
tract.
74742............... .............. A X-ray, fallopian tube 0.61 3.37 NA 0.19 4.17 NA XXX
74742............... 26............ A X-ray, fallopian tube 0.61 0.20 0.20 0.02 0.83 0.83 XXX
74742............... TC............ A X-ray, fallopian tube 0.00 3.17 NA 0.17 3.34 NA XXX
74775............... .............. A X-ray exam of 0.62 1.67 NA 0.12 2.41 NA XXX
perineum.
74775............... 26............ A X-ray exam of 0.62 0.21 0.21 0.04 0.87 0.87 XXX
perineum.
74775............... TC............ A X-ray exam of 0.00 1.46 NA 0.08 1.54 NA XXX
perineum.
[[Page 1200]]
75552............... .............. A Heart mri for morph w/ 1.60 11.77 NA 0.67 14.04 NA XXX
o dye.
75552............... 26............ A Heart mri for morph w/ 1.60 0.53 0.53 0.08 2.21 2.21 XXX
o dye.
75552............... TC............ A Heart mri for morph w/ 0.00 11.24 NA 0.59 11.83 NA XXX
o dye.
75553............... .............. A Heart mri for morph w/ 2.00 11.89 NA 0.70 14.59 NA XXX
dye.
75553............... 26............ A Heart mri for morph w/ 2.00 0.65 0.65 0.11 2.76 2.76 XXX
dye.
75553............... TC............ A Heart mri for morph w/ 0.00 11.24 NA 0.59 11.83 NA XXX
dye.
75554............... .............. A Cardiac MRI/function. 1.83 11.88 NA 0.67 14.38 NA XXX
75554............... 26............ A Cardiac MRI/function. 1.83 0.64 0.64 0.08 2.55 2.55 XXX
75554............... TC............ A Cardiac MRI/function. 0.00 11.24 NA 0.59 11.83 NA XXX
75555............... .............. A Cardiac MRI/limited 1.74 11.88 NA 0.67 14.29 NA XXX
study.
75555............... 26............ A Cardiac MRI/limited 1.74 0.64 0.64 0.08 2.46 2.46 XXX
study.
75555............... TC............ A Cardiac MRI/limited 0.00 11.24 NA 0.59 11.83 NA XXX
study.
75556............... .............. N Cardiac MRI/flow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mapping.
75600............... .............. A Contrast x-ray exam 0.49 12.83 NA 0.67 13.99 NA XXX
of aorta.
75600............... 26............ A Contrast x-ray exam 0.49 0.19 0.19 0.02 0.70 0.70 XXX
of aorta.
75600............... TC............ A Contrast x-ray exam 0.00 12.64 NA 0.65 13.29 NA XXX
of aorta.
75605............... .............. A Contrast x-ray exam 1.14 13.03 NA 0.71 14.88 NA XXX
of aorta.
75605............... 26............ A Contrast x-ray exam 1.14 0.39 0.39 0.06 1.59 1.59 XXX
of aorta.
75605............... TC............ A Contrast x-ray exam 0.00 12.64 NA 0.65 13.29 NA XXX
of aorta.
75625............... .............. A Contrast x-ray exam 1.14 13.02 NA 0.71 14.87 NA XXX
of aorta.
75625............... 26............ A Contrast x-ray exam 1.14 0.38 0.38 0.06 1.58 1.58 XXX
of aorta.
75625............... TC............ A Contrast x-ray exam 0.00 12.64 NA 0.65 13.29 NA XXX
of aorta.
75630............... .............. A X-ray aorta, leg 1.79 13.78 NA 0.79 16.36 NA XXX
arteries.
75630............... 26............ A X-ray aorta, leg 1.79 0.61 0.61 0.10 2.50 2.50 XXX
arteries.
75630............... TC............ A X-ray aorta, leg 0.00 13.17 NA 0.69 13.86 NA XXX
arteries.
75635............... .............. A Ct angio abdominal 2.40 16.77 NA 0.50 19.67 NA XXX
arteries.
75635............... 26............ A Ct angio abdominal 2.40 0.80 0.80 0.11 3.31 3.31 XXX
arteries.
75635............... TC............ A Ct angio abdominal 0.00 15.97 NA 0.39 16.36 NA XXX
arteries.
75650............... .............. A Artery x-rays, head & 1.49 13.13 NA 0.73 15.35 NA XXX
neck.
75650............... 26............ A Artery x-rays, head & 1.49 0.49 0.49 0.08 2.06 2.06 XXX
neck.
75650............... TC............ A Artery x-rays, head & 0.00 12.64 NA 0.65 13.29 NA XXX
neck.
75658............... .............. A Artery x-rays, arm... 1.31 13.11 NA 0.72 15.14 NA XXX
75658............... 26............ A Artery x-rays, arm... 1.31 0.47 0.47 0.07 1.85 1.85 XXX
75658............... TC............ A Artery x-rays, arm... 0.00 12.64 NA 0.65 13.29 NA XXX
75660............... .............. A Artery x-rays, head & 1.31 13.08 NA 0.72 15.11 NA XXX
neck.
75660............... 26............ A Artery x-rays, head & 1.31 0.44 0.44 0.07 1.82 1.82 XXX
neck.
75660............... TC............ A Artery x-rays, head & 0.00 12.64 NA 0.65 13.29 NA XXX
neck.
75662............... .............. A Artery x-rays, head & 1.66 13.23 NA 0.75 15.64 NA XXX
neck.
75662............... 26............ A Artery x-rays, head & 1.66 0.59 0.59 0.10 2.35 2.35 XXX
neck.
75662............... TC............ A Artery x-rays, head & 0.00 12.64 NA 0.65 13.29 NA XXX
neck.
75665............... .............. A Artery x-rays, head & 1.31 13.07 NA 0.73 15.11 NA XXX
neck.
75665............... 26............ A Artery x-rays, head & 1.31 0.43 0.43 0.08 1.82 1.82 XXX
neck.
75665............... TC............ A Artery x-rays, head & 0.00 12.64 NA 0.65 13.29 NA XXX
neck.
75671............... .............. A Artery x-rays, head & 1.66 13.19 NA 0.75 15.60 NA XXX
neck.
75671............... 26............ A Artery x-rays, head & 1.66 0.55 0.55 0.10 2.31 2.31 XXX
neck.
75671............... TC............ A Artery x-rays, head & 0.00 12.64 NA 0.65 13.29 NA XXX
neck.
75676............... .............. A Artery x-rays, neck.. 1.31 13.08 NA 0.73 15.12 NA XXX
75676............... 26............ A Artery x-rays, neck.. 1.31 0.44 0.44 0.08 1.83 1.83 XXX
75676............... TC............ A Artery x-rays, neck.. 0.00 12.64 NA 0.65 13.29 NA XXX
75680............... .............. A Artery x-rays, neck.. 1.66 13.19 NA 0.75 15.60 NA XXX
75680............... 26............ A Artery x-rays, neck.. 1.66 0.55 0.55 0.10 2.31 2.31 XXX
75680............... TC............ A Artery x-rays, neck.. 0.00 12.64 NA 0.65 13.29 NA XXX
75685............... .............. A Artery x-rays, spine. 1.31 13.07 NA 0.72 15.10 NA XXX
75685............... 26............ A Artery x-rays, spine. 1.31 0.43 0.43 0.07 1.81 1.81 XXX
75685............... TC............ A Artery x-rays, spine. 0.00 12.64 NA 0.65 13.29 NA XXX
75705............... .............. A Artery x-rays, spine. 2.18 13.37 NA 0.78 16.33 NA XXX
75705............... 26............ A Artery x-rays, spine. 2.18 0.73 0.73 0.13 3.04 3.04 XXX
75705............... TC............ A Artery x-rays, spine. 0.00 12.64 NA 0.65 13.29 NA XXX
75710............... .............. A Artery x-rays, arm/ 1.14 13.02 NA 0.72 14.88 NA XXX
leg.
75710............... 26............ A Artery x-rays, arm/ 1.14 0.38 0.38 0.07 1.59 1.59 XXX
leg.
75710............... TC............ A Artery x-rays, arm/ 0.00 12.64 NA 0.65 13.29 NA XXX
leg.
75716............... .............. A Artery x-rays, arms/ 1.31 13.07 NA 0.72 15.10 NA XXX
legs.
75716............... 26............ A Artery x-rays, arms/ 1.31 0.43 0.43 0.07 1.81 1.81 XXX
legs.
75716............... TC............ A Artery x-rays, arms/ 0.00 12.64 NA 0.65 13.29 NA XXX
legs.
75722............... .............. A Artery x-rays, kidney 1.14 13.04 NA 0.71 14.89 NA XXX
75722............... 26............ A Artery x-rays, kidney 1.14 0.40 0.40 0.06 1.60 1.60 XXX
75722............... TC............ A Artery x-rays, kidney 0.00 12.64 NA 0.65 13.29 NA XXX
75724............... .............. A Artery x-rays, 1.49 13.20 NA 0.71 15.40 NA XXX
kidneys.
75724............... 26............ A Artery x-rays, 1.49 0.56 0.56 0.06 2.11 2.11 XXX
kidneys.
75724............... TC............ A Artery x-rays, 0.00 12.64 NA 0.65 13.29 NA XXX
kidneys.
75726............... .............. A Artery x-rays, 1.14 13.01 NA 0.71 14.86 NA XXX
abdomen.
75726............... 26............ A Artery x-rays, 1.14 0.37 0.37 0.06 1.57 1.57 XXX
abdomen.
75726............... TC............ A Artery x-rays, 0.00 12.64 NA 0.65 13.29 NA XXX
abdomen.
75731............... .............. A Artery x-rays, 1.14 13.01 NA 0.71 14.86 NA XXX
adrenal gland.
75731............... 26............ A Artery x-rays, 1.14 0.37 0.37 0.06 1.57 1.57 XXX
adrenal gland.
[[Page 1201]]
75731............... TC............ A Artery x-rays, 0.00 12.64 NA 0.65 13.29 NA XXX
adrenal gland.
75733............... .............. A Artery x-rays, 1.31 13.07 NA 0.72 15.10 NA XXX
adrenals.
75733............... 26............ A Artery x-rays, 1.31 0.43 0.43 0.07 1.81 1.81 XXX
adrenals.
75733............... TC............ A Artery x-rays, 0.00 12.64 NA 0.65 13.29 NA XXX
adrenals.
75736............... .............. A Artery x-rays, pelvis 1.14 13.01 NA 0.71 14.86 NA XXX
75736............... 26............ A Artery x-rays, pelvis 1.14 0.37 0.37 0.06 1.57 1.57 XXX
75736............... TC............ A Artery x-rays, pelvis 0.00 12.64 NA 0.65 13.29 NA XXX
75741............... .............. A Artery x-rays, lung.. 1.31 13.07 NA 0.72 15.10 NA XXX
75741............... 26............ A Artery x-rays, lung.. 1.31 0.43 0.43 0.07 1.81 1.81 XXX
75741............... TC............ A Artery x-rays, lung.. 0.00 12.64 NA 0.65 13.29 NA XXX
75743............... .............. A Artery x-rays, lungs. 1.66 13.18 NA 0.73 15.57 NA XXX
75743............... 26............ A Artery x-rays, lungs. 1.66 0.54 0.54 0.08 2.28 2.28 XXX
75743............... TC............ A Artery x-rays, lungs. 0.00 12.64 NA 0.65 13.29 NA XXX
75746............... .............. A Artery x-rays, lung.. 1.14 13.01 NA 0.71 14.86 NA XXX
75746............... 26............ A Artery x-rays, lung.. 1.14 0.37 0.37 0.06 1.57 1.57 XXX
75746............... TC............ A Artery x-rays, lung.. 0.00 12.64 NA 0.65 13.29 NA XXX
75756............... .............. A Artery x-rays, chest. 1.14 13.08 NA 0.70 14.92 NA XXX
75756............... 26............ A Artery x-rays, chest. 1.14 0.44 0.44 0.05 1.63 1.63 XXX
75756............... TC............ A Artery x-rays, chest. 0.00 12.64 NA 0.65 13.29 NA XXX
75774............... .............. A Artery x-ray, each 0.36 12.77 NA 0.67 13.80 NA ZZZ
vessel.
75774............... 26............ A Artery x-ray, each 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ
vessel.
75774............... TC............ A Artery x-ray, each 0.00 12.64 NA 0.65 13.29 NA ZZZ
vessel.
75790............... .............. A Visualize A-V shunt.. 1.84 1.96 NA 0.19 3.99 NA XXX
75790............... 26............ A Visualize A-V shunt.. 1.84 0.60 0.60 0.11 2.55 2.55 XXX
75790............... TC............ A Visualize A-V shunt.. 0.00 1.36 NA 0.08 1.44 NA XXX
75801............... .............. A Lymph vessel x-ray, 0.81 5.71 NA 0.35 6.87 NA XXX
arm/leg.
75801............... 26............ A Lymph vessel x-ray, 0.81 0.27 0.27 0.06 1.14 1.14 XXX
arm/leg.
75801............... TC............ A Lymph vessel x-ray, 0.00 5.44 NA 0.29 5.73 NA XXX
arm/leg.
75803............... .............. A Lymph vessel x- 1.17 5.82 NA 0.35 7.34 NA XXX
ray,arms/legs.
75803............... 26............ A Lymph vessel x- 1.17 0.38 0.38 0.06 1.61 1.61 XXX
ray,arms/legs.
75803............... TC............ A Lymph vessel x- 0.00 5.44 NA 0.29 5.73 NA XXX
ray,arms/legs.
75805............... .............. A Lymph vessel x-ray, 0.81 6.39 NA 0.38 7.58 NA XXX
trunk.
75805............... 26............ A Lymph vessel x-ray, 0.81 0.27 0.27 0.05 1.13 1.13 XXX
trunk.
75805............... TC............ A Lymph vessel x-ray, 0.00 6.12 NA 0.33 6.45 NA XXX
trunk.
75807............... .............. A Lymph vessel x-ray, 1.17 6.50 NA 0.39 8.06 NA XXX
trunk.
75807............... 26............ A Lymph vessel x-ray, 1.17 0.38 0.38 0.06 1.61 1.61 XXX
trunk.
75807............... TC............ A Lymph vessel x-ray, 0.00 6.12 NA 0.33 6.45 NA XXX
trunk.
75809............... .............. A Nonvascular shunt, x- 0.47 0.95 NA 0.07 1.49 NA XXX
ray.
75809............... 26............ A Nonvascular shunt, x- 0.47 0.16 0.16 0.02 0.65 0.65 XXX
ray.
75809............... TC............ A Nonvascular shunt, x- 0.00 0.79 NA 0.05 0.84 NA XXX
ray.
75810............... .............. A Vein x-ray, spleen/ 1.14 13.01 NA 0.72 14.87 NA XXX
liver.
75810............... 26............ A Vein x-ray, spleen/ 1.14 0.37 0.37 0.07 1.58 1.58 XXX
liver.
75810............... TC............ A Vein x-ray, spleen/ 0.00 12.64 NA 0.65 13.29 NA XXX
liver.
75820............... .............. A Vein x-ray, arm/leg.. 0.70 1.18 NA 0.10 1.98 NA XXX
75820............... 26............ A Vein x-ray, arm/leg.. 0.70 0.23 0.23 0.04 0.97 0.97 XXX
75820............... TC............ A Vein x-ray, arm/leg.. 0.00 0.95 NA 0.06 1.01 NA XXX
75822............... .............. A Vein x-ray, arms/legs 1.06 1.83 NA 0.14 3.03 NA XXX
75822............... 26............ A Vein x-ray, arms/legs 1.06 0.35 0.35 0.06 1.47 1.47 XXX
75822............... TC............ A Vein x-ray, arms/legs 0.00 1.48 NA 0.08 1.56 NA XXX
75825............... .............. A Vein x-ray, trunk.... 1.14 13.01 NA 0.72 14.87 NA XXX
75825............... 26............ A Vein x-ray, trunk.... 1.14 0.37 0.37 0.07 1.58 1.58 XXX
75825............... TC............ A Vein x-ray, trunk.... 0.00 12.64 NA 0.65 13.29 NA XXX
75827............... .............. A Vein x-ray, chest.... 1.14 13.01 NA 0.71 14.86 NA XXX
75827............... 26............ A Vein x-ray, chest.... 1.14 0.37 0.37 0.06 1.57 1.57 XXX
75827............... TC............ A Vein x-ray, chest.... 0.00 12.64 NA 0.65 13.29 NA XXX
75831............... .............. A Vein x-ray, kidney... 1.14 13.01 NA 0.71 14.86 NA XXX
75831............... 26............ A Vein x-ray, kidney... 1.14 0.37 0.37 0.06 1.57 1.57 XXX
75831............... TC............ A Vein x-ray, kidney... 0.00 12.64 NA 0.65 13.29 NA XXX
75833............... .............. A Vein x-ray, kidneys.. 1.49 13.13 NA 0.73 15.35 NA XXX
75833............... 26............ A Vein x-ray, kidneys.. 1.49 0.49 0.49 0.08 2.06 2.06 XXX
75833............... TC............ A Vein x-ray, kidneys.. 0.00 12.64 NA 0.65 13.29 NA XXX
75840............... .............. A Vein x-ray, adrenal 1.14 13.01 NA 0.73 14.88 NA XXX
gland.
75840............... 26............ A Vein x-ray, adrenal 1.14 0.37 0.37 0.08 1.59 1.59 XXX
gland.
75840............... TC............ A Vein x-ray, adrenal 0.00 12.64 NA 0.65 13.29 NA XXX
gland.
75842............... .............. A Vein x-ray, adrenal 1.49 13.12 NA 0.73 15.34 NA XXX
glands.
75842............... 26............ A Vein x-ray, adrenal 1.49 0.48 0.48 0.08 2.05 2.05 XXX
glands.
75842............... TC............ A Vein x-ray, adrenal 0.00 12.64 NA 0.65 13.29 NA XXX
glands.
75860............... .............. A Vein x-ray, neck..... 1.14 13.03 NA 0.72 14.89 NA XXX
75860............... 26............ A Vein x-ray, neck..... 1.14 0.39 0.39 0.07 1.60 1.60 XXX
75860............... TC............ A Vein x-ray, neck..... 0.00 12.64 NA 0.65 13.29 NA XXX
75870............... .............. A Vein x-ray, skull.... 1.14 13.03 NA 0.72 14.89 NA XXX
75870............... 26............ A Vein x-ray, skull.... 1.14 0.39 0.39 0.07 1.60 1.60 XXX
75870............... TC............ A Vein x-ray, skull.... 0.00 12.64 NA 0.65 13.29 NA XXX
75872............... .............. A Vein x-ray, skull.... 1.14 13.01 NA 0.71 14.86 NA XXX
75872............... 26............ A Vein x-ray, skull.... 1.14 0.37 0.37 0.06 1.57 1.57 XXX
[[Page 1202]]
75872............... TC............ A Vein x-ray, skull.... 0.00 12.64 NA 0.65 13.29 NA XXX
75880............... .............. A Vein x-ray, eye 0.70 1.18 NA 0.10 1.98 NA XXX
socket.
75880............... 26............ A Vein x-ray, eye 0.70 0.23 0.23 0.04 0.97 0.97 XXX
socket.
75880............... TC............ A Vein x-ray, eye 0.00 0.95 NA 0.06 1.01 NA XXX
socket.
75885............... .............. A Vein x-ray, liver.... 1.44 13.11 NA 0.72 15.27 NA XXX
75885............... 26............ A Vein x-ray, liver.... 1.44 0.47 0.47 0.07 1.98 1.98 XXX
75885............... TC............ A Vein x-ray, liver.... 0.00 12.64 NA 0.65 13.29 NA XXX
75887............... .............. A Vein x-ray, liver.... 1.44 13.11 NA 0.72 15.27 NA XXX
75887............... 26............ A Vein x-ray, liver.... 1.44 0.47 0.47 0.07 1.98 1.98 XXX
75887............... TC............ A Vein x-ray, liver.... 0.00 12.64 NA 0.65 13.29 NA XXX
75889............... .............. A Vein x-ray, liver.... 1.14 13.01 NA 0.71 14.86 NA XXX
75889............... 26............ A Vein x-ray, liver.... 1.14 0.37 0.37 0.06 1.57 1.57 XXX
75889............... TC............ A Vein x-ray, liver.... 0.00 12.64 NA 0.65 13.29 NA XXX
75891............... .............. A Vein x-ray, liver.... 1.14 13.01 NA 0.71 14.86 NA XXX
75891............... 26............ A Vein x-ray, liver.... 1.14 0.37 0.37 0.06 1.57 1.57 XXX
75891............... TC............ A Vein x-ray, liver.... 0.00 12.64 NA 0.65 13.29 NA XXX
75893............... .............. A Venous sampling by 0.54 12.82 NA 0.67 14.03 NA XXX
catheter.
75893............... 26............ A Venous sampling by 0.54 0.18 0.18 0.02 0.74 0.74 XXX
catheter.
75893............... TC............ A Venous sampling by 0.00 12.64 NA 0.65 13.29 NA XXX
catheter.
75894............... .............. A X-rays, transcath 1.31 24.65 NA 1.35 27.31 NA XXX
therapy.
75894............... 26............ A X-rays, transcath 1.31 0.43 0.43 0.08 1.82 1.82 XXX
therapy.
75894............... TC............ A X-rays, transcath 0.00 24.22 NA 1.27 25.49 NA XXX
therapy.
75896............... .............. A X-rays, transcath 1.31 21.51 NA 1.17 23.99 NA XXX
therapy.
75896............... 26............ A X-rays, transcath 1.31 0.45 0.45 0.07 1.83 1.83 XXX
therapy.
75896............... TC............ A X-rays, transcath 0.00 21.06 NA 1.10 22.16 NA XXX
therapy.
75898............... .............. A Follow-up angiography 1.65 1.61 NA 0.14 3.40 NA XXX
75898............... 26............ A Follow-up angiography 1.65 0.55 0.55 0.08 2.28 2.28 XXX
75898............... TC............ A Follow-up angiography 0.00 1.06 NA 0.06 1.12 NA XXX
75900............... .............. A Arterial catheter 0.49 21.20 NA 1.13 22.82 NA XXX
exchange.
75900............... 26............ A Arterial catheter 0.49 0.16 0.16 0.02 0.67 0.67 XXX
exchange.
75900............... TC............ A Arterial catheter 0.00 21.04 NA 1.11 22.15 NA XXX
exchange.
75901............... .............. A Remove cva device 0.49 1.47 NA 0.85 2.81 NA XXX
obstruct.
75901............... 26............ A Remove cva device 0.49 0.16 0.16 0.02 0.67 0.67 XXX
obstruct.
75901............... TC............ A Remove cva device 0.00 1.31 NA 0.83 2.14 NA XXX
obstruct.
75902............... .............. A Remove cva lumen 0.39 1.44 NA 0.85 2.68 NA XXX
obstruct.
75902............... 26............ A Remove cva lumen 0.39 0.13 0.13 0.02 0.54 0.54 XXX
obstruct.
75902............... TC............ A Remove cva lumen 0.00 1.31 NA 0.83 2.14 NA XXX
obstruct.
75940............... .............. A X-ray placement, vein 0.54 12.82 NA 0.69 14.05 NA XXX
filter.
75940............... 26............ A X-ray placement, vein 0.54 0.18 0.18 0.04 0.76 0.76 XXX
filter.
75940............... TC............ A X-ray placement, vein 0.00 12.64 NA 0.65 13.29 NA XXX
filter.
75945............... .............. A Intravascular us..... 0.40 4.72 NA 0.28 5.40 NA XXX
75945............... 26............ A Intravascular us..... 0.40 0.14 0.14 0.04 0.58 0.58 XXX
75945............... TC............ A Intravascular us..... 0.00 4.58 NA 0.24 4.82 NA XXX
75946............... .............. A Intravascular us add- 0.40 2.44 NA 0.17 3.01 NA ZZZ
on.
75946............... 26............ A Intravascular us add- 0.40 0.14 0.14 0.04 0.58 0.58 ZZZ
on.
75946............... TC............ A Intravascular us add- 0.00 2.30 NA 0.13 2.43 NA ZZZ
on.
75952............... .............. C Endovasc repair abdom 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aorta.
75952............... 26............ A Endovasc repair abdom 4.49 1.50 1.50 0.82 6.81 6.81 XXX
aorta.
75952............... TC............ C Endovasc repair abdom 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aorta.
75953............... .............. C Abdom aneurysm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
endovas rpr.
75953............... 26............ A Abdom aneurysm 1.36 0.45 0.45 0.82 2.63 2.63 XXX
endovas rpr.
75953............... TC............ C Abdom aneurysm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
endovas rpr.
75954............... .............. C Iliac aneurysm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
endovas rpr.
75954............... 26............ A Iliac aneurysm 2.25 0.47 0.47 0.82 3.54 3.54 XXX
endovas rpr.
75954............... TC............ C Iliac aneurysm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
endovas rpr.
75960............... .............. A Transcatheter intro, 0.82 15.24 NA 0.82 16.88 NA XXX
stent.
75960............... 26............ A Transcatheter intro, 0.82 0.29 0.29 0.05 1.16 1.16 XXX
stent.
75960............... TC............ A Transcatheter intro, 0.00 14.95 NA 0.77 15.72 NA XXX
stent.
75961............... .............. A Retrieval, broken 4.24 11.94 NA 0.77 16.95 NA XXX
catheter.
75961............... 26............ A Retrieval, broken 4.24 1.40 1.40 0.22 5.86 5.86 XXX
catheter.
75961............... TC............ A Retrieval, broken 0.00 10.54 NA 0.55 11.09 NA XXX
catheter.
75962............... .............. A Repair arterial 0.54 15.99 NA 0.87 17.40 NA XXX
blockage.
75962............... 26............ A Repair arterial 0.54 0.19 0.19 0.04 0.77 0.77 XXX
blockage.
75962............... TC............ A Repair arterial 0.00 15.80 NA 0.83 16.63 NA XXX
blockage.
75964............... .............. A Repair artery 0.36 8.54 NA 0.45 9.35 NA ZZZ
blockage, each.
75964............... 26............ A Repair artery 0.36 0.12 0.12 0.02 0.50 0.50 ZZZ
blockage, each.
75964............... TC............ A Repair artery 0.00 8.42 NA 0.43 8.85 NA ZZZ
blockage, each.
75966............... .............. A Repair arterial 1.31 16.26 NA 0.90 18.47 NA XXX
blockage.
75966............... 26............ A Repair arterial 1.31 0.46 0.46 0.07 1.84 1.84 XXX
blockage.
75966............... TC............ A Repair arterial 0.00 15.80 NA 0.83 16.63 NA XXX
blockage.
75968............... .............. A Repair artery 0.36 8.55 NA 0.44 9.35 NA ZZZ
blockage, each.
75968............... 26............ A Repair artery 0.36 0.13 0.13 0.01 0.50 0.50 ZZZ
blockage, each.
75968............... TC............ A Repair artery 0.00 8.42 NA 0.43 8.85 NA ZZZ
blockage, each.
75970............... .............. A Vascular biopsy...... 0.83 11.88 NA 0.65 13.36 NA XXX
75970............... 26............ A Vascular biopsy...... 0.83 0.29 0.29 0.05 1.17 1.17 XXX
[[Page 1203]]
75970............... TC............ A Vascular biopsy...... 0.00 11.59 NA 0.60 12.19 NA XXX
75978............... .............. A Repair venous 0.54 15.98 NA 0.85 17.37 NA XXX
blockage.
75978............... 26............ A Repair venous 0.54 0.18 0.18 0.02 0.74 0.74 XXX
blockage.
75978............... TC............ A Repair venous 0.00 15.80 NA 0.83 16.63 NA XXX
blockage.
75980............... .............. A Contrast xray exam 1.44 5.91 NA 0.36 7.71 NA XXX
bile duct.
75980............... 26............ A Contrast xray exam 1.44 0.47 0.47 0.07 1.98 1.98 XXX
bile duct.
75980............... TC............ A Contrast xray exam 0.00 5.44 NA 0.29 5.73 NA XXX
bile duct.
75982............... .............. A Contrast xray exam 1.44 6.58 NA 0.40 8.42 NA XXX
bile duct.
75982............... 26............ A Contrast xray exam 1.44 0.46 0.46 0.07 1.97 1.97 XXX
bile duct.
75982............... TC............ A Contrast xray exam 0.00 6.12 NA 0.33 6.45 NA XXX
bile duct.
75984............... .............. A Xray control catheter 0.72 2.20 NA 0.15 3.07 NA XXX
change.
75984............... 26............ A Xray control catheter 0.72 0.24 0.24 0.04 1.00 1.00 XXX
change.
75984............... TC............ A Xray control catheter 0.00 1.96 NA 0.11 2.07 NA XXX
change.
75989............... .............. A Abscess drainage 1.19 3.55 NA 0.23 4.97 NA XXX
under x-ray.
75989............... 26............ A Abscess drainage 1.19 0.38 0.38 0.06 1.63 1.63 XXX
under x-ray.
75989............... TC............ A Abscess drainage 0.00 3.17 NA 0.17 3.34 NA XXX
under x-ray.
75992............... .............. A Atherectomy, x-ray 0.54 15.99 NA 0.85 17.38 NA XXX
exam.
75992............... 26............ A Atherectomy, x-ray 0.54 0.19 0.19 0.02 0.75 0.75 XXX
exam.
75992............... TC............ A Atherectomy, x-ray 0.00 15.80 NA 0.83 16.63 NA XXX
exam.
75993............... .............. A Atherectomy, x-ray 0.36 8.56 NA 0.44 9.36 NA ZZZ
exam.
75993............... 26............ A Atherectomy, x-ray 0.36 0.14 0.14 0.01 0.51 0.51 ZZZ
exam.
75993............... TC............ A Atherectomy, x-ray 0.00 8.42 NA 0.43 8.85 NA ZZZ
exam.
75994............... .............. A Atherectomy, x-ray 1.31 16.26 NA 0.90 18.47 NA XXX
exam.
75994............... 26............ A Atherectomy, x-ray 1.31 0.46 0.46 0.07 1.84 1.84 XXX
exam.
75994............... TC............ A Atherectomy, x-ray 0.00 15.80 NA 0.83 16.63 NA XXX
exam.
75995............... .............. A Atherectomy, x-ray 1.31 16.27 NA 0.90 18.48 NA XXX
exam.
75995............... 26............ A Atherectomy, x-ray 1.31 0.47 0.47 0.07 1.85 1.85 XXX
exam.
75995............... TC............ A Atherectomy, x-ray 0.00 15.80 NA 0.83 16.63 NA XXX
exam.
75996............... .............. A Atherectomy, x-ray 0.36 8.54 NA 0.44 9.34 NA ZZZ
exam.
75996............... 26............ A Atherectomy, x-ray 0.36 0.12 0.12 0.01 0.49 0.49 ZZZ
exam.
75996............... TC............ A Atherectomy, x-ray 0.00 8.42 NA 0.43 8.85 NA ZZZ
exam.
75998............... .............. A Fluoroguide for vein 0.38 1.44 NA 0.15 1.97 NA ZZZ
device.
75998............... 26............ A Fluoroguide for vein 0.38 0.13 0.13 0.05 0.56 0.56 ZZZ
device.
75998............... TC............ A Fluoroguide for vein 0.00 1.31 NA 0.10 1.41 NA ZZZ
device.
76000............... .............. A Fluoroscope 0.17 1.36 NA 0.08 1.61 NA XXX
examination.
76000............... 26............ A Fluoroscope 0.17 0.05 0.05 0.01 0.23 0.23 XXX
examination.
76000............... TC............ A Fluoroscope 0.00 1.31 NA 0.07 1.38 NA XXX
examination.
76001............... .............. A Fluoroscope exam, 0.67 2.84 NA 0.18 3.69 NA XXX
extensive.
76001............... 26............ A Fluoroscope exam, 0.67 0.22 0.22 0.04 0.93 0.93 XXX
extensive.
76001............... TC............ A Fluoroscope exam, 0.00 2.62 NA 0.14 2.76 NA XXX
extensive.
76003............... .............. A Needle localization 0.54 1.48 NA 0.11 2.13 NA XXX
by x-ray.
76003............... 26............ A Needle localization 0.54 0.17 0.17 0.04 0.75 0.75 XXX
by x-ray.
76003............... TC............ A Needle localization 0.00 1.31 NA 0.07 1.38 NA XXX
by x-ray.
76005............... .............. A Fluoroguide for spine 0.60 1.47 NA 0.11 2.18 NA XXX
inject.
76005............... 26............ A Fluoroguide for spine 0.60 0.16 0.16 0.04 0.80 0.80 XXX
inject.
76005............... TC............ A Fluoroguide for spine 0.00 1.31 NA 0.07 1.38 NA XXX
inject.
76006............... .............. A X-ray stress view.... 0.41 0.19 0.19 0.05 0.65 0.65 XXX
76010............... .............. A X-ray, nose to rectum 0.18 0.58 NA 0.03 0.79 NA XXX
76010............... 26............ A X-ray, nose to rectum 0.18 0.06 0.06 0.01 0.25 0.25 XXX
76010............... TC............ A X-ray, nose to rectum 0.00 0.52 NA 0.02 0.54 NA XXX
76012............... .............. C Percut vertebroplasty 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fluor.
76012............... 26............ A Percut vertebroplasty 1.31 0.46 0.46 0.28 2.05 2.05 XXX
fluor.
76012............... TC............ C Percut vertebroplasty 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fluor.
76013............... .............. C Percut 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vertebroplasty, ct.
76013............... 26............ A Percut 1.38 0.47 0.47 0.58 2.43 2.43 XXX
vertebroplasty, ct.
76013............... TC............ C Percut 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vertebroplasty, ct.
76020............... .............. A X-rays for bone age.. 0.19 0.58 NA 0.03 0.80 NA XXX
76020............... 26............ A X-rays for bone age.. 0.19 0.06 0.06 0.01 0.26 0.26 XXX
76020............... TC............ A X-rays for bone age.. 0.00 0.52 NA 0.02 0.54 NA XXX
76040............... .............. A X-rays, bone 0.27 0.88 NA 0.09 1.24 NA XXX
evaluation.
76040............... 26............ A X-rays, bone 0.27 0.09 0.09 0.04 0.40 0.40 XXX
evaluation.
76040............... TC............ A X-rays, bone 0.00 0.79 NA 0.05 0.84 NA XXX
evaluation.
76061............... .............. A X-rays, bone survey.. 0.45 1.15 NA 0.08 1.68 NA XXX
76061............... 26............ A X-rays, bone survey.. 0.45 0.15 0.15 0.02 0.62 0.62 XXX
76061............... TC............ A X-rays, bone survey.. 0.00 1.00 NA 0.06 1.06 NA XXX
76062............... .............. A X-rays, bone survey.. 0.54 1.62 NA 0.10 2.26 NA XXX
76062............... 26............ A X-rays, bone survey.. 0.54 0.18 0.18 0.02 0.74 0.74 XXX
76062............... TC............ A X-rays, bone survey.. 0.00 1.44 NA 0.08 1.52 NA XXX
76065............... .............. A X-rays, bone 0.70 0.98 NA 0.06 1.74 NA XXX
evaluation.
76065............... 26............ A X-rays, bone 0.70 0.24 0.24 0.01 0.95 0.95 XXX
evaluation.
76065............... TC............ A X-rays, bone 0.00 0.74 NA 0.05 0.79 NA XXX
evaluation.
76066............... .............. A Joint survey, single 0.31 1.23 NA 0.08 1.62 NA XXX
view.
76066............... 26............ A Joint survey, single 0.31 0.11 0.11 0.02 0.44 0.44 XXX
view.
76066............... TC............ A Joint survey, single 0.00 1.12 NA 0.06 1.18 NA XXX
view.
76070............... .............. A Ct bone density, 0.25 3.04 NA 0.17 3.46 NA XXX
axial.
[[Page 1204]]
76070............... 26............ A Ct bone density, 0.25 0.08 0.08 0.01 0.34 0.34 XXX
axial.
76070............... TC............ A Ct bone density, 0.00 2.96 NA 0.16 3.12 NA XXX
axial.
76071............... .............. A Ct bone density, 0.22 3.03 NA 0.06 3.31 NA XXX
peripheral.
76071............... 26............ A Ct bone density, 0.22 0.07 0.07 0.01 0.30 0.30 XXX
peripheral.
76071............... TC............ A Ct bone density, 0.00 2.96 NA 0.05 3.01 NA XXX
peripheral.
76075............... .............. A Dexa, axial skeleton 0.30 3.21 NA 0.18 3.69 NA XXX
study.
76075............... 26............ A Dexa, axial skeleton 0.30 0.10 0.10 0.01 0.41 0.41 XXX
study.
76075............... TC............ A Dexa, axial skeleton 0.00 3.11 NA 0.17 3.28 NA XXX
study.
76076............... .............. A Dexa, peripheral 0.22 0.84 NA 0.06 1.12 NA XXX
study.
76076............... 26............ A Dexa, peripheral 0.22 0.08 0.08 0.01 0.31 0.31 XXX
study.
76076............... TC............ A Dexa, peripheral 0.00 0.76 NA 0.05 0.81 NA XXX
study.
76078............... .............. A Radiographic 0.20 0.83 NA 0.06 1.09 NA XXX
absorptiometry.
76078............... 26............ A Radiographic 0.20 0.07 0.07 0.01 0.28 0.28 XXX
absorptiometry.
76078............... TC............ A Radiographic 0.00 0.76 NA 0.05 0.81 NA XXX
absorptiometry.
76080............... .............. A X-ray exam of fistula 0.54 1.24 NA 0.08 1.86 NA XXX
76080............... 26............ A X-ray exam of fistula 0.54 0.18 0.18 0.02 0.74 0.74 XXX
76080............... TC............ A X-ray exam of fistula 0.00 1.06 NA 0.06 1.12 NA XXX
76082............... .............. A Computer mammogram 0.06 0.43 NA 0.02 0.51 NA ZZZ
add-on.
76082............... 26............ A Computer mammogram 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ
add-on.
76082............... TC............ A Computer mammogram 0.00 0.41 NA 0.01 0.42 NA ZZZ
add-on.
76083............... .............. A Computer mammogram 0.06 0.43 NA 0.02 0.51 NA ZZZ
add-on.
76083............... 26............ A Computer mammogram 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ
add-on.
76083............... TC............ A Computer mammogram 0.00 0.41 NA 0.01 0.42 NA ZZZ
add-on.
76085............... .............. F Computer mammogram +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
add-on.
76085............... 26............ F Computer mammogram +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
add-on.
76085............... TC............ F Computer mammogram +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
add-on.
76086............... .............. A X-ray of mammary duct 0.36 2.74 NA 0.16 3.26 NA XXX
76086............... 26............ A X-ray of mammary duct 0.36 0.12 0.12 0.02 0.50 0.50 XXX
76086............... TC............ A X-ray of mammary duct 0.00 2.62 NA 0.14 2.76 NA XXX
76088............... .............. A X-ray of mammary 0.45 3.83 NA 0.21 4.49 NA XXX
ducts.
76088............... 26............ A X-ray of mammary 0.45 0.15 0.15 0.02 0.62 0.62 XXX
ducts.
76088............... TC............ A X-ray of mammary 0.00 3.68 NA 0.19 3.87 NA XXX
ducts.
76090............... .............. A Mammogram, one breast 0.70 1.29 NA 0.10 2.09 NA XXX
76090............... 26............ A Mammogram, one breast 0.70 0.23 0.23 0.04 0.97 0.97 XXX
76090............... TC............ A Mammogram, one breast 0.00 1.06 NA 0.06 1.12 NA XXX
76091............... .............. A Mammogram, both 0.87 1.60 NA 0.11 2.58 NA XXX
breasts.
76091............... 26............ A Mammogram, both 0.87 0.29 0.29 0.04 1.20 1.20 XXX
breasts.
76091............... TC............ A Mammogram, both 0.00 1.31 NA 0.07 1.38 NA XXX
breasts.
76092............... .............. A Mammogram, screening. 0.70 1.46 NA 0.11 2.27 NA XXX
76092............... 26............ A Mammogram, screening. 0.70 0.23 0.23 0.04 0.97 0.97 XXX
76092............... TC............ A Mammogram, screening. 0.00 1.23 NA 0.07 1.30 NA XXX
76093............... .............. A Magnetic image, 1.63 18.21 NA 1.00 20.84 NA XXX
breast.
76093............... 26............ A Magnetic image, 1.63 0.53 0.53 0.08 2.24 2.24 XXX
breast.
76093............... TC............ A Magnetic image, 0.00 17.68 NA 0.92 18.60 NA XXX
breast.
76094............... .............. A Magnetic image, both 1.63 24.52 NA 1.32 27.47 NA XXX
breasts.
76094............... 26............ A Magnetic image, both 1.63 0.53 0.53 0.08 2.24 2.24 XXX
breasts.
76094............... TC............ A Magnetic image, both 0.00 23.99 NA 1.24 25.23 NA XXX
breasts.
76095............... .............. A Stereotactic breast 1.59 7.71 NA 0.48 9.78 NA XXX
biopsy.
76095............... 26............ A Stereotactic breast 1.59 0.52 0.52 0.11 2.22 2.22 XXX
biopsy.
76095............... TC............ A Stereotactic breast 0.00 7.19 NA 0.37 7.56 NA XXX
biopsy.
76096............... .............. A X-ray of needle wire, 0.56 1.50 NA 0.11 2.17 NA XXX
breast.
76096............... 26............ A X-ray of needle wire, 0.56 0.19 0.19 0.04 0.79 0.79 XXX
breast.
76096............... TC............ A X-ray of needle wire, 0.00 1.31 NA 0.07 1.38 NA XXX
breast.
76098............... .............. A X-ray exam, breast 0.16 0.46 NA 0.03 0.65 NA XXX
specimen.
76098............... 26............ A X-ray exam, breast 0.16 0.05 0.05 0.01 0.22 0.22 XXX
specimen.
76098............... TC............ A X-ray exam, breast 0.00 0.41 NA 0.02 0.43 NA XXX
specimen.
76100............... .............. A X-ray exam of body 0.58 1.44 NA 0.11 2.13 NA XXX
section.
76100............... 26............ A X-ray exam of body 0.58 0.19 0.19 0.04 0.81 0.81 XXX
section.
76100............... TC............ A X-ray exam of body 0.00 1.25 NA 0.07 1.32 NA XXX
section.
76101............... .............. A Complex body section 0.58 1.62 NA 0.12 2.32 NA XXX
x-ray.
76101............... 26............ A Complex body section 0.58 0.19 0.19 0.04 0.81 0.81 XXX
x-ray.
76101............... TC............ A Complex body section 0.00 1.43 NA 0.08 1.51 NA XXX
x-ray.
76102............... .............. A Complex body section 0.58 1.94 NA 0.15 2.67 NA XXX
x-rays.
76102............... 26............ A Complex body section 0.58 0.20 0.20 0.04 0.82 0.82 XXX
x-rays.
76102............... TC............ A Complex body section 0.00 1.74 NA 0.11 1.85 NA XXX
x-rays.
76120............... .............. A Cine/video x-rays.... 0.38 1.19 NA 0.08 1.65 NA XXX
76120............... 26............ A Cine/video x-rays.... 0.38 0.13 0.13 0.02 0.53 0.53 XXX
76120............... TC............ A Cine/video x-rays.... 0.00 1.06 NA 0.06 1.12 NA XXX
76125............... .............. A Cine/video x-rays add- 0.27 0.88 NA 0.06 1.21 NA ZZZ
on.
76125............... 26............ A Cine/video x-rays add- 0.27 0.09 0.09 0.01 0.37 0.37 ZZZ
on.
76125............... TC............ A Cine/video x-rays add- 0.00 0.79 NA 0.05 0.84 NA ZZZ
on.
76140............... .............. I X-ray consultation... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76150............... .............. A X-ray exam, dry 0.00 0.41 NA 0.02 0.43 NA XXX
process.
76350............... .............. C Special x-ray 0.00 0.00 0.00 0.00 0.00 0.00 XXX
contrast study.
76355............... .............. A Ct scan for 1.21 8.69 NA 0.49 10.39 NA XXX
localization.
[[Page 1205]]
76355............... 26............ A Ct scan for 1.21 0.40 0.40 0.07 1.68 1.68 XXX
localization.
76355............... TC............ A Ct scan for 0.00 8.29 NA 0.42 8.71 NA XXX
localization.
76360............... .............. A Ct scan for needle 1.16 8.66 NA 0.48 10.30 NA XXX
biopsy.
76360............... 26............ A Ct scan for needle 1.16 0.37 0.37 0.06 1.59 1.59 XXX
biopsy.
76360............... TC............ A Ct scan for needle 0.00 8.29 NA 0.42 8.71 NA XXX
biopsy.
76362............... .............. A Ct guide for tissue 3.99 9.59 NA 1.68 15.26 NA XXX
ablation.
76362............... 26............ A Ct guide for tissue 3.99 1.30 1.30 0.22 5.51 5.51 XXX
ablation.
76362............... TC............ A Ct guide for tissue 0.00 8.29 NA 1.46 9.75 NA XXX
ablation.
76370............... .............. A Ct scan for therapy 0.85 3.24 NA 0.21 4.30 NA XXX
guide.
76370............... 26............ A Ct scan for therapy 0.85 0.28 0.28 0.05 1.18 1.18 XXX
guide.
76370............... TC............ A Ct scan for therapy 0.00 2.96 NA 0.16 3.12 NA XXX
guide.
76375............... .............. A 3d/holograph reconstr 0.16 3.60 NA 0.19 3.95 NA XXX
add-on.
76375............... 26............ A 3d/holograph reconstr 0.16 0.05 0.05 0.01 0.22 0.22 XXX
add-on.
76375............... TC............ A 3d/holograph reconstr 0.00 3.55 NA 0.18 3.73 NA XXX
add-on.
76380............... .............. A CAT scan follow-up 0.98 3.84 NA 0.23 5.05 NA XXX
study.
76380............... 26............ A CAT scan follow-up 0.98 0.33 0.33 0.05 1.36 1.36 XXX
study.
76380............... TC............ A CAT scan follow-up 0.00 3.51 NA 0.18 3.69 NA XXX
study.
76390............... .............. N Mr spectroscopy...... +1.40 11.48 11.48 0.66 13.54 13.54 XXX
76390............... 26............ N Mr spectroscopy...... +1.40 0.47 0.47 0.07 1.94 1.94 XXX
76390............... TC............ N Mr spectroscopy...... +0.00 11.01 11.01 0.59 11.60 11.60 XXX
76393............... .............. A Mr guidance for 1.50 11.74 NA 0.63 13.87 NA XXX
needle place.
76393............... 26............ A Mr guidance for 1.50 0.50 0.50 0.08 2.08 2.08 XXX
needle place.
76393............... TC............ A Mr guidance for 0.00 11.24 NA 0.55 11.79 NA XXX
needle place.
76394............... .............. A Mri for tissue 4.24 12.63 NA 1.79 18.66 NA XXX
ablation.
76394............... 26............ A Mri for tissue 4.24 1.39 1.39 0.23 5.86 5.86 XXX
ablation.
76394............... TC............ A Mri for tissue 0.00 11.24 NA 1.56 12.80 NA XXX
ablation.
76400............... .............. A Magnetic image, bone 1.60 11.76 NA 0.67 14.03 NA XXX
marrow.
76400............... 26............ A Magnetic image, bone 1.60 0.52 0.52 0.08 2.20 2.20 XXX
marrow.
76400............... TC............ A Magnetic image, bone 0.00 11.24 NA 0.59 11.83 NA XXX
marrow.
76490............... .............. D Us for tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ablation.
76490............... 26............ D Us for tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ablation.
76490............... TC............ D Us for tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ablation.
76496............... .............. C Fluoroscopic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76496............... 26............ C Fluoroscopic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76496............... TC............ C Fluoroscopic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76497............... .............. C Ct procedure......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76497............... 26............ C Ct procedure......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76497............... TC............ C Ct procedure......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76498............... .............. C Mri procedure........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76498............... 26............ C Mri procedure........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76498............... TC............ C Mri procedure........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76499............... .............. C Radiographic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76499............... 26............ C Radiographic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76499............... TC............ C Radiographic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76506............... .............. A Echo exam of head.... 0.63 1.68 NA 0.12 2.43 NA XXX
76506............... 26............ A Echo exam of head.... 0.63 0.25 0.25 0.04 0.92 0.92 XXX
76506............... TC............ A Echo exam of head.... 0.00 1.43 NA 0.08 1.51 NA XXX
76511............... .............. A Echo exam of eye..... 0.94 1.09 NA 0.09 2.12 NA XXX
76511............... 26............ A Echo exam of eye..... 0.94 0.40 0.40 0.02 1.36 1.36 XXX
76511............... TC............ A Echo exam of eye..... 0.00 0.69 NA 0.07 0.76 NA XXX
76512............... .............. A Echo exam of eye..... 0.66 1.02 NA 0.11 1.79 NA XXX
76512............... 26............ A Echo exam of eye..... 0.66 0.30 0.30 0.01 0.97 0.97 XXX
76512............... TC............ A Echo exam of eye..... 0.00 0.72 NA 0.10 0.82 NA XXX
76513............... .............. A Echo exam of eye, 0.66 1.10 NA 0.11 1.87 NA XXX
water bath.
76513............... 26............ A Echo exam of eye, 0.66 0.30 0.30 0.01 0.97 0.97 XXX
water bath.
76513............... TC............ A Echo exam of eye, 0.00 0.80 NA 0.10 0.90 NA XXX
water bath.
76514............... .............. A Echo exam of eye, 0.17 0.14 NA 0.02 0.33 NA XXX
thickness.
76514............... 26............ A Echo exam of eye, 0.17 0.08 0.08 0.01 0.26 0.26 XXX
thickness.
76514............... TC............ A Echo exam of eye, 0.00 0.06 NA 0.01 0.07 NA XXX
thickness.
76516............... .............. A Echo exam of eye..... 0.54 0.73 NA 0.08 1.35 NA XXX
76516............... 26............ A Echo exam of eye..... 0.54 0.25 0.25 0.01 0.80 0.80 XXX
76516............... TC............ A Echo exam of eye..... 0.00 0.48 NA 0.07 0.55 NA XXX
76519............... .............. A Echo exam of eye..... 0.54 0.81 NA 0.08 1.43 NA XXX
76519............... 26............ A Echo exam of eye..... 0.54 0.25 0.25 0.01 0.80 0.80 XXX
76519............... TC............ A Echo exam of eye..... 0.00 0.56 NA 0.07 0.63 NA XXX
76529............... .............. A Echo exam of eye..... 0.57 0.77 NA 0.09 1.43 NA XXX
76529............... 26............ A Echo exam of eye..... 0.57 0.25 0.25 0.01 0.83 0.83 XXX
76529............... TC............ A Echo exam of eye..... 0.00 0.52 NA 0.08 0.60 NA XXX
76536............... .............. A Us exam of head and 0.56 1.62 NA 0.10 2.28 NA XXX
neck.
76536............... 26............ A Us exam of head and 0.56 0.19 0.19 0.02 0.77 0.77 XXX
neck.
76536............... TC............ A Us exam of head and 0.00 1.43 NA 0.08 1.51 NA XXX
neck.
76604............... .............. A Us exam, chest, b- 0.55 1.49 NA 0.09 2.13 NA XXX
scan.
76604............... 26............ A Us exam, chest, b- 0.55 0.18 0.18 0.02 0.75 0.75 XXX
scan.
76604............... TC............ A Us exam, chest, b- 0.00 1.31 NA 0.07 1.38 NA XXX
scan.
76645............... .............. A Us exam, breast(s)... 0.54 1.24 NA 0.10 1.88 NA XXX
[[Page 1206]]
76645............... 26............ A Us exam, breast(s)... 0.54 0.18 0.18 0.04 0.76 0.76 XXX
76645............... TC............ A Us exam, breast(s)... 0.00 1.06 NA 0.06 1.12 NA XXX
76700............... .............. A Us exam, abdom, 0.81 2.25 NA 0.16 3.22 NA XXX
complete.
76700............... 26............ A Us exam, abdom, 0.81 0.27 0.27 0.05 1.13 1.13 XXX
complete.
76700............... TC............ A Us exam, abdom, 0.00 1.98 NA 0.11 2.09 NA XXX
complete.
76705............... .............. A Echo exam of abdomen. 0.59 1.63 NA 0.12 2.34 NA XXX
76705............... 26............ A Echo exam of abdomen. 0.59 0.20 0.20 0.04 0.83 0.83 XXX
76705............... TC............ A Echo exam of abdomen. 0.00 1.43 NA 0.08 1.51 NA XXX
76770............... .............. A Us exam abdo back 0.74 2.23 NA 0.15 3.12 NA XXX
wall, comp.
76770............... 26............ A Us exam abdo back 0.74 0.25 0.25 0.04 1.03 1.03 XXX
wall, comp.
76770............... TC............ A Us exam abdo back 0.00 1.98 NA 0.11 2.09 NA XXX
wall, comp.
76775............... .............. A Us exam abdo back 0.58 1.62 NA 0.12 2.32 NA XXX
wall, lim.
76775............... 26............ A Us exam abdo back 0.58 0.19 0.19 0.04 0.81 0.81 XXX
wall, lim.
76775............... TC............ A Us exam abdo back 0.00 1.43 NA 0.08 1.51 NA XXX
wall, lim.
76778............... .............. A Us exam kidney 0.74 2.23 NA 0.15 3.12 NA XXX
transplant.
76778............... 26............ A Us exam kidney 0.74 0.25 0.25 0.04 1.03 1.03 XXX
transplant.
76778............... TC............ A Us exam kidney 0.00 1.98 NA 0.11 2.09 NA XXX
transplant.
76800............... .............. A Us exam, spinal canal 1.13 1.78 NA 0.13 3.04 NA XXX
76800............... 26............ A Us exam, spinal canal 1.13 0.35 0.35 0.05 1.53 1.53 XXX
76800............... TC............ A Us exam, spinal canal 0.00 1.43 NA 0.08 1.51 NA XXX
76801............... .............. A Ob us < 14 wks, 0.99 2.45 NA 0.17 3.61 NA XXX
single fetus.
76801............... 26............ A Ob us < 14 wks, 0.99 0.35 0.35 0.05 1.39 1.39 XXX
single fetus.
76801............... TC............ A Ob us < 14 wks, 0.00 2.10 NA 0.12 2.22 NA XXX
single fetus.
76802............... .............. A Ob us < 14 wks, add'l 0.83 1.35 NA 0.17 2.35 NA ZZZ
fetus.
76802............... 26............ A Ob us < 14 wks, add'l 0.83 0.29 0.29 0.05 1.17 1.17 ZZZ
fetus.
76802............... TC............ A Ob us < 14 wks, add'l 0.00 1.06 NA 0.12 1.18 NA ZZZ
fetus.
76805............... .............. A Ob us /= 0.99 2.45 NA 0.17 3.61 NA XXX
14 wks, sngl fetus.
76805............... 26............ A Ob us /= 0.99 0.35 0.35 0.05 1.39 1.39 XXX
14 wks, sngl fetus.
76805............... TC............ A Ob us /= 0.00 2.10 NA 0.12 2.22 NA XXX
14 wks, sngl fetus.
76810............... .............. A Ob us /= 0.98 1.41 NA 0.30 2.69 NA ZZZ
14 wks, addl fetus.
76810............... 26............ A Ob us /= 0.98 0.35 0.35 0.08 1.41 1.41 ZZZ
14 wks, addl fetus.
76810............... TC............ A Ob us /= 0.00 1.06 NA 0.22 1.28 NA ZZZ
14 wks, addl fetus.
76811............... .............. A Ob us, detailed, sngl 1.90 4.20 NA 0.61 6.71 NA XXX
fetus.
76811............... 26............ A Ob us, detailed, sngl 1.90 0.66 0.66 0.18 2.74 2.74 XXX
fetus.
76811............... TC............ A Ob us, detailed, sngl 0.00 3.54 NA 0.43 3.97 NA XXX
fetus.
76812............... .............. A Ob us, detailed, addl 1.78 1.69 NA 0.55 4.02 NA ZZZ
fetus.
76812............... 26............ A Ob us, detailed, addl 1.78 0.63 0.63 0.14 2.55 2.55 ZZZ
fetus.
76812............... TC............ A Ob us, detailed, addl 0.00 1.06 NA 0.41 1.47 NA ZZZ
fetus.
76815............... .............. A Ob us, limited, 0.65 1.66 NA 0.10 2.41 NA XXX
fetus(s).
76815............... 26............ A Ob us, limited, 0.65 0.23 0.23 0.02 0.90 0.90 XXX
fetus(s).
76815............... TC............ A Ob us, limited, 0.00 1.43 NA 0.08 1.51 NA XXX
fetus(s).
76816............... .............. A Ob us, follow-up, per 0.85 1.44 NA 0.08 2.37 NA XXX
fetus.
76816............... 26............ A Ob us, follow-up, per 0.85 0.32 0.32 0.02 1.19 1.19 XXX
fetus.
76816............... TC............ A Ob us, follow-up, per 0.00 1.12 NA 0.06 1.18 NA XXX
fetus.
76817............... .............. A Transvaginal us, 0.75 1.80 NA 0.08 2.63 NA XXX
obstetric.
76817............... 26............ A Transvaginal us, 0.75 0.28 0.28 0.02 1.05 1.05 XXX
obstetric.
76817............... TC............ A Transvaginal us, 0.00 1.52 NA 0.06 1.58 NA XXX
obstetric.
76818............... .............. A Fetal biophys profile 1.05 2.00 NA 0.15 3.20 NA XXX
w/nst.
76818............... 26............ A Fetal biophys profile 1.05 0.38 0.38 0.05 1.48 1.48 XXX
w/nst.
76818............... TC............ A Fetal biophys profile 0.00 1.62 NA 0.10 1.72 NA XXX
w/nst.
76819............... .............. A Fetal biophys profil 0.77 1.90 NA 0.12 2.79 NA XXX
w/o nst.
76819............... 26............ A Fetal biophys profil 0.77 0.28 0.28 0.02 1.07 1.07 XXX
w/o nst.
76819............... TC............ A Fetal biophys profil 0.00 1.62 NA 0.10 1.72 NA XXX
w/o nst.
76825............... .............. A Echo exam of fetal 1.67 2.58 NA 0.18 4.43 NA XXX
heart.
76825............... 26............ A Echo exam of fetal 1.67 0.60 0.60 0.07 2.34 2.34 XXX
heart.
76825............... TC............ A Echo exam of fetal 0.00 1.98 NA 0.11 2.09 NA XXX
heart.
76826............... .............. A Echo exam of fetal 0.83 1.00 NA 0.09 1.92 NA XXX
heart.
76826............... 26............ A Echo exam of fetal 0.83 0.29 0.29 0.04 1.16 1.16 XXX
heart.
76826............... TC............ A Echo exam of fetal 0.00 0.71 NA 0.05 0.76 NA XXX
heart.
76827............... .............. A Echo exam of fetal 0.58 1.95 NA 0.14 2.67 NA XXX
heart.
76827............... 26............ A Echo exam of fetal 0.58 0.22 0.22 0.02 0.82 0.82 XXX
heart.
76827............... TC............ A Echo exam of fetal 0.00 1.73 NA 0.12 1.85 NA XXX
heart.
76828............... .............. A Echo exam of fetal 0.56 1.34 NA 0.10 2.00 NA XXX
heart.
76828............... 26............ A Echo exam of fetal 0.56 0.22 0.22 0.02 0.80 0.80 XXX
heart.
76828............... TC............ A Echo exam of fetal 0.00 1.12 NA 0.08 1.20 NA XXX
heart.
76830............... .............. A Transvaginal us, non- 0.69 1.75 NA 0.14 2.58 NA XXX
ob.
76830............... 26............ A Transvaginal us, non- 0.69 0.23 0.23 0.04 0.96 0.96 XXX
ob.
76830............... TC............ A Transvaginal us, non- 0.00 1.52 NA 0.10 1.62 NA XXX
ob.
76831............... .............. A Echo exam, uterus.... 0.72 1.78 NA 0.12 2.62 NA XXX
76831............... 26............ A Echo exam, uterus.... 0.72 0.26 0.26 0.02 1.00 1.00 XXX
76831............... TC............ A Echo exam, uterus.... 0.00 1.52 NA 0.10 1.62 NA XXX
76856............... .............. A Us exam, pelvic, 0.69 1.75 NA 0.14 2.58 NA XXX
complete.
76856............... 26............ A Us exam, pelvic, 0.69 0.23 0.23 0.04 0.96 0.96 XXX
complete.
76856............... TC............ A Us exam, pelvic, 0.00 1.52 NA 0.10 1.62 NA XXX
complete.
76857............... .............. A Us exam, pelvic, 0.38 1.70 NA 0.08 2.16 NA XXX
limited.
[[Page 1207]]
76857............... 26............ A Us exam, pelvic, 0.38 0.13 0.13 0.02 0.53 0.53 XXX
limited.
76857............... TC............ A Us exam, pelvic, 0.00 1.57 NA 0.06 1.63 NA XXX
limited.
76870............... .............. A Us exam, scrotum..... 0.64 1.73 NA 0.14 2.51 NA XXX
76870............... 26............ A Us exam, scrotum..... 0.64 0.21 0.21 0.04 0.89 0.89 XXX
76870............... TC............ A Us exam, scrotum..... 0.00 1.52 NA 0.10 1.62 NA XXX
76872............... .............. A Us, transrectal...... 0.69 2.09 NA 0.15 2.93 NA XXX
76872............... 26............ A Us, transrectal...... 0.69 0.23 0.23 0.05 0.97 0.97 XXX
76872............... TC............ A Us, transrectal...... 0.00 1.86 NA 0.10 1.96 NA XXX
76873............... .............. A Echograp trans r, 1.55 2.59 NA 0.26 4.40 NA XXX
pros study.
76873............... 26............ A Echograp trans r, 1.55 0.49 0.49 0.10 2.14 2.14 XXX
pros study.
76873............... TC............ A Echograp trans r, 0.00 2.10 NA 0.16 2.26 NA XXX
pros study.
76880............... .............. A Us exam, extremity... 0.59 1.63 NA 0.12 2.34 NA XXX
76880............... 26............ A Us exam, extremity... 0.59 0.20 0.20 0.04 0.83 0.83 XXX
76880............... TC............ A Us exam, extremity... 0.00 1.43 NA 0.08 1.51 NA XXX
76885............... .............. A Us exam infant hips, 0.74 1.77 NA 0.14 2.65 NA XXX
dynamic.
76885............... 26............ A Us exam infant hips, 0.74 0.25 0.25 0.04 1.03 1.03 XXX
dynamic.
76885............... TC............ A Us exam infant hips, 0.00 1.52 NA 0.10 1.62 NA XXX
dynamic.
76886............... .............. A Us exam infant hips, 0.62 1.64 NA 0.12 2.38 NA XXX
static.
76886............... 26............ A Us exam infant hips, 0.62 0.21 0.21 0.04 0.87 0.87 XXX
static.
76886............... TC............ A Us exam infant hips, 0.00 1.43 NA 0.08 1.51 NA XXX
static.
76930............... .............. A Echo guide, 0.67 1.78 NA 0.12 2.57 NA XXX
cardiocentesis.
76930............... 26............ A Echo guide, 0.67 0.26 0.26 0.02 0.95 0.95 XXX
cardiocentesis.
76930............... TC............ A Echo guide, 0.00 1.52 NA 0.10 1.62 NA XXX
cardiocentesis.
76932............... .............. A Echo guide for heart 0.67 1.78 NA 0.12 2.57 NA XXX
biopsy.
76932............... 26............ A Echo guide for heart 0.67 0.26 0.26 0.02 0.95 0.95 XXX
biopsy.
76932............... TC............ A Echo guide for heart 0.00 1.52 NA 0.10 1.62 NA XXX
biopsy.
76936............... .............. A Echo guide for artery 1.99 6.98 NA 0.47 9.44 NA XXX
repair.
76936............... 26............ A Echo guide for artery 1.99 0.66 0.66 0.13 2.78 2.78 XXX
repair.
76936............... TC............ A Echo guide for artery 0.00 6.32 NA 0.34 6.66 NA XXX
repair.
76937............... .............. A Us guide, vascular 0.30 0.47 NA 0.15 0.92 NA ZZZ
access.
76937............... 26............ A Us guide, vascular 0.30 0.10 0.10 0.05 0.45 0.45 ZZZ
access.
76937............... TC............ A Us guide, vascular 0.00 0.37 NA 0.10 0.47 NA ZZZ
access.
76940............... .............. A Us guide, tissue 2.00 2.17 NA 0.42 4.59 NA XXX
ablation.
76940............... 26............ A Us guide, tissue 2.00 0.65 0.65 0.13 2.78 2.78 XXX
ablation.
76940............... TC............ A Us guide, tissue 0.00 1.52 NA 0.29 1.81 NA XXX
ablation.
76941............... .............. A Echo guide for 1.34 2.00 NA 0.15 3.49 NA XXX
transfusion.
76941............... 26............ A Echo guide for 1.34 0.47 0.47 0.07 1.88 1.88 XXX
transfusion.
76941............... TC............ A Echo guide for 0.00 1.53 NA 0.08 1.61 NA XXX
transfusion.
76942............... .............. A Echo guide for biopsy 0.67 2.76 NA 0.15 3.58 NA XXX
76942............... 26............ A Echo guide for biopsy 0.67 0.22 0.22 0.05 0.94 0.94 XXX
76942............... TC............ A Echo guide for biopsy 0.00 2.54 NA 0.10 2.64 NA XXX
76945............... .............. A Echo guide, villus 0.67 1.76 NA 0.12 2.55 NA XXX
sampling.
76945............... 26............ A Echo guide, villus 0.67 0.23 0.23 0.04 0.94 0.94 XXX
sampling.
76945............... TC............ A Echo guide, villus 0.00 1.53 NA 0.08 1.61 NA XXX
sampling.
76946............... .............. A Echo guide for 0.38 1.66 NA 0.11 2.15 NA XXX
amniocentesis.
76946............... 26............ A Echo guide for 0.38 0.14 0.14 0.01 0.53 0.53 XXX
amniocentesis.
76946............... TC............ A Echo guide for 0.00 1.52 NA 0.10 1.62 NA XXX
amniocentesis.
76948............... .............. A Echo guide, ova 0.38 1.65 NA 0.12 2.15 NA XXX
aspiration.
76948............... 26............ A Echo guide, ova 0.38 0.13 0.13 0.02 0.53 0.53 XXX
aspiration.
76948............... TC............ A Echo guide, ova 0.00 1.52 NA 0.10 1.62 NA XXX
aspiration.
76950............... .............. A Echo guidance 0.58 1.50 NA 0.11 2.19 NA XXX
radiotherapy.
76950............... 26............ A Echo guidance 0.58 0.19 0.19 0.04 0.81 0.81 XXX
radiotherapy.
76950............... TC............ A Echo guidance 0.00 1.31 NA 0.07 1.38 NA XXX
radiotherapy.
76965............... .............. A Echo guidance 1.34 6.01 NA 0.37 7.72 NA XXX
radiotherapy.
76965............... 26............ A Echo guidance 1.34 0.42 0.42 0.08 1.84 1.84 XXX
radiotherapy.
76965............... TC............ A Echo guidance 0.00 5.59 NA 0.29 5.88 NA XXX
radiotherapy.
76970............... .............. A Ultrasound exam 0.40 1.19 NA 0.08 1.67 NA XXX
follow-up.
76970............... 26............ A Ultrasound exam 0.40 0.13 0.13 0.02 0.55 0.55 XXX
follow-up.
76970............... TC............ A Ultrasound exam 0.00 1.06 NA 0.06 1.12 NA XXX
follow-up.
76975............... .............. A GI endoscopic 0.81 1.80 NA 0.14 2.75 NA XXX
ultrasound.
76975............... 26............ A GI endoscopic 0.81 0.28 0.28 0.04 1.13 1.13 XXX
ultrasound.
76975............... TC............ A GI endoscopic 0.00 1.52 NA 0.10 1.62 NA XXX
ultrasound.
76977............... .............. A Us bone density 0.05 0.85 NA 0.06 0.96 NA XXX
measure.
76977............... 26............ A Us bone density 0.05 0.02 0.02 0.01 0.08 0.08 XXX
measure.
76977............... TC............ A Us bone density 0.00 0.83 NA 0.05 0.88 NA XXX
measure.
76986............... .............. A Ultrasound guide 1.20 3.02 NA 0.22 4.44 NA XXX
intraoper.
76986............... 26............ A Ultrasound guide 1.20 0.40 0.40 0.08 1.68 1.68 XXX
intraoper.
76986............... TC............ A Ultrasound guide 0.00 2.62 NA 0.14 2.76 NA XXX
intraoper.
76999............... .............. C Echo examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76999............... 26............ C Echo examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76999............... TC............ C Echo examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
77261............... .............. A Radiation therapy 1.39 0.51 0.51 0.07 1.97 1.97 XXX
planning.
77262............... .............. A Radiation therapy 2.11 0.75 0.75 0.11 2.97 2.97 XXX
planning.
77263............... .............. A Radiation therapy 3.14 1.12 1.12 0.16 4.42 4.42 XXX
planning.
77280............... .............. A Set radiation therapy 0.70 3.70 NA 0.22 4.62 NA XXX
field.
[[Page 1208]]
77280............... 26............ A Set radiation therapy 0.70 0.22 0.22 0.04 0.96 0.96 XXX
field.
77280............... TC............ A Set radiation therapy 0.00 3.48 NA 0.18 3.66 NA XXX
field.
77285............... .............. A Set radiation therapy 1.05 5.93 NA 0.35 7.33 NA XXX
field.
77285............... 26............ A Set radiation therapy 1.05 0.34 0.34 0.05 1.44 1.44 XXX
field.
77285............... TC............ A Set radiation therapy 0.00 5.59 NA 0.30 5.89 NA XXX
field.
77290............... .............. A Set radiation therapy 1.56 7.02 NA 0.42 9.00 NA XXX
field.
77290............... 26............ A Set radiation therapy 1.56 0.49 0.49 0.07 2.12 2.12 XXX
field.
77290............... TC............ A Set radiation therapy 0.00 6.53 NA 0.35 6.88 NA XXX
field.
77295............... .............. A Set radiation therapy 4.56 29.48 NA 1.70 35.74 NA XXX
field.
77295............... 26............ A Set radiation therapy 4.56 1.45 1.45 0.22 6.23 6.23 XXX
field.
77295............... TC............ A Set radiation therapy 0.00 28.03 NA 1.48 29.51 NA XXX
field.
77299............... .............. C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
planning.
77299............... 26............ C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
planning.
77299............... TC............ C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
planning.
77300............... .............. A Radiation therapy 0.62 1.55 NA 0.11 2.28 NA XXX
dose plan.
77300............... 26............ A Radiation therapy 0.62 0.20 0.20 0.04 0.86 0.86 XXX
dose plan.
77300............... TC............ A Radiation therapy 0.00 1.35 NA 0.07 1.42 NA XXX
dose plan.
77301............... .............. A Radiotherapy dose 7.99 30.57 NA 1.70 40.26 NA XXX
plan, imrt.
77301............... 26............ A Radiotherapy dose 7.99 2.54 2.54 0.22 10.75 10.75 XXX
plan, imrt.
77301............... TC............ A Radiotherapy dose 0.00 28.03 NA 1.48 29.51 NA XXX
plan, imrt.
77305............... .............. A Teletx isodose plan 0.70 2.10 NA 0.15 2.95 NA XXX
simple.
77305............... 26............ A Teletx isodose plan 0.70 0.23 0.23 0.04 0.97 0.97 XXX
simple.
77305............... TC............ A Teletx isodose plan 0.00 1.87 NA 0.11 1.98 NA XXX
simple.
77310............... .............. A Teletx isodose plan 1.05 2.68 NA 0.18 3.91 NA XXX
intermed.
77310............... 26............ A Teletx isodose plan 1.05 0.34 0.34 0.05 1.44 1.44 XXX
intermed.
77310............... TC............ A Teletx isodose plan 0.00 2.34 NA 0.13 2.47 NA XXX
intermed.
77315............... .............. A Teletx isodose plan 1.56 3.15 NA 0.21 4.92 NA XXX
complex.
77315............... 26............ A Teletx isodose plan 1.56 0.49 0.49 0.07 2.12 2.12 XXX
complex.
77315............... TC............ A Teletx isodose plan 0.00 2.66 NA 0.14 2.80 NA XXX
complex.
77321............... .............. A Special teletx port 0.95 4.37 NA 0.26 5.58 NA XXX
plan.
77321............... 26............ A Special teletx port 0.95 0.31 0.31 0.05 1.31 1.31 XXX
plan.
77321............... TC............ A Special teletx port 0.00 4.06 NA 0.21 4.27 NA XXX
plan.
77326............... .............. A Brachytx isodose calc 0.93 2.67 NA 0.18 3.78 NA XXX
simp.
77326............... 26............ A Brachytx isodose calc 0.93 0.30 0.30 0.05 1.28 1.28 XXX
simp.
77326............... TC............ A Brachytx isodose calc 0.00 2.37 NA 0.13 2.50 NA XXX
simp.
77327............... .............. A Brachytx isodose calc 1.39 3.92 NA 0.25 5.56 NA XXX
interm.
77327............... 26............ A Brachytx isodose calc 1.39 0.44 0.44 0.07 1.90 1.90 XXX
interm.
77327............... TC............ A Brachytx isodose calc 0.00 3.48 NA 0.18 3.66 NA XXX
interm.
77328............... .............. A Brachytx isodose plan 2.09 5.63 NA 0.36 8.08 NA XXX
compl.
77328............... 26............ A Brachytx isodose plan 2.09 0.66 0.66 0.11 2.86 2.86 XXX
compl.
77328............... TC............ A Brachytx isodose plan 0.00 4.97 NA 0.25 5.22 NA XXX
compl.
77331............... .............. A Special radiation 0.87 0.78 NA 0.07 1.72 NA XXX
dosimetry.
77331............... 26............ A Special radiation 0.87 0.28 0.28 0.05 1.20 1.20 XXX
dosimetry.
77331............... TC............ A Special radiation 0.00 0.50 NA 0.02 0.52 NA XXX
dosimetry.
77332............... .............. A Radiation treatment 0.54 1.52 NA 0.09 2.15 NA XXX
aid(s).
77332............... 26............ A Radiation treatment 0.54 0.17 0.17 0.02 0.73 0.73 XXX
aid(s).
77332............... TC............ A Radiation treatment 0.00 1.35 NA 0.07 1.42 NA XXX
aid(s).
77333............... .............. A Radiation treatment 0.84 2.17 NA 0.16 3.17 NA XXX
aid(s).
77333............... 26............ A Radiation treatment 0.84 0.27 0.27 0.05 1.16 1.16 XXX
aid(s).
77333............... TC............ A Radiation treatment 0.00 1.90 NA 0.11 2.01 NA XXX
aid(s).
77334............... .............. A Radiation treatment 1.24 3.65 NA 0.23 5.12 NA XXX
aid(s).
77334............... 26............ A Radiation treatment 1.24 0.39 0.39 0.06 1.69 1.69 XXX
aid(s).
77334............... TC............ A Radiation treatment 0.00 3.26 NA 0.17 3.43 NA XXX
aid(s).
77336............... .............. A Radiation physics 0.00 2.99 NA 0.16 3.15 NA XXX
consult.
77370............... .............. A Radiation physics 0.00 3.50 NA 0.18 3.68 NA XXX
consult.
77399............... .............. C External radiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dosimetry.
77399............... 26............ C External radiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dosimetry.
77399............... TC............ C External radiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dosimetry.
77401............... .............. A Radiation treatment 0.00 1.78 NA 0.11 1.89 NA XXX
delivery.
77402............... .............. A Radiation treatment 0.00 1.78 NA 0.11 1.89 NA XXX
delivery.
77403............... .............. A Radiation treatment 0.00 1.78 NA 0.11 1.89 NA XXX
delivery.
77404............... .............. A Radiation treatment 0.00 1.78 NA 0.11 1.89 NA XXX
delivery.
77406............... .............. A Radiation treatment 0.00 1.78 NA 0.11 1.89 NA XXX
delivery.
77407............... .............. A Radiation treatment 0.00 2.09 NA 0.12 2.21 NA XXX
delivery.
77408............... .............. A Radiation treatment 0.00 2.09 NA 0.12 2.21 NA XXX
delivery.
77409............... .............. A Radiation treatment 0.00 2.09 NA 0.12 2.21 NA XXX
delivery.
77411............... .............. A Radiation treatment 0.00 2.09 NA 0.12 2.21 NA XXX
delivery.
77412............... .............. A Radiation treatment 0.00 2.34 NA 0.13 2.47 NA XXX
delivery.
77413............... .............. A Radiation treatment 0.00 2.34 NA 0.13 2.47 NA XXX
delivery.
77414............... .............. A Radiation treatment 0.00 2.34 NA 0.13 2.47 NA XXX
delivery.
77416............... .............. A Radiation treatment 0.00 2.34 NA 0.13 2.47 NA XXX
delivery.
77417............... .............. A Radiology port 0.00 0.59 NA 0.04 0.63 NA XXX
film(s).
77418............... .............. A Radiation tx 0.00 18.05 NA 0.13 18.18 NA XXX
delivery, imrt.
77427............... .............. A Radiation tx 3.31 1.05 1.05 0.17 4.53 4.53 XXX
management, x5.
77431............... .............. A Radiation therapy 1.81 0.68 0.68 0.08 2.57 2.57 XXX
management.
[[Page 1209]]
77432............... .............. A Stereotactic 7.92 2.91 2.91 0.40 11.23 11.23 XXX
radiation trmt.
77470............... .............. A Special radiation 2.09 11.85 NA 0.70 14.64 NA XXX
treatment.
77470............... 26............ A Special radiation 2.09 0.66 0.66 0.11 2.86 2.86 XXX
treatment.
77470............... TC............ A Special radiation 0.00 11.19 NA 0.59 11.78 NA XXX
treatment.
77499............... .............. C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
management.
77499............... 26............ C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
management.
77499............... TC............ C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
management.
77520............... .............. C Proton trmt, simple w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o comp.
77522............... .............. C Proton trmt, simple w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
comp.
77523............... .............. C Proton trmt, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intermediate.
77525............... .............. C Proton treatment, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complex.
77600............... .............. R Hyperthermia 1.56 3.55 NA 0.26 5.37 NA XXX
treatment.
77600............... 26............ R Hyperthermia 1.56 0.49 0.49 0.10 2.15 2.15 XXX
treatment.
77600............... TC............ R Hyperthermia 0.00 3.06 NA 0.16 3.22 NA XXX
treatment.
77605............... .............. R Hyperthermia 2.09 4.74 NA 0.38 7.21 NA XXX
treatment.
77605............... 26............ R Hyperthermia 2.09 0.66 0.66 0.16 2.91 2.91 XXX
treatment.
77605............... TC............ R Hyperthermia 0.00 4.08 NA 0.22 4.30 NA XXX
treatment.
77610............... .............. R Hyperthermia 1.56 3.56 NA 0.24 5.36 NA XXX
treatment.
77610............... 26............ R Hyperthermia 1.56 0.50 0.50 0.08 2.14 2.14 XXX
treatment.
77610............... TC............ R Hyperthermia 0.00 3.06 NA 0.16 3.22 NA XXX
treatment.
77615............... .............. R Hyperthermia 2.09 4.74 NA 0.33 7.16 NA XXX
treatment.
77615............... 26............ R Hyperthermia 2.09 0.66 0.66 0.11 2.86 2.86 XXX
treatment.
77615............... TC............ R Hyperthermia 0.00 4.08 NA 0.22 4.30 NA XXX
treatment.
77620............... .............. R Hyperthermia 1.56 3.57 NA 0.23 5.36 NA XXX
treatment.
77620............... 26............ R Hyperthermia 1.56 0.51 0.51 0.07 2.14 2.14 XXX
treatment.
77620............... TC............ R Hyperthermia 0.00 3.06 NA 0.16 3.22 NA XXX
treatment.
77750............... .............. A Infuse radioactive 4.90 2.91 NA 0.28 8.09 NA 090
materials.
77750............... 26............ A Infuse radioactive 4.90 1.57 1.57 0.21 6.68 6.68 090
materials.
77750............... TC............ A Infuse radioactive 0.00 1.34 NA 0.07 1.41 NA 090
materials.
77761............... .............. A Apply intrcav radiat 3.80 3.62 NA 0.33 7.75 NA 090
simple.
77761............... 26............ A Apply intrcav radiat 3.80 1.10 1.10 0.19 5.09 5.09 090
simple.
77761............... TC............ A Apply intrcav radiat 0.00 2.52 NA 0.14 2.66 NA 090
simple.
77762............... .............. A Apply intrcav radiat 5.71 5.45 NA 0.46 11.62 NA 090
interm.
77762............... 26............ A Apply intrcav radiat 5.71 1.83 1.83 0.27 7.81 7.81 090
interm.
77762............... TC............ A Apply intrcav radiat 0.00 3.62 NA 0.19 3.81 NA 090
interm.
77763............... .............. A Apply intrcav radiat 8.56 7.22 NA 0.64 16.42 NA 090
compl.
77763............... 26............ A Apply intrcav radiat 8.56 2.72 2.72 0.41 11.69 11.69 090
compl.
77763............... TC............ A Apply intrcav radiat 0.00 4.50 NA 0.23 4.73 NA 090
compl.
77776............... .............. A Apply interstit 4.65 3.14 NA 0.42 8.21 NA 090
radiat simpl.
77776............... 26............ A Apply interstit 4.65 0.96 0.96 0.29 5.90 5.90 090
radiat simpl.
77776............... TC............ A Apply interstit 0.00 2.18 NA 0.13 2.31 NA 090
radiat simpl.
77777............... .............. A Apply interstit 7.47 6.61 NA 0.61 14.69 NA 090
radiat inter.
77777............... 26............ A Apply interstit 7.47 2.36 2.36 0.39 10.22 10.22 090
radiat inter.
77777............... TC............ A Apply interstit 0.00 4.25 NA 0.22 4.47 NA 090
radiat inter.
77778............... .............. A Apply interstit 11.17 8.69 NA 0.84 20.70 NA 090
radiat compl.
77778............... 26............ A Apply interstit 11.17 3.54 3.54 0.57 15.28 15.28 090
radiat compl.
77778............... TC............ A Apply interstit 0.00 5.15 NA 0.27 5.42 NA 090
radiat compl.
77781............... .............. A High intensity 1.66 20.91 NA 1.14 23.71 NA 090
brachytherapy.
77781............... 26............ A High intensity 1.66 0.53 0.53 0.08 2.27 2.27 090
brachytherapy.
77781............... TC............ A High intensity 0.00 20.38 NA 1.06 21.44 NA 090
brachytherapy.
77782............... .............. A High intensity 2.49 21.18 NA 1.18 24.85 NA 090
brachytherapy.
77782............... 26............ A High intensity 2.49 0.80 0.80 0.12 3.41 3.41 090
brachytherapy.
77782............... TC............ A High intensity 0.00 20.38 NA 1.06 21.44 NA 090
brachytherapy.
77783............... .............. A High intensity 3.72 21.56 NA 1.24 26.52 NA 090
brachytherapy.
77783............... 26............ A High intensity 3.72 1.18 1.18 0.18 5.08 5.08 090
brachytherapy.
77783............... TC............ A High intensity 0.00 20.38 NA 1.06 21.44 NA 090
brachytherapy.
77784............... .............. A High intensity 5.60 22.16 NA 1.33 29.09 NA 090
brachytherapy.
77784............... 26............ A High intensity 5.60 1.78 1.78 0.27 7.65 7.65 090
brachytherapy.
77784............... TC............ A High intensity 0.00 20.38 NA 1.06 21.44 NA 090
brachytherapy.
77789............... .............. A Apply surface 1.12 0.82 NA 0.06 2.00 NA 000
radiation.
77789............... 26............ A Apply surface 1.12 0.37 0.37 0.04 1.53 1.53 000
radiation.
77789............... TC............ A Apply surface 0.00 0.45 NA 0.02 0.47 NA 000
radiation.
77790............... .............. A Radiation handling... 1.05 0.84 NA 0.07 1.96 NA XXX
77790............... 26............ A Radiation handling... 1.05 0.34 0.34 0.05 1.44 1.44 XXX
77790............... TC............ A Radiation handling... 0.00 0.50 NA 0.02 0.52 NA XXX
77799............... .............. C Radium/radioisotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
77799............... 26............ C Radium/radioisotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
77799............... TC............ C Radium/radioisotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
78000............... .............. A Thyroid, single 0.19 1.04 NA 0.07 1.30 NA XXX
uptake.
78000............... 26............ A Thyroid, single 0.19 0.07 0.07 0.01 0.27 0.27 XXX
uptake.
78000............... TC............ A Thyroid, single 0.00 0.97 NA 0.06 1.03 NA XXX
uptake.
78001............... .............. A Thyroid, multiple 0.26 1.40 NA 0.08 1.74 NA XXX
uptakes.
78001............... 26............ A Thyroid, multiple 0.26 0.09 0.09 0.01 0.36 0.36 XXX
uptakes.
78001............... TC............ A Thyroid, multiple 0.00 1.31 NA 0.07 1.38 NA XXX
uptakes.
78003............... .............. A Thyroid suppress/ 0.33 1.08 NA 0.07 1.48 NA XXX
stimul.
[[Page 1210]]
78003............... 26............ A Thyroid suppress/ 0.33 0.11 0.11 0.01 0.45 0.45 XXX
stimul.
78003............... TC............ A Thyroid suppress/ 0.00 0.97 NA 0.06 1.03 NA XXX
stimul.
78006............... .............. A Thyroid imaging with 0.49 2.56 NA 0.15 3.20 NA XXX
uptake.
78006............... 26............ A Thyroid imaging with 0.49 0.17 0.17 0.02 0.68 0.68 XXX
uptake.
78006............... TC............ A Thyroid imaging with 0.00 2.39 NA 0.13 2.52 NA XXX
uptake.
78007............... .............. A Thyroid image, mult 0.50 2.76 NA 0.16 3.42 NA XXX
uptakes.
78007............... 26............ A Thyroid image, mult 0.50 0.17 0.17 0.02 0.69 0.69 XXX
uptakes.
78007............... TC............ A Thyroid image, mult 0.00 2.59 NA 0.14 2.73 NA XXX
uptakes.
78010............... .............. A Thyroid imaging...... 0.39 1.96 NA 0.13 2.48 NA XXX
78010............... 26............ A Thyroid imaging...... 0.39 0.13 0.13 0.02 0.54 0.54 XXX
78010............... TC............ A Thyroid imaging...... 0.00 1.83 NA 0.11 1.94 NA XXX
78011............... .............. A Thyroid imaging with 0.45 2.57 NA 0.15 3.17 NA XXX
flow.
78011............... 26............ A Thyroid imaging with 0.45 0.15 0.15 0.02 0.62 0.62 XXX
flow.
78011............... TC............ A Thyroid imaging with 0.00 2.42 NA 0.13 2.55 NA XXX
flow.
78015............... .............. A Thyroid met imaging.. 0.67 2.82 NA 0.18 3.67 NA XXX
78015............... 26............ A Thyroid met imaging.. 0.67 0.23 0.23 0.04 0.94 0.94 XXX
78015............... TC............ A Thyroid met imaging.. 0.00 2.59 NA 0.14 2.73 NA XXX
78016............... .............. A Thyroid met imaging/ 0.82 3.78 NA 0.22 4.82 NA XXX
studies.
78016............... 26............ A Thyroid met imaging/ 0.82 0.29 0.29 0.04 1.15 1.15 XXX
studies.
78016............... TC............ A Thyroid met imaging/ 0.00 3.49 NA 0.18 3.67 NA XXX
studies.
78018............... .............. A Thyroid met imaging, 0.86 5.75 NA 0.33 6.94 NA XXX
body.
78018............... 26............ A Thyroid met imaging, 0.86 0.30 0.30 0.04 1.20 1.20 XXX
body.
78018............... TC............ A Thyroid met imaging, 0.00 5.45 NA 0.29 5.74 NA XXX
body.
78020............... .............. A Thyroid met uptake... 0.60 1.52 NA 0.16 2.28 NA ZZZ
78020............... 26............ A Thyroid met uptake... 0.60 0.21 0.21 0.02 0.83 0.83 ZZZ
78020............... TC............ A Thyroid met uptake... 0.00 1.31 NA 0.14 1.45 NA ZZZ
78070............... .............. A Parathyroid nuclear 0.82 2.11 NA 0.15 3.08 NA XXX
imaging.
78070............... 26............ A Parathyroid nuclear 0.82 0.28 0.28 0.04 1.14 1.14 XXX
imaging.
78070............... TC............ A Parathyroid nuclear 0.00 1.83 NA 0.11 1.94 NA XXX
imaging.
78075............... .............. A Adrenal nuclear 0.74 5.72 NA 0.33 6.79 NA XXX
imaging.
78075............... 26............ A Adrenal nuclear 0.74 0.27 0.27 0.04 1.05 1.05 XXX
imaging.
78075............... TC............ A Adrenal nuclear 0.00 5.45 NA 0.29 5.74 NA XXX
imaging.
78099............... .............. C Endocrine nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
78099............... 26............ C Endocrine nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
78099............... TC............ C Endocrine nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
78102............... .............. A Bone marrow imaging, 0.55 2.24 NA 0.14 2.93 NA XXX
ltd.
78102............... 26............ A Bone marrow imaging, 0.55 0.20 0.20 0.02 0.77 0.77 XXX
ltd.
78102............... TC............ A Bone marrow imaging, 0.00 2.04 NA 0.12 2.16 NA XXX
ltd.
78103............... .............. A Bone marrow imaging, 0.75 3.44 NA 0.21 4.40 NA XXX
mult.
78103............... 26............ A Bone marrow imaging, 0.75 0.26 0.26 0.04 1.05 1.05 XXX
mult.
78103............... TC............ A Bone marrow imaging, 0.00 3.18 NA 0.17 3.35 NA XXX
mult.
78104............... .............. A Bone marrow imaging, 0.80 4.36 NA 0.26 5.42 NA XXX
body.
78104............... 26............ A Bone marrow imaging, 0.80 0.27 0.27 0.04 1.11 1.11 XXX
body.
78104............... TC............ A Bone marrow imaging, 0.00 4.09 NA 0.22 4.31 NA XXX
body.
78110............... .............. A Plasma volume, single 0.19 1.02 NA 0.07 1.28 NA XXX
78110............... 26............ A Plasma volume, single 0.19 0.07 0.07 0.01 0.27 0.27 XXX
78110............... TC............ A Plasma volume, single 0.00 0.95 NA 0.06 1.01 NA XXX
78111............... .............. A Plasma volume, 0.22 2.67 NA 0.15 3.04 NA XXX
multiple.
78111............... 26............ A Plasma volume, 0.22 0.08 0.08 0.01 0.31 0.31 XXX
multiple.
78111............... TC............ A Plasma volume, 0.00 2.59 NA 0.14 2.73 NA XXX
multiple.
78120............... .............. A Red cell mass, single 0.23 1.82 NA 0.12 2.17 NA XXX
78120............... 26............ A Red cell mass, single 0.23 0.08 0.08 0.01 0.32 0.32 XXX
78120............... TC............ A Red cell mass, single 0.00 1.74 NA 0.11 1.85 NA XXX
78121............... .............. A Red cell mass, 0.32 3.03 NA 0.15 3.50 NA XXX
multiple.
78121............... 26............ A Red cell mass, 0.32 0.11 0.11 0.01 0.44 0.44 XXX
multiple.
78121............... TC............ A Red cell mass, 0.00 2.92 NA 0.14 3.06 NA XXX
multiple.
78122............... .............. A Blood volume......... 0.45 4.78 NA 0.26 5.49 NA XXX
78122............... 26............ A Blood volume......... 0.45 0.16 0.16 0.02 0.63 0.63 XXX
78122............... TC............ A Blood volume......... 0.00 4.62 NA 0.24 4.86 NA XXX
78130............... .............. A Red cell survival 0.61 3.07 NA 0.18 3.86 NA XXX
study.
78130............... 26............ A Red cell survival 0.61 0.21 0.21 0.04 0.86 0.86 XXX
study.
78130............... TC............ A Red cell survival 0.00 2.86 NA 0.14 3.00 NA XXX
study.
78135............... .............. A Red cell survival 0.64 5.11 NA 0.29 6.04 NA XXX
kinetics.
78135............... 26............ A Red cell survival 0.64 0.22 0.22 0.04 0.90 0.90 XXX
kinetics.
78135............... TC............ A Red cell survival 0.00 4.89 NA 0.25 5.14 NA XXX
kinetics.
78140............... .............. A Red cell 0.61 4.15 NA 0.25 5.01 NA XXX
sequestration.
78140............... 26............ A Red cell 0.61 0.20 0.20 0.04 0.85 0.85 XXX
sequestration.
78140............... TC............ A Red cell 0.00 3.95 NA 0.21 4.16 NA XXX
sequestration.
78160............... .............. A Plasma iron turnover. 0.33 3.80 NA 0.23 4.36 NA XXX
78160............... 26............ A Plasma iron turnover. 0.33 0.12 0.12 0.04 0.49 0.49 XXX
78160............... TC............ A Plasma iron turnover. 0.00 3.68 NA 0.19 3.87 NA XXX
78162............... .............. A Radioiron absorption 0.45 3.40 NA 0.18 4.03 NA XXX
exam.
78162............... 26............ A Radioiron absorption 0.45 0.19 0.19 0.01 0.65 0.65 XXX
exam.
78162............... TC............ A Radioiron absorption 0.00 3.21 NA 0.17 3.38 NA XXX
exam.
78170............... .............. A Red cell iron 0.41 5.47 NA 0.33 6.21 NA XXX
utilization.
[[Page 1211]]
78170............... 26............ A Red cell iron 0.41 0.14 0.14 0.05 0.60 0.60 XXX
utilization.
78170............... TC............ A Red cell iron 0.00 5.33 NA 0.28 5.61 NA XXX
utilization.
78172............... .............. C Total body iron 0.00 0.00 0.00 0.00 0.00 0.00 XXX
estimation.
78172............... 26............ A Total body iron 0.53 0.18 0.18 0.02 0.73 0.73 XXX
estimation.
78172............... TC............ C Total body iron 0.00 0.00 0.00 0.00 0.00 0.00 XXX
estimation.
78185............... .............. A Spleen imaging....... 0.40 2.51 NA 0.15 3.06 NA XXX
78185............... 26............ A Spleen imaging....... 0.40 0.14 0.14 0.02 0.56 0.56 XXX
78185............... TC............ A Spleen imaging....... 0.00 2.37 NA 0.13 2.50 NA XXX
78190............... .............. A Platelet survival, 1.09 6.12 NA 0.37 7.58 NA XXX
kinetics.
78190............... 26............ A Platelet survival, 1.09 0.39 0.39 0.07 1.55 1.55 XXX
kinetics.
78190............... TC............ A Platelet survival, 0.00 5.73 NA 0.30 6.03 NA XXX
kinetics.
78191............... .............. A Platelet survival.... 0.61 7.56 NA 0.41 8.58 NA XXX
78191............... 26............ A Platelet survival.... 0.61 0.20 0.20 0.04 0.85 0.85 XXX
78191............... TC............ A Platelet survival.... 0.00 7.36 NA 0.37 7.73 NA XXX
78195............... .............. A Lymph system imaging. 1.20 4.50 NA 0.28 5.98 NA XXX
78195............... 26............ A Lymph system imaging. 1.20 0.41 0.41 0.06 1.67 1.67 XXX
78195............... TC............ A Lymph system imaging. 0.00 4.09 NA 0.22 4.31 NA XXX
78199............... .............. C Blood/lymph nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78199............... 26............ C Blood/lymph nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78199............... TC............ C Blood/lymph nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78201............... .............. A Liver imaging........ 0.44 2.52 NA 0.15 3.11 NA XXX
78201............... 26............ A Liver imaging........ 0.44 0.15 0.15 0.02 0.61 0.61 XXX
78201............... TC............ A Liver imaging........ 0.00 2.37 NA 0.13 2.50 NA XXX
78202............... .............. A Liver imaging with 0.51 3.07 NA 0.16 3.74 NA XXX
flow.
78202............... 26............ A Liver imaging with 0.51 0.18 0.18 0.02 0.71 0.71 XXX
flow.
78202............... TC............ A Liver imaging with 0.00 2.89 NA 0.14 3.03 NA XXX
flow.
78205............... .............. A Liver imaging (3D)... 0.71 6.18 NA 0.35 7.24 NA XXX
78205............... 26............ A Liver imaging (3D)... 0.71 0.25 0.25 0.04 1.00 1.00 XXX
78205............... TC............ A Liver imaging (3D)... 0.00 5.93 NA 0.31 6.24 NA XXX
78206............... .............. A Liver image (3d) with 0.96 6.27 NA 0.16 7.39 NA XXX
flow.
78206............... 26............ A Liver image (3d) with 0.96 0.34 0.34 0.05 1.35 1.35 XXX
flow.
78206............... TC............ A Liver image (3d) with 0.00 5.93 NA 0.11 6.04 NA XXX
flow.
78215............... .............. A Liver and spleen 0.49 3.12 NA 0.16 3.77 NA XXX
imaging.
78215............... 26............ A Liver and spleen 0.49 0.17 0.17 0.02 0.68 0.68 XXX
imaging.
78215............... TC............ A Liver and spleen 0.00 2.95 NA 0.14 3.09 NA XXX
imaging.
78216............... .............. A Liver & spleen image/ 0.57 3.69 NA 0.20 4.46 NA XXX
flow.
78216............... 26............ A Liver & spleen image/ 0.57 0.20 0.20 0.02 0.79 0.79 XXX
flow.
78216............... TC............ A Liver & spleen image/ 0.00 3.49 NA 0.18 3.67 NA XXX
flow.
78220............... .............. A Liver function study. 0.49 3.91 NA 0.21 4.61 NA XXX
78220............... 26............ A Liver function study. 0.49 0.17 0.17 0.02 0.68 0.68 XXX
78220............... TC............ A Liver function study. 0.00 3.74 NA 0.19 3.93 NA XXX
78223............... .............. A Hepatobiliary imaging 0.84 3.96 NA 0.24 5.04 NA XXX
78223............... 26............ A Hepatobiliary imaging 0.84 0.28 0.28 0.05 1.17 1.17 XXX
78223............... TC............ A Hepatobiliary imaging 0.00 3.68 NA 0.19 3.87 NA XXX
78230............... .............. A Salivary gland 0.45 2.33 NA 0.15 2.93 NA XXX
imaging.
78230............... 26............ A Salivary gland 0.45 0.15 0.15 0.02 0.62 0.62 XXX
imaging.
78230............... TC............ A Salivary gland 0.00 2.18 NA 0.13 2.31 NA XXX
imaging.
78231............... .............. A Serial salivary 0.52 3.37 NA 0.19 4.08 NA XXX
imaging.
78231............... 26............ A Serial salivary 0.52 0.19 0.19 0.02 0.73 0.73 XXX
imaging.
78231............... TC............ A Serial salivary 0.00 3.18 NA 0.17 3.35 NA XXX
imaging.
78232............... .............. A Salivary gland 0.47 3.72 NA 0.19 4.38 NA XXX
function exam.
78232............... 26............ A Salivary gland 0.47 0.17 0.17 0.01 0.65 0.65 XXX
function exam.
78232............... TC............ A Salivary gland 0.00 3.55 NA 0.18 3.73 NA XXX
function exam.
78258............... .............. A Esophageal motility 0.74 3.14 NA 0.18 4.06 NA XXX
study.
78258............... 26............ A Esophageal motility 0.74 0.25 0.25 0.04 1.03 1.03 XXX
study.
78258............... TC............ A Esophageal motility 0.00 2.89 NA 0.14 3.03 NA XXX
study.
78261............... .............. A Gastric mucosa 0.69 4.36 NA 0.26 5.31 NA XXX
imaging.
78261............... 26............ A Gastric mucosa 0.69 0.25 0.25 0.04 0.98 0.98 XXX
imaging.
78261............... TC............ A Gastric mucosa 0.00 4.11 NA 0.22 4.33 NA XXX
imaging.
78262............... .............. A Gastroesophageal 0.68 4.51 NA 0.26 5.45 NA XXX
reflux exam.
78262............... 26............ A Gastroesophageal 0.68 0.24 0.24 0.04 0.96 0.96 XXX
reflux exam.
78262............... TC............ A Gastroesophageal 0.00 4.27 NA 0.22 4.49 NA XXX
reflux exam.
78264............... .............. A Gastric emptying 0.78 4.41 NA 0.26 5.45 NA XXX
study.
78264............... 26............ A Gastric emptying 0.78 0.27 0.27 0.04 1.09 1.09 XXX
study.
78264............... TC............ A Gastric emptying 0.00 4.14 NA 0.22 4.36 NA XXX
study.
78267............... .............. X Breath tst attain/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anal c-14.
78268............... .............. X Breath test analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
c-14.
78270............... .............. A Vit B-12 absorption 0.20 1.62 NA 0.11 1.93 NA XXX
exam.
78270............... 26............ A Vit B-12 absorption 0.20 0.07 0.07 0.01 0.28 0.28 XXX
exam.
78270............... TC............ A Vit B-12 absorption 0.00 1.55 NA 0.10 1.65 NA XXX
exam.
78271............... .............. A Vit b-12 absrp exam, 0.20 1.72 NA 0.11 2.03 NA XXX
int fac.
78271............... 26............ A Vit b-12 absrp exam, 0.20 0.07 0.07 0.01 0.28 0.28 XXX
int fac.
78271............... TC............ A Vit b-12 absrp exam, 0.00 1.65 NA 0.10 1.75 NA XXX
int fac.
78272............... .............. A Vit B-12 absorp, 0.27 2.43 NA 0.14 2.84 NA XXX
combined.
78272............... 26............ A Vit B-12 absorp, 0.27 0.10 0.10 0.01 0.38 0.38 XXX
combined.
[[Page 1212]]
78272............... TC............ A Vit B-12 absorp, 0.00 2.33 NA 0.13 2.46 NA XXX
combined.
78278............... .............. A Acute GI blood loss 0.99 5.23 NA 0.30 6.52 NA XXX
imaging.
78278............... 26............ A Acute GI blood loss 0.99 0.34 0.34 0.05 1.38 1.38 XXX
imaging.
78278............... TC............ A Acute GI blood loss 0.00 4.89 NA 0.25 5.14 NA XXX
imaging.
78282............... .............. C GI protein loss exam. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78282............... 26............ A GI protein loss exam. 0.38 0.13 0.13 0.02 0.53 0.53 XXX
78282............... TC............ C GI protein loss exam. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78290............... .............. A Meckel's divert exam. 0.68 3.29 NA 0.20 4.17 NA XXX
78290............... 26............ A Meckel's divert exam. 0.68 0.23 0.23 0.04 0.95 0.95 XXX
78290............... TC............ A Meckel's divert exam. 0.00 3.06 NA 0.16 3.22 NA XXX
78291............... .............. A Leveen/shunt patency 0.88 3.38 NA 0.21 4.47 NA XXX
exam.
78291............... 26............ A Leveen/shunt patency 0.88 0.30 0.30 0.05 1.23 1.23 XXX
exam.
78291............... TC............ A Leveen/shunt patency 0.00 3.08 NA 0.16 3.24 NA XXX
exam.
78299............... .............. C GI nuclear procedure. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78299............... 26............ C GI nuclear procedure. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78299............... TC............ C GI nuclear procedure. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78300............... .............. A Bone imaging, limited 0.62 2.71 NA 0.18 3.51 NA XXX
area.
78300............... 26............ A Bone imaging, limited 0.62 0.21 0.21 0.04 0.87 0.87 XXX
area.
78300............... TC............ A Bone imaging, limited 0.00 2.50 NA 0.14 2.64 NA XXX
area.
78305............... .............. A Bone imaging, 0.83 3.96 NA 0.23 5.02 NA XXX
multiple areas.
78305............... 26............ A Bone imaging, 0.83 0.28 0.28 0.04 1.15 1.15 XXX
multiple areas.
78305............... TC............ A Bone imaging, 0.00 3.68 NA 0.19 3.87 NA XXX
multiple areas.
78306............... .............. A Bone imaging, whole 0.86 4.58 NA 0.27 5.71 NA XXX
body.
78306............... 26............ A Bone imaging, whole 0.86 0.29 0.29 0.05 1.20 1.20 XXX
body.
78306............... TC............ A Bone imaging, whole 0.00 4.29 NA 0.22 4.51 NA XXX
body.
78315............... .............. A Bone imaging, 3 phase 1.02 5.15 NA 0.30 6.47 NA XXX
78315............... 26............ A Bone imaging, 3 phase 1.02 0.35 0.35 0.05 1.42 1.42 XXX
78315............... TC............ A Bone imaging, 3 phase 0.00 4.80 NA 0.25 5.05 NA XXX
78320............... .............. A Bone imaging (3D).... 1.04 6.30 NA 0.36 7.70 NA XXX
78320............... 26............ A Bone imaging (3D).... 1.04 0.37 0.37 0.05 1.46 1.46 XXX
78320............... TC............ A Bone imaging (3D).... 0.00 5.93 NA 0.31 6.24 NA XXX
78350............... .............. A Bone mineral, single 0.22 0.83 NA 0.06 1.11 NA XXX
photon.
78350............... 26............ A Bone mineral, single 0.22 0.07 0.07 0.01 0.30 0.30 XXX
photon.
78350............... TC............ A Bone mineral, single 0.00 0.76 NA 0.05 0.81 NA XXX
photon.
78351............... .............. N Bone mineral, dual +0.30 1.72 0.12 0.01 2.03 0.43 XXX
photon.
78399............... .............. C Musculoskeletal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78399............... 26............ C Musculoskeletal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78399............... TC............ C Musculoskeletal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78414............... .............. C Non-imaging heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX
function.
78414............... 26............ A Non-imaging heart 0.45 0.16 0.16 0.02 0.63 0.63 XXX
function.
78414............... TC............ C Non-imaging heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX
function.
78428............... .............. A Cardiac shunt imaging 0.78 2.56 NA 0.17 3.51 NA XXX
78428............... 26............ A Cardiac shunt imaging 0.78 0.30 0.30 0.04 1.12 1.12 XXX
78428............... TC............ A Cardiac shunt imaging 0.00 2.26 NA 0.13 2.39 NA XXX
78445............... .............. A Vascular flow imaging 0.49 2.04 NA 0.13 2.66 NA XXX
78445............... 26............ A Vascular flow imaging 0.49 0.17 0.17 0.02 0.68 0.68 XXX
78445............... TC............ A Vascular flow imaging 0.00 1.87 NA 0.11 1.98 NA XXX
78455............... .............. A Venous thrombosis 0.73 4.25 NA 0.25 5.23 NA XXX
study.
78455............... 26............ A Venous thrombosis 0.73 0.25 0.25 0.04 1.02 1.02 XXX
study.
78455............... TC............ A Venous thrombosis 0.00 4.00 NA 0.21 4.21 NA XXX
study.
78456............... .............. A Acute venous thrombus 1.00 4.35 NA 0.34 5.69 NA XXX
image.
78456............... 26............ A Acute venous thrombus 1.00 0.35 0.35 0.05 1.40 1.40 XXX
image.
78456............... TC............ A Acute venous thrombus 0.00 4.00 NA 0.29 4.29 NA XXX
image.
78457............... .............. A Venous thrombosis 0.77 2.92 NA 0.18 3.87 NA XXX
imaging.
78457............... 26............ A Venous thrombosis 0.77 0.26 0.26 0.04 1.07 1.07 XXX
imaging.
78457............... TC............ A Venous thrombosis 0.00 2.66 NA 0.14 2.80 NA XXX
imaging.
78458............... .............. A Ven thrombosis 0.90 4.37 NA 0.25 5.52 NA XXX
images, bilat.
78458............... 26............ A Ven thrombosis 0.90 0.33 0.33 0.04 1.27 1.27 XXX
images, bilat.
78458............... TC............ A Ven thrombosis 0.00 4.04 NA 0.21 4.25 NA XXX
images, bilat.
78459............... .............. C Heart muscle imaging 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(PET).
78459............... 26............ R Heart muscle imaging 1.50 0.57 0.57 0.05 2.12 2.12 XXX
(PET).
78459............... TC............ C Heart muscle imaging 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(PET).
78460............... .............. A Heart muscle blood, 0.86 2.67 NA 0.17 3.70 NA XXX
single.
78460............... 26............ A Heart muscle blood, 0.86 0.30 0.30 0.04 1.20 1.20 XXX
single.
78460............... TC............ A Heart muscle blood, 0.00 2.37 NA 0.13 2.50 NA XXX
single.
78461............... .............. A Heart muscle blood, 1.23 5.17 NA 0.31 6.71 NA XXX
multiple.
78461............... 26............ A Heart muscle blood, 1.23 0.43 0.43 0.06 1.72 1.72 XXX
multiple.
78461............... TC............ A Heart muscle blood, 0.00 4.74 NA 0.25 4.99 NA XXX
multiple.
78464............... .............. A Heart image (3d), 1.09 7.48 NA 0.42 8.99 NA XXX
single.
78464............... 26............ A Heart image (3d), 1.09 0.38 0.38 0.05 1.52 1.52 XXX
single.
78464............... TC............ A Heart image (3d), 0.00 7.10 NA 0.37 7.47 NA XXX
single.
78465............... .............. A Heart image (3d), 1.46 12.35 NA 0.68 14.49 NA XXX
multiple.
78465............... 26............ A Heart image (3d), 1.46 0.52 0.52 0.06 2.04 2.04 XXX
multiple.
78465............... TC............ A Heart image (3d), 0.00 11.83 NA 0.62 12.45 NA XXX
multiple.
78466............... .............. A Heart infarct image.. 0.69 2.87 NA 0.18 3.74 NA XXX
[[Page 1213]]
78466............... 26............ A Heart infarct image.. 0.69 0.25 0.25 0.04 0.98 0.98 XXX
78466............... TC............ A Heart infarct image.. 0.00 2.62 NA 0.14 2.76 NA XXX
78468............... .............. A Heart infarct image 0.80 3.96 NA 0.23 4.99 NA XXX
(ef).
78468............... 26............ A Heart infarct image 0.80 0.28 0.28 0.04 1.12 1.12 XXX
(ef).
78468............... TC............ A Heart infarct image 0.00 3.68 NA 0.19 3.87 NA XXX
(ef).
78469............... .............. A Heart infarct image 0.92 5.56 NA 0.32 6.80 NA XXX
(3D).
78469............... 26............ A Heart infarct image 0.92 0.32 0.32 0.04 1.28 1.28 XXX
(3D).
78469............... TC............ A Heart infarct image 0.00 5.24 NA 0.28 5.52 NA XXX
(3D).
78472............... .............. A Gated heart, planar, 0.98 5.88 NA 0.35 7.21 NA XXX
single.
78472............... 26............ A Gated heart, planar, 0.98 0.35 0.35 0.05 1.38 1.38 XXX
single.
78472............... TC............ A Gated heart, planar, 0.00 5.53 NA 0.30 5.83 NA XXX
single.
78473............... .............. A Gated heart, multiple 1.47 8.80 NA 0.48 10.75 NA XXX
78473............... 26............ A Gated heart, multiple 1.47 0.51 0.51 0.06 2.04 2.04 XXX
78473............... TC............ A Gated heart, multiple 0.00 8.29 NA 0.42 8.71 NA XXX
78478............... .............. A Heart wall motion add- 0.62 1.79 NA 0.12 2.53 NA XXX
on.
78478............... 26............ A Heart wall motion add- 0.62 0.23 0.23 0.02 0.87 0.87 XXX
on.
78478............... TC............ A Heart wall motion add- 0.00 1.56 NA 0.10 1.66 NA XXX
on.
78480............... .............. A Heart function add-on 0.62 1.79 NA 0.12 2.53 NA XXX
78480............... 26............ A Heart function add-on 0.62 0.23 0.23 0.02 0.87 0.87 XXX
78480............... TC............ A Heart function add-on 0.00 1.56 NA 0.10 1.66 NA XXX
78481............... .............. A Heart first pass, 0.98 5.61 NA 0.32 6.91 NA XXX
single.
78481............... 26............ A Heart first pass, 0.98 0.37 0.37 0.04 1.39 1.39 XXX
single.
78481............... TC............ A Heart first pass, 0.00 5.24 NA 0.28 5.52 NA XXX
single.
78483............... .............. A Heart first pass, 1.47 8.43 NA 0.47 10.37 NA XXX
multiple.
78483............... 26............ A Heart first pass, 1.47 0.54 0.54 0.06 2.07 2.07 XXX
multiple.
78483............... TC............ A Heart first pass, 0.00 7.89 NA 0.41 8.30 NA XXX
multiple.
78491............... .............. I Heart image (pet), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
78491............... 26............ I Heart image (pet), +1.50 0.59 0.59 0.06 2.15 2.15 XXX
single.
78491............... TC............ I Heart image (pet), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
78492............... .............. I Heart image (pet), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multiple.
78492............... 26............ I Heart image (pet), +1.87 0.74 0.74 0.07 2.68 2.68 XXX
multiple.
78492............... TC............ I Heart image (pet), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multiple.
78494............... .............. A Heart image, spect... 1.19 7.51 NA 0.35 9.05 NA XXX
78494............... 26............ A Heart image, spect... 1.19 0.41 0.41 0.05 1.65 1.65 XXX
78494............... TC............ A Heart image, spect... 0.00 7.10 NA 0.30 7.40 NA XXX
78496............... .............. A Heart first pass add- 0.50 7.28 NA 0.32 8.10 NA ZZZ
on.
78496............... 26............ A Heart first pass add- 0.50 0.18 0.18 0.02 0.70 0.70 ZZZ
on.
78496............... TC............ A Heart first pass add- 0.00 7.10 NA 0.30 7.40 NA ZZZ
on.
78499............... .............. C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78499............... 26............ C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78499............... TC............ C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78580............... .............. A Lung perfusion 0.74 3.69 NA 0.22 4.65 NA XXX
imaging.
78580............... 26............ A Lung perfusion 0.74 0.25 0.25 0.04 1.03 1.03 XXX
imaging.
78580............... TC............ A Lung perfusion 0.00 3.44 NA 0.18 3.62 NA XXX
imaging.
78584............... .............. A Lung V/Q image single 0.99 3.54 NA 0.22 4.75 NA XXX
breath.
78584............... 26............ A Lung V/Q image single 0.99 0.33 0.33 0.05 1.37 1.37 XXX
breath.
78584............... TC............ A Lung V/Q image single 0.00 3.21 NA 0.17 3.38 NA XXX
breath.
78585............... .............. A Lung V/Q imaging..... 1.09 6.02 NA 0.36 7.47 NA XXX
78585............... 26............ A Lung V/Q imaging..... 1.09 0.37 0.37 0.06 1.52 1.52 XXX
78585............... TC............ A Lung V/Q imaging..... 0.00 5.65 NA 0.30 5.95 NA XXX
78586............... .............. A Aerosol lung image, 0.40 2.73 NA 0.16 3.29 NA XXX
single.
78586............... 26............ A Aerosol lung image, 0.40 0.13 0.13 0.02 0.55 0.55 XXX
single.
78586............... TC............ A Aerosol lung image, 0.00 2.60 NA 0.14 2.74 NA XXX
single.
78587............... .............. A Aerosol lung image, 0.49 2.98 NA 0.16 3.63 NA XXX
multiple.
78587............... 26............ A Aerosol lung image, 0.49 0.17 0.17 0.02 0.68 0.68 XXX
multiple.
78587............... TC............ A Aerosol lung image, 0.00 2.81 NA 0.14 2.95 NA XXX
multiple.
78588............... .............. A Perfusion lung image. 1.09 3.58 NA 0.24 4.91 NA XXX
78588............... 26............ A Perfusion lung image. 1.09 0.37 0.37 0.06 1.52 1.52 XXX
78588............... TC............ A Perfusion lung image. 0.00 3.21 NA 0.18 3.39 NA XXX
78591............... .............. A Vent image, 1 breath, 0.40 3.00 NA 0.16 3.56 NA XXX
1 proj.
78591............... 26............ A Vent image, 1 breath, 0.40 0.14 0.14 0.02 0.56 0.56 XXX
1 proj.
78591............... TC............ A Vent image, 1 breath, 0.00 2.86 NA 0.14 3.00 NA XXX
1 proj.
78593............... .............. A Vent image, 1 proj, 0.49 3.63 NA 0.20 4.32 NA XXX
gas.
78593............... 26............ A Vent image, 1 proj, 0.49 0.17 0.17 0.02 0.68 0.68 XXX
gas.
78593............... TC............ A Vent image, 1 proj, 0.00 3.46 NA 0.18 3.64 NA XXX
gas.
78594............... .............. A Vent image, mult 0.53 5.17 NA 0.27 5.97 NA XXX
proj, gas.
78594............... 26............ A Vent image, mult 0.53 0.18 0.18 0.02 0.73 0.73 XXX
proj, gas.
78594............... TC............ A Vent image, mult 0.00 4.99 NA 0.25 5.24 NA XXX
proj, gas.
78596............... .............. A Lung differential 1.27 7.52 NA 0.43 9.22 NA XXX
function.
78596............... 26............ A Lung differential 1.27 0.42 0.42 0.06 1.75 1.75 XXX
function.
78596............... TC............ A Lung differential 0.00 7.10 NA 0.37 7.47 NA XXX
function.
78599............... .............. C Respiratory nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78599............... 26............ C Respiratory nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78599............... TC............ C Respiratory nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78600............... .............. A Brain imaging, ltd 0.44 3.04 NA 0.16 3.64 NA XXX
static.
[[Page 1214]]
78600............... 26............ A Brain imaging, ltd 0.44 0.15 0.15 0.02 0.61 0.61 XXX
static.
78600............... TC............ A Brain imaging, ltd 0.00 2.89 NA 0.14 3.03 NA XXX
static.
78601............... .............. A Brain imaging, ltd w/ 0.51 3.58 NA 0.20 4.29 NA XXX
flow.
78601............... 26............ A Brain imaging, ltd w/ 0.51 0.17 0.17 0.02 0.70 0.70 XXX
flow.
78601............... TC............ A Brain imaging, ltd w/ 0.00 3.41 NA 0.18 3.59 NA XXX
flow.
78605............... .............. A Brain imaging, 0.53 3.60 NA 0.20 4.33 NA XXX
complete.
78605............... 26............ A Brain imaging, 0.53 0.19 0.19 0.02 0.74 0.74 XXX
complete.
78605............... TC............ A Brain imaging, 0.00 3.41 NA 0.18 3.59 NA XXX
complete.
78606............... .............. A Brain imaging, compl 0.64 4.10 NA 0.25 4.99 NA XXX
w/flow.
78606............... 26............ A Brain imaging, compl 0.64 0.22 0.22 0.04 0.90 0.90 XXX
w/flow.
78606............... TC............ A Brain imaging, compl 0.00 3.88 NA 0.21 4.09 NA XXX
w/flow.
78607............... .............. A Brain imaging (3D)... 1.23 7.01 NA 0.41 8.65 NA XXX
78607............... 26............ A Brain imaging (3D)... 1.23 0.43 0.43 0.06 1.72 1.72 XXX
78607............... TC............ A Brain imaging (3D)... 0.00 6.58 NA 0.35 6.93 NA XXX
78608............... .............. N Brain imaging (PET).. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78609............... .............. N Brain imaging (PET).. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78610............... .............. A Brain flow imaging 0.30 1.69 NA 0.11 2.10 NA XXX
only.
78610............... 26............ A Brain flow imaging 0.30 0.11 0.11 0.01 0.42 0.42 XXX
only.
78610............... TC............ A Brain flow imaging 0.00 1.58 NA 0.10 1.68 NA XXX
only.
78615............... .............. A Cerebral vascular 0.42 4.02 NA 0.23 4.67 NA XXX
flow image.
78615............... 26............ A Cerebral vascular 0.42 0.16 0.16 0.02 0.60 0.60 XXX
flow image.
78615............... TC............ A Cerebral vascular 0.00 3.86 NA 0.21 4.07 NA XXX
flow image.
78630............... .............. A Cerebrospinal fluid 0.68 5.28 NA 0.31 6.27 NA XXX
scan.
78630............... 26............ A Cerebrospinal fluid 0.68 0.23 0.23 0.04 0.95 0.95 XXX
scan.
78630............... TC............ A Cerebrospinal fluid 0.00 5.05 NA 0.27 5.32 NA XXX
scan.
78635............... .............. A CSF ventriculography. 0.61 2.80 NA 0.16 3.57 NA XXX
78635............... 26............ A CSF ventriculography. 0.61 0.24 0.24 0.02 0.87 0.87 XXX
78635............... TC............ A CSF ventriculography. 0.00 2.56 NA 0.14 2.70 NA XXX
78645............... .............. A CSF shunt evaluation. 0.57 3.64 NA 0.20 4.41 NA XXX
78645............... 26............ A CSF shunt evaluation. 0.57 0.20 0.20 0.02 0.79 0.79 XXX
78645............... TC............ A CSF shunt evaluation. 0.00 3.44 NA 0.18 3.62 NA XXX
78647............... .............. A Cerebrospinal fluid 0.90 6.25 NA 0.35 7.50 NA XXX
scan.
78647............... 26............ A Cerebrospinal fluid 0.90 0.32 0.32 0.04 1.26 1.26 XXX
scan.
78647............... TC............ A Cerebrospinal fluid 0.00 5.93 NA 0.31 6.24 NA XXX
scan.
78650............... .............. A CSF leakage imaging.. 0.61 4.87 NA 0.26 5.74 NA XXX
78650............... 26............ A CSF leakage imaging.. 0.61 0.21 0.21 0.02 0.84 0.84 XXX
78650............... TC............ A CSF leakage imaging.. 0.00 4.66 NA 0.24 4.90 NA XXX
78660............... .............. A Nuclear exam of tear 0.53 2.30 NA 0.14 2.97 NA XXX
flow.
78660............... 26............ A Nuclear exam of tear 0.53 0.18 0.18 0.02 0.73 0.73 XXX
flow.
78660............... TC............ A Nuclear exam of tear 0.00 2.12 NA 0.12 2.24 NA XXX
flow.
78699............... .............. C Nervous system 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78699............... 26............ C Nervous system 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78699............... TC............ C Nervous system 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78700............... .............. A Kidney imaging, 0.45 3.21 NA 0.18 3.84 NA XXX
static.
78700............... 26............ A Kidney imaging, 0.45 0.15 0.15 0.02 0.62 0.62 XXX
static.
78700............... TC............ A Kidney imaging, 0.00 3.06 NA 0.16 3.22 NA XXX
static.
78701............... .............. A Kidney imaging with 0.49 3.74 NA 0.20 4.43 NA XXX
flow.
78701............... 26............ A Kidney imaging with 0.49 0.17 0.17 0.02 0.68 0.68 XXX
flow.
78701............... TC............ A Kidney imaging with 0.00 3.57 NA 0.18 3.75 NA XXX
flow.
78704............... .............. A Imaging renogram..... 0.74 4.22 NA 0.25 5.21 NA XXX
78704............... 26............ A Imaging renogram..... 0.74 0.25 0.25 0.04 1.03 1.03 XXX
78704............... TC............ A Imaging renogram..... 0.00 3.97 NA 0.21 4.18 NA XXX
78707............... .............. A Kidney flow/function 0.96 4.81 NA 0.28 6.05 NA XXX
image.
78707............... 26............ A Kidney flow/function 0.96 0.33 0.33 0.05 1.34 1.34 XXX
image.
78707............... TC............ A Kidney flow/function 0.00 4.48 NA 0.23 4.71 NA XXX
image.
78708............... .............. A Kidney flow/function 1.21 4.89 NA 0.29 6.39 NA XXX
image.
78708............... 26............ A Kidney flow/function 1.21 0.41 0.41 0.06 1.68 1.68 XXX
image.
78708............... TC............ A Kidney flow/function 0.00 4.48 NA 0.23 4.71 NA XXX
image.
78709............... .............. A Kidney flow/function 1.41 4.95 NA 0.30 6.66 NA XXX
image.
78709............... 26............ A Kidney flow/function 1.41 0.47 0.47 0.07 1.95 1.95 XXX
image.
78709............... TC............ A Kidney flow/function 0.00 4.48 NA 0.23 4.71 NA XXX
image.
78710............... .............. A Kidney imaging (3D).. 0.66 6.15 NA 0.35 7.16 NA XXX
78710............... 26............ A Kidney imaging (3D).. 0.66 0.22 0.22 0.04 0.92 0.92 XXX
78710............... TC............ A Kidney imaging (3D).. 0.00 5.93 NA 0.31 6.24 NA XXX
78715............... .............. A Renal vascular flow 0.30 1.69 NA 0.11 2.10 NA XXX
exam.
78715............... 26............ A Renal vascular flow 0.30 0.11 0.11 0.01 0.42 0.42 XXX
exam.
78715............... TC............ A Renal vascular flow 0.00 1.58 NA 0.10 1.68 NA XXX
exam.
78725............... .............. A Kidney function study 0.38 1.92 NA 0.12 2.42 NA XXX
78725............... 26............ A Kidney function study 0.38 0.13 0.13 0.01 0.52 0.52 XXX
78725............... TC............ A Kidney function study 0.00 1.79 NA 0.11 1.90 NA XXX
78730............... .............. A Urinary bladder 0.36 1.59 NA 0.10 2.05 NA XXX
retention.
78730............... 26............ A Urinary bladder 0.36 0.13 0.13 0.02 0.51 0.51 XXX
retention.
78730............... TC............ A Urinary bladder 0.00 1.46 NA 0.08 1.54 NA XXX
retention.
78740............... .............. A Ureteral reflux study 0.57 2.31 NA 0.14 3.02 NA XXX
78740............... 26............ A Ureteral reflux study 0.57 0.19 0.19 0.02 0.78 0.78 XXX
[[Page 1215]]
78740............... TC............ A Ureteral reflux study 0.00 2.12 NA 0.12 2.24 NA XXX
78760............... .............. A Testicular imaging... 0.66 2.90 NA 0.18 3.74 NA XXX
78760............... 26............ A Testicular imaging... 0.66 0.22 0.22 0.04 0.92 0.92 XXX
78760............... TC............ A Testicular imaging... 0.00 2.68 NA 0.14 2.82 NA XXX
78761............... .............. A Testicular imaging/ 0.71 3.45 NA 0.21 4.37 NA XXX
flow.
78761............... 26............ A Testicular imaging/ 0.71 0.24 0.24 0.04 0.99 0.99 XXX
flow.
78761............... TC............ A Testicular imaging/ 0.00 3.21 NA 0.17 3.38 NA XXX
flow.
78799............... .............. C Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78799............... 26............ C Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78799............... TC............ C Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78800............... .............. A Tumor imaging, 0.66 3.63 NA 0.22 4.51 NA XXX
limited area.
78800............... 26............ A Tumor imaging, 0.66 0.22 0.22 0.04 0.92 0.92 XXX
limited area.
78800............... TC............ A Tumor imaging, 0.00 3.41 NA 0.18 3.59 NA XXX
limited area.
78801............... .............. A Tumor imaging, mult 0.79 4.51 NA 0.26 5.56 NA XXX
areas.
78801............... 26............ A Tumor imaging, mult 0.79 0.27 0.27 0.04 1.10 1.10 XXX
areas.
78801............... TC............ A Tumor imaging, mult 0.00 4.24 NA 0.22 4.46 NA XXX
areas.
78802............... .............. A Tumor imaging, whole 0.86 5.85 NA 0.34 7.05 NA XXX
body.
78802............... 26............ A Tumor imaging, whole 0.86 0.30 0.30 0.04 1.20 1.20 XXX
body.
78802............... TC............ A Tumor imaging, whole 0.00 5.55 NA 0.30 5.85 NA XXX
body.
78803............... .............. A Tumor imaging (3D)... 1.09 6.96 NA 0.40 8.45 NA XXX
78803............... 26............ A Tumor imaging (3D)... 1.09 0.38 0.38 0.05 1.52 1.52 XXX
78803............... TC............ A Tumor imaging (3D)... 0.00 6.58 NA 0.35 6.93 NA XXX
78804............... .............. A Tumor imaging, whole 1.07 4.66 NA 0.34 6.07 NA XXX
body.
78804............... 26............ A Tumor imaging, whole 1.07 0.37 0.37 0.04 1.48 1.48 XXX
body.
78804............... TC............ A Tumor imaging, whole 0.00 4.29 NA 0.30 4.59 NA XXX
body.
78805............... .............. A Abscess imaging, ltd 0.73 3.66 NA 0.22 4.61 NA XXX
area.
78805............... 26............ A Abscess imaging, ltd 0.73 0.25 0.25 0.04 1.02 1.02 XXX
area.
78805............... TC............ A Abscess imaging, ltd 0.00 3.41 NA 0.18 3.59 NA XXX
area.
78806............... .............. A Abscess imaging, 0.86 6.75 NA 0.39 8.00 NA XXX
whole body.
78806............... 26............ A Abscess imaging, 0.86 0.30 0.30 0.04 1.20 1.20 XXX
whole body.
78806............... TC............ A Abscess imaging, 0.00 6.45 NA 0.35 6.80 NA XXX
whole body.
78807............... .............. A Nuclear localization/ 1.09 6.97 NA 0.40 8.46 NA XXX
abscess.
78807............... 26............ A Nuclear localization/ 1.09 0.39 0.39 0.05 1.53 1.53 XXX
abscess.
78807............... TC............ A Nuclear localization/ 0.00 6.58 NA 0.35 6.93 NA XXX
abscess.
78810............... .............. N Tumor imaging (PET).. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78810............... 26............ N Tumor imaging (PET).. +1.93 0.74 0.74 0.11 2.78 2.78 XXX
78810............... TC............ N Tumor imaging (PET).. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78890............... .............. B Nuclear medicine data +0.05 1.33 NA 0.07 1.45 NA XXX
proc.
78890............... 26............ B Nuclear medicine data +0.05 0.02 0.02 0.01 0.08 0.08 XXX
proc.
78890............... TC............ B Nuclear medicine data +0.00 1.31 NA 0.06 1.37 NA XXX
proc.
78891............... .............. B Nuclear med data proc +0.10 2.66 NA 0.14 2.90 NA XXX
78891............... 26............ B Nuclear med data proc +0.10 0.04 0.04 0.01 0.15 0.15 XXX
78891............... TC............ B Nuclear med data proc +0.00 2.62 NA 0.13 2.75 NA XXX
78990............... .............. I Provide diag 0.00 0.00 0.00 0.00 0.00 0.00 XXX
radionuclide(s).
78999............... .............. C Nuclear diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78999............... 26............ C Nuclear diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78999............... TC............ C Nuclear diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
79000............... .............. A Init hyperthyroid 1.80 3.22 NA 0.22 5.24 NA XXX
therapy.
79000............... 26............ A Init hyperthyroid 1.80 0.60 0.60 0.08 2.48 2.48 XXX
therapy.
79000............... TC............ A Init hyperthyroid 0.00 2.62 NA 0.14 2.76 NA XXX
therapy.
79001............... .............. A Repeat hyperthyroid 1.05 1.67 NA 0.12 2.84 NA XXX
therapy.
79001............... 26............ A Repeat hyperthyroid 1.05 0.36 0.36 0.05 1.46 1.46 XXX
therapy.
79001............... TC............ A Repeat hyperthyroid 0.00 1.31 NA 0.07 1.38 NA XXX
therapy.
79020............... .............. A Thyroid ablation..... 1.81 3.22 NA 0.22 5.25 NA XXX
79020............... 26............ A Thyroid ablation..... 1.81 0.60 0.60 0.08 2.49 2.49 XXX
79020............... TC............ A Thyroid ablation..... 0.00 2.62 NA 0.14 2.76 NA XXX
79030............... .............. A Thyroid ablation, 2.10 3.33 NA 0.24 5.67 NA XXX
carcinoma.
79030............... 26............ A Thyroid ablation, 2.10 0.71 0.71 0.10 2.91 2.91 XXX
carcinoma.
79030............... TC............ A Thyroid ablation, 0.00 2.62 NA 0.14 2.76 NA XXX
carcinoma.
79035............... .............. A Thyroid metastatic 2.52 3.50 NA 0.25 6.27 NA XXX
therapy.
79035............... 26............ A Thyroid metastatic 2.52 0.88 0.88 0.11 3.51 3.51 XXX
therapy.
79035............... TC............ A Thyroid metastatic 0.00 2.62 NA 0.14 2.76 NA XXX
therapy.
79100............... .............. A Hematopoetic nuclear 1.32 3.08 NA 0.20 4.60 NA XXX
therapy.
79100............... 26............ A Hematopoetic nuclear 1.32 0.46 0.46 0.06 1.84 1.84 XXX
therapy.
79100............... TC............ A Hematopoetic nuclear 0.00 2.62 NA 0.14 2.76 NA XXX
therapy.
79200............... .............. A Intracavitary nuclear 1.99 3.31 NA 0.22 5.52 NA XXX
trmt.
79200............... 26............ A Intracavitary nuclear 1.99 0.69 0.69 0.08 2.76 2.76 XXX
trmt.
79200............... TC............ A Intracavitary nuclear 0.00 2.62 NA 0.14 2.76 NA XXX
trmt.
79300............... .............. C Interstitial nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
79300............... 26............ A Interstitial nuclear 1.60 0.56 0.56 0.08 2.24 2.24 XXX
therapy.
79300............... TC............ C Interstitial nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
79400............... .............. A Nonhemato nuclear 1.96 3.29 NA 0.24 5.49 NA XXX
therapy.
79400............... 26............ A Nonhemato nuclear 1.96 0.67 0.67 0.10 2.73 2.73 XXX
therapy.
79400............... TC............ A Nonhemato nuclear 0.00 2.62 NA 0.14 2.76 NA XXX
therapy.
79403............... .............. A Hematopoetic nuclear 2.25 5.19 NA 0.24 7.68 NA XXX
therapy.
[[Page 1216]]
79403............... 26............ A Hematopoetic nuclear 2.25 0.90 0.90 0.10 3.25 3.25 XXX
therapy.
79403............... TC............ A Hematopoetic nuclear 0.00 4.29 NA 0.14 4.43 NA XXX
therapy.
79420............... .............. C Intravascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ther.
79420............... 26............ A Intravascular nuclear 1.51 0.49 0.49 0.07 2.07 2.07 XXX
ther.
79420............... TC............ C Intravascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ther.
79440............... .............. A Nuclear joint therapy 1.99 3.34 NA 0.24 5.57 NA XXX
79440............... 26............ A Nuclear joint therapy 1.99 0.72 0.72 0.10 2.81 2.81 XXX
79440............... TC............ A Nuclear joint therapy 0.00 2.62 NA 0.14 2.76 NA XXX
79900............... .............. C Provide ther 0.00 0.00 0.00 0.00 0.00 0.00 XXX
radiopharm(s).
79999............... .............. C Nuclear medicine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
79999............... 26............ C Nuclear medicine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
79999............... TC............ C Nuclear medicine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
80500............... .............. A Lab pathology 0.37 0.22 0.16 0.01 0.60 0.54 XXX
consultation.
80502............... .............. A Lab pathology 1.33 0.62 0.58 0.06 2.01 1.97 XXX
consultation.
83020............... 26............ A Hemoglobin 0.37 0.16 0.16 0.01 0.54 0.54 XXX
electrophoresis.
83912............... 26............ A Genetic examination.. 0.37 0.15 0.15 0.01 0.53 0.53 XXX
84165............... 26............ A Electrophoreisis of 0.37 0.16 0.16 0.01 0.54 0.54 XXX
proteins.
84181............... 26............ A Western blot test.... 0.37 0.14 0.14 0.01 0.52 0.52 XXX
84182............... 26............ A Protein, western blot 0.37 0.17 0.16 0.01 0.55 0.54 XXX
test.
85060............... .............. A Blood smear 0.45 0.20 0.20 0.02 0.67 0.67 XXX
interpretation.
85097............... .............. A Bone marrow 0.94 1.75 0.41 0.04 2.73 1.39 XXX
interpretation.
85390............... 26............ A Fibrinolysins screen. 0.37 0.15 0.15 0.01 0.53 0.53 XXX
85396............... .............. A Clotting assay, whole 0.37 NA 0.17 0.04 NA 0.58 XXX
blood.
85576............... 26............ A Blood platelet 0.37 0.17 0.16 0.01 0.55 0.54 XXX
aggregation.
86077............... .............. A Physician blood bank 0.94 0.46 0.41 0.04 1.44 1.39 XXX
service.
86078............... .............. A Physician blood bank 0.94 0.49 0.40 0.04 1.47 1.38 XXX
service.
86079............... .............. A Physician blood bank 0.94 0.49 0.41 0.04 1.47 1.39 XXX
service.
86255............... 26............ A Fluorescent antibody, 0.37 0.17 0.16 0.01 0.55 0.54 XXX
screen.
86256............... 26............ A Fluorescent antibody, 0.37 0.16 0.16 0.01 0.54 0.54 XXX
titer.
86320............... 26............ A Serum 0.37 0.16 0.16 0.01 0.54 0.54 XXX
immunoelectrophoresi
s.
86325............... 26............ A Other 0.37 0.16 0.16 0.01 0.54 0.54 XXX
immunoelectrophoresi
s.
86327............... 26............ A Immunoelectrophoresis 0.42 0.19 0.19 0.01 0.62 0.62 XXX
assay.
86334............... 26............ A Immunofixation 0.37 0.16 0.16 0.01 0.54 0.54 XXX
procedure.
86485............... .............. C Skin test, candida... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86490............... .............. A Coccidioidomycosis 0.00 0.29 NA 0.02 0.31 NA XXX
skin test.
86510............... .............. A Histoplasmosis skin 0.00 0.32 NA 0.02 0.34 NA XXX
test.
86580............... .............. A TB intradermal test.. 0.00 0.26 NA 0.02 0.28 NA XXX
86585............... .............. A TB tine test......... 0.00 0.21 NA 0.01 0.22 NA XXX
86586............... .............. C Skin test, unlisted.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87164............... 26............ A Dark field 0.37 0.12 0.12 0.01 0.50 0.50 XXX
examination.
87207............... 26............ A Smear, special stain. 0.37 0.17 0.16 0.01 0.55 0.54 XXX
88104............... .............. A Cytopathology, fluids 0.56 0.75 NA 0.04 1.35 NA XXX
88104............... 26............ A Cytopathology, fluids 0.56 0.25 0.25 0.02 0.83 0.83 XXX
88104............... TC............ A Cytopathology, fluids 0.00 0.50 NA 0.02 0.52 NA XXX
88106............... .............. A Cytopathology, fluids 0.56 0.62 NA 0.04 1.22 NA XXX
88106............... 26............ A Cytopathology, fluids 0.56 0.25 0.25 0.02 0.83 0.83 XXX
88106............... TC............ A Cytopathology, fluids 0.00 0.37 NA 0.02 0.39 NA XXX
88107............... .............. A Cytopathology, fluids 0.76 0.98 NA 0.06 1.80 NA XXX
88107............... 26............ A Cytopathology, fluids 0.76 0.34 0.34 0.04 1.14 1.14 XXX
88107............... TC............ A Cytopathology, fluids 0.00 0.64 NA 0.02 0.66 NA XXX
88108............... .............. A Cytopath, concentrate 0.56 0.81 NA 0.04 1.41 NA XXX
tech.
88108............... 26............ A Cytopath, concentrate 0.56 0.25 0.25 0.02 0.83 0.83 XXX
tech.
88108............... TC............ A Cytopath, concentrate 0.00 0.56 NA 0.02 0.58 NA XXX
tech.
88112............... .............. A Cytopath, cell 1.18 1.98 NA 0.08 3.24 NA XXX
enhance tech.
88112............... 26............ A Cytopath, cell 1.18 0.51 0.51 0.06 1.75 1.75 XXX
enhance tech.
88112............... TC............ A Cytopath, cell 0.00 1.47 NA 0.02 1.49 NA XXX
enhance tech.
88125............... .............. A Forensic 0.26 0.26 NA 0.02 0.54 NA XXX
cytopathology.
88125............... 26............ A Forensic 0.26 0.12 0.12 0.01 0.39 0.39 XXX
cytopathology.
88125............... TC............ A Forensic 0.00 0.14 NA 0.01 0.15 NA XXX
cytopathology.
88141............... .............. A Cytopath, c/v, 0.42 0.18 0.18 0.01 0.61 0.61 XXX
interpret.
88160............... .............. A Cytopath smear, other 0.50 0.92 NA 0.04 1.46 NA XXX
source.
88160............... 26............ A Cytopath smear, other 0.50 0.22 0.22 0.02 0.74 0.74 XXX
source.
88160............... TC............ A Cytopath smear, other 0.00 0.70 NA 0.02 0.72 NA XXX
source.
88161............... .............. A Cytopath smear, other 0.50 0.88 NA 0.04 1.42 NA XXX
source.
88161............... 26............ A Cytopath smear, other 0.50 0.22 0.22 0.02 0.74 0.74 XXX
source.
88161............... TC............ A Cytopath smear, other 0.00 0.66 NA 0.02 0.68 NA XXX
source.
88162............... .............. A Cytopath smear, other 0.76 0.68 NA 0.06 1.50 NA XXX
source.
88162............... 26............ A Cytopath smear, other 0.76 0.34 0.34 0.04 1.14 1.14 XXX
source.
88162............... TC............ A Cytopath smear, other 0.00 0.34 NA 0.02 0.36 NA XXX
source.
88172............... .............. A Cytopathology eval of 0.60 0.66 NA 0.04 1.30 NA XXX
fna.
88172............... 26............ A Cytopathology eval of 0.60 0.27 0.27 0.02 0.89 0.89 XXX
fna.
88172............... TC............ A Cytopathology eval of 0.00 0.39 NA 0.02 0.41 NA XXX
fna.
88173............... .............. A Cytopath eval, fna, 1.39 1.75 NA 0.08 3.22 NA XXX
report.
88173............... 26............ A Cytopath eval, fna, 1.39 0.60 0.60 0.06 2.05 2.05 XXX
report.
88173............... TC............ A Cytopath eval, fna, 0.00 1.15 NA 0.02 1.17 NA XXX
report.
[[Page 1217]]
88180............... .............. A Cell marker study.... 0.36 1.43 NA 0.03 1.82 NA XXX
88180............... 26............ A Cell marker study.... 0.36 0.16 0.16 0.01 0.53 0.53 XXX
88180............... TC............ A Cell marker study.... 0.00 1.27 NA 0.02 1.29 NA XXX
88182............... .............. A Cell marker study.... 0.77 1.59 NA 0.08 2.44 NA XXX
88182............... 26............ A Cell marker study.... 0.77 0.34 0.34 0.04 1.15 1.15 XXX
88182............... TC............ A Cell marker study.... 0.00 1.25 NA 0.04 1.29 NA XXX
88199............... .............. C Cytopathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88199............... 26............ C Cytopathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88199............... TC............ C Cytopathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88291............... .............. A Cyto/molecular report 0.52 0.28 0.28 0.02 0.82 0.82 XXX
88299............... .............. C Cytogenetic study.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88300............... .............. A Surgical path, gross. 0.08 0.28 NA 0.02 0.38 NA XXX
88300............... 26............ A Surgical path, gross. 0.08 0.04 0.04 0.01 0.13 0.13 XXX
88300............... TC............ A Surgical path, gross. 0.00 0.24 NA 0.01 0.25 NA XXX
88302............... .............. A Tissue exam by 0.13 0.69 NA 0.03 0.85 NA XXX
pathologist.
88302............... 26............ A Tissue exam by 0.13 0.06 0.06 0.01 0.20 0.20 XXX
pathologist.
88302............... TC............ A Tissue exam by 0.00 0.63 NA 0.02 0.65 NA XXX
pathologist.
88304............... .............. A Tissue exam by 0.22 0.87 NA 0.03 1.12 NA XXX
pathologist.
88304............... 26............ A Tissue exam by 0.22 0.10 0.10 0.01 0.33 0.33 XXX
pathologist.
88304............... TC............ A Tissue exam by 0.00 0.77 NA 0.02 0.79 NA XXX
pathologist.
88305............... .............. A Tissue exam by 0.75 1.74 NA 0.06 2.55 NA XXX
pathologist.
88305............... 26............ A Tissue exam by 0.75 0.34 0.34 0.02 1.11 1.11 XXX
pathologist.
88305............... TC............ A Tissue exam by 0.00 1.40 NA 0.04 1.44 NA XXX
pathologist.
88307............... .............. A Tissue exam by 1.59 2.65 NA 0.13 4.37 NA XXX
pathologist.
88307............... 26............ A Tissue exam by 1.59 0.69 0.69 0.07 2.35 2.35 XXX
pathologist.
88307............... TC............ A Tissue exam by 0.00 1.96 NA 0.06 2.02 NA XXX
pathologist.
88309............... .............. A Tissue exam by 2.28 3.25 NA 0.16 5.69 NA XXX
pathologist.
88309............... 26............ A Tissue exam by 2.28 1.00 1.00 0.10 3.38 3.38 XXX
pathologist.
88309............... TC............ A Tissue exam by 0.00 2.25 NA 0.06 2.31 NA XXX
pathologist.
88311............... .............. A Decalcify tissue..... 0.24 0.20 NA 0.02 0.46 NA XXX
88311............... 26............ A Decalcify tissue..... 0.24 0.11 0.11 0.01 0.36 0.36 XXX
88311............... TC............ A Decalcify tissue..... 0.00 0.09 NA 0.01 0.10 NA XXX
88312............... .............. A Special stains....... 0.54 1.35 NA 0.03 1.92 NA XXX
88312............... 26............ A Special stains....... 0.54 0.24 0.24 0.02 0.80 0.80 XXX
88312............... TC............ A Special stains....... 0.00 1.11 NA 0.01 1.12 NA XXX
88313............... .............. A Special stains....... 0.24 1.09 NA 0.02 1.35 NA XXX
88313............... 26............ A Special stains....... 0.24 0.11 0.11 0.01 0.36 0.36 XXX
88313............... TC............ A Special stains....... 0.00 0.98 NA 0.01 0.99 NA XXX
88314............... .............. A Histochemical stain.. 0.45 0.89 NA 0.04 1.38 NA XXX
88314............... 26............ A Histochemical stain.. 0.45 0.20 0.20 0.02 0.67 0.67 XXX
88314............... TC............ A Histochemical stain.. 0.00 0.69 NA 0.02 0.71 NA XXX
88318............... .............. A Chemical 0.42 0.80 NA 0.02 1.24 NA XXX
histochemistry.
88318............... 26............ A Chemical 0.42 0.19 0.19 0.01 0.62 0.62 XXX
histochemistry.
88318............... TC............ A Chemical 0.00 0.61 NA 0.01 0.62 NA XXX
histochemistry.
88319............... .............. A Enzyme histochemistry 0.53 1.89 NA 0.04 2.46 NA XXX
88319............... 26............ A Enzyme histochemistry 0.53 0.23 0.23 0.02 0.78 0.78 XXX
88319............... TC............ A Enzyme histochemistry 0.00 1.66 NA 0.02 1.68 NA XXX
88321............... .............. A Microslide 1.30 0.82 0.56 0.05 2.17 1.91 XXX
consultation.
88323............... .............. A Microslide 1.35 1.44 NA 0.08 2.87 NA XXX
consultation.
88323............... 26............ A Microslide 1.35 0.59 0.59 0.06 2.00 2.00 XXX
consultation.
88323............... TC............ A Microslide 0.00 0.85 NA 0.02 0.87 NA XXX
consultation.
88325............... .............. A Comprehensive review 2.22 2.90 0.97 0.10 5.22 3.29 XXX
of data.
88329............... .............. A Path consult introp.. 0.67 0.63 0.30 0.02 1.32 0.99 XXX
88331............... .............. A Path consult intraop, 1.19 0.98 NA 0.09 2.26 NA XXX
1 bloc.
88331............... 26............ A Path consult intraop, 1.19 0.52 0.52 0.05 1.76 1.76 XXX
1 bloc.
88331............... TC............ A Path consult intraop, 0.00 0.46 NA 0.04 0.50 NA XXX
1 bloc.
88332............... .............. A Path consult intraop, 0.59 0.50 NA 0.04 1.13 NA XXX
add'l.
88332............... 26............ A Path consult intraop, 0.59 0.26 0.26 0.02 0.87 0.87 XXX
add'l.
88332............... TC............ A Path consult intraop, 0.00 0.24 NA 0.02 0.26 NA XXX
add'l.
88342............... .............. A Immunohistochemistry. 0.85 1.35 NA 0.06 2.26 NA XXX
88342............... 26............ A Immunohistochemistry. 0.85 0.37 0.37 0.04 1.26 1.26 XXX
88342............... TC............ A Immunohistochemistry. 0.00 0.98 NA 0.02 1.00 NA XXX
88346............... .............. A Immunofluorescent 0.86 1.44 NA 0.06 2.36 NA XXX
study.
88346............... 26............ A Immunofluorescent 0.86 0.37 0.37 0.04 1.27 1.27 XXX
study.
88346............... TC............ A Immunofluorescent 0.00 1.07 NA 0.02 1.09 NA XXX
study.
88347............... .............. A Immunofluorescent 0.86 1.76 NA 0.06 2.68 NA XXX
study.
88347............... 26............ A Immunofluorescent 0.86 0.36 0.36 0.04 1.26 1.26 XXX
study.
88347............... TC............ A Immunofluorescent 0.00 1.40 NA 0.02 1.42 NA XXX
study.
88348............... .............. A Electron microscopy.. 1.51 8.47 NA 0.13 10.11 NA XXX
88348............... 26............ A Electron microscopy.. 1.51 0.65 0.65 0.06 2.22 2.22 XXX
88348............... TC............ A Electron microscopy.. 0.00 7.82 NA 0.07 7.89 NA XXX
88349............... .............. A Scanning electron 0.76 9.99 NA 0.10 10.85 NA XXX
microscopy.
88349............... 26............ A Scanning electron 0.76 0.34 0.34 0.04 1.14 1.14 XXX
microscopy.
88349............... TC............ A Scanning electron 0.00 9.65 NA 0.06 9.71 NA XXX
microscopy.
88355............... .............. A Analysis, skeletal 1.85 2.60 NA 0.14 4.59 NA XXX
muscle.
[[Page 1218]]
88355............... 26............ A Analysis, skeletal 1.85 0.80 0.80 0.08 2.73 2.73 XXX
muscle.
88355............... TC............ A Analysis, skeletal 0.00 1.80 NA 0.06 1.86 NA XXX
muscle.
88356............... .............. A Analysis, nerve...... 3.02 2.87 NA 0.19 6.08 NA XXX
88356............... 26............ A Analysis, nerve...... 3.02 1.27 1.27 0.12 4.41 4.41 XXX
88356............... TC............ A Analysis, nerve...... 0.00 1.60 NA 0.07 1.67 NA XXX
88358............... .............. A Analysis, tumor...... 0.95 1.38 NA 0.19 2.52 NA XXX
88358............... 26............ A Analysis, tumor...... 0.95 1.23 1.23 0.12 2.30 2.30 XXX
88358............... TC............ A Analysis, tumor...... 0.00 0.15 NA 0.07 0.22 NA XXX
88361............... .............. A Immunohistochemistry, 0.94 2.59 NA 0.19 3.72 NA XXX
tumor.
88361............... 26............ A Immunohistochemistry, 0.94 0.41 0.41 0.12 1.47 1.47 XXX
tumor.
88361............... TC............ A Immunohistochemistry, 0.00 2.18 NA 0.07 2.25 NA XXX
tumor.
88362............... .............. A Nerve teasing 2.17 4.40 NA 0.14 6.71 NA XXX
preparations.
88362............... 26............ A Nerve teasing 2.17 0.93 0.93 0.08 3.18 3.18 XXX
preparations.
88362............... TC............ A Nerve teasing 0.00 3.47 NA 0.06 3.53 NA XXX
preparations.
88365............... .............. A Tissue hybridization. 0.93 2.21 NA 0.06 3.20 NA XXX
88365............... 26............ A Tissue hybridization. 0.93 0.41 0.41 0.04 1.38 1.38 XXX
88365............... TC............ A Tissue hybridization. 0.00 1.80 NA 0.02 1.82 NA XXX
88371............... 26............ A Protein, western blot 0.37 0.13 0.13 0.01 0.51 0.51 XXX
tissue.
88372............... 26............ A Protein analysis w/ 0.37 0.17 0.17 0.01 0.55 0.55 XXX
probe.
88380............... .............. C Microdissection...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88380............... 26............ C Microdissection...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88380............... TC............ C Microdissection...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88399............... .............. C Surgical pathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88399............... 26............ C Surgical pathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88399............... TC............ C Surgical pathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
89060............... 26............ A Exam,synovial fluid 0.37 0.17 0.16 0.01 0.55 0.54 XXX
crystals.
89100............... .............. A Sample intestinal 0.60 1.60 0.22 0.02 2.22 0.84 XXX
contents.
89105............... .............. A Sample intestinal 0.50 2.24 0.17 0.02 2.76 0.69 XXX
contents.
89130............... .............. A Sample stomach 0.45 1.74 0.13 0.02 2.21 0.60 XXX
contents.
89132............... .............. A Sample stomach 0.19 1.48 0.06 0.01 1.68 0.26 XXX
contents.
89135............... .............. A Sample stomach 0.79 1.59 0.25 0.04 2.42 1.08 XXX
contents.
89136............... .............. A Sample stomach 0.21 1.60 0.09 0.01 1.82 0.31 XXX
contents.
89140............... .............. A Sample stomach 0.94 2.06 0.28 0.04 3.04 1.26 XXX
contents.
89141............... .............. A Sample stomach 0.85 2.72 0.34 0.04 3.61 1.23 XXX
contents.
90281............... .............. I Human ig, im......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90283............... .............. I Human ig, iv......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90287............... .............. I Botulinum antitoxin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90288............... .............. I Botulism ig, iv...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90291............... .............. I Cmv ig, iv........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90296............... .............. E Diphtheria antitoxin. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90371............... .............. E Hep b ig, im......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90375............... .............. E Rabies ig, im/sc..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90376............... .............. E Rabies ig, heat 0.00 0.00 0.00 0.00 0.00 0.00 XXX
treated.
90378............... .............. X Rsv ig, im, 50mg..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90379............... .............. I Rsv ig, iv........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90384............... .............. I Rh ig, full-dose, im. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90385............... .............. E Rh ig, minidose, im.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90386............... .............. I Rh ig, iv............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90389............... .............. I Tetanus ig, im....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90393............... .............. E Vaccina ig, im....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90396............... .............. E Varicella-zoster ig, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90399............... .............. I Immune globulin...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90471............... .............. A Immunization admin... 0.00 0.21 NA 0.01 0.22 NA XXX
90472............... .............. A Immunization admin, 0.00 0.14 NA 0.01 0.15 NA ZZZ
each add.
90473............... .............. N Immune admin oral/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nasal.
90474............... .............. N Immune admin oral/ 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
nasal addl.
90476............... .............. E Adenovirus vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type 4.
90477............... .............. E Adenovirus vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type 7.
90581............... .............. E Anthrax vaccine, sc.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90585............... .............. E Bcg vaccine, percut.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90586............... .............. E Bcg vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intravesical.
90632............... .............. E Hep a vaccine, adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90633............... .............. E Hep a vacc, ped/adol, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2 dose.
90634............... .............. E Hep a vacc, ped/adol, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3 dose.
90636............... .............. E Hep a/hep b vacc, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adult im.
90645............... .............. E Hib vaccine, hboc, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90646............... .............. E Hib vaccine, prp-d, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90647............... .............. E Hib vaccine, prp-omp, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90648............... .............. E Hib vaccine, prp-t, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90655............... .............. X Flu vaccine, 6-35 mo, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90657............... .............. X Flu vaccine, 6-35 mo, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90658............... .............. X Flu vaccine, 3 yrs, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90659............... .............. D Flu vaccine, whole, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90660............... .............. X Flu vaccine, nasal... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90665............... .............. E Lyme disease vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
[[Page 1219]]
90669............... .............. N Pneumococcal vacc, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped <5.
90675............... .............. E Rabies vaccine, im... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90676............... .............. E Rabies vaccine, id... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90680............... .............. E Rotovirus vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oral.
90690............... .............. E Typhoid vaccine, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90691............... .............. E Typhoid vaccine, im.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90692............... .............. E Typhoid vaccine, h-p, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc/id.
90693............... .............. E Typhoid vaccine, akd, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90698............... .............. E Dtap-hib-ip vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90700............... .............. E Dtap vaccine, im..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90701............... .............. E Dtp vaccine, im...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90702............... .............. E Dt vaccine < 7, im... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90703............... .............. E Tetanus vaccine, im.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90704............... .............. E Mumps vaccine, sc.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90705............... .............. E Measles vaccine, sc.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90706............... .............. E Rubella vaccine, sc.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90707............... .............. E Mmr vaccine, sc...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90708............... .............. E Measles-rubella 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine, sc.
90710............... .............. E Mmrv vaccine, sc..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90712............... .............. E Oral poliovirus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine.
90713............... .............. E Poliovirus, ipv, sc.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90715............... .............. E Tdap vaccine 7 im.
90716............... .............. E Chicken pox vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90717............... .............. E Yellow fever vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90718............... .............. E Td vaccine 7, im.
90719............... .............. E Diphtheria vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90720............... .............. E Dtp/hib vaccine, im.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90721............... .............. E Dtap/hib vaccine, im. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90723............... .............. I Dtap-hep b-ipv 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine, im.
90725............... .............. E Cholera vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injectable.
90727............... .............. E Plague vaccine, im... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90732............... .............. X Pneumococcal vaccine. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90733............... .............. E Meningococcal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine, sc.
90734............... .............. E Meningococcal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine, im.
90735............... .............. E Encephalitis vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90740............... .............. X Hepb vacc, ill pat 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose im.
90743............... .............. X Hep b vacc, adol, 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose, im.
90744............... .............. X Hepb vacc ped/adol 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose im.
90746............... .............. X Hep b vaccine, adult, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90747............... .............. X Hepb vacc, ill pat 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose im.
90748............... .............. I Hep b/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90749............... .............. E Vaccine toxoid....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90780............... .............. A IV infusion therapy, 0.17 2.15 NA 0.07 2.39 NA XXX
1 hour.
90781............... .............. A IV infusion, 0.17 0.46 NA 0.04 0.67 NA ZZZ
additional hour.
90782............... .............. T Injection, sc/im..... 0.17 0.32 NA 0.01 0.50 NA XXX
90783............... .............. T Injection, ia........ 0.17 0.32 NA 0.02 0.51 NA XXX
90784............... .............. T Injection, iv........ 0.17 0.80 NA 0.04 1.01 NA XXX
90788............... .............. T Injection of 0.17 0.27 NA 0.01 0.45 NA XXX
antibiotic.
90799............... .............. C Ther/prophylactic/dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inject.
90801............... .............. A Psy dx interview..... 2.80 1.17 0.94 0.07 4.04 3.81 XXX
90802............... .............. A Intac psy dx 3.01 1.20 0.98 0.08 4.29 4.07 XXX
interview.
90804............... .............. A Psytx, office, 20-30 1.21 0.49 0.38 0.04 1.74 1.63 XXX
min.
90805............... .............. A Psytx, off, 20-30 min 1.37 0.50 0.42 0.04 1.91 1.83 XXX
w/e&m.
90806............... .............. A Psytx, off, 45-50 min 1.86 0.70 0.60 0.05 2.61 2.51 XXX
90807............... .............. A Psytx, off, 45-50 min 2.02 0.70 0.63 0.06 2.78 2.71 XXX
w/e&m.
90808............... .............. A Psytx, office, 75-80 2.79 1.03 0.91 0.08 3.90 3.78 XXX
min.
90809............... .............. A Psytx, off, 75-80, w/ 2.95 1.00 0.92 0.08 4.03 3.95 XXX
e&m.
90810............... .............. A Intac psytx, off, 20- 1.32 0.50 0.42 0.04 1.86 1.78 XXX
30 min.
90811............... .............. A Intac psytx, 20-30, w/ 1.48 0.57 0.46 0.04 2.09 1.98 XXX
e&m.
90812............... .............. A Intac psytx, off, 45- 1.97 0.79 0.64 0.06 2.82 2.67 XXX
50 min.
90813............... .............. A Intac psytx, 45-50 2.13 0.77 0.67 0.06 2.96 2.86 XXX
min w/e&m.
90814............... .............. A Intac psytx, off, 75- 2.90 1.11 0.99 0.08 4.09 3.97 XXX
80 min.
90815............... .............. A Intac psytx, 75-80 w/ 3.06 1.05 0.95 0.08 4.19 4.09 XXX
e&m.
90816............... .............. A Psytx, hosp, 20-30 1.25 NA 0.46 0.04 NA 1.75 XXX
min.
90817............... .............. A Psytx, hosp, 20-30 1.41 NA 0.45 0.04 NA 1.90 XXX
min w/e&m.
90818............... .............. A Psytx, hosp, 45-50 1.89 NA 0.69 0.05 NA 2.63 XXX
min.
90819............... .............. A Psytx, hosp, 45-50 2.05 NA 0.65 0.06 NA 2.76 XXX
min w/e&m.
90821............... .............. A Psytx, hosp, 75-80 2.83 NA 1.01 0.07 NA 3.91 XXX
min.
90822............... .............. A Psytx, hosp, 75-80 2.99 NA 0.95 0.08 NA 4.02 XXX
min w/e&m.
90823............... .............. A Intac psytx, hosp, 20- 1.36 NA 0.48 0.04 NA 1.88 XXX
30 min.
90824............... .............. A Intac psytx, hsp 20- 1.52 NA 0.49 0.04 NA 2.05 XXX
30 w/e&m.
90826............... .............. A Intac psytx, hosp, 45- 2.01 NA 0.73 0.05 NA 2.79 XXX
50 min.
90827............... .............. A Intac psytx, hsp 45- 2.16 NA 0.69 0.06 NA 2.91 XXX
50 w/e&m.
90828............... .............. A Intac psytx, hosp, 75- 2.94 NA 1.07 0.08 NA 4.09 XXX
80 min.
90829............... .............. A Intac psytx, hsp 75- 3.10 NA 0.99 0.08 NA 4.17 XXX
80 w/e&m.
[[Page 1220]]
90845............... .............. A Psychoanalysis....... 1.79 0.58 0.55 0.05 2.42 2.39 XXX
90846............... .............. R Family psytx w/o 1.83 0.65 0.65 0.05 2.53 2.53 XXX
patient.
90847............... .............. R Family psytx w/ 2.21 0.82 0.76 0.06 3.09 3.03 XXX
patient.
90849............... .............. R Multiple family group 0.59 0.27 0.24 0.01 0.87 0.84 XXX
psytx.
90853............... .............. A Group psychotherapy.. 0.59 0.25 0.23 0.01 0.85 0.83 XXX
90857............... .............. A Intac group psytx.... 0.63 0.30 0.26 0.02 0.95 0.91 XXX
90862............... .............. A Medication management 0.95 0.40 0.32 0.02 1.37 1.29 XXX
90865............... .............. A Narcosynthesis....... 2.84 1.59 0.89 0.08 4.51 3.81 XXX
90870............... .............. A Electroconvulsive 1.88 0.79 0.79 0.05 2.72 2.72 000
therapy.
90871............... .............. N Electroconvulsive +2.72 1.07 1.07 0.07 3.86 3.86 000
therapy.
90875............... .............. N Psychophysiological +1.20 0.90 0.46 0.04 2.14 1.70 XXX
therapy.
90876............... .............. N Psychophysiological +1.90 1.16 0.73 0.05 3.11 2.68 XXX
therapy.
90880............... .............. A Hypnotherapy......... 2.19 1.04 0.69 0.06 3.29 2.94 XXX
90882............... .............. N Environmental 0.00 0.00 0.00 0.00 0.00 0.00 XXX
manipulation.
90885............... .............. B Psy evaluation of +0.97 0.37 0.37 0.02 1.36 1.36 XXX
records.
90887............... .............. B Consultation with +1.48 0.82 0.56 0.04 2.34 2.08 XXX
family.
90889............... .............. B Preparation of report 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90899............... .............. C Psychiatric service/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
90901............... .............. A Biofeedback train, 0.41 0.66 0.14 0.02 1.09 0.57 000
any meth.
90911............... .............. A Biofeedback peri/uro/ 0.89 1.61 0.31 0.05 2.55 1.25 000
rectal.
90918............... .............. I ESRD related +11.16 7.34 7.34 0.36 18.86 18.86 XXX
services, month.
90919............... .............. I ESRD related +8.53 4.07 4.07 0.29 12.89 12.89 XXX
services, month.
90920............... .............. I ESRD related +7.26 3.81 3.81 0.23 11.30 11.30 XXX
services, month.
90921............... .............. I ESRD related +4.46 2.48 2.48 0.14 7.08 7.08 XXX
services, month.
90922............... .............. I ESRD related +0.37 0.22 0.22 0.01 0.60 0.60 XXX
services, day.
90923............... .............. I Esrd related +0.28 0.13 0.13 0.01 0.42 0.42 XXX
services, day.
90924............... .............. I Esrd related +0.24 0.12 0.12 0.01 0.37 0.37 XXX
services, day.
90925............... .............. I Esrd related +0.15 0.08 0.08 0.01 0.24 0.24 XXX
services, day.
90935............... .............. A Hemodialysis, one 1.22 NA 0.67 0.04 NA 1.93 000
evaluation.
90937............... .............. A Hemodialysis, 2.11 NA 0.98 0.07 NA 3.16 000
repeated eval.
90939............... .............. X Hemodialysis study, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transcut.
90940............... .............. X Hemodialysis access 0.00 0.00 0.00 0.00 0.00 0.00 XXX
study.
90945............... .............. A Dialysis, one 1.28 NA 0.70 0.05 NA 2.03 000
evaluation.
90947............... .............. A Dialysis, repeated 2.16 NA 1.01 0.07 NA 3.24 000
eval.
90989............... .............. X Dialysis training, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
90993............... .............. X Dialysis training, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
incompl.
90997............... .............. A Hemoperfusion........ 1.84 NA 1.41 0.06 NA 3.31 000
90999............... .............. C Dialysis procedure... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
91000............... .............. A Esophageal intubation 0.73 0.33 NA 0.05 1.11 NA 000
91000............... 26............ A Esophageal intubation 0.73 0.25 0.25 0.04 1.02 1.02 000
91000............... TC............ A Esophageal intubation 0.00 0.08 NA 0.01 0.09 NA 000
91010............... .............. A Esophagus motility 1.25 2.71 NA 0.12 4.08 NA 000
study.
91010............... 26............ A Esophagus motility 1.25 0.43 0.43 0.06 1.74 1.74 000
study.
91010............... TC............ A Esophagus motility 0.00 2.28 NA 0.06 2.34 NA 000
study.
91011............... .............. A Esophagus motility 1.50 3.20 NA 0.12 4.82 NA 000
study.
91011............... 26............ A Esophagus motility 1.50 0.53 0.53 0.06 2.09 2.09 000
study.
91011............... TC............ A Esophagus motility 0.00 2.67 NA 0.06 2.73 NA 000
study.
91012............... .............. A Esophagus motility 1.46 3.34 NA 0.14 4.94 NA 000
study.
91012............... 26............ A Esophagus motility 1.46 0.51 0.51 0.07 2.04 2.04 000
study.
91012............... TC............ A Esophagus motility 0.00 2.83 NA 0.07 2.90 NA 000
study.
91020............... .............. A Gastric motility..... 1.44 2.93 NA 0.13 4.50 NA 000
91020............... 26............ A Gastric motility..... 1.44 0.48 0.48 0.07 1.99 1.99 000
91020............... TC............ A Gastric motility..... 0.00 2.45 NA 0.06 2.51 NA 000
91030............... .............. A Acid perfusion of 0.91 2.40 NA 0.06 3.37 NA 000
esophagus.
91030............... 26............ A Acid perfusion of 0.91 0.33 0.33 0.04 1.28 1.28 000
esophagus.
91030............... TC............ A Acid perfusion of 0.00 2.07 NA 0.02 2.09 NA 000
esophagus.
91032............... .............. A Esophagus, acid 1.21 4.10 NA 0.12 5.43 NA 000
reflux test.
91032............... 26............ A Esophagus, acid 1.21 0.41 0.41 0.06 1.68 1.68 000
reflux test.
91032............... TC............ A Esophagus, acid 0.00 3.69 NA 0.06 3.75 NA 000
reflux test.
91033............... .............. A Prolonged acid reflux 1.30 4.16 NA 0.17 5.63 NA 000
test.
91033............... 26............ A Prolonged acid reflux 1.30 0.45 0.45 0.06 1.81 1.81 000
test.
91033............... TC............ A Prolonged acid reflux 0.00 3.71 NA 0.11 3.82 NA 000
test.
91052............... .............. A Gastric analysis test 0.79 2.19 NA 0.06 3.04 NA 000
91052............... 26............ A Gastric analysis test 0.79 0.28 0.28 0.04 1.11 1.11 000
91052............... TC............ A Gastric analysis test 0.00 1.91 NA 0.02 1.93 NA 000
91055............... .............. A Gastric intubation 0.94 2.37 NA 0.07 3.38 NA 000
for smear.
91055............... 26............ A Gastric intubation 0.94 0.27 0.27 0.05 1.26 1.26 000
for smear.
91055............... TC............ A Gastric intubation 0.00 2.10 NA 0.02 2.12 NA 000
for smear.
91060............... .............. A Gastric saline load 0.45 0.30 NA 0.04 0.79 NA 000
test.
91060............... 26............ A Gastric saline load 0.45 0.14 0.14 0.02 0.61 0.61 000
test.
91060............... TC............ A Gastric saline load 0.00 0.16 NA 0.02 0.18 NA 000
test.
91065............... .............. A Breath hydrogen test. 0.20 1.96 NA 0.03 2.19 NA 000
91065............... 26............ A Breath hydrogen test. 0.20 0.07 0.07 0.01 0.28 0.28 000
91065............... TC............ A Breath hydrogen test. 0.00 1.89 NA 0.02 1.91 NA 000
91100............... .............. A Pass intestine 1.08 NA 0.29 0.07 NA 1.44 000
bleeding tube.
[[Page 1221]]
91105............... .............. A Gastric intubation 0.37 NA 0.09 0.02 NA 0.48 000
treatment.
91110............... .............. A Gi tract capsule 3.64 21.13 NA 0.09 24.86 NA XXX
endoscopy.
91110............... 26............ A Gi tract capsule 3.64 1.30 1.30 0.02 4.96 4.96 XXX
endoscopy.
91110............... TC............ A Gi tract capsule 0.00 19.83 NA 0.07 19.90 NA XXX
endoscopy.
91122............... .............. A Anal pressure record. 1.77 6.06 NA 0.20 8.03 NA 000
91122............... 26............ A Anal pressure record. 1.77 0.60 0.60 0.12 2.49 2.49 000
91122............... TC............ A Anal pressure record. 0.00 5.46 NA 0.08 5.54 NA 000
91123............... .............. B Irrigate fecal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
impaction.
91132............... .............. C Electrogastrography.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
91132............... 26............ A Electrogastrography.. 0.52 0.19 0.19 0.04 0.75 0.75 XXX
91132............... TC............ C Electrogastrography.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
91133............... .............. C Electrogastrography w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
91133............... 26............ A Electrogastrography w/ 0.66 0.24 0.24 0.04 0.94 0.94 XXX
test.
91133............... TC............ C Electrogastrography w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
91299............... .............. C Gastroenterology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
91299............... 26............ C Gastroenterology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
91299............... TC............ C Gastroenterology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
92002............... .............. A Eye exam, new patient 0.88 0.96 0.35 0.02 1.86 1.25 XXX
92004............... .............. A Eye exam, new patient 1.67 1.68 0.68 0.04 3.39 2.39 XXX
92012............... .............. A Eye exam established 0.67 1.02 0.29 0.01 1.70 0.97 XXX
pat.
92014............... .............. A Eye exam & treatment. 1.10 1.38 0.46 0.02 2.50 1.58 XXX
92015............... .............. N Refraction........... +0.38 1.49 0.15 0.01 1.88 0.54 XXX
92018............... .............. A New eye exam & 2.50 NA 1.08 0.04 NA 3.62 XXX
treatment.
92019............... .............. A Eye exam & treatment. 1.31 NA 0.56 0.04 NA 1.91 XXX
92020............... .............. A Special eye 0.37 0.33 0.16 0.01 0.71 0.54 XXX
evaluation.
92060............... .............. A Special eye 0.69 0.72 NA 0.02 1.43 NA XXX
evaluation.
92060............... 26............ A Special eye 0.69 0.29 0.29 0.01 0.99 0.99 XXX
evaluation.
92060............... TC............ A Special eye 0.00 0.43 NA 0.01 0.44 NA XXX
evaluation.
92065............... .............. A Orthoptic/pleoptic 0.37 0.54 NA 0.02 0.93 NA XXX
training.
92065............... 26............ A Orthoptic/pleoptic 0.37 0.15 0.15 0.01 0.53 0.53 XXX
training.
92065............... TC............ A Orthoptic/pleoptic 0.00 0.39 NA 0.01 0.40 NA XXX
training.
92070............... .............. A Fitting of contact 0.70 1.08 0.32 0.01 1.79 1.03 XXX
lens.
92081............... .............. A Visual field 0.36 0.85 NA 0.02 1.23 NA XXX
examination(s).
92081............... 26............ A Visual field 0.36 0.15 0.15 0.01 0.52 0.52 XXX
examination(s).
92081............... TC............ A Visual field 0.00 0.70 NA 0.01 0.71 NA XXX
examination(s).
92082............... .............. A Visual field 0.44 1.15 NA 0.02 1.61 NA XXX
examination(s).
92082............... 26............ A Visual field 0.44 0.19 0.19 0.01 0.64 0.64 XXX
examination(s).
92082............... TC............ A Visual field 0.00 0.96 NA 0.01 0.97 NA XXX
examination(s).
92083............... .............. A Visual field 0.50 1.33 NA 0.02 1.85 NA XXX
examination(s).
92083............... 26............ A Visual field 0.50 0.22 0.22 0.01 0.73 0.73 XXX
examination(s).
92083............... TC............ A Visual field 0.00 1.11 NA 0.01 1.12 NA XXX
examination(s).
92100............... .............. A Serial tonometry 0.92 1.26 0.37 0.02 2.20 1.31 XXX
exam(s).
92120............... .............. A Tonography & eye 0.81 1.04 0.32 0.02 1.87 1.15 XXX
evaluation.
92130............... .............. A Water provocation 0.81 1.23 0.37 0.02 2.06 1.20 XXX
tonography.
92135............... .............. A Opthalmic dx imaging. 0.35 0.78 NA 0.02 1.15 NA XXX
92135............... 26............ A Opthalmic dx imaging. 0.35 0.16 0.16 0.01 0.52 0.52 XXX
92135............... TC............ A Opthalmic dx imaging. 0.00 0.62 NA 0.01 0.63 NA XXX
92136............... .............. A Ophthalmic biometry.. 0.54 1.75 NA 0.08 2.37 NA XXX
92136............... 26............ A Ophthalmic biometry.. 0.54 0.25 0.25 0.01 0.80 0.80 XXX
92136............... TC............ A Ophthalmic biometry.. 0.00 1.50 NA 0.07 1.57 NA XXX
92140............... .............. A Glaucoma provocative 0.50 0.94 0.21 0.01 1.45 0.72 XXX
tests.
92225............... .............. A Special eye exam, 0.38 0.22 0.16 0.01 0.61 0.55 XXX
initial.
92226............... .............. A Special eye exam, 0.33 0.21 0.15 0.01 0.55 0.49 XXX
subsequent.
92230............... .............. A Eye exam with photos. 0.60 1.67 0.20 0.02 2.29 0.82 XXX
92235............... .............. A Eye exam with photos. 0.81 2.93 NA 0.08 3.82 NA XXX
92235............... 26............ A Eye exam with photos. 0.81 0.37 0.37 0.02 1.20 1.20 XXX
92235............... TC............ A Eye exam with photos. 0.00 2.56 NA 0.06 2.62 NA XXX
92240............... .............. A Icg angiography...... 1.10 7.03 NA 0.08 8.21 NA XXX
92240............... 26............ A Icg angiography...... 1.10 0.49 0.49 0.02 1.61 1.61 XXX
92240............... TC............ A Icg angiography...... 0.00 6.54 NA 0.06 6.60 NA XXX
92250............... .............. A Eye exam with photos. 0.44 1.73 NA 0.02 2.19 NA XXX
92250............... 26............ A Eye exam with photos. 0.44 0.20 0.20 0.01 0.65 0.65 XXX
92250............... TC............ A Eye exam with photos. 0.00 1.53 NA 0.01 1.54 NA XXX
92260............... .............. A Ophthalmoscopy/ 0.20 0.29 0.09 0.01 0.50 0.30 XXX
dynamometry.
92265............... .............. A Eye muscle evaluation 0.81 1.88 NA 0.04 2.73 NA XXX
92265............... 26............ A Eye muscle evaluation 0.81 0.28 0.28 0.02 1.11 1.11 XXX
92265............... TC............ A Eye muscle evaluation 0.00 1.60 NA 0.02 1.62 NA XXX
92270............... .............. A Electro-oculography.. 0.81 1.56 NA 0.06 2.43 NA XXX
92270............... 26............ A Electro-oculography.. 0.81 0.34 0.34 0.04 1.19 1.19 XXX
92270............... TC............ A Electro-oculography.. 0.00 1.22 NA 0.02 1.24 NA XXX
92275............... .............. A Electroretinography.. 1.01 1.93 NA 0.04 2.98 NA XXX
92275............... 26............ A Electroretinography.. 1.01 0.42 0.42 0.02 1.45 1.45 XXX
92275............... TC............ A Electroretinography.. 0.00 1.51 NA 0.02 1.53 NA XXX
92283............... .............. A Color vision 0.17 0.83 NA 0.02 1.02 NA XXX
examination.
92283............... 26............ A Color vision 0.17 0.07 0.07 0.01 0.25 0.25 XXX
examination.
[[Page 1222]]
92283............... TC............ A Color vision 0.00 0.76 NA 0.01 0.77 NA XXX
examination.
92284............... .............. A Dark adaptation eye 0.24 2.31 NA 0.02 2.57 NA XXX
exam.
92284............... 26............ A Dark adaptation eye 0.24 0.09 0.09 0.01 0.34 0.34 XXX
exam.
92284............... TC............ A Dark adaptation eye 0.00 2.22 NA 0.01 2.23 NA XXX
exam.
92285............... .............. A Eye photography...... 0.20 1.07 NA 0.02 1.29 NA XXX
92285............... 26............ A Eye photography...... 0.20 0.09 0.09 0.01 0.30 0.30 XXX
92285............... TC............ A Eye photography...... 0.00 0.98 NA 0.01 0.99 NA XXX
92286............... .............. A Internal eye 0.66 3.37 NA 0.03 4.06 NA XXX
photography.
92286............... 26............ A Internal eye 0.66 0.30 0.30 0.01 0.97 0.97 XXX
photography.
92286............... TC............ A Internal eye 0.00 3.07 NA 0.02 3.09 NA XXX
photography.
92287............... .............. A Internal eye 0.81 2.69 0.31 0.02 3.52 1.14 XXX
photography.
92310............... .............. N Contact lens fitting. +1.17 1.12 0.45 0.04 2.33 1.66 XXX
92311............... .............. A Contact lens fitting. 1.08 1.18 0.35 0.04 2.30 1.47 XXX
92312............... .............. A Contact lens fitting. 1.26 1.16 0.49 0.04 2.46 1.79 XXX
92313............... .............. A Contact lens fitting. 0.92 1.16 0.29 0.02 2.10 1.23 XXX
92314............... .............. N Prescription of +0.69 0.94 0.27 0.01 1.64 0.97 XXX
contact lens.
92315............... .............. A Prescription of 0.45 0.95 0.16 0.01 1.41 0.62 XXX
contact lens.
92316............... .............. A Prescription of 0.68 1.00 0.30 0.01 1.69 0.99 XXX
contact lens.
92317............... .............. A Prescription of 0.45 1.05 0.15 0.01 1.51 0.61 XXX
contact lens.
92325............... .............. A Modification of 0.00 0.39 NA 0.01 0.40 NA XXX
contact lens.
92326............... .............. A Replacement of 0.00 1.64 NA 0.06 1.70 NA XXX
contact lens.
92330............... .............. A Fitting of artificial 1.08 1.08 0.33 0.05 2.21 1.46 XXX
eye.
92335............... .............. A Fitting of artificial 0.45 1.01 0.17 0.01 1.47 0.63 XXX
eye.
92340............... .............. N Fitting of spectacles +0.37 0.70 0.14 0.01 1.08 0.52 XXX
92341............... .............. N Fitting of spectacles +0.47 0.74 0.18 0.01 1.22 0.66 XXX
92342............... .............. N Fitting of spectacles +0.53 0.76 0.21 0.01 1.30 0.75 XXX
92352............... .............. B Special spectacles +0.37 0.73 0.14 0.01 1.11 0.52 XXX
fitting.
92353............... .............. B Special spectacles +0.50 0.78 0.19 0.02 1.30 0.71 XXX
fitting.
92354............... .............. B Special spectacles +0.00 8.89 NA 0.10 8.99 NA XXX
fitting.
92355............... .............. B Special spectacles +0.00 4.34 NA 0.01 4.35 NA XXX
fitting.
92358............... .............. B Eye prosthesis +0.00 0.97 NA 0.05 1.02 NA XXX
service.
92370............... .............. N Repair & adjust +0.32 0.55 0.13 0.02 0.89 0.47 XXX
spectacles.
92371............... .............. B Repair & adjust +0.00 0.62 NA 0.02 0.64 NA XXX
spectacles.
92390............... .............. N Supply of spectacles. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
92391............... .............. N Supply of contact 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lenses.
92392............... .............. I Supply of low vision +0.00 3.79 3.79 0.02 3.81 3.81 XXX
aids.
92393............... .............. I Supply of artificial +0.00 11.76 11.76 0.57 12.33 12.33 XXX
eye.
92395............... .............. I Supply of spectacles. +0.00 1.28 1.28 0.10 1.38 1.38 XXX
92396............... .............. I Supply of contact +0.00 2.16 2.16 0.07 2.23 2.23 XXX
lenses.
92499............... .............. C Eye service or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
92499............... 26............ C Eye service or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
92499............... TC............ C Eye service or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
92502............... .............. A Ear and throat 1.51 NA 1.13 0.07 NA 2.71 000
examination.
92504............... .............. A Ear microscopy 0.18 0.49 0.09 0.01 0.68 0.28 XXX
examination.
92506............... .............. A Speech/hearing 0.86 2.61 0.40 0.05 3.52 1.31 XXX
evaluation.
92507............... .............. A Speech/hearing 0.52 1.13 0.24 0.02 1.67 0.78 XXX
therapy.
92508............... .............. A Speech/hearing 0.26 0.52 0.12 0.01 0.79 0.39 XXX
therapy.
92510............... .............. I Rehab for ear implant +1.50 2.08 0.82 0.07 3.65 2.39 XXX
92511............... .............. A Nasopharyngoscopy.... 0.84 3.14 0.79 0.04 4.02 1.67 000
92512............... .............. A Nasal function 0.55 1.08 0.18 0.02 1.65 0.75 XXX
studies.
92516............... .............. A Facial nerve function 0.43 0.89 0.22 0.02 1.34 0.67 XXX
test.
92520............... .............. A Laryngeal function 0.76 0.50 0.38 0.04 1.30 1.18 XXX
studies.
92526............... .............. A Oral function therapy 0.55 1.66 0.20 0.02 2.23 0.77 XXX
92531............... .............. B Spontaneous nystagmus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
study.
92532............... .............. B Positional nystagmus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
92533............... .............. B Caloric vestibular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
92534............... .............. B Optokinetic nystagmus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
92541............... .............. A Spontaneous nystagmus 0.40 0.97 NA 0.04 1.41 NA XXX
test.
92541............... 26............ A Spontaneous nystagmus 0.40 0.19 0.19 0.02 0.61 0.61 XXX
test.
92541............... TC............ A Spontaneous nystagmus 0.00 0.78 NA 0.02 0.80 NA XXX
test.
92542............... .............. A Positional nystagmus 0.33 1.06 NA 0.03 1.42 NA XXX
test.
92542............... 26............ A Positional nystagmus 0.33 0.16 0.16 0.01 0.50 0.50 XXX
test.
92542............... TC............ A Positional nystagmus 0.00 0.90 NA 0.02 0.92 NA XXX
test.
92543............... .............. A Caloric vestibular 0.10 0.53 NA 0.02 0.65 NA XXX
test.
92543............... 26............ A Caloric vestibular 0.10 0.05 0.05 0.01 0.16 0.16 XXX
test.
92543............... TC............ A Caloric vestibular 0.00 0.48 NA 0.01 0.49 NA XXX
test.
92544............... .............. A Optokinetic nystagmus 0.26 0.84 NA 0.03 1.13 NA XXX
test.
92544............... 26............ A Optokinetic nystagmus 0.26 0.12 0.12 0.01 0.39 0.39 XXX
test.
92544............... TC............ A Optokinetic nystagmus 0.00 0.72 NA 0.02 0.74 NA XXX
test.
92545............... .............. A Oscillating tracking 0.23 0.79 NA 0.03 1.05 NA XXX
test.
92545............... 26............ A Oscillating tracking 0.23 0.11 0.11 0.01 0.35 0.35 XXX
test.
92545............... TC............ A Oscillating tracking 0.00 0.68 NA 0.02 0.70 NA XXX
test.
92546............... .............. A Sinusoidal rotational 0.29 1.80 NA 0.03 2.12 NA XXX
test.
92546............... 26............ A Sinusoidal rotational 0.29 0.13 0.13 0.01 0.43 0.43 XXX
test.
92546............... TC............ A Sinusoidal rotational 0.00 1.67 NA 0.02 1.69 NA XXX
test.
[[Page 1223]]
92547............... .............. A Supplemental 0.00 1.15 NA 0.06 1.21 NA ZZZ
electrical test.
92548............... .............. A Posturography........ 0.50 3.19 NA 0.15 3.84 NA XXX
92548............... 26............ A Posturography........ 0.50 0.26 0.26 0.02 0.78 0.78 XXX
92548............... TC............ A Posturography........ 0.00 2.93 NA 0.13 3.06 NA XXX
92551............... .............. N Pure tone hearing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test, air.
92552............... .............. A Pure tone audiometry, 0.00 0.44 NA 0.04 0.48 NA XXX
air.
92553............... .............. A Audiometry, air & 0.00 0.66 NA 0.06 0.72 NA XXX
bone.
92555............... .............. A Speech threshold 0.00 0.37 NA 0.04 0.41 NA XXX
audiometry.
92556............... .............. A Speech audiometry, 0.00 0.57 NA 0.06 0.63 NA XXX
complete.
92557............... .............. A Comprehensive hearing 0.00 1.19 NA 0.12 1.31 NA XXX
test.
92559............... .............. N Group audiometric 0.00 0.00 0.00 0.00 0.00 0.00 XXX
testing.
92560............... .............. N Bekesy audiometry, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
92561............... .............. A Bekesy audiometry, 0.00 0.72 NA 0.06 0.78 NA XXX
diagnosis.
92562............... .............. A Loudness balance test 0.00 0.40 NA 0.04 0.44 NA XXX
92563............... .............. A Tone decay hearing 0.00 0.37 NA 0.04 0.41 NA XXX
test.
92564............... .............. A Sisi hearing test.... 0.00 0.47 NA 0.05 0.52 NA XXX
92565............... .............. A Stenger test, pure 0.00 0.39 NA 0.04 0.43 NA XXX
tone.
92567............... .............. A Tympanometry......... 0.00 0.52 NA 0.06 0.58 NA XXX
92568............... .............. A Acoustic reflex 0.00 0.37 NA 0.04 0.41 NA XXX
testing.
92569............... .............. A Acoustic reflex decay 0.00 0.40 NA 0.04 0.44 NA XXX
test.
92571............... .............. A Filtered speech 0.00 0.38 NA 0.04 0.42 NA XXX
hearing test.
92572............... .............. A Staggered spondaic 0.00 0.09 NA 0.01 0.10 NA XXX
word test.
92573............... .............. A Lombard test......... 0.00 0.35 NA 0.04 0.39 NA XXX
92575............... .............. A Sensorineural acuity 0.00 0.30 NA 0.02 0.32 NA XXX
test.
92576............... .............. A Synthetic sentence 0.00 0.44 NA 0.05 0.49 NA XXX
test.
92577............... .............. A Stenger test, speech. 0.00 0.72 NA 0.07 0.79 NA XXX
92579............... .............. A Visual audiometry 0.00 0.73 NA 0.06 0.79 NA XXX
(vra).
92582............... .............. A Conditioning play 0.00 0.73 NA 0.06 0.79 NA XXX
audiometry.
92583............... .............. A Select picture 0.00 0.89 NA 0.08 0.97 NA XXX
audiometry.
92584............... .............. A Electrocochleography. 0.00 2.49 NA 0.21 2.70 NA XXX
92585............... .............. A Auditor evoke potent, 0.50 2.08 NA 0.16 2.74 NA XXX
compre.
92585............... 26............ A Auditor evoke potent, 0.50 0.22 0.22 0.02 0.74 0.74 XXX
compre.
92585............... TC............ A Auditor evoke potent, 0.00 1.86 NA 0.14 2.00 NA XXX
compre.
92586............... .............. A Auditor evoke potent, 0.00 1.86 NA 0.14 2.00 NA XXX
limit.
92587............... .............. A Evoked auditory test. 0.13 1.38 NA 0.12 1.63 NA XXX
92587............... 26............ A Evoked auditory test. 0.13 0.07 0.07 0.01 0.21 0.21 XXX
92587............... TC............ A Evoked auditory test. 0.00 1.31 NA 0.11 1.42 NA XXX
92588............... .............. A Evoked auditory test. 0.36 1.64 NA 0.14 2.14 NA XXX
92588............... 26............ A Evoked auditory test. 0.36 0.17 0.17 0.01 0.54 0.54 XXX
92588............... TC............ A Evoked auditory test. 0.00 1.47 NA 0.13 1.60 NA XXX
92589............... .............. A Auditory function 0.00 0.53 NA 0.06 0.59 NA XXX
test(s).
92590............... .............. N Hearing aid exam, one 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ear.
92591............... .............. N Hearing aid exam, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
both ears.
92592............... .............. N Hearing aid check, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
one ear.
92593............... .............. N Hearing aid check, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
both ears.
92594............... .............. N Electro hearng aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test, one.
92595............... .............. N Electro hearng aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tst, both.
92596............... .............. A Ear protector 0.00 0.59 NA 0.06 0.65 NA XXX
evaluation.
92597............... .............. A Oral speech device 0.86 1.69 0.45 0.05 2.60 1.36 XXX
eval.
92601............... .............. A Cochlear implt f/up 0.00 3.41 NA 0.07 3.48 NA XXX
exam < 7.
92602............... .............. A Reprogram cochlear 0.00 2.36 NA 0.07 2.43 NA XXX
implt < 7.
92603............... .............. A Cochlear implt f/up 0.00 2.23 NA 0.07 2.30 NA XXX
exam 7 .
92604............... .............. A Reprogram cochlear 0.00 1.47 NA 0.07 1.54 NA XXX
implt 7 .
92605............... .............. B Eval for nonspeech 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device rx.
92606............... .............. B Non-speech device 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
92607............... .............. A Ex for speech device 0.00 3.22 NA 0.05 3.27 NA XXX
rx, 1hr.
92608............... .............. A Ex for speech device 0.00 0.67 NA 0.05 0.72 NA XXX
rx addl.
92609............... .............. A Use of speech device 0.00 1.60 NA 0.04 1.64 NA XXX
service.
92610............... .............. A Evaluate swallowing 0.00 3.44 NA 0.08 3.52 NA XXX
function.
92611............... .............. A Motion fluoroscopy/ 0.00 3.44 NA 0.08 3.52 NA XXX
swallow.
92612............... .............. A Endoscopy swallow tst 1.27 2.71 0.67 0.08 4.06 2.02 XXX
(fees).
92613............... .............. A Endoscopy swallow tst 0.71 0.39 0.39 0.05 1.15 1.15 XXX
(fees).
92614............... .............. A Laryngoscopic sensory 1.27 2.41 0.61 0.08 3.76 1.96 XXX
test.
92615............... .............. A Eval laryngoscopy 0.63 0.36 0.36 0.05 1.04 1.04 XXX
sense tst.
92616............... .............. A Fees w/laryngeal 1.88 3.29 0.97 0.08 5.25 2.93 XXX
sense test.
92617............... .............. A Interprt fees/ 0.79 0.44 0.44 0.05 1.28 1.28 XXX
laryngeal test.
92700............... .............. C Ent procedure/service 0.00 0.00 0.00 0.00 0.00 0.00 XXX
92950............... .............. A Heart/lung 3.79 NA 0.98 0.25 NA 5.02 000
resuscitation cpr.
92953............... .............. A Temporary external 0.23 NA 0.23 0.01 NA 0.47 000
pacing.
92960............... .............. A Cardioversion 2.25 6.66 1.17 0.10 9.01 3.52 000
electric, ext.
92961............... .............. A Cardioversion, 4.59 NA 2.09 0.21 NA 6.89 000
electric, int.
92970............... .............. A Cardioassist, 3.51 NA 1.07 0.21 NA 4.79 000
internal.
92971............... .............. A Cardioassist, 1.77 NA 0.85 0.07 NA 2.69 000
external.
92973............... .............. A Percut coronary 3.28 NA 1.29 0.14 NA 4.71 ZZZ
thrombectomy.
92974............... .............. A Cath place, cardio 3.00 NA 1.18 0.17 NA 4.35 ZZZ
brachytx.
[[Page 1224]]
92975............... .............. A Dissolve clot, heart 7.24 NA 2.81 0.27 NA 10.32 000
vessel.
92977............... .............. A Dissolve clot, heart 0.00 8.08 NA 0.46 8.54 NA XXX
vessel.
92978............... .............. A Intravasc us, heart 1.80 5.29 NA 0.31 7.40 NA ZZZ
add-on.
92978............... 26............ A Intravasc us, heart 1.80 0.71 0.71 0.07 2.58 2.58 ZZZ
add-on.
92978............... TC............ A Intravasc us, heart 0.00 4.58 NA 0.24 4.82 NA ZZZ
add-on.
92979............... .............. A Intravasc us, heart 1.44 2.86 NA 0.18 4.48 NA ZZZ
add-on.
92979............... 26............ A Intravasc us, heart 1.44 0.56 0.56 0.05 2.05 2.05 ZZZ
add-on.
92979............... TC............ A Intravasc us, heart 0.00 2.30 NA 0.13 2.43 NA ZZZ
add-on.
92980............... .............. A Insert intracoronary 14.82 NA 6.07 0.86 NA 21.75 000
stent.
92981............... .............. A Insert intracoronary 4.16 NA 1.64 0.24 NA 6.04 ZZZ
stent.
92982............... .............. A Coronary artery 10.96 NA 4.55 0.63 NA 16.14 000
dilation.
92984............... .............. A Coronary artery 2.97 NA 1.16 0.17 NA 4.30 ZZZ
dilation.
92986............... .............. A Revision of aortic 21.77 NA 11.62 1.37 NA 34.76 090
valve.
92987............... .............. A Revision of mitral 22.67 NA 12.01 1.42 NA 36.10 090
valve.
92990............... .............. A Revision of pulmonary 17.31 NA 9.63 1.09 NA 28.03 090
valve.
92992............... .............. C Revision of heart 0.00 0.00 0.00 0.00 0.00 0.00 090
chamber.
92993............... .............. C Revision of heart 0.00 0.00 0.00 0.00 0.00 0.00 090
chamber.
92995............... .............. A Coronary atherectomy. 12.07 NA 4.98 0.70 NA 17.75 000
92996............... .............. A Coronary atherectomy 3.26 NA 1.28 0.19 NA 4.73 ZZZ
add-on.
92997............... .............. A Pul art balloon repr, 11.98 NA 4.85 0.76 NA 17.59 000
percut.
92998............... .............. A Pul art balloon repr, 5.99 NA 2.21 0.37 NA 8.57 ZZZ
percut.
93000............... .............. A Electrocardiogram, 0.17 0.51 NA 0.03 0.71 NA XXX
complete.
93005............... .............. A Electrocardiogram, 0.00 0.45 NA 0.02 0.47 NA XXX
tracing.
93010............... .............. A Electrocardiogram 0.17 0.06 0.06 0.01 0.24 0.24 XXX
report.
93012............... .............. A Transmission of ecg.. 0.00 6.04 NA 0.18 6.22 NA XXX
93014............... .............. A Report on transmitted 0.52 0.19 0.19 0.02 0.73 0.73 XXX
ecg.
93015............... .............. A Cardiovascular stress 0.75 1.98 NA 0.13 2.86 NA XXX
test.
93016............... .............. A Cardiovascular stress 0.45 0.17 0.17 0.01 0.63 0.63 XXX
test.
93017............... .............. A Cardiovascular stress 0.00 1.69 NA 0.11 1.80 NA XXX
test.
93018............... .............. A Cardiovascular stress 0.30 0.12 0.12 0.01 0.43 0.43 XXX
test.
93024............... .............. A Cardiac drug stress 1.17 1.57 NA 0.13 2.87 NA XXX
test.
93024............... 26............ A Cardiac drug stress 1.17 0.45 0.45 0.05 1.67 1.67 XXX
test.
93024............... TC............ A Cardiac drug stress 0.00 1.12 NA 0.08 1.20 NA XXX
test.
93025............... .............. A Microvolt t-wave 0.75 8.18 NA 0.13 9.06 NA XXX
assess.
93025............... 26............ A Microvolt t-wave 0.75 0.29 0.29 0.02 1.06 1.06 XXX
assess.
93025............... TC............ A Microvolt t-wave 0.00 7.89 NA 0.11 8.00 NA XXX
assess.
93040............... .............. A Rhythm ECG with 0.16 0.20 NA 0.02 0.38 NA XXX
report.
93041............... .............. A Rhythm ECG, tracing.. 0.00 0.15 NA 0.01 0.16 NA XXX
93042............... .............. A Rhythm ECG, report... 0.16 0.05 0.05 0.01 0.22 0.22 XXX
93224............... .............. A ECG monitor/report, 0.52 3.63 NA 0.24 4.39 NA XXX
24 hrs.
93225............... .............. A ECG monitor/record, 0.00 1.24 NA 0.08 1.32 NA XXX
24 hrs.
93226............... .............. A ECG monitor/report, 0.00 2.19 NA 0.14 2.33 NA XXX
24 hrs.
93227............... .............. A ECG monitor/review, 0.52 0.20 0.20 0.02 0.74 0.74 XXX
24 hrs.
93230............... .............. A ECG monitor/report, 0.52 3.90 NA 0.26 4.68 NA XXX
24 hrs.
93231............... .............. A Ecg monitor/record, 0.00 1.52 NA 0.11 1.63 NA XXX
24 hrs.
93232............... .............. A ECG monitor/report, 0.00 2.18 NA 0.13 2.31 NA XXX
24 hrs.
93233............... .............. A ECG monitor/review, 0.52 0.20 0.20 0.02 0.74 0.74 XXX
24 hrs.
93235............... .............. A ECG monitor/report, 0.45 2.79 NA 0.15 3.39 NA XXX
24 hrs.
93236............... .............. A ECG monitor/report, 0.00 2.62 NA 0.14 2.76 NA XXX
24 hrs.
93237............... .............. A ECG monitor/review, 0.45 0.17 0.17 0.01 0.63 0.63 XXX
24 hrs.
93268............... .............. A ECG record/review.... 0.52 7.47 NA 0.28 8.27 NA XXX
93270............... .............. A ECG recording........ 0.00 1.24 NA 0.08 1.32 NA XXX
93271............... .............. A Ecg/monitoring and 0.00 6.04 NA 0.18 6.22 NA XXX
analysis.
93272............... .............. A Ecg/review, interpret 0.52 0.19 0.19 0.02 0.73 0.73 XXX
only.
93278............... .............. A ECG/signal-averaged.. 0.25 1.25 NA 0.12 1.62 NA XXX
93278............... 26............ A ECG/signal-averaged.. 0.25 0.10 0.10 0.01 0.36 0.36 XXX
93278............... TC............ A ECG/signal-averaged.. 0.00 1.15 NA 0.11 1.26 NA XXX
93303............... .............. A Echo transthoracic... 1.30 4.35 NA 0.28 5.93 NA XXX
93303............... 26............ A Echo transthoracic... 1.30 0.48 0.48 0.05 1.83 1.83 XXX
93303............... TC............ A Echo transthoracic... 0.00 3.87 NA 0.23 4.10 NA XXX
93304............... .............. A Echo transthoracic... 0.75 2.23 NA 0.15 3.13 NA XXX
93304............... 26............ A Echo transthoracic... 0.75 0.28 0.28 0.02 1.05 1.05 XXX
93304............... TC............ A Echo transthoracic... 0.00 1.95 NA 0.13 2.08 NA XXX
93307............... .............. A Echo exam of heart... 0.92 4.23 NA 0.27 5.42 NA XXX
93307............... 26............ A Echo exam of heart... 0.92 0.36 0.36 0.04 1.32 1.32 XXX
93307............... TC............ A Echo exam of heart... 0.00 3.87 NA 0.23 4.10 NA XXX
93308............... .............. A Echo exam of heart... 0.53 2.16 NA 0.15 2.84 NA XXX
93308............... 26............ A Echo exam of heart... 0.53 0.21 0.21 0.02 0.76 0.76 XXX
93308............... TC............ A Echo exam of heart... 0.00 1.95 NA 0.13 2.08 NA XXX
93312............... .............. A Echo transesophageal. 2.20 4.58 NA 0.39 7.17 NA XXX
93312............... 26............ A Echo transesophageal. 2.20 0.79 0.79 0.10 3.09 3.09 XXX
93312............... TC............ A Echo transesophageal. 0.00 3.79 NA 0.29 4.08 NA XXX
93313............... .............. A Echo transesophageal. 0.95 NA 0.21 0.06 NA 1.22 XXX
93314............... .............. A Echo transesophageal. 1.25 4.26 NA 0.34 5.85 NA XXX
93314............... 26............ A Echo transesophageal. 1.25 0.47 0.47 0.05 1.77 1.77 XXX
[[Page 1225]]
93314............... TC............ A Echo transesophageal. 0.00 3.79 NA 0.29 4.08 NA XXX
93315............... .............. C Echo transesophageal. 0.00 0.00 NA 0.00 0.00 NA XXX
93315............... 26............ A Echo transesophageal. 2.78 1.02 1.02 0.12 3.92 3.92 XXX
93315............... TC............ C Echo transesophageal. 0.00 0.00 NA 0.00 0.00 NA XXX
93316............... .............. A Echo transesophageal. 0.95 NA 0.24 0.06 NA 1.25 XXX
93317............... .............. C Echo transesophageal. 0.00 0.00 NA 0.00 0.00 NA XXX
93317............... 26............ A Echo transesophageal. 1.83 0.67 0.67 0.07 2.57 2.57 XXX
93317............... TC............ C Echo transesophageal. 0.00 0.00 NA 0.00 0.00 NA XXX
93318............... .............. C Echo transesophageal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intraop.
93318............... 26............ A Echo transesophageal 2.20 0.47 0.47 0.07 2.74 2.74 XXX
intraop.
93318............... TC............ C Echo transesophageal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intraop.
93320............... .............. A Doppler echo exam, 0.38 1.87 NA 0.13 2.38 NA ZZZ
heart.
93320............... 26............ A Doppler echo exam, 0.38 0.15 0.15 0.01 0.54 0.54 ZZZ
heart.
93320............... TC............ A Doppler echo exam, 0.00 1.72 NA 0.12 1.84 NA ZZZ
heart.
93321............... .............. A Doppler echo exam, 0.15 1.18 NA 0.09 1.42 NA ZZZ
heart.
93321............... 26............ A Doppler echo exam, 0.15 0.06 0.06 0.01 0.22 0.22 ZZZ
heart.
93321............... TC............ A Doppler echo exam, 0.00 1.12 NA 0.08 1.20 NA ZZZ
heart.
93325............... .............. A Doppler color flow 0.07 2.94 NA 0.22 3.23 NA ZZZ
add-on.
93325............... 26............ A Doppler color flow 0.07 0.03 0.03 0.01 0.11 0.11 ZZZ
add-on.
93325............... TC............ A Doppler color flow 0.00 2.91 NA 0.21 3.12 NA ZZZ
add-on.
93350............... .............. A Echo transthoracic... 1.48 2.34 NA 0.15 3.97 NA XXX
93350............... 26............ A Echo transthoracic... 1.48 0.57 0.57 0.02 2.07 2.07 XXX
93350............... TC............ A Echo transthoracic... 0.00 1.77 NA 0.13 1.90 NA XXX
93501............... .............. A Right heart 3.02 18.11 NA 1.24 22.37 NA 000
catheterization.
93501............... 26............ A Right heart 3.02 1.15 1.15 0.19 4.36 4.36 000
catheterization.
93501............... TC............ A Right heart 0.00 16.96 NA 1.05 18.01 NA 000
catheterization.
93503............... .............. A Insert/place heart 2.91 NA 0.68 0.19 NA 3.78 000
catheter.
93505............... .............. A Biopsy of heart 4.37 3.68 NA 0.44 8.49 NA 000
lining.
93505............... 26............ A Biopsy of heart 4.37 1.69 1.69 0.28 6.34 6.34 000
lining.
93505............... TC............ A Biopsy of heart 0.00 1.99 NA 0.16 2.15 NA 000
lining.
93508............... .............. A Cath placement, 4.09 14.73 NA 0.90 19.72 NA 000
angiography.
93508............... 26............ A Cath placement, 4.09 2.09 2.09 0.25 6.43 6.43 000
angiography.
93508............... TC............ A Cath placement, 0.00 12.64 NA 0.65 13.29 NA 000
angiography.
93510............... .............. A Left heart 4.32 39.26 NA 2.57 46.15 NA 000
catheterization.
93510............... 26............ A Left heart 4.32 2.18 2.18 0.27 6.77 6.77 000
catheterization.
93510............... TC............ A Left heart 0.00 37.08 NA 2.30 39.38 NA 000
catheterization.
93511............... .............. A Left heart 5.02 38.55 NA 2.54 46.11 NA 000
catheterization.
93511............... 26............ A Left heart 5.02 2.45 2.45 0.31 7.78 7.78 000
catheterization.
93511............... TC............ A Left heart 0.00 36.10 NA 2.23 38.33 NA 000
catheterization.
93514............... .............. A Left heart 7.04 39.24 NA 2.68 48.96 NA 000
catheterization.
93514............... 26............ A Left heart 7.04 3.14 3.14 0.45 10.63 10.63 000
catheterization.
93514............... TC............ A Left heart 0.00 36.10 NA 2.23 38.33 NA 000
catheterization.
93524............... .............. A Left heart 6.94 50.36 NA 3.36 60.66 NA 000
catheterization.
93524............... 26............ A Left heart 6.94 3.19 3.19 0.43 10.56 10.56 000
catheterization.
93524............... TC............ A Left heart 0.00 47.17 NA 2.93 50.10 NA 000
catheterization.
93526............... .............. A Rt & Lt heart 5.98 51.28 NA 3.39 60.65 NA 000
catheters.
93526............... 26............ A Rt & Lt heart 5.98 2.82 2.82 0.37 9.17 9.17 000
catheters.
93526............... TC............ A Rt & Lt heart 0.00 48.46 NA 3.02 51.48 NA 000
catheters.
93527............... .............. A Rt & Lt heart 7.27 50.50 NA 3.39 61.16 NA 000
catheters.
93527............... 26............ A Rt & Lt heart 7.27 3.33 3.33 0.46 11.06 11.06 000
catheters.
93527............... TC............ A Rt & Lt heart 0.00 47.17 NA 2.93 50.10 NA 000
catheters.
93528............... .............. A Rt & Lt heart 8.99 51.22 NA 3.50 63.71 NA 000
catheters.
93528............... 26............ A Rt & Lt heart 8.99 4.05 4.05 0.57 13.61 13.61 000
catheters.
93528............... TC............ A Rt & Lt heart 0.00 47.17 NA 2.93 50.10 NA 000
catheters.
93529............... .............. A Rt, lt heart 4.79 49.46 NA 3.23 57.48 NA 000
catheterization.
93529............... 26............ A Rt, lt heart 4.79 2.29 2.29 0.30 7.38 7.38 000
catheterization.
93529............... TC............ A Rt, lt heart 0.00 47.17 NA 2.93 50.10 NA 000
catheterization.
93530............... .............. A Rt heart cath, 4.22 18.90 NA 1.34 24.46 NA 000
congenital.
93530............... 26............ A Rt heart cath, 4.22 1.94 1.94 0.29 6.45 6.45 000
congenital.
93530............... TC............ A Rt heart cath, 0.00 16.96 NA 1.05 18.01 NA 000
congenital.
93531............... .............. A R & l heart cath, 8.34 52.05 NA 3.57 63.96 NA 000
congenital.
93531............... 26............ A R & l heart cath, 8.34 3.59 3.59 0.55 12.48 12.48 000
congenital.
93531............... TC............ A R & l heart cath, 0.00 48.46 NA 3.02 51.48 NA 000
congenital.
93532............... .............. A R & l heart cath, 9.99 51.44 NA 3.56 64.99 NA 000
congenital.
93532............... 26............ A R & l heart cath, 9.99 4.27 4.27 0.63 14.89 14.89 000
congenital.
93532............... TC............ A R & l heart cath, 0.00 47.17 NA 2.93 50.10 NA 000
congenital.
93533............... .............. A R & l heart cath, 6.69 49.98 NA 3.45 60.12 NA 000
congenital.
93533............... 26............ A R & l heart cath, 6.69 2.81 2.81 0.52 10.02 10.02 000
congenital.
93533............... TC............ A R & l heart cath, 0.00 47.17 NA 2.93 50.10 NA 000
congenital.
93539............... .............. A Injection, cardiac 0.40 NA 0.16 0.01 NA 0.57 000
cath.
93540............... .............. A Injection, cardiac 0.43 NA 0.17 0.01 NA 0.61 000
cath.
93541............... .............. A Injection for lung 0.29 NA 0.11 0.01 NA 0.41 000
angiogram.
93542............... .............. A Injection for heart x- 0.29 NA 0.11 0.01 NA 0.41 000
rays.
93543............... .............. A Injection for heart x- 0.29 NA 0.12 0.01 NA 0.42 000
rays.
93544............... .............. A Injection for 0.25 NA 0.10 0.01 NA 0.36 000
aortography.
[[Page 1226]]
93545............... .............. A Inject for coronary x- 0.40 NA 0.16 0.01 NA 0.57 000
rays.
93555............... .............. A Imaging, cardiac cath 0.81 6.62 NA 0.38 7.81 NA XXX
93555............... 26............ A Imaging, cardiac cath 0.81 0.32 0.32 0.04 1.17 1.17 XXX
93555............... TC............ A Imaging, cardiac cath 0.00 6.30 NA 0.34 6.64 NA XXX
93556............... .............. A Imaging, cardiac cath 0.83 10.26 NA 0.55 11.64 NA XXX
93556............... 26............ A Imaging, cardiac cath 0.83 0.33 0.33 0.04 1.20 1.20 XXX
93556............... TC............ A Imaging, cardiac cath 0.00 9.93 NA 0.51 10.44 NA XXX
93561............... .............. A Cardiac output 0.50 0.68 NA 0.08 1.26 NA 000
measurement.
93561............... 26............ A Cardiac output 0.50 0.16 0.16 0.02 0.68 0.68 000
measurement.
93561............... TC............ A Cardiac output 0.00 0.52 NA 0.06 0.58 NA 000
measurement.
93562............... .............. A Cardiac output 0.16 0.37 NA 0.05 0.58 NA 000
measurement.
93562............... 26............ A Cardiac output 0.16 0.05 0.05 0.01 0.22 0.22 000
measurement.
93562............... TC............ A Cardiac output 0.00 0.32 NA 0.04 0.36 NA 000
measurement.
93571............... .............. A Heart flow reserve 1.80 5.26 NA 0.37 7.43 NA ZZZ
measure.
93571............... 26............ A Heart flow reserve 1.80 0.68 0.68 0.13 2.61 2.61 ZZZ
measure.
93571............... TC............ A Heart flow reserve 0.00 4.58 NA 0.24 4.82 NA ZZZ
measure.
93572............... .............. A Heart flow reserve 1.44 2.80 NA 0.34 4.58 NA ZZZ
measure.
93572............... 26............ A Heart flow reserve 1.44 0.50 0.50 0.21 2.15 2.15 ZZZ
measure.
93572............... TC............ A Heart flow reserve 0.00 2.30 NA 0.13 2.43 NA ZZZ
measure.
93580............... .............. A Transcath closure of 17.97 NA 7.21 1.37 NA 26.55 000
asd.
93581............... .............. A Transcath closure of 24.39 NA 9.66 1.37 NA 35.42 000
vsd.
93600............... .............. A Bundle of His 2.12 2.79 NA 0.26 5.17 NA 000
recording.
93600............... 26............ A Bundle of His 2.12 0.83 0.83 0.13 3.08 3.08 000
recording.
93600............... TC............ A Bundle of His 0.00 1.96 NA 0.13 2.09 NA 000
recording.
93602............... .............. A Intra-atrial 2.12 1.95 NA 0.21 4.28 NA 000
recording.
93602............... 26............ A Intra-atrial 2.12 0.83 0.83 0.14 3.09 3.09 000
recording.
93602............... TC............ A Intra-atrial 0.00 1.12 NA 0.07 1.19 NA 000
recording.
93603............... .............. A Right ventricular 2.12 2.51 NA 0.24 4.87 NA 000
recording.
93603............... 26............ A Right ventricular 2.12 0.82 0.82 0.13 3.07 3.07 000
recording.
93603............... TC............ A Right ventricular 0.00 1.69 NA 0.11 1.80 NA 000
recording.
93609............... .............. A Map tachycardia, add- 4.99 4.67 NA 0.80 10.46 NA ZZZ
on.
93609............... 26............ A Map tachycardia, add- 4.99 1.95 1.95 0.63 7.57 7.57 ZZZ
on.
93609............... TC............ A Map tachycardia, add- 0.00 2.72 NA 0.17 2.89 NA ZZZ
on.
93610............... .............. A Intra-atrial pacing.. 3.02 2.52 NA 0.31 5.85 NA 000
93610............... 26............ A Intra-atrial pacing.. 3.02 1.16 1.16 0.21 4.39 4.39 000
93610............... TC............ A Intra-atrial pacing.. 0.00 1.36 NA 0.10 1.46 NA 000
93612............... .............. A Intraventricular 3.02 2.78 NA 0.32 6.12 NA 000
pacing.
93612............... 26............ A Intraventricular 3.02 1.16 1.16 0.21 4.39 4.39 000
pacing.
93612............... TC............ A Intraventricular 0.00 1.62 NA 0.11 1.73 NA 000
pacing.
93613............... .............. A Electrophys map 3d, 6.99 NA 2.76 0.63 NA 10.38 ZZZ
add-on.
93615............... .............. A Esophageal recording. 0.99 0.59 NA 0.06 1.64 NA 000
93615............... 26............ A Esophageal recording. 0.99 0.27 0.27 0.04 1.30 1.30 000
93615............... TC............ A Esophageal recording. 0.00 0.32 NA 0.02 0.34 NA 000
93616............... .............. A Esophageal recording. 1.49 0.74 NA 0.09 2.32 NA 000
93616............... 26............ A Esophageal recording. 1.49 0.42 0.42 0.07 1.98 1.98 000
93616............... TC............ A Esophageal recording. 0.00 0.32 NA 0.02 0.34 NA 000
93618............... .............. A Heart rhythm pacing.. 4.25 5.66 NA 0.51 10.42 NA 000
93618............... 26............ A Heart rhythm pacing.. 4.25 1.68 1.68 0.27 6.20 6.20 000
93618............... TC............ A Heart rhythm pacing.. 0.00 3.98 NA 0.24 4.22 NA 000
93619............... .............. A Electrophysiology 7.31 10.94 NA 0.93 19.18 NA 000
evaluation.
93619............... 26............ A Electrophysiology 7.31 3.20 3.20 0.46 10.97 10.97 000
evaluation.
93619............... TC............ A Electrophysiology 0.00 7.74 NA 0.47 8.21 NA 000
evaluation.
93620............... .............. C Electrophysiology 0.00 0.00 NA 0.00 0.00 NA 000
evaluation.
93620............... 26............ A Electrophysiology 11.57 4.86 4.86 0.72 17.15 17.15 000
evaluation.
93620............... TC............ C Electrophysiology 0.00 0.00 NA 0.00 0.00 NA 000
evaluation.
93621............... .............. C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93621............... 26............ A Electrophysiology 2.10 0.82 0.82 0.18 3.10 3.10 ZZZ
evaluation.
93621............... TC............ C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93622............... .............. C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93622............... 26............ A Electrophysiology 3.10 1.21 1.21 0.81 5.12 5.12 ZZZ
evaluation.
93622............... TC............ C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93623............... .............. C Stimulation, pacing 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
heart.
93623............... 26............ A Stimulation, pacing 2.85 1.12 1.12 0.18 4.15 4.15 ZZZ
heart.
93623............... TC............ C Stimulation, pacing 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
heart.
93624............... .............. A Electrophysiologic 4.80 4.19 NA 0.43 9.42 NA 000
study.
93624............... 26............ A Electrophysiologic 4.80 2.20 2.20 0.30 7.30 7.30 000
study.
93624............... TC............ A Electrophysiologic 0.00 1.99 NA 0.13 2.12 NA 000
study.
93631............... .............. A Heart pacing, mapping 7.59 8.95 NA 1.42 17.96 NA 000
93631............... 26............ A Heart pacing, mapping 7.59 2.78 2.78 0.80 11.17 11.17 000
93631............... TC............ A Heart pacing, mapping 0.00 6.17 NA 0.62 6.79 NA 000
93640............... .............. A Evaluation heart 3.51 8.56 NA 0.64 12.71 NA 000
device.
93640............... 26............ A Evaluation heart 3.51 1.36 1.36 0.22 5.09 5.09 000
device.
93640............... TC............ A Evaluation heart 0.00 7.20 NA 0.42 7.62 NA 000
device.
93641............... .............. A Electrophysiology 5.92 9.52 NA 0.79 16.23 NA 000
evaluation.
93641............... 26............ A Electrophysiology 5.92 2.32 2.32 0.37 8.61 8.61 000
evaluation.
[[Page 1227]]
93641............... TC............ A Electrophysiology 0.00 7.20 NA 0.42 7.62 NA 000
evaluation.
93642............... .............. A Electrophysiology 4.88 9.42 NA 0.61 14.91 NA 000
evaluation.
93642............... 26............ A Electrophysiology 4.88 2.22 2.22 0.19 7.29 7.29 000
evaluation.
93642............... TC............ A Electrophysiology 0.00 7.20 NA 0.42 7.62 NA 000
evaluation.
93650............... .............. A Ablate heart 10.49 NA 4.45 0.66 NA 15.60 000
dysrhythm focus.
93651............... .............. A Ablate heart 16.23 NA 6.35 1.03 NA 23.61 000
dysrhythm focus.
93652............... .............. A Ablate heart 17.65 NA 6.91 1.11 NA 25.67 000
dysrhythm focus.
93660............... .............. A Tilt table evaluation 1.89 2.43 NA 0.09 4.41 NA 000
93660............... 26............ A Tilt table evaluation 1.89 0.74 0.74 0.07 2.70 2.70 000
93660............... TC............ A Tilt table evaluation 0.00 1.69 NA 0.02 1.71 NA 000
93662............... .............. C Intracardiac ecg 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
(ice).
93662............... 26............ A Intracardiac ecg 2.80 1.11 1.11 0.49 4.40 4.40 ZZZ
(ice).
93662............... TC............ C Intracardiac ecg 0.00 0.00 NA 0.00 0.00 NA ZZZ
(ice).
93668............... .............. N Peripheral vascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
rehab.
93701............... .............. A Bioimpedance, 0.17 1.02 NA 0.02 1.21 NA XXX
thoracic.
93701............... 26............ A Bioimpedance, 0.17 0.07 0.07 0.01 0.25 0.25 XXX
thoracic.
93701............... TC............ A Bioimpedance, 0.00 0.95 NA 0.01 0.96 NA XXX
thoracic.
93720............... .............. A Total body 0.17 0.76 NA 0.07 1.00 NA XXX
plethysmography.
93721............... .............. A Plethysmography 0.00 0.71 NA 0.06 0.77 NA XXX
tracing.
93722............... .............. A Plethysmography 0.17 0.05 0.05 0.01 0.23 0.23 XXX
report.
93724............... .............. A Analyze pacemaker 4.88 5.90 NA 0.46 11.24 NA 000
system.
93724............... 26............ A Analyze pacemaker 4.88 1.92 1.92 0.22 7.02 7.02 000
system.
93724............... TC............ A Analyze pacemaker 0.00 3.98 NA 0.24 4.22 NA 000
system.
93727............... .............. A Analyze ilr system... 0.52 0.20 0.20 0.06 0.78 0.78 XXX
93731............... .............. A Analyze pacemaker 0.45 0.67 NA 0.06 1.18 NA XXX
system.
93731............... 26............ A Analyze pacemaker 0.45 0.18 0.18 0.02 0.65 0.65 XXX
system.
93731............... TC............ A Analyze pacemaker 0.00 0.49 NA 0.04 0.53 NA XXX
system.
93732............... .............. A Analyze pacemaker 0.92 0.87 NA 0.08 1.87 NA XXX
system.
93732............... 26............ A Analyze pacemaker 0.92 0.36 0.36 0.04 1.32 1.32 XXX
system.
93732............... TC............ A Analyze pacemaker 0.00 0.51 NA 0.04 0.55 NA XXX
system.
93733............... .............. A Telephone analy, 0.17 0.80 NA 0.07 1.04 NA XXX
pacemaker.
93733............... 26............ A Telephone analy, 0.17 0.07 0.07 0.01 0.25 0.25 XXX
pacemaker.
93733............... TC............ A Telephone analy, 0.00 0.73 NA 0.06 0.79 NA XXX
pacemaker.
93734............... .............. A Analyze pacemaker 0.38 0.50 NA 0.03 0.91 NA XXX
system.
93734............... 26............ A Analyze pacemaker 0.38 0.15 0.15 0.01 0.54 0.54 XXX
system.
93734............... TC............ A Analyze pacemaker 0.00 0.35 NA 0.02 0.37 NA XXX
system.
93735............... .............. A Analyze pacemaker 0.74 0.73 NA 0.08 1.55 NA XXX
system.
93735............... 26............ A Analyze pacemaker 0.74 0.29 0.29 0.04 1.07 1.07 XXX
system.
93735............... TC............ A Analyze pacemaker 0.00 0.44 NA 0.04 0.48 NA XXX
system.
93736............... .............. A Telephonic analy, 0.15 0.69 NA 0.07 0.91 NA XXX
pacemaker.
93736............... 26............ A Telephonic analy, 0.15 0.06 0.06 0.01 0.22 0.22 XXX
pacemaker.
93736............... TC............ A Telephonic analy, 0.00 0.63 NA 0.06 0.69 NA XXX
pacemaker.
93740............... .............. B Temperature gradient +0.16 0.20 NA 0.02 0.38 NA XXX
studies.
93740............... 26............ B Temperature gradient +0.16 0.04 0.04 0.01 0.21 0.21 XXX
studies.
93740............... TC............ B Temperature gradient +0.00 0.16 NA 0.01 0.17 NA XXX
studies.
93741............... .............. A Analyze ht pace 0.80 0.99 NA 0.06 1.85 NA XXX
device sngl.
93741............... 26............ A Analyze ht pace 0.80 0.32 0.32 0.02 1.14 1.14 XXX
device sngl.
93741............... TC............ A Analyze ht pace 0.00 0.67 NA 0.04 0.71 NA XXX
device sngl.
93742............... .............. A Analyze ht pace 0.91 1.03 NA 0.06 2.00 NA XXX
device sngl.
93742............... 26............ A Analyze ht pace 0.91 0.36 0.36 0.02 1.29 1.29 XXX
device sngl.
93742............... TC............ A Analyze ht pace 0.00 0.67 NA 0.04 0.71 NA XXX
device sngl.
93743............... .............. A Analyze ht pace 1.03 1.14 NA 0.08 2.25 NA XXX
device dual.
93743............... 26............ A Analyze ht pace 1.03 0.40 0.40 0.04 1.47 1.47 XXX
device dual.
93743............... TC............ A Analyze ht pace 0.00 0.74 NA 0.04 0.78 NA XXX
device dual.
93744............... .............. A Analyze ht pace 1.18 1.13 NA 0.08 2.39 NA XXX
device dual.
93744............... 26............ A Analyze ht pace 1.18 0.46 0.46 0.04 1.68 1.68 XXX
device dual.
93744............... TC............ A Analyze ht pace 0.00 0.67 NA 0.04 0.71 NA XXX
device dual.
93760............... .............. N Cephalic thermogram.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
93762............... .............. N Peripheral thermogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX
93770............... .............. B Measure venous +0.16 0.08 NA 0.02 0.26 NA XXX
pressure.
93770............... 26............ B Measure venous +0.16 0.05 0.05 0.01 0.22 0.22 XXX
pressure.
93770............... TC............ B Measure venous +0.00 0.03 NA 0.01 0.04 NA XXX
pressure.
93784............... .............. A Ambulatory BP 0.38 1.55 NA 0.03 1.96 NA XXX
monitoring.
93786............... .............. A Ambulatory BP 0.00 0.91 NA 0.01 0.92 NA XXX
recording.
93788............... .............. A Ambulatory BP 0.00 0.51 NA 0.01 0.52 NA XXX
analysis.
93790............... .............. A Review/report BP 0.38 0.13 0.13 0.01 0.52 0.52 XXX
recording.
93797............... .............. A Cardiac rehab........ 0.18 0.37 0.07 0.01 0.56 0.26 000
93798............... .............. A Cardiac rehab/monitor 0.28 0.49 0.11 0.01 0.78 0.40 000
93799............... .............. C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
93799............... 26............ C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
93799............... TC............ C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
93875............... .............. A Extracranial study... 0.22 1.66 NA 0.12 2.00 NA XXX
93875............... 26............ A Extracranial study... 0.22 0.08 0.08 0.01 0.31 0.31 XXX
93875............... TC............ A Extracranial study... 0.00 1.58 NA 0.11 1.69 NA XXX
93880............... .............. A Extracranial study... 0.60 4.18 NA 0.40 5.18 NA XXX
[[Page 1228]]
93880............... 26............ A Extracranial study... 0.60 0.21 0.21 0.05 0.86 0.86 XXX
93880............... TC............ A Extracranial study... 0.00 3.97 NA 0.35 4.32 NA XXX
93882............... .............. A Extracranial study... 0.40 3.01 NA 0.27 3.68 NA XXX
93882............... 26............ A Extracranial study... 0.40 0.14 0.14 0.05 0.59 0.59 XXX
93882............... TC............ A Extracranial study... 0.00 2.87 NA 0.22 3.09 NA XXX
93886............... .............. A Intracranial study... 0.94 4.47 NA 0.45 5.86 NA XXX
93886............... 26............ A Intracranial study... 0.94 0.37 0.37 0.06 1.37 1.37 XXX
93886............... TC............ A Intracranial study... 0.00 4.10 NA 0.39 4.49 NA XXX
93888............... .............. A Intracranial study... 0.62 3.02 NA 0.32 3.96 NA XXX
93888............... 26............ A Intracranial study... 0.62 0.23 0.23 0.05 0.90 0.90 XXX
93888............... TC............ A Intracranial study... 0.00 2.79 NA 0.27 3.06 NA XXX
93922............... .............. A Extremity study...... 0.25 1.93 NA 0.15 2.33 NA XXX
93922............... 26............ A Extremity study...... 0.25 0.09 0.09 0.02 0.36 0.36 XXX
93922............... TC............ A Extremity study...... 0.00 1.84 NA 0.13 1.97 NA XXX
93923............... .............. A Extremity study...... 0.45 3.00 NA 0.27 3.72 NA XXX
93923............... 26............ A Extremity study...... 0.45 0.15 0.15 0.05 0.65 0.65 XXX
93923............... TC............ A Extremity study...... 0.00 2.85 NA 0.22 3.07 NA XXX
93924............... .............. A Extremity study...... 0.50 3.76 NA 0.31 4.57 NA XXX
93924............... 26............ A Extremity study...... 0.50 0.17 0.17 0.06 0.73 0.73 XXX
93924............... TC............ A Extremity study...... 0.00 3.59 NA 0.25 3.84 NA XXX
93925............... .............. A Lower extremity study 0.58 4.87 NA 0.40 5.85 NA XXX
93925............... 26............ A Lower extremity study 0.58 0.20 0.20 0.05 0.83 0.83 XXX
93925............... TC............ A Lower extremity study 0.00 4.67 NA 0.35 5.02 NA XXX
93926............... .............. A Lower extremity study 0.39 3.49 NA 0.27 4.15 NA XXX
93926............... 26............ A Lower extremity study 0.39 0.13 0.13 0.04 0.56 0.56 XXX
93926............... TC............ A Lower extremity study 0.00 3.36 NA 0.23 3.59 NA XXX
93930............... .............. A Upper extremity study 0.46 3.85 NA 0.41 4.72 NA XXX
93930............... 26............ A Upper extremity study 0.46 0.16 0.16 0.04 0.66 0.66 XXX
93930............... TC............ A Upper extremity study 0.00 3.69 NA 0.37 4.06 NA XXX
93931............... .............. A Upper extremity study 0.31 2.82 NA 0.26 3.39 NA XXX
93931............... 26............ A Upper extremity study 0.31 0.11 0.11 0.02 0.44 0.44 XXX
93931............... TC............ A Upper extremity study 0.00 2.71 NA 0.24 2.95 NA XXX
93965............... .............. A Extremity study...... 0.35 1.86 NA 0.14 2.35 NA XXX
93965............... 26............ A Extremity study...... 0.35 0.12 0.12 0.02 0.49 0.49 XXX
93965............... TC............ A Extremity study...... 0.00 1.74 NA 0.12 1.86 NA XXX
93970............... .............. A Extremity study...... 0.68 3.97 NA 0.46 5.11 NA XXX
93970............... 26............ A Extremity study...... 0.68 0.23 0.23 0.06 0.97 0.97 XXX
93970............... TC............ A Extremity study...... 0.00 3.74 NA 0.40 4.14 NA XXX
93971............... .............. A Extremity study...... 0.45 2.86 NA 0.31 3.62 NA XXX
93971............... 26............ A Extremity study...... 0.45 0.15 0.15 0.04 0.64 0.64 XXX
93971............... TC............ A Extremity study...... 0.00 2.71 NA 0.27 2.98 NA XXX
93975............... .............. A Vascular study....... 1.80 5.82 NA 0.56 8.18 NA XXX
93975............... 26............ A Vascular study....... 1.80 0.60 0.60 0.13 2.53 2.53 XXX
93975............... TC............ A Vascular study....... 0.00 5.22 NA 0.43 5.65 NA XXX
93976............... .............. A Vascular study....... 1.21 3.46 NA 0.37 5.04 NA XXX
93976............... 26............ A Vascular study....... 1.21 0.40 0.40 0.07 1.68 1.68 XXX
93976............... TC............ A Vascular study....... 0.00 3.06 NA 0.30 3.36 NA XXX
93978............... .............. A Vascular study....... 0.65 3.58 NA 0.43 4.66 NA XXX
93978............... 26............ A Vascular study....... 0.65 0.22 0.22 0.06 0.93 0.93 XXX
93978............... TC............ A Vascular study....... 0.00 3.36 NA 0.37 3.73 NA XXX
93979............... .............. A Vascular study....... 0.44 2.65 NA 0.29 3.38 NA XXX
93979............... 26............ A Vascular study....... 0.44 0.15 0.15 0.05 0.64 0.64 XXX
93979............... TC............ A Vascular study....... 0.00 2.50 NA 0.24 2.74 NA XXX
93980............... .............. A Penile vascular study 1.25 4.78 NA 0.42 6.45 NA XXX
93980............... 26............ A Penile vascular study 1.25 0.41 0.41 0.08 1.74 1.74 XXX
93980............... TC............ A Penile vascular study 0.00 4.37 NA 0.34 4.71 NA XXX
93981............... .............. A Penile vascular study 0.44 4.61 NA 0.33 5.38 NA XXX
93981............... 26............ A Penile vascular study 0.44 0.15 0.15 0.02 0.61 0.61 XXX
93981............... TC............ A Penile vascular study 0.00 4.46 NA 0.31 4.77 NA XXX
93990............... .............. A Doppler flow testing. 0.25 3.42 NA 0.25 3.92 NA XXX
93990............... 26............ A Doppler flow testing. 0.25 0.09 0.09 0.02 0.36 0.36 XXX
93990............... TC............ A Doppler flow testing. 0.00 3.33 NA 0.23 3.56 NA XXX
94010............... .............. A Breathing capacity 0.17 0.67 NA 0.03 0.87 NA XXX
test.
94010............... 26............ A Breathing capacity 0.17 0.05 0.05 0.01 0.23 0.23 XXX
test.
94010............... TC............ A Breathing capacity 0.00 0.62 NA 0.02 0.64 NA XXX
test.
94014............... .............. A Patient recorded 0.52 0.77 NA 0.03 1.32 NA XXX
spirometry.
94015............... .............. A Patient recorded 0.00 0.60 NA 0.01 0.61 NA XXX
spirometry.
94016............... .............. A Review patient 0.52 0.17 0.17 0.02 0.71 0.71 XXX
spirometry.
94060............... .............. A Evaluation of 0.31 1.12 NA 0.07 1.50 NA XXX
wheezing.
94060............... 26............ A Evaluation of 0.31 0.10 0.10 0.01 0.42 0.42 XXX
wheezing.
94060............... TC............ A Evaluation of 0.00 1.02 NA 0.06 1.08 NA XXX
wheezing.
94070............... .............. A Evaluation of 0.60 2.99 NA 0.12 3.71 NA XXX
wheezing.
94070............... 26............ A Evaluation of 0.60 0.19 0.19 0.02 0.81 0.81 XXX
wheezing.
94070............... TC............ A Evaluation of 0.00 2.80 NA 0.10 2.90 NA XXX
wheezing.
94150............... .............. B Vital capacity test.. +0.07 0.48 NA 0.02 0.57 NA XXX
[[Page 1229]]
94150............... 26............ B Vital capacity test.. +0.07 0.03 0.03 0.01 0.11 0.11 XXX
94150............... TC............ B Vital capacity test.. +0.00 0.45 NA 0.01 0.46 NA XXX
94200............... .............. A Lung function test 0.11 0.44 NA 0.03 0.58 NA XXX
(MBC/MVV).
94200............... 26............ A Lung function test 0.11 0.03 0.03 0.01 0.15 0.15 XXX
(MBC/MVV).
94200............... TC............ A Lung function test 0.00 0.41 NA 0.02 0.43 NA XXX
(MBC/MVV).
94240............... .............. A Residual lung 0.26 0.65 NA 0.06 0.97 NA XXX
capacity.
94240............... 26............ A Residual lung 0.26 0.08 0.08 0.01 0.35 0.35 XXX
capacity.
94240............... TC............ A Residual lung 0.00 0.57 NA 0.05 0.62 NA XXX
capacity.
94250............... .............. A Expired gas 0.11 0.65 NA 0.02 0.78 NA XXX
collection.
94250............... 26............ A Expired gas 0.11 0.03 0.03 0.01 0.15 0.15 XXX
collection.
94250............... TC............ A Expired gas 0.00 0.62 NA 0.01 0.63 NA XXX
collection.
94260............... .............. A Thoracic gas volume.. 0.13 0.57 NA 0.05 0.75 NA XXX
94260............... 26............ A Thoracic gas volume.. 0.13 0.04 0.04 0.01 0.18 0.18 XXX
94260............... TC............ A Thoracic gas volume.. 0.00 0.53 NA 0.04 0.57 NA XXX
94350............... .............. A Lung nitrogen washout 0.26 0.75 NA 0.05 1.06 NA XXX
curve.
94350............... 26............ A Lung nitrogen washout 0.26 0.08 0.08 0.01 0.35 0.35 XXX
curve.
94350............... TC............ A Lung nitrogen washout 0.00 0.67 NA 0.04 0.71 NA XXX
curve.
94360............... .............. A Measure airflow 0.26 0.69 NA 0.07 1.02 NA XXX
resistance.
94360............... 26............ A Measure airflow 0.26 0.08 0.08 0.01 0.35 0.35 XXX
resistance.
94360............... TC............ A Measure airflow 0.00 0.61 NA 0.06 0.67 NA XXX
resistance.
94370............... .............. A Breath airway closing 0.26 0.72 NA 0.03 1.01 NA XXX
volume.
94370............... 26............ A Breath airway closing 0.26 0.08 0.08 0.01 0.35 0.35 XXX
volume.
94370............... TC............ A Breath airway closing 0.00 0.64 NA 0.02 0.66 NA XXX
volume.
94375............... .............. A Respiratory flow 0.31 0.61 NA 0.03 0.95 NA XXX
volume loop.
94375............... 26............ A Respiratory flow 0.31 0.10 0.10 0.01 0.42 0.42 XXX
volume loop.
94375............... TC............ A Respiratory flow 0.00 0.51 NA 0.02 0.53 NA XXX
volume loop.
94400............... .............. A CO2 breathing 0.40 0.84 NA 0.07 1.31 NA XXX
response curve.
94400............... 26............ A CO2 breathing 0.40 0.12 0.12 0.01 0.53 0.53 XXX
response curve.
94400............... TC............ A CO2 breathing 0.00 0.72 NA 0.06 0.78 NA XXX
response curve.
94450............... .............. A Hypoxia response 0.40 0.68 NA 0.04 1.12 NA XXX
curve.
94450............... 26............ A Hypoxia response 0.40 0.12 0.12 0.02 0.54 0.54 XXX
curve.
94450............... TC............ A Hypoxia response 0.00 0.56 NA 0.02 0.58 NA XXX
curve.
94620............... .............. A Pulmonary stress test/ 0.64 2.42 NA 0.12 3.18 NA XXX
simple.
94620............... 26............ A Pulmonary stress test/ 0.64 0.20 0.20 0.02 0.86 0.86 XXX
simple.
94620............... TC............ A Pulmonary stress test/ 0.00 2.22 NA 0.10 2.32 NA XXX
simple.
94621............... .............. A Pulm stress test/ 1.42 2.06 NA 0.16 3.64 NA XXX
complex.
94621............... 26............ A Pulm stress test/ 1.42 0.43 0.43 0.06 1.91 1.91 XXX
complex.
94621............... TC............ A Pulm stress test/ 0.00 1.63 NA 0.10 1.73 NA XXX
complex.
94640............... .............. A Airway inhalation 0.00 0.32 NA 0.02 0.34 NA XXX
treatment.
94642............... .............. C Aerosol inhalation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
treatment.
94656............... .............. A Initial ventilator 1.22 1.18 0.32 0.07 2.47 1.61 XXX
mgmt.
94657............... .............. A Continued ventilator 0.83 1.00 0.25 0.04 1.87 1.12 XXX
mgmt.
94660............... .............. A Pos airway pressure, 0.76 0.66 0.24 0.04 1.46 1.04 XXX
CPAP.
94662............... .............. A Neg press 0.76 NA 0.24 0.02 NA 1.02 XXX
ventilation, cnp.
94664............... .............. A Evaluate pt use of 0.00 0.32 NA 0.04 0.36 NA XXX
inhaler.
94667............... .............. A Chest wall 0.00 0.54 NA 0.05 0.59 NA XXX
manipulation.
94668............... .............. A Chest wall 0.00 0.46 NA 0.02 0.48 NA XXX
manipulation.
94680............... .............. A Exhaled air analysis, 0.26 1.89 NA 0.07 2.22 NA XXX
o2.
94680............... 26............ A Exhaled air analysis, 0.26 0.08 0.08 0.01 0.35 0.35 XXX
o2.
94680............... TC............ A Exhaled air analysis, 0.00 1.81 NA 0.06 1.87 NA XXX
o2.
94681............... .............. A Exhaled air analysis, 0.20 2.62 NA 0.13 2.95 NA XXX
o2/co2.
94681............... 26............ A Exhaled air analysis, 0.20 0.07 0.07 0.01 0.28 0.28 XXX
o2/co2.
94681............... TC............ A Exhaled air analysis, 0.00 2.55 NA 0.12 2.67 NA XXX
o2/co2.
94690............... .............. A Exhaled air analysis. 0.07 1.97 NA 0.05 2.09 NA XXX
94690............... 26............ A Exhaled air analysis. 0.07 0.02 0.02 0.01 0.10 0.10 XXX
94690............... TC............ A Exhaled air analysis. 0.00 1.95 NA 0.04 1.99 NA XXX
94720............... .............. A Monoxide diffusing 0.26 1.00 NA 0.07 1.33 NA XXX
capacity.
94720............... 26............ A Monoxide diffusing 0.26 0.08 0.08 0.01 0.35 0.35 XXX
capacity.
94720............... TC............ A Monoxide diffusing 0.00 0.92 NA 0.06 0.98 NA XXX
capacity.
94725............... .............. A Membrane diffusion 0.26 2.92 NA 0.13 3.31 NA XXX
capacity.
94725............... 26............ A Membrane diffusion 0.26 0.08 0.08 0.01 0.35 0.35 XXX
capacity.
94725............... TC............ A Membrane diffusion 0.00 2.84 NA 0.12 2.96 NA XXX
capacity.
94750............... .............. A Pulmonary compliance 0.23 1.35 NA 0.05 1.63 NA XXX
study.
94750............... 26............ A Pulmonary compliance 0.23 0.07 0.07 0.01 0.31 0.31 XXX
study.
94750............... TC............ A Pulmonary compliance 0.00 1.28 NA 0.04 1.32 NA XXX
study.
94760............... .............. T Measure blood oxygen 0.00 0.04 NA 0.02 0.06 NA XXX
level.
94761............... .............. T Measure blood oxygen 0.00 0.07 NA 0.06 0.13 NA XXX
level.
94762............... .............. A Measure blood oxygen 0.00 0.40 NA 0.10 0.50 NA XXX
level.
94770............... .............. A Exhaled carbon 0.15 1.67 NA 0.08 1.90 NA XXX
dioxide test.
94770............... 26............ A Exhaled carbon 0.15 0.04 0.04 0.01 0.20 0.20 XXX
dioxide test.
94770............... TC............ A Exhaled carbon 0.00 1.63 NA 0.07 1.70 NA XXX
dioxide test.
94772............... .............. C Breath recording, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infant.
94772............... 26............ C Breath recording, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infant.
94772............... TC............ C Breath recording, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infant.
94799............... .............. C Pulmonary service/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
[[Page 1230]]
94799............... 26............ C Pulmonary service/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
94799............... TC............ C Pulmonary service/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
95004............... .............. A Percut allergy skin 0.00 0.10 NA 0.01 0.11 NA XXX
tests.
95010............... .............. A Percut allergy 0.15 0.33 0.06 0.01 0.49 0.22 XXX
titrate test.
95015............... .............. A Id allergy titrate- 0.15 0.15 0.06 0.01 0.31 0.22 XXX
drug/bug.
95024............... .............. A Id allergy test, drug/ 0.00 0.15 NA 0.01 0.16 NA XXX
bug.
95027............... .............. A Id allergy titrate- 0.00 0.15 NA 0.01 0.16 NA XXX
airborne.
95028............... .............. A Id allergy test- 0.00 0.24 NA 0.01 0.25 NA XXX
delayed type.
95044............... .............. A Allergy patch tests.. 0.00 0.21 NA 0.01 0.22 NA XXX
95052............... .............. A Photo patch test..... 0.00 0.26 NA 0.01 0.27 NA XXX
95056............... .............. A Photosensitivity 0.00 0.18 NA 0.01 0.19 NA XXX
tests.
95060............... .............. A Eye allergy tests.... 0.00 0.35 NA 0.02 0.37 NA XXX
95065............... .............. A Nose allergy test.... 0.00 0.21 NA 0.01 0.22 NA XXX
95070............... .............. A Bronchial allergy 0.00 2.29 NA 0.02 2.31 NA XXX
tests.
95071............... .............. A Bronchial allergy 0.00 2.93 NA 0.02 2.95 NA XXX
tests.
95075............... .............. A Ingestion challenge 0.95 0.83 0.38 0.04 1.82 1.37 XXX
test.
95078............... .............. A Provocative testing.. 0.00 0.26 NA 0.02 0.28 NA XXX
95115............... .............. A Immunotherapy, one 0.00 0.38 NA 0.02 0.40 NA 000
injection.
95117............... .............. A Immunotherapy 0.00 0.50 NA 0.02 0.52 NA 000
injections.
95120............... .............. I Immunotherapy, one 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
95125............... .............. I Immunotherapy, many 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antigens.
95130............... .............. I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venom.
95131............... .............. I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venoms.
95132............... .............. I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venoms.
95133............... .............. I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venoms.
95134............... .............. I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venoms.
95144............... .............. A Antigen therapy 0.06 0.15 0.02 0.01 0.22 0.09 000
services.
95145............... .............. A Antigen therapy 0.06 0.33 0.02 0.01 0.40 0.09 000
services.
95146............... .............. A Antigen therapy 0.06 0.44 0.03 0.01 0.51 0.10 000
services.
95147............... .............. A Antigen therapy 0.06 0.42 0.02 0.01 0.49 0.09 000
services.
95148............... .............. A Antigen therapy 0.06 0.58 0.03 0.01 0.65 0.10 000
services.
95149............... .............. A Antigen therapy 0.06 0.81 0.03 0.01 0.88 0.10 000
services.
95165............... .............. A Antigen therapy 0.06 0.20 0.02 0.01 0.27 0.09 000
services.
95170............... .............. A Antigen therapy 0.06 0.14 0.02 0.01 0.21 0.09 000
services.
95180............... .............. A Rapid desensitization 2.01 1.52 0.82 0.05 3.58 2.88 000
95199............... .............. C Allergy immunology 0.00 0.00 0.00 0.00 0.00 0.00 000
services.
95250............... .............. A Glucose monitoring, 0.00 3.82 NA 0.01 3.83 NA XXX
cont.
95805............... .............. A Multiple sleep 1.88 16.26 NA 0.41 18.55 NA XXX
latency test.
95805............... 26............ A Multiple sleep 1.88 0.66 0.66 0.07 2.61 2.61 XXX
latency test.
95805............... TC............ A Multiple sleep 0.00 15.60 NA 0.34 15.94 NA XXX
latency test.
95806............... .............. A Sleep study, 1.66 3.81 NA 0.38 5.85 NA XXX
unattended.
95806............... 26............ A Sleep study, 1.66 0.53 0.53 0.07 2.26 2.26 XXX
unattended.
95806............... TC............ A Sleep study, 0.00 3.28 NA 0.31 3.59 NA XXX
unattended.
95807............... .............. A Sleep study, attended 1.66 11.67 NA 0.48 13.81 NA XXX
95807............... 26............ A Sleep study, attended 1.66 0.53 0.53 0.06 2.25 2.25 XXX
95807............... TC............ A Sleep study, attended 0.00 11.14 NA 0.42 11.56 NA XXX
95808............... .............. A Polysomnography, 1-3. 2.65 12.91 NA 0.53 16.09 NA XXX
95808............... 26............ A Polysomnography, 1-3. 2.65 0.93 0.93 0.11 3.69 3.69 XXX
95808............... TC............ A Polysomnography, 1-3. 0.00 11.98 NA 0.42 12.40 NA XXX
95810............... .............. A Polysomnography, 4 or 3.52 17.02 NA 0.56 21.10 NA XXX
more.
95810............... 26............ A Polysomnography, 4 or 3.52 1.18 1.18 0.14 4.84 4.84 XXX
more.
95810............... TC............ A Polysomnography, 4 or 0.00 15.84 NA 0.42 16.26 NA XXX
more.
95811............... .............. A Polysomnography w/ 3.79 18.45 NA 0.59 22.83 NA XXX
cpap.
95811............... 26............ A Polysomnography w/ 3.79 1.27 1.27 0.16 5.22 5.22 XXX
cpap.
95811............... TC............ A Polysomnography w/ 0.00 17.18 NA 0.43 17.61 NA XXX
cpap.
95812............... .............. A Eeg, 41-60 minutes... 1.08 3.91 NA 0.16 5.15 NA XXX
95812............... 26............ A Eeg, 41-60 minutes... 1.08 0.45 0.45 0.05 1.58 1.58 XXX
95812............... TC............ A Eeg, 41-60 minutes... 0.00 3.46 NA 0.11 3.57 NA XXX
95813............... .............. A Eeg, over 1 hour..... 1.73 4.93 NA 0.18 6.84 NA XXX
95813............... 26............ A Eeg, over 1 hour..... 1.73 0.70 0.70 0.07 2.50 2.50 XXX
95813............... TC............ A Eeg, over 1 hour..... 0.00 4.23 NA 0.11 4.34 NA XXX
95816............... .............. A Eeg, awake and drowsy 1.08 3.14 NA 0.15 4.37 NA XXX
95816............... 26............ A Eeg, awake and drowsy 1.08 0.46 0.46 0.05 1.59 1.59 XXX
95816............... TC............ A Eeg, awake and drowsy 0.00 2.68 NA 0.10 2.78 NA XXX
95819............... .............. A Eeg, awake and asleep 1.08 3.69 NA 0.15 4.92 NA XXX
95819............... 26............ A Eeg, awake and asleep 1.08 0.46 0.46 0.05 1.59 1.59 XXX
95819............... TC............ A Eeg, awake and asleep 0.00 3.23 NA 0.10 3.33 NA XXX
95822............... .............. A Eeg, coma or sleep 1.08 4.35 NA 0.18 5.61 NA XXX
only.
95822............... 26............ A Eeg, coma or sleep 1.08 0.45 0.45 0.05 1.58 1.58 XXX
only.
95822............... TC............ A Eeg, coma or sleep 0.00 3.90 NA 0.13 4.03 NA XXX
only.
95824............... .............. C Eeg, cerebral death 0.00 0.00 0.00 0.00 0.00 0.00 XXX
only.
95824............... 26............ A Eeg, cerebral death 0.74 0.32 0.32 0.06 1.12 1.12 XXX
only.
95824............... TC............ C Eeg, cerebral death 0.00 0.00 NA 0.00 0.00 NA XXX
only.
95827............... .............. A Eeg, all night 1.08 2.70 NA 0.18 3.96 NA XXX
recording.
95827............... 26............ A Eeg, all night 1.08 0.40 0.40 0.04 1.52 1.52 XXX
recording.
[[Page 1231]]
95827............... TC............ A Eeg, all night 0.00 2.30 NA 0.14 2.44 NA XXX
recording.
95829............... .............. A Surgery 6.20 31.30 NA 0.39 37.89 NA XXX
electrocorticogram.
95829............... 26............ A Surgery 6.20 2.33 2.33 0.37 8.90 8.90 XXX
electrocorticogram.
95829............... TC............ A Surgery 0.00 28.97 NA 0.02 28.99 NA XXX
electrocorticogram.
95830............... .............. A Insert electrodes for 1.70 3.37 0.73 0.08 5.15 2.51 XXX
EEG.
95831............... .............. A Limb muscle testing, 0.28 0.34 0.13 0.01 0.63 0.42 XXX
manual.
95832............... .............. A Hand muscle testing, 0.29 0.25 0.12 0.01 0.55 0.42 XXX
manual.
95833............... .............. A Body muscle testing, 0.47 0.45 0.23 0.01 0.93 0.71 XXX
manual.
95834............... .............. A Body muscle testing, 0.60 0.50 0.28 0.02 1.12 0.90 XXX
manual.
95851............... .............. A Range of motion 0.16 0.37 0.08 0.01 0.54 0.25 XXX
measurements.
95852............... .............. A Range of motion 0.11 0.26 0.05 0.01 0.38 0.17 XXX
measurements.
95857............... .............. A Tensilon test........ 0.53 0.61 0.23 0.02 1.16 0.78 XXX
95858............... .............. A Tensilon test & 1.56 1.06 NA 0.09 2.71 NA XXX
myogram.
95858............... 26............ A Tensilon test & 1.56 0.67 0.67 0.05 2.28 2.28 XXX
myogram.
95858............... TC............ A Tensilon test & 0.00 0.39 NA 0.04 0.43 NA XXX
myogram.
95860............... .............. A Muscle test, one limb 0.96 1.45 NA 0.06 2.47 NA XXX
95860............... 26............ A Muscle test, one limb 0.96 0.42 0.42 0.04 1.42 1.42 XXX
95860............... TC............ A Muscle test, one limb 0.00 1.03 NA 0.02 1.05 NA XXX
95861............... .............. A Muscle test, 2 limbs. 1.54 1.42 NA 0.12 3.08 NA XXX
95861............... 26............ A Muscle test, 2 limbs. 1.54 0.68 0.68 0.06 2.28 2.28 XXX
95861............... TC............ A Muscle test, 2 limbs. 0.00 0.74 NA 0.06 0.80 NA XXX
95863............... .............. A Muscle test, 3 limbs. 1.87 1.75 NA 0.13 3.75 NA XXX
95863............... 26............ A Muscle test, 3 limbs. 1.87 0.81 0.81 0.07 2.75 2.75 XXX
95863............... TC............ A Muscle test, 3 limbs. 0.00 0.94 NA 0.06 1.00 NA XXX
95864............... .............. A Muscle test, 4 limbs. 1.99 2.66 NA 0.19 4.84 NA XXX
95864............... 26............ A Muscle test, 4 limbs. 1.99 0.87 0.87 0.07 2.93 2.93 XXX
95864............... TC............ A Muscle test, 4 limbs. 0.00 1.79 NA 0.12 1.91 NA XXX
95867............... .............. A Muscle test cran nerv 0.79 0.93 NA 0.08 1.80 NA XXX
unilat.
95867............... 26............ A Muscle test cran nerv 0.79 0.35 0.35 0.04 1.18 1.18 XXX
unilat.
95867............... TC............ A Muscle test cran nerv 0.00 0.58 NA 0.04 0.62 NA XXX
unilat.
95868............... .............. A Muscle test cran 1.18 1.21 NA 0.10 2.49 NA XXX
nerve bilat.
95868............... 26............ A Muscle test cran 1.18 0.51 0.51 0.05 1.74 1.74 XXX
nerve bilat.
95868............... TC............ A Muscle test cran 0.00 0.70 NA 0.05 0.75 NA XXX
nerve bilat.
95869............... .............. A Muscle test, thor 0.37 0.38 NA 0.03 0.78 NA XXX
paraspinal.
95869............... 26............ A Muscle test, thor 0.37 0.16 0.16 0.01 0.54 0.54 XXX
paraspinal.
95869............... TC............ A Muscle test, thor 0.00 0.22 NA 0.02 0.24 NA XXX
paraspinal.
95870............... .............. A Muscle test, 0.37 0.38 NA 0.03 0.78 NA XXX
nonparaspinal.
95870............... 26............ A Muscle test, 0.37 0.16 0.16 0.01 0.54 0.54 XXX
nonparaspinal.
95870............... TC............ A Muscle test, 0.00 0.22 NA 0.02 0.24 NA XXX
nonparaspinal.
95872............... .............. A Muscle test, one 1.50 1.23 NA 0.10 2.83 NA XXX
fiber.
95872............... 26............ A Muscle test, one 1.50 0.63 0.63 0.05 2.18 2.18 XXX
fiber.
95872............... TC............ A Muscle test, one 0.00 0.60 NA 0.05 0.65 NA XXX
fiber.
95875............... .............. A Limb exercise test... 1.10 1.46 NA 0.11 2.67 NA XXX
95875............... 26............ A Limb exercise test... 1.10 0.46 0.46 0.05 1.61 1.61 XXX
95875............... TC............ A Limb exercise test... 0.00 1.00 NA 0.06 1.06 NA XXX
95900............... .............. A Motor nerve 0.42 1.29 NA 0.03 1.74 NA XXX
conduction test.
95900............... 26............ A Motor nerve 0.42 0.19 0.19 0.01 0.62 0.62 XXX
conduction test.
95900............... TC............ A Motor nerve 0.00 1.10 NA 0.02 1.12 NA XXX
conduction test.
95903............... .............. A Motor nerve 0.60 1.21 NA 0.04 1.85 NA XXX
conduction test.
95903............... 26............ A Motor nerve 0.60 0.26 0.26 0.02 0.88 0.88 XXX
conduction test.
95903............... TC............ A Motor nerve 0.00 0.95 NA 0.02 0.97 NA XXX
conduction test.
95904............... .............. A Sense nerve 0.34 1.11 NA 0.03 1.48 NA XXX
conduction test.
95904............... 26............ A Sense nerve 0.34 0.15 0.15 0.01 0.50 0.50 XXX
conduction test.
95904............... TC............ A Sense nerve 0.00 0.96 NA 0.02 0.98 NA XXX
conduction test.
95920............... .............. A Intraop nerve test 2.11 2.25 NA 0.24 4.60 NA ZZZ
add-on.
95920............... 26............ A Intraop nerve test 2.11 0.94 0.94 0.17 3.22 3.22 ZZZ
add-on.
95920............... TC............ A Intraop nerve test 0.00 1.31 NA 0.07 1.38 NA ZZZ
add-on.
95921............... .............. A Autonomic nerv 0.90 0.70 NA 0.06 1.66 NA XXX
function test.
95921............... 26............ A Autonomic nerv 0.90 0.33 0.33 0.04 1.27 1.27 XXX
function test.
95921............... TC............ A Autonomic nerv 0.00 0.37 NA 0.02 0.39 NA XXX
function test.
95922............... .............. A Autonomic nerv 0.96 0.77 NA 0.06 1.79 NA XXX
function test.
95922............... 26............ A Autonomic nerv 0.96 0.40 0.40 0.04 1.40 1.40 XXX
function test.
95922............... TC............ A Autonomic nerv 0.00 0.37 NA 0.02 0.39 NA XXX
function test.
95923............... .............. A Autonomic nerv 0.90 2.08 NA 0.06 3.04 NA XXX
function test.
95923............... 26............ A Autonomic nerv 0.90 0.37 0.37 0.04 1.31 1.31 XXX
function test.
95923............... TC............ A Autonomic nerv 0.00 1.71 NA 0.02 1.73 NA XXX
function test.
95925............... .............. A Somatosensory testing 0.54 1.14 NA 0.08 1.76 NA XXX
95925............... 26............ A Somatosensory testing 0.54 0.23 0.23 0.02 0.79 0.79 XXX
95925............... TC............ A Somatosensory testing 0.00 0.91 NA 0.06 0.97 NA XXX
95926............... .............. A Somatosensory testing 0.54 1.15 NA 0.08 1.77 NA XXX
95926............... 26............ A Somatosensory testing 0.54 0.24 0.24 0.02 0.80 0.80 XXX
95926............... TC............ A Somatosensory testing 0.00 0.91 NA 0.06 0.97 NA XXX
95927............... .............. A Somatosensory testing 0.54 1.16 NA 0.10 1.80 NA XXX
95927............... 26............ A Somatosensory testing 0.54 0.25 0.25 0.04 0.83 0.83 XXX
95927............... TC............ A Somatosensory testing 0.00 0.91 NA 0.06 0.97 NA XXX
[[Page 1232]]
95930............... .............. A Visual evoked 0.35 1.43 NA 0.02 1.80 NA XXX
potential test.
95930............... 26............ A Visual evoked 0.35 0.15 0.15 0.01 0.51 0.51 XXX
potential test.
95930............... TC............ A Visual evoked 0.00 1.28 NA 0.01 1.29 NA XXX
potential test.
95933............... .............. A Blink reflex test.... 0.59 1.03 NA 0.08 1.70 NA XXX
95933............... 26............ A Blink reflex test.... 0.59 0.24 0.24 0.02 0.85 0.85 XXX
95933............... TC............ A Blink reflex test.... 0.00 0.79 NA 0.06 0.85 NA XXX
95934............... .............. A H-reflex test........ 0.51 0.44 NA 0.04 0.99 NA XXX
95934............... 26............ A H-reflex test........ 0.51 0.22 0.22 0.02 0.75 0.75 XXX
95934............... TC............ A H-reflex test........ 0.00 0.22 NA 0.02 0.24 NA XXX
95936............... .............. A H-reflex test........ 0.55 0.46 NA 0.04 1.05 NA XXX
95936............... 26............ A H-reflex test........ 0.55 0.24 0.24 0.02 0.81 0.81 XXX
95936............... TC............ A H-reflex test........ 0.00 0.22 NA 0.02 0.24 NA XXX
95937............... .............. A Neuromuscular 0.65 0.61 NA 0.04 1.30 NA XXX
junction test.
95937............... 26............ A Neuromuscular 0.65 0.27 0.27 0.02 0.94 0.94 XXX
junction test.
95937............... TC............ A Neuromuscular 0.00 0.34 NA 0.02 0.36 NA XXX
junction test.
95950............... .............. A Ambulatory eeg 1.51 4.47 NA 0.53 6.51 NA XXX
monitoring.
95950............... 26............ A Ambulatory eeg 1.51 0.64 0.64 0.10 2.25 2.25 XXX
monitoring.
95950............... TC............ A Ambulatory eeg 0.00 3.83 NA 0.43 4.26 NA XXX
monitoring.
95951............... .............. C EEG monitoring/ 0.00 0.00 NA 0.00 0.00 NA XXX
videorecord.
95951............... 26............ A EEG monitoring/ 5.99 2.57 2.57 0.24 8.80 8.80 XXX
videorecord.
95951............... TC............ C EEG monitoring/ 0.00 0.00 NA 0.00 0.00 NA XXX
videorecord.
95953............... .............. A EEG monitoring/ 3.08 7.64 NA 0.55 11.27 NA XXX
computer.
95953............... 26............ A EEG monitoring/ 3.08 1.29 1.29 0.12 4.49 4.49 XXX
computer.
95953............... TC............ A EEG monitoring/ 0.00 6.35 NA 0.43 6.78 NA XXX
computer.
95954............... .............. A EEG monitoring/giving 2.45 4.29 NA 0.18 6.92 NA XXX
drugs.
95954............... 26............ A EEG monitoring/giving 2.45 1.05 1.05 0.12 3.62 3.62 XXX
drugs.
95954............... TC............ A EEG monitoring/giving 0.00 3.24 NA 0.06 3.30 NA XXX
drugs.
95955............... .............. A EEG during surgery... 1.01 2.33 NA 0.23 3.57 NA XXX
95955............... 26............ A EEG during surgery... 1.01 0.36 0.36 0.06 1.43 1.43 XXX
95955............... TC............ A EEG during surgery... 0.00 1.97 NA 0.17 2.14 NA XXX
95956............... .............. A Eeg monitoring, cable/ 3.08 14.14 NA 0.56 17.78 NA XXX
radio.
95956............... 26............ A Eeg monitoring, cable/ 3.08 1.30 1.30 0.13 4.51 4.51 XXX
radio.
95956............... TC............ A Eeg monitoring, cable/ 0.00 12.84 NA 0.43 13.27 NA XXX
radio.
95957............... .............. A EEG digital analysis. 1.98 2.56 NA 0.20 4.74 NA XXX
95957............... 26............ A EEG digital analysis. 1.98 0.85 0.85 0.08 2.91 2.91 XXX
95957............... TC............ A EEG digital analysis. 0.00 1.71 NA 0.12 1.83 NA XXX
95958............... .............. A EEG monitoring/ 4.24 3.50 NA 0.35 8.09 NA XXX
function test.
95958............... 26............ A EEG monitoring/ 4.24 1.75 1.75 0.22 6.21 6.21 XXX
function test.
95958............... TC............ A EEG monitoring/ 0.00 1.75 NA 0.13 1.88 NA XXX
function test.
95961............... .............. A Electrode 2.97 2.63 NA 0.29 5.89 NA XXX
stimulation, brain.
95961............... 26............ A Electrode 2.97 1.32 1.32 0.22 4.51 4.51 XXX
stimulation, brain.
95961............... TC............ A Electrode 0.00 1.31 NA 0.07 1.38 NA XXX
stimulation, brain.
95962............... .............. A Electrode stim, brain 3.21 2.70 NA 0.28 6.19 NA ZZZ
add-on.
95962............... 26............ A Electrode stim, brain 3.21 1.39 1.39 0.21 4.81 4.81 ZZZ
add-on.
95962............... TC............ A Electrode stim, brain 0.00 1.31 NA 0.07 1.38 NA ZZZ
add-on.
95965............... .............. C Meg, spontaneous..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95965............... 26............ A Meg, spontaneous..... 7.99 3.42 3.42 0.37 11.78 11.78 XXX
95965............... TC............ C Meg, spontaneous..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95966............... .............. C Meg, evoked, single.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95966............... 26............ A Meg, evoked, single.. 3.99 1.73 1.73 0.18 5.90 5.90 XXX
95966............... TC............ C Meg, evoked, single.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95967............... .............. C Meg, evoked, each 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
add'l.
95967............... 26............ A Meg, evoked, each 3.49 1.33 1.33 0.16 4.98 4.98 ZZZ
add'l.
95967............... TC............ C Meg, evoked, each 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
add'l.
95970............... .............. A Analyze neurostim, no 0.45 0.17 0.15 0.04 0.66 0.64 XXX
prog.
95971............... .............. A Analyze neurostim, 0.78 0.28 0.23 0.07 1.13 1.08 XXX
simple.
95972............... .............. A Analyze neurostim, 1.50 0.59 0.49 0.21 2.30 2.20 XXX
complex.
95973............... .............. A Analyze neurostim, 0.92 0.39 0.35 0.08 1.39 1.35 ZZZ
complex.
95974............... .............. A Cranial neurostim, 3.00 1.29 1.29 0.18 4.47 4.47 XXX
complex.
95975............... .............. A Cranial neurostim, 1.70 0.73 0.73 0.08 2.51 2.51 ZZZ
complex.
95990............... .............. A Spin/brain pump refil 0.00 1.50 NA 0.06 1.56 NA XXX
& main.
95991............... .............. A Spin/brain pump refil 0.77 1.43 0.19 0.06 2.26 1.02 XXX
& main.
95999............... .............. C Neurological 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
96000............... .............. A Motion analysis, 1.80 NA 0.55 0.02 NA 2.37 XXX
video/3d.
96001............... .............. A Motion test w/ft 2.15 NA 0.66 0.02 NA 2.83 XXX
press meas.
96002............... .............. A Dynamic surface emg.. 0.41 NA 0.15 0.02 NA 0.58 XXX
96003............... .............. A Dynamic fine wire emg 0.37 NA 0.14 0.04 NA 0.55 XXX
96004............... .............. A Phys review of motion 2.14 0.95 0.95 0.10 3.19 3.19 XXX
tests.
96100............... .............. A Psychological testing 0.00 1.77 NA 0.18 1.95 NA XXX
96105............... .............. A Assessment of aphasia 0.00 1.77 NA 0.18 1.95 NA XXX
96110............... .............. A Developmental test, 0.00 0.19 NA 0.18 0.37 NA XXX
lim.
96111............... .............. A Developmental test, 2.60 1.07 NA 0.18 3.85 NA XXX
extend.
96115............... .............. A Neurobehavior status 0.00 1.77 NA 0.18 1.95 NA XXX
exam.
96117............... .............. A Neuropsych test 0.00 1.77 NA 0.18 1.95 NA XXX
battery.
96150............... .............. A Assess lth/behave, 0.50 0.19 0.18 0.02 0.71 0.70 XXX
init.
[[Page 1233]]
96151............... .............. A Assess hlth/behave, 0.48 0.18 0.17 0.02 0.68 0.67 XXX
subseq.
96152............... .............. A Intervene hlth/ 0.46 0.17 0.16 0.02 0.65 0.64 XXX
behave, indiv.
96153............... .............. A Intervene hlth/ 0.10 0.04 0.04 0.01 0.15 0.15 XXX
behave, group.
96154............... .............. A Interv hlth/behav, 0.45 0.17 0.16 0.02 0.64 0.63 XXX
fam w/pt.
96155............... .............. N Interv hlth/behav fam +0.44 0.18 0.17 0.02 0.64 0.63 XXX
no pt.
96400............... .............. A Chemotherapy, sc/im.. 0.17 1.12 NA 0.01 1.30 NA XXX
96405............... .............. A Intralesional chemo 0.52 2.35 0.24 0.02 2.89 0.78 000
admin.
96406............... .............. A Intralesional chemo 0.80 3.10 0.30 0.02 3.92 1.12 000
admin.
96408............... .............. A Chemotherapy, push 0.17 2.91 NA 0.06 3.14 NA XXX
technique.
96410............... .............. A Chemotherapy,infusion 0.17 4.16 NA 0.08 4.41 NA XXX
method.
96412............... .............. A Chemo, infuse method 0.17 0.74 NA 0.07 0.98 NA ZZZ
add-on.
96414............... .............. A Chemo, infuse method 0.17 5.22 NA 0.08 5.47 NA XXX
add-on.
96420............... .............. A Chemotherapy, push 0.17 2.81 NA 0.08 3.06 NA XXX
technique.
96422............... .............. A Chemotherapy,infusion 0.17 5.19 NA 0.08 5.44 NA XXX
method.
96423............... .............. A Chemo, infuse method 0.17 1.96 NA 0.02 2.15 NA ZZZ
add-on.
96425............... .............. A Chemotherapy,infusion 0.17 4.73 NA 0.08 4.98 NA XXX
method.
96440............... .............. A Chemotherapy, 2.37 8.42 1.24 0.14 10.93 3.75 000
intracavitary.
96445............... .............. A Chemotherapy, 2.20 8.54 1.19 0.08 10.82 3.47 000
intracavitary.
96450............... .............. A Chemotherapy, into 1.89 7.32 1.10 0.07 9.28 3.06 000
CNS.
96520............... .............. A Port pump refill & 0.17 3.94 NA 0.06 4.17 NA XXX
main.
96530............... .............. A Syst pump refill & 0.17 2.86 NA 0.06 3.09 NA XXX
main.
96542............... .............. A Chemotherapy 1.42 4.43 0.66 0.06 5.91 2.14 XXX
injection.
96545............... .............. B Provide chemotherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
agent.
96549............... .............. C Chemotherapy, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unspecified.
96567............... .............. A Photodynamic tx, skin 0.00 0.98 NA 0.04 1.02 NA XXX
96570............... .............. A Photodynamic tx, 30 1.10 NA 0.37 0.05 NA 1.52 ZZZ
min.
96571............... .............. A Photodynamic tx, addl 0.55 NA 0.20 0.02 NA 0.77 ZZZ
15 min.
96900............... .............. A Ultraviolet light 0.00 0.48 NA 0.02 0.50 NA XXX
therapy.
96902............... .............. B Trichogram........... +0.41 0.25 0.16 0.01 0.67 0.58 XXX
96910............... .............. A Photochemotherapy 0.00 1.07 NA 0.04 1.11 NA XXX
with UV-B.
96912............... .............. A Photochemotherapy 0.00 1.34 NA 0.05 1.39 NA XXX
with UV-A.
96913............... .............. A Photochemotherapy, UV- 0.00 1.78 NA 0.10 1.88 NA XXX
A or B.
96920............... .............. A Laser tx, skin < 250 1.15 7.67 0.56 0.11 8.93 1.82 000
sq cm.
96921............... .............. A Laser tx, skin 250- 1.17 7.74 0.57 0.11 9.02 1.85 000
500 sq cm.
96922............... .............. A Laser tx, skin 500 sq cm.
96999............... .............. C Dermatological 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
97001............... .............. A Pt evaluation........ 1.20 0.73 0.45 0.06 1.99 1.71 XXX
97002............... .............. A Pt re-evaluation..... 0.60 0.43 0.24 0.02 1.05 0.86 XXX
97003............... .............. A Ot evaluation........ 1.20 0.86 0.40 0.06 2.12 1.66 XXX
97004............... .............. A Ot re-evaluation..... 0.60 0.60 0.20 0.02 1.22 0.82 XXX
97005............... .............. I Athletic train eval.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97006............... .............. I Athletic train reeval 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97010............... .............. B Hot or cold packs +0.06 0.05 NA 0.01 0.12 NA XXX
therapy.
97012............... .............. A Mechanical traction 0.25 0.14 NA 0.01 0.40 NA XXX
therapy.
97014............... .............. I Electric stimulation +0.18 0.19 0.19 0.01 0.38 0.38 XXX
therapy.
97016............... .............. A Vasopneumatic device 0.18 0.19 NA 0.01 0.38 NA XXX
therapy.
97018............... .............. A Paraffin bath therapy 0.06 0.11 NA 0.01 0.18 NA XXX
97020............... .............. A Microwave therapy.... 0.06 0.06 NA 0.01 0.13 NA XXX
97022............... .............. A Whirlpool therapy.... 0.17 0.22 NA 0.01 0.40 NA XXX
97024............... .............. A Diathermy treatment.. 0.06 0.09 NA 0.01 0.16 NA XXX
97026............... .............. A Infrared therapy..... 0.06 0.06 NA 0.01 0.13 NA XXX
97028............... .............. A Ultraviolet therapy.. 0.08 0.07 NA 0.01 0.16 NA XXX
97032............... .............. A Electrical 0.25 0.16 NA 0.01 0.42 NA XXX
stimulation.
97033............... .............. A Electric current 0.26 0.28 NA 0.02 0.56 NA XXX
therapy.
97034............... .............. A Contrast bath therapy 0.21 0.16 NA 0.01 0.38 NA XXX
97035............... .............. A Ultrasound therapy... 0.21 0.11 NA 0.01 0.33 NA XXX
97036............... .............. A Hydrotherapy......... 0.28 0.33 NA 0.01 0.62 NA XXX
97039............... .............. A Physical therapy 0.20 0.10 NA 0.01 0.31 NA XXX
treatment.
97110............... .............. A Therapeutic exercises 0.45 0.28 NA 0.04 0.77 NA XXX
97112............... .............. A Neuromuscular 0.45 0.30 NA 0.02 0.77 NA XXX
reeducation.
97113............... .............. A Aquatic therapy/ 0.44 0.40 NA 0.04 0.88 NA XXX
exercises.
97116............... .............. A Gait training therapy 0.40 0.24 NA 0.02 0.66 NA XXX
97124............... .............. A Massage therapy...... 0.35 0.23 NA 0.01 0.59 NA XXX
97139............... .............. A Physical medicine 0.21 0.20 NA 0.01 0.42 NA XXX
procedure.
97140............... .............. A Manual therapy....... 0.43 0.26 NA 0.02 0.71 NA XXX
97150............... .............. A Group therapeutic 0.27 0.18 NA 0.02 0.47 NA XXX
procedures.
97504............... .............. A Orthotic training.... 0.45 0.33 NA 0.04 0.82 NA XXX
97520............... .............. A Prosthetic training.. 0.45 0.28 NA 0.02 0.75 NA XXX
97530............... .............. A Therapeutic 0.44 0.32 NA 0.02 0.78 NA XXX
activities.
97532............... .............. A Cognitive skills 0.44 0.21 NA 0.01 0.66 NA XXX
development.
97533............... .............. A Sensory integration.. 0.44 0.24 NA 0.01 0.69 NA XXX
97535............... .............. A Self care mngment 0.45 0.33 NA 0.02 0.80 NA XXX
training.
97537............... .............. A Community/work 0.45 0.27 NA 0.01 0.73 NA XXX
reintegration.
97542............... .............. A Wheelchair mngment 0.45 0.28 NA 0.01 0.74 NA XXX
training.
97545............... .............. R Work hardening....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 1234]]
97546............... .............. R Work hardening add-on 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
97601............... .............. A Wound(s) care, 0.50 0.49 NA 0.05 1.04 NA XXX
selective.
97602............... .............. B Wound(s) care non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
selective.
97703............... .............. A Prosthetic checkout.. 0.25 0.41 NA 0.02 0.68 NA XXX
97750............... .............. A Physical performance 0.45 0.30 NA 0.02 0.77 NA XXX
test.
97755............... .............. A Assistive technology 0.62 0.29 NA 0.02 0.93 NA XXX
assess.
97780............... .............. N Acupuncture w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stimul.
97781............... .............. N Acupuncture w/stimul. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97799............... .............. C Physical medicine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
97802............... .............. A Medical nutrition, 0.00 0.47 NA 0.01 0.48 NA XXX
indiv, in.
97803............... .............. A Med nutrition, indiv, 0.00 0.47 NA 0.01 0.48 NA XXX
subseq.
97804............... .............. A Medical nutrition, 0.00 0.19 NA 0.01 0.20 NA XXX
group.
98925............... .............. A Osteopathic 0.45 0.33 0.14 0.01 0.79 0.60 000
manipulation.
98926............... .............. A Osteopathic 0.65 0.42 0.25 0.02 1.09 0.92 000
manipulation.
98927............... .............. A Osteopathic 0.87 0.51 0.30 0.04 1.42 1.21 000
manipulation.
98928............... .............. A Osteopathic 1.03 0.60 0.35 0.04 1.67 1.42 000
manipulation.
98929............... .............. A Osteopathic 1.19 0.68 0.37 0.05 1.92 1.61 000
manipulation.
98940............... .............. A Chiropractic 0.45 0.24 0.12 0.01 0.70 0.58 000
manipulation.
98941............... .............. A Chiropractic 0.65 0.30 0.18 0.02 0.97 0.85 000
manipulation.
98942............... .............. A Chiropractic 0.87 0.36 0.24 0.04 1.27 1.15 000
manipulation.
98943............... .............. N Chiropractic +0.40 0.24 0.16 0.01 0.65 0.57 XXX
manipulation.
99000............... .............. B Specimen handling.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99001............... .............. B Specimen handling.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99002............... .............. B Device handling...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99024............... .............. B Postop follow-up 0.00 0.00 0.00 0.00 0.00 0.00 XXX
visit.
99025............... .............. F Initial surgical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
evaluation.
99026............... .............. N In-hospital on call 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
99027............... .............. N Out-of-hosp on call 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
99050............... .............. B Medical services 0.00 0.00 0.00 0.00 0.00 0.00 XXX
after hrs.
99052............... .............. B Medical services at 0.00 0.00 0.00 0.00 0.00 0.00 XXX
night.
99054............... .............. B Medical servcs, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unusual hrs.
99056............... .............. B Non-office medical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
99058............... .............. B Office emergency care 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99070............... .............. B Special supplies..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99071............... .............. B Patient education 0.00 0.00 0.00 0.00 0.00 0.00 XXX
materials.
99075............... .............. N Medical testimony.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99078............... .............. B Group health 0.00 0.00 0.00 0.00 0.00 0.00 XXX
education.
99080............... .............. B Special reports or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
forms.
99082............... .............. C Unusual physician 0.00 0.00 0.00 0.00 0.00 0.00 XXX
travel.
99090............... .............. B Computer data 0.00 0.00 0.00 0.00 0.00 0.00 XXX
analysis.
99091............... .............. B Collect/review data 0.00 0.00 0.00 0.00 0.00 0.00 XXX
from pt.
99100............... .............. B Special anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
service.
99116............... .............. B Anesthesia with 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
hypothermia.
99135............... .............. B Special anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
procedure.
99140............... .............. B Emergency anesthesia. 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
99141............... .............. B Sedation, iv/im or +0.80 1.92 0.38 0.05 2.77 1.23 XXX
inhalant.
99142............... .............. B Sedation, oral/rectal/ +0.60 0.99 0.31 0.04 1.63 0.95 XXX
nasal.
99170............... .............. A Anogenital exam, 1.75 1.72 0.52 0.08 3.55 2.35 000
child.
99172............... .............. N Ocular function 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
99173............... .............. N Visual acuity screen. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99175............... .............. A Induction of vomiting 0.00 1.40 NA 0.10 1.50 NA XXX
99183............... .............. A Hyperbaric oxygen 2.34 4.75 0.72 0.14 7.23 3.20 XXX
therapy.
99185............... .............. A Regional hypothermia. 0.00 0.64 NA 0.04 0.68 NA XXX
99186............... .............. A Total body 0.00 1.79 NA 0.45 2.24 NA XXX
hypothermia.
99190............... .............. X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99191............... .............. X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99192............... .............. X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99195............... .............. A Phlebotomy........... 0.00 0.44 NA 0.02 0.46 NA XXX
99199............... .............. C Special service/proc/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
report.
99201............... .............. A Office/outpatient 0.45 0.50 0.16 0.02 0.97 0.63 XXX
visit, new.
99202............... .............. A Office/outpatient 0.88 0.79 0.32 0.06 1.73 1.26 XXX
visit, new.
99203............... .............. A Office/outpatient 1.34 1.13 0.48 0.10 2.57 1.92 XXX
visit, new.
99204............... .............. A Office/outpatient 2.00 1.51 0.71 0.12 3.63 2.83 XXX
visit, new.
99205............... .............. A Office/outpatient 2.67 1.80 0.95 0.14 4.61 3.76 XXX
visit, new.
99211............... .............. A Office/outpatient 0.17 0.39 0.06 0.01 0.57 0.24 XXX
visit, est.
99212............... .............. A Office/outpatient 0.45 0.54 0.16 0.02 1.01 0.63 XXX
visit, est.
99213............... .............. A Office/outpatient 0.67 0.70 0.24 0.04 1.41 0.95 XXX
visit, est.
99214............... .............. A Office/outpatient 1.10 1.05 0.40 0.05 2.20 1.55 XXX
visit, est.
99215............... .............. A Office/outpatient 1.77 1.34 0.65 0.08 3.19 2.50 XXX
visit, est.
99217............... .............. A Observation care 1.28 NA 0.53 0.06 NA 1.87 XXX
discharge.
99218............... .............. A Observation care..... 1.28 NA 0.43 0.06 NA 1.77 XXX
99219............... .............. A Observation care..... 2.14 NA 0.72 0.10 NA 2.96 XXX
99220............... .............. A Observation care..... 2.99 NA 1.03 0.13 NA 4.15 XXX
99221............... .............. A Initial hospital care 1.28 NA 0.45 0.06 NA 1.79 XXX
99222............... .............. A Initial hospital care 2.14 NA 0.74 0.10 NA 2.98 XXX
[[Page 1235]]
99223............... .............. A Initial hospital care 2.99 NA 1.04 0.12 NA 4.15 XXX
99231............... .............. A Subsequent hospital 0.64 NA 0.23 0.02 NA 0.89 XXX
care.
99232............... .............. A Subsequent hospital 1.06 NA 0.37 0.04 NA 1.47 XXX
care.
99233............... .............. A Subsequent hospital 1.51 NA 0.52 0.06 NA 2.09 XXX
care.
99234............... .............. A Observ/hosp same date 2.56 NA 1.00 0.13 NA 3.69 XXX
99235............... .............. A Observ/hosp same date 3.41 NA 1.29 0.16 NA 4.86 XXX
99236............... .............. A Observ/hosp same date 4.26 NA 1.59 0.21 NA 6.06 XXX
99238............... .............. A Hospital discharge 1.28 NA 0.54 0.05 NA 1.87 XXX
day.
99239............... .............. A Hospital discharge 1.75 NA 0.74 0.06 NA 2.55 XXX
day.
99241............... .............. A Office consultation.. 0.64 0.65 0.22 0.05 1.34 0.91 XXX
99242............... .............. A Office consultation.. 1.29 1.05 0.46 0.11 2.45 1.86 XXX
99243............... .............. A Office consultation.. 1.72 1.39 0.63 0.12 3.23 2.47 XXX
99244............... .............. A Office consultation.. 2.58 1.83 0.92 0.16 4.57 3.66 XXX
99245............... .............. A Office consultation.. 3.42 2.29 1.24 0.19 5.90 4.85 XXX
99251............... .............. A Initial inpatient 0.66 NA 0.25 0.05 NA 0.96 XXX
consult.
99252............... .............. A Initial inpatient 1.32 NA 0.50 0.10 NA 1.92 XXX
consult.
99253............... .............. A Initial inpatient 1.82 NA 0.68 0.11 NA 2.61 XXX
consult.
99254............... .............. A Initial inpatient 2.64 NA 0.99 0.13 NA 3.76 XXX
consult.
99255............... .............. A Initial inpatient 3.64 NA 1.35 0.18 NA 5.17 XXX
consult.
99261............... .............. A Follow-up inpatient 0.42 NA 0.16 0.02 NA 0.60 XXX
consult.
99262............... .............. A Follow-up inpatient 0.85 NA 0.31 0.04 NA 1.20 XXX
consult.
99263............... .............. A Follow-up inpatient 1.27 NA 0.45 0.05 NA 1.77 XXX
consult.
99271............... .............. A Confirmatory 0.45 0.55 0.16 0.04 1.04 0.65 XXX
consultation.
99272............... .............. A Confirmatory 0.84 0.82 0.31 0.07 1.73 1.22 XXX
consultation.
99273............... .............. A Confirmatory 1.19 1.10 0.44 0.08 2.37 1.71 XXX
consultation.
99274............... .............. A Confirmatory 1.73 1.36 0.64 0.11 3.20 2.48 XXX
consultation.
99275............... .............. A Confirmatory 2.31 1.64 0.84 0.12 4.07 3.27 XXX
consultation.
99281............... .............. A Emergency dept visit. 0.33 NA 0.09 0.02 NA 0.44 XXX
99282............... .............. A Emergency dept visit. 0.55 NA 0.15 0.04 NA 0.74 XXX
99283............... .............. A Emergency dept visit. 1.24 NA 0.31 0.10 NA 1.65 XXX
99284............... .............. A Emergency dept visit. 1.95 NA 0.47 0.14 NA 2.56 XXX
99285............... .............. A Emergency dept visit. 3.06 NA 0.72 0.23 NA 4.01 XXX
99288............... .............. B Direct advanced life 0.00 0.00 0.00 0.00 0.00 0.00 XXX
support.
99289............... .............. A Ped crit care 4.79 NA 1.91 0.17 NA 6.87 XXX
transport.
99290............... .............. A Ped crit care 2.40 NA 0.83 0.08 NA 3.31 ZZZ
transport addl.
99291............... .............. A Critical care, first 3.99 2.34 1.28 0.17 6.50 5.44 XXX
hour.
99292............... .............. A Critical care, add'l 2.00 0.81 0.64 0.08 2.89 2.72 ZZZ
30 min.
99293............... .............. A Ped critical care, 15.98 NA 4.96 0.84 NA 21.78 XXX
initial.
99294............... .............. A Ped critical care, 7.99 NA 2.49 0.28 NA 10.76 XXX
subseq.
99295............... .............. A Neonate crit care, 18.46 NA 5.39 0.84 NA 24.69 XXX
initial.
99296............... .............. A Neonate critical care 7.99 NA 2.55 0.28 NA 10.82 XXX
subseq.
99298............... .............. A Ic for lbw infant < 2.75 NA 0.93 0.12 NA 3.80 XXX
1500 gm.
99299............... .............. A Ic, lbw infant 1500- 2.50 NA 0.95 0.12 NA 3.57 XXX
2500 gm.
99301............... .............. A Nursing facility care 1.20 0.67 0.40 0.05 1.92 1.65 XXX
99302............... .............. A Nursing facility care 1.61 0.95 0.54 0.06 2.62 2.21 XXX
99303............... .............. A Nursing facility care 2.01 1.16 0.67 0.07 3.24 2.75 XXX
99311............... .............. A Nursing fac care, 0.60 0.47 0.20 0.02 1.09 0.82 XXX
subseq.
99312............... .............. A Nursing fac care, 1.00 0.65 0.34 0.04 1.69 1.38 XXX
subseq.
99313............... .............. A Nursing fac care, 1.42 0.84 0.47 0.05 2.31 1.94 XXX
subseq.
99315............... .............. A Nursing fac discharge 1.13 0.70 0.37 0.05 1.88 1.55 XXX
day.
99316............... .............. A Nursing fac discharge 1.50 0.90 0.51 0.06 2.46 2.07 XXX
day.
99321............... .............. A Rest home visit, new 0.71 0.35 NA 0.02 1.08 NA XXX
patient.
99322............... .............. A Rest home visit, new 1.01 0.46 NA 0.04 1.51 NA XXX
patient.
99323............... .............. A Rest home visit, new 1.28 0.55 NA 0.05 1.88 NA XXX
patient.
99331............... .............. A Rest home visit, est 0.60 0.32 NA 0.02 0.94 NA XXX
pat.
99332............... .............. A Rest home visit, est 0.80 0.38 NA 0.04 1.22 NA XXX
pat.
99333............... .............. A Rest home visit, est 1.00 0.45 NA 0.04 1.49 NA XXX
pat.
99341............... .............. A Home visit, new 1.01 0.48 NA 0.06 1.55 NA XXX
patient.
99342............... .............. A Home visit, new 1.52 0.68 NA 0.06 2.26 NA XXX
patient.
99343............... .............. A Home visit, new 2.27 0.95 NA 0.08 3.30 NA XXX
patient.
99344............... .............. A Home visit, new 3.03 1.18 NA 0.12 4.33 NA XXX
patient.
99345............... .............. A Home visit, new 3.78 1.44 NA 0.14 5.36 NA XXX
patient.
99347............... .............. A Home visit, est 0.76 0.39 NA 0.04 1.19 NA XXX
patient.
99348............... .............. A Home visit, est 1.26 0.71 NA 0.05 2.02 NA XXX
patient.
99349............... .............. A Home visit, est 2.02 1.04 NA 0.07 3.13 NA XXX
patient.
99350............... .............. A Home visit, est 3.03 1.40 NA 0.12 4.55 NA XXX
patient.
99354............... .............. A Prolonged service, 1.77 0.75 0.66 0.07 2.59 2.50 ZZZ
office.
99355............... .............. A Prolonged service, 1.77 0.73 0.62 0.07 2.57 2.46 ZZZ
office.
99356............... .............. A Prolonged service, 1.71 NA 0.62 0.07 NA 2.40 ZZZ
inpatient.
99357............... .............. A Prolonged service, 1.71 NA 0.63 0.07 NA 2.41 ZZZ
inpatient.
99358............... .............. B Prolonged serv, w/o 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
contact.
99359............... .............. B Prolonged serv, w/o 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
contact.
99360............... .............. X Physician standby 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
99361............... .............. B Physician/team 0.00 0.00 0.00 0.00 0.00 0.00 XXX
conference.
99362............... .............. B Physician/team 0.00 0.00 0.00 0.00 0.00 0.00 XXX
conference.
[[Page 1236]]
99371............... .............. B Physician phone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
consultation.
99372............... .............. B Physician phone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
consultation.
99373............... .............. B Physician phone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
consultation.
99374............... .............. B Home health care +1.10 0.70 0.41 0.05 1.85 1.56 XXX
supervision.
99375............... .............. I Home health care +1.73 1.55 1.55 0.07 3.35 3.35 XXX
supervision.
99377............... .............. B Hospice care +1.10 0.70 0.41 0.05 1.85 1.56 XXX
supervision.
99378............... .............. I Hospice care +1.73 1.94 1.94 0.07 3.74 3.74 XXX
supervision.
99379............... .............. B Nursing fac care +1.10 0.70 0.70 0.04 1.84 1.84 XXX
supervision.
99380............... .............. B Nursing fac care +1.73 1.00 1.00 0.06 2.79 2.79 XXX
supervision.
99381............... .............. N Prev visit, new, +1.19 1.50 0.45 0.05 2.74 1.69 XXX
infant.
99382............... .............. N Prev visit, new, age +1.36 1.54 0.52 0.05 2.95 1.93 XXX
1-4.
99383............... .............. N Prev visit, new, age +1.36 1.48 0.52 0.05 2.89 1.93 XXX
5-11.
99384............... .............. N Prev visit, new, age +1.53 1.55 0.59 0.06 3.14 2.18 XXX
12-17.
99385............... .............. N Prev visit, new, age +1.53 1.55 0.59 0.06 3.14 2.18 XXX
18-39.
99386............... .............. N Prev visit, new, age +1.88 1.74 0.72 0.07 3.69 2.67 XXX
40-64.
99387............... .............. N Prev visit, new, 65 & +2.06 1.87 0.79 0.07 4.00 2.92 XXX
over.
99391............... .............. N Prev visit, est, +1.02 1.02 0.39 0.04 2.08 1.45 XXX
infant.
99392............... .............. N Prev visit, est, age +1.19 1.09 0.45 0.05 2.33 1.69 XXX
1-4.
99393............... .............. N Prev visit, est, age +1.19 1.06 0.45 0.05 2.30 1.69 XXX
5-11.
99394............... .............. N Prev visit, est, age +1.36 1.13 0.52 0.05 2.54 1.93 XXX
12-17.
99395............... .............. N Prev visit, est, age +1.36 1.16 0.52 0.05 2.57 1.93 XXX
18-39.
99396............... .............. N Prev visit, est, age +1.53 1.25 0.59 0.06 2.84 2.18 XXX
40-64.
99397............... .............. N Prev visit, est, 65 & +1.71 1.36 0.66 0.06 3.13 2.43 XXX
over.
99401............... .............. N Preventive +0.48 0.62 0.19 0.01 1.11 0.68 XXX
counseling, indiv.
99402............... .............. N Preventive +0.98 0.87 0.37 0.02 1.87 1.37 XXX
counseling, indiv.
99403............... .............. N Preventive +1.46 1.09 0.56 0.04 2.59 2.06 XXX
counseling, indiv.
99404............... .............. N Preventive +1.95 1.32 0.75 0.05 3.32 2.75 XXX
counseling, indiv.
99411............... .............. N Preventive +0.15 0.18 0.06 0.01 0.34 0.22 XXX
counseling, group.
99412............... .............. N Preventive +0.25 0.25 0.10 0.01 0.51 0.36 XXX
counseling, group.
99420............... .............. N Health risk 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assessment test.
99429............... .............. N Unlisted preventive 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
99431............... .............. A Initial care, normal 1.17 NA 0.38 0.05 NA 1.60 XXX
newborn.
99432............... .............. A Newborn care, not in 1.26 0.90 0.40 0.07 2.23 1.73 XXX
hosp.
99433............... .............. A Normal newborn care/ 0.62 NA 0.20 0.02 NA 0.84 XXX
hospital.
99435............... .............. A Newborn discharge day 1.50 NA 0.50 0.06 NA 2.06 XXX
hosp.
99436............... .............. A Attendance, birth.... 1.50 NA 0.46 0.06 NA 2.02 XXX
99440............... .............. A Newborn resuscitation 2.93 NA 0.94 0.13 NA 4.00 XXX
99450............... .............. N Life/disability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
evaluation.
99455............... .............. R Disability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
examination.
99456............... .............. R Disability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
examination.
99499............... .............. C Unlisted e&m service. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99500............... .............. I Home visit, prenatal. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99501............... .............. I Home visit, postnatal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99502............... .............. I Home visit, nb care.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99503............... .............. I Home visit, resp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
99504............... .............. I Home visit mech 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventilator.
99505............... .............. I Home visit, stoma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
care.
99506............... .............. I Home visit, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
99507............... .............. I Home visit, cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maintain.
99509............... .............. I Home visit day life 0.00 0.00 0.00 0.00 0.00 0.00 XXX
activity.
99510............... .............. I Home visit, sing/m/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fam couns.
99511............... .............. I Home visit, fecal/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
enema mgmt.
99512............... .............. I Home visit for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hemodialysis.
99551............... .............. F Home infus, pain 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mgmt, iv/sc.
99552............... .............. F Hm infus pain mgmt, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
epid/ith.
99553............... .............. F Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tocolytic tx.
99554............... .............. F Home infus, hormone/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
platelet.
99555............... .............. F Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chemotheraphy.
99556............... .............. F Home infus, antibio/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fung/vir.
99557............... .............. F Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anticoagulant.
99558............... .............. F Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
immunotherapy.
99559............... .............. F Home infus, periton 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dialysis.
99560............... .............. F Home infus, entero 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nutrition.
99561............... .............. F Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydration tx.
99562............... .............. F Home infus, parent 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nutrition.
99563............... .............. F Home admin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pentamidine.
99564............... .............. F Hme infus, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antihemophil agnt.
99565............... .............. F Home infus, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
proteinase inhib.
99566............... .............. F Home infuse, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
99567............... .............. F Home infuse, sympath 0.00 0.00 0.00 0.00 0.00 0.00 XXX
agent.
99568............... .............. F Home infus, misc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
drug, daily.
99569............... .............. F Home infuse, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX
addl tx.
99600............... .............. I Home visit nos....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99601............... .............. I Home infusion/visit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2 hrs.
99602............... .............. I Home infusion, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX
addtl hr.
[[Page 1237]]
A4890............... .............. R Repair/maint cont 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hemo equip.
D0150............... .............. R Comprehensve oral 0.00 0.00 0.00 0.00 0.00 0.00 YYY
evaluation.
D0240............... .............. R Intraoral occlusal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
film.
D0250............... .............. R Extraoral first film. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D0260............... .............. R Extraoral ea 0.00 0.00 0.00 0.00 0.00 0.00 YYY
additional film.
D0270............... .............. R Dental bitewing 0.00 0.00 0.00 0.00 0.00 0.00 YYY
single film.
D0272............... .............. R Dental bitewings two 0.00 0.00 0.00 0.00 0.00 0.00 YYY
films.
D0274............... .............. R Dental bitewings four 0.00 0.00 0.00 0.00 0.00 0.00 YYY
films.
D0277............... .............. R Vert bitewings-sev to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eight.
D0460............... .............. R Pulp vitality test... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D0472............... .............. R Gross exam, prep & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
report.
D0473............... .............. R Micro exam, prep & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
report.
D0474............... .............. R Micro w exam of surg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
margins.
D0480............... .............. R Cytopath smear prep & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
report.
D0502............... .............. R Other oral pathology 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedu.
D0999............... .............. R Unspecified 0.00 0.00 0.00 0.00 0.00 0.00 YYY
diagnostic proce.
D1510............... .............. R Space maintainer fxd 0.00 0.00 0.00 0.00 0.00 0.00 YYY
unilat.
D1515............... .............. R Fixed bilat space 0.00 0.00 0.00 0.00 0.00 0.00 YYY
maintainer.
D1520............... .............. R Remove unilat space 0.00 0.00 0.00 0.00 0.00 0.00 YYY
maintain.
D1525............... .............. R Remove bilat space 0.00 0.00 0.00 0.00 0.00 0.00 YYY
maintain.
D1550............... .............. R Recement space 0.00 0.00 0.00 0.00 0.00 0.00 YYY
maintainer.
D2970............... .............. R Temporary- fractured 0.00 0.00 0.00 0.00 0.00 0.00 YYY
tooth.
D2999............... .............. R Dental unspec 0.00 0.00 0.00 0.00 0.00 0.00 YYY
restorative pr.
D3460............... .............. R Endodontic endosseous 0.00 0.00 0.00 0.00 0.00 0.00 YYY
implan.
D3999............... .............. R Endodontic procedure. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D4260............... .............. R Osseous surgery per 0.00 0.00 0.00 0.00 0.00 0.00 YYY
quadrant.
D4263............... .............. R Bone replce graft 0.00 0.00 0.00 0.00 0.00 0.00 YYY
first site.
D4264............... .............. R Bone replce graft 0.00 0.00 0.00 0.00 0.00 0.00 YYY
each add.
D4268............... .............. R Surgical revision 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
D4270............... .............. R Pedicle soft tissue 0.00 0.00 0.00 0.00 0.00 0.00 YYY
graft pr.
D4271............... .............. R Free soft tissue 0.00 0.00 0.00 0.00 0.00 0.00 YYY
graft proc.
D4273............... .............. R Subepithelial tissue 0.00 0.00 0.00 0.00 0.00 0.00 YYY
graft.
D4355............... .............. R Full mouth 0.00 0.00 0.00 0.00 0.00 0.00 YYY
debridement.
D4381............... .............. R Localized chemo 0.00 0.00 0.00 0.00 0.00 0.00 YYY
delivery.
D5911............... .............. R Facial moulage 0.00 0.00 0.00 0.00 0.00 0.00 YYY
sectional.
D5912............... .............. R Facial moulage 0.00 0.00 0.00 0.00 0.00 0.00 YYY
complete.
D5951............... .............. R Feeding aid.......... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D5983............... .............. R Radiation applicator. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D5984............... .............. R Radiation shield..... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D5985............... .............. R Radiation cone 0.00 0.00 0.00 0.00 0.00 0.00 YYY
locator.
D5987............... .............. R Commissure splint.... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D6920............... .............. R Dental connector bar. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D7111............... .............. R Coronal remnants 0.00 0.00 0.00 0.00 0.00 0.00 XXX
deciduous t.
D7140............... .............. R Extraction erupted 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tooth/exr.
D7210............... .............. R Rem imp tooth w 0.00 0.00 0.00 0.00 0.00 0.00 YYY
mucoper flp.
D7220............... .............. R Impact tooth remov 0.00 0.00 0.00 0.00 0.00 0.00 YYY
soft tiss.
D7230............... .............. R Impact tooth remov 0.00 0.00 0.00 0.00 0.00 0.00 YYY
part bony.
D7240............... .............. R Impact tooth remov 0.00 0.00 0.00 0.00 0.00 0.00 YYY
comp bony.
D7241............... .............. R Impact tooth rem bony 0.00 0.00 0.00 0.00 0.00 0.00 YYY
w/comp.
D7250............... .............. R Tooth root removal... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D7260............... .............. R Oral antral fistula 0.00 0.00 0.00 0.00 0.00 0.00 YYY
closure.
D7261............... .............. R Primary closure sinus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf.
D7291............... .............. R Transseptal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
fiberotomy.
D7940............... .............. R Reshaping bone 0.00 0.00 0.00 0.00 0.00 0.00 YYY
orthognathic.
D9110............... .............. R Tx dental pain minor 0.00 0.00 0.00 0.00 0.00 0.00 YYY
proc.
D9230............... .............. R Analgesia............ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D9248............... .............. R Sedation (non-iv).... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9630............... .............. R Other drugs/ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
medicaments.
D9930............... .............. R Treatment of 0.00 0.00 0.00 0.00 0.00 0.00 YYY
complications.
D9940............... .............. R Dental occlusal guard 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D9950............... .............. R Occlusion analysis... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D9951............... .............. R Limited occlusal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
adjustment.
D9952............... .............. R Complete occlusal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
adjustment.
G0001............... .............. X Drawing blood for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
specimen.
G0008............... .............. X Admin influenza virus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vac.
G0009............... .............. X Admin pneumococcal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine.
G0010............... .............. X Admin hepatitis b 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine.
G0027............... .............. X Semen analysis....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0030............... .............. C PET imaging prev PET 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
G0030............... 26............ A PET imaging prev PET 1.50 0.58 0.58 0.05 2.13 2.13 XXX
single.
G0030............... TC............ C PET imaging prev PET 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
G0031............... .............. C PET imaging prev PET 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multple.
G0031............... 26............ A PET imaging prev PET 1.87 0.72 0.72 0.07 2.66 2.66 XXX
multple.
G0031............... TC............ C PET imaging prev PET 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multple.
G0032............... .............. C PET follow SPECT 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78464 singl.
[[Page 1238]]
G0032............... 26............ A PET follow SPECT 1.50 0.54 0.54 0.06 2.10 2.10 XXX
78464 singl.
G0032............... TC............ C PET follow SPECT 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78464 singl.
G0033............... .............. C PET follow SPECT 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78464 mult.
G0033............... 26............ A PET follow SPECT 1.87 0.74 0.74 0.07 2.68 2.68 XXX
78464 mult.
G0033............... TC............ C PET follow SPECT 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78464 mult.
G0034............... .............. C PET follow SPECT 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76865 singl.
G0034............... 26............ A PET follow SPECT 1.50 0.57 0.57 0.06 2.13 2.13 XXX
76865 singl.
G0034............... TC............ C PET follow SPECT 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76865 singl.
G0035............... .............. C PET follow SPECT 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78465 mult.
G0035............... 26............ A PET follow SPECT 1.87 0.73 0.73 0.07 2.67 2.67 XXX
78465 mult.
G0035............... TC............ C PET follow SPECT 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78465 mult.
G0036............... .............. C PET follow cornry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
angio sing.
G0036............... 26............ A PET follow cornry 1.50 0.56 0.56 0.05 2.11 2.11 XXX
angio sing.
G0036............... TC............ C PET follow cornry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
angio sing.
G0037............... .............. C PET follow cornry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
angio mult.
G0037............... 26............ A PET follow cornry 1.87 0.71 0.71 0.07 2.65 2.65 XXX
angio mult.
G0037............... TC............ C PET follow cornry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
angio mult.
G0038............... .............. C PET follow myocard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf sing.
G0038............... 26............ A PET follow myocard 1.50 0.52 0.52 0.05 2.07 2.07 XXX
perf sing.
G0038............... TC............ C PET follow myocard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf sing.
G0039............... .............. C PET follow myocard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf mult.
G0039............... 26............ A PET follow myocard 1.87 0.71 0.71 0.08 2.66 2.66 XXX
perf mult.
G0039............... TC............ C PET follow myocard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf mult.
G0040............... .............. C PET follow stress 0.00 0.00 0.00 0.00 0.00 0.00 XXX
echo singl.
G0040............... 26............ A PET follow stress 1.50 0.59 0.59 0.05 2.14 2.14 XXX
echo singl.
G0040............... TC............ C PET follow stress 0.00 0.00 0.00 0.00 0.00 0.00 XXX
echo singl.
G0041............... .............. C PET follow stress 0.00 0.00 0.00 0.00 0.00 0.00 XXX
echo mult.
G0041............... 26............ A PET follow stress 1.87 0.73 0.73 0.06 2.66 2.66 XXX
echo mult.
G0041............... TC............ C PET follow stress 0.00 0.00 0.00 0.00 0.00 0.00 XXX
echo mult.
G0042............... .............. C PET follow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventriculogm sing.
G0042............... 26............ A PET follow 1.50 0.61 0.61 0.05 2.16 2.16 XXX
ventriculogm sing.
G0042............... TC............ C PET follow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventriculogm sing.
G0043............... .............. C PET follow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventriculogm mult.
G0043............... 26............ A PET follow 1.87 0.75 0.75 0.07 2.69 2.69 XXX
ventriculogm mult.
G0043............... TC............ C PET follow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventriculogm mult.
G0044............... .............. C PET following rest 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ECG singl.
G0044............... 26............ A PET following rest 1.50 0.59 0.59 0.05 2.14 2.14 XXX
ECG singl.
G0044............... TC............ C PET following rest 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ECG singl.
G0045............... .............. C PET following rest 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ECG mult.
G0045............... 26............ A PET following rest 1.87 0.72 0.72 0.07 2.66 2.66 XXX
ECG mult.
G0045............... TC............ C PET following rest 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ECG mult.
G0046............... .............. C PET follow stress ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0046............... 26............ A PET follow stress ECG 1.50 0.59 0.59 0.05 2.14 2.14 XXX
singl.
G0046............... TC............ C PET follow stress ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0047............... .............. C PET follow stress ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0047............... 26............ A PET follow stress ECG 1.87 0.73 0.73 0.07 2.67 2.67 XXX
mult.
G0047............... TC............ C PET follow stress ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0101............... .............. A CA screen;pelvic/ 0.45 0.52 0.17 0.01 0.98 0.63 XXX
breast exam.
G0102............... .............. A Prostate ca 0.17 0.39 0.06 0.01 0.57 0.24 XXX
screening; dre.
G0103............... .............. X Psa, total screening. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0104............... .............. A CA screen;flexi 0.96 2.20 0.52 0.06 3.22 1.54 000
sigmoidscope.
G0105............... .............. A Colorectal scrn; hi 3.69 6.04 1.58 0.24 9.97 5.51 000
risk ind.
G0105............... 53............ A Colorectal scrn; hi 0.96 2.20 0.52 0.06 3.22 1.54 000
risk ind.
G0106............... .............. A Colon CA 0.99 2.57 NA 0.18 3.74 NA XXX
screen;barium enema.
G0106............... 26............ A Colon CA 0.99 0.33 0.33 0.05 1.37 1.37 XXX
screen;barium enema.
G0106............... TC............ A Colon CA 0.00 2.24 NA 0.13 2.37 NA XXX
screen;barium enema.
G0107............... .............. X CA screen; fecal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
blood test.
G0108............... .............. A Diab manage trn per 0.00 0.84 NA 0.01 0.85 NA XXX
indiv.
G0109............... .............. A Diab manage trn ind/ 0.00 0.48 NA 0.01 0.49 NA XXX
group.
G0110............... .............. R Nett pulm-rehab educ; 0.90 0.70 0.30 0.04 1.64 1.24 XXX
ind.
G0111............... .............. R Nett pulm-rehab educ; 0.27 0.29 0.14 0.01 0.57 0.42 XXX
group.
G0112............... .............. R Nett;nutrition guid, 1.72 1.20 0.66 0.06 2.98 2.44 XXX
initial.
G0113............... .............. R Nett;nutrition 1.29 0.83 0.41 0.05 2.17 1.75 XXX
guid,subseqnt.
G0114............... .............. R Nett; psychosocial 1.20 0.49 0.37 0.04 1.73 1.61 XXX
consult.
G0115............... .............. R Nett; psychological 1.20 0.64 0.37 0.05 1.89 1.62 XXX
testing.
G0116............... .............. R Nett; psychosocial 1.11 1.01 0.34 0.05 2.17 1.50 XXX
counsel.
G0117............... .............. T Glaucoma scrn hgh 0.45 0.71 0.19 0.02 1.18 0.66 XXX
risk direc.
G0118............... .............. T Glaucoma scrn hgh 0.17 0.52 0.07 0.01 0.70 0.25 XXX
risk direc.
G0120............... .............. A Colon ca scrn; barium 0.99 2.57 NA 0.18 3.74 NA XXX
enema.
G0120............... 26............ A Colon ca scrn; barium 0.99 0.33 0.33 0.05 1.37 1.37 XXX
enema.
G0120............... TC............ A Colon ca scrn; barium 0.00 2.24 NA 0.13 2.37 NA XXX
enema.
G0121............... .............. A Colon ca scrn not hi 3.69 6.04 1.58 0.24 9.97 5.51 000
rsk ind.
G0121............... 53............ A Colon ca scrn not hi 0.96 2.20 0.52 0.06 3.22 1.54 000
rsk ind.
G0122............... .............. N Colon ca scrn; barium +0.99 2.57 2.57 0.18 3.74 3.74 XXX
enema.
G0122............... 26............ N Colon ca scrn; barium +0.99 0.38 0.38 0.05 1.42 1.42 XXX
enema.
[[Page 1239]]
G0122............... TC............ N Colon ca scrn; barium +0.00 2.19 2.19 0.13 2.32 2.32 XXX
enema.
G0123............... .............. X Screen cerv/vag thin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
layer.
G0124............... .............. A Screen c/v thin layer 0.42 0.18 0.18 0.01 0.61 0.61 XXX
by MD.
G0125............... .............. C PET image pulmonary 0.00 0.00 NA 0.00 0.00 NA XXX
nodule.
G0125............... 26............ A PET image pulmonary 1.50 0.52 0.52 0.06 2.08 2.08 XXX
nodule.
G0125............... TC............ C PET image pulmonary 0.00 0.00 NA 0.00 0.00 NA XXX
nodule.
G0127............... .............. R Trim nail(s)......... 0.17 0.25 0.07 0.01 0.43 0.25 000
G0128............... .............. R CORF skilled nursing 0.08 0.03 0.03 0.01 0.12 0.12 XXX
service.
G0130............... .............. A Single energy x-ray 0.22 0.88 NA 0.06 1.16 NA XXX
study.
G0130............... 26............ A Single energy x-ray 0.22 0.07 0.07 0.01 0.30 0.30 XXX
study.
G0130............... TC............ A Single energy x-ray 0.00 0.81 NA 0.05 0.86 NA XXX
study.
G0141............... .............. A Scr c/v cyto,autosys 0.42 0.18 0.18 0.01 0.61 0.61 XXX
and md.
G0143............... .............. X Scr c/v 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cyto,thinlayer,rescr.
G0144............... .............. X Scr c/v 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cyto,thinlayer,rescr.
G0145............... .............. X Scr c/v 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cyto,thinlayer,rescr.
G0147............... .............. X Scr c/v cyto, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
automated sys.
G0148............... .............. X Scr c/v cyto, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
autosys, rescr.
G0166............... .............. A Extrnl counterpulse, 0.07 3.58 0.03 0.01 3.66 0.11 XXX
per tx.
G0167............... .............. D Hyperbaric oz tx;no 0.00 0.00 0.00 0.00 0.00 0.00 XXX
md reqrd.
G0168............... .............. A Wound closure by 0.45 1.92 0.16 0.01 2.38 0.62 000
adhesive.
G0173............... .............. X Stereo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
radoisurgery,complet
e.
G0175............... .............. X OPPS Service,sched 0.00 0.00 0.00 0.00 0.00 0.00 XXX
team conf.
G0176............... .............. X OPPS/PHP;activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
G0177............... .............. X OPPS/PHP; train & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
educ serv.
G0179............... .............. A MD recertification 0.45 1.07 NA 0.01 1.53 NA XXX
HHA PT.
G0180............... .............. A MD certification HHA 0.67 1.29 NA 0.02 1.98 NA XXX
patient.
G0181............... .............. A Home health care 1.73 1.52 NA 0.07 3.32 NA XXX
supervision.
G0182............... .............. A Hospice care 1.73 1.71 NA 0.07 3.51 NA XXX
supervision.
G0186............... .............. C Dstry eye lesn,fdr 0.00 0.00 0.00 0.00 0.00 0.00 YYY
vssl tech.
G0202............... .............. A Screeningmammographyd 0.70 2.79 NA 0.11 3.60 NA XXX
igital.
G0202............... 26............ A Screeningmammographyd 0.70 0.23 0.23 0.04 0.97 0.97 XXX
igital.
G0202............... TC............ A Screeningmammographyd 0.00 2.56 NA 0.07 2.63 NA XXX
igital.
G0204............... .............. A Diagnosticmammography 0.87 2.81 NA 0.12 3.80 NA XXX
digital.
G0204............... 26............ A Diagnosticmammography 0.87 0.29 0.29 0.05 1.21 1.21 XXX
digital.
G0204............... TC............ A Diagnosticmammography 0.00 2.52 NA 0.07 2.59 NA XXX
digital.
G0206............... .............. A Diagnosticmammography 0.70 2.25 NA 0.11 3.06 NA XXX
digital.
G0206............... 26............ A Diagnosticmammography 0.70 0.23 0.23 0.05 0.98 0.98 XXX
digital.
G0206............... TC............ A Diagnosticmammography 0.00 2.02 NA 0.06 2.08 NA XXX
digital.
G0210............... .............. C PET img wholebody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dxlung.
G0210............... 26............ A PET img wholebody 1.50 0.51 0.51 0.05 2.06 2.06 XXX
dxlung.
G0210............... TC............ C PET img wholebody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dxlung.
G0211............... .............. C PET img wholbody init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lung.
G0211............... 26............ A PET img wholbody init 1.50 0.51 0.51 0.05 2.06 2.06 XXX
lung.
G0211............... TC............ C PET img wholbody init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lung.
G0212............... .............. C PET img wholebod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag lung.
G0212............... 26............ A PET img wholebod 1.50 0.51 0.51 0.05 2.06 2.06 XXX
restag lung.
G0212............... TC............ C PET img wholebod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag lung.
G0213............... .............. C PET img wholbody dx.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0213............... 26............ A PET img wholbody dx.. 1.50 0.51 0.51 0.05 2.06 2.06 XXX
G0213............... TC............ C PET img wholbody dx.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0214............... .............. C PET img wholebod init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0214............... 26............ A PET img wholebod init 1.50 0.51 0.51 0.05 2.06 2.06 XXX
G0214............... TC............ C PET img wholebod init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0215............... .............. C PETimg wholebod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag.
G0215............... 26............ A PETimg wholebod 1.50 0.51 0.51 0.05 2.06 2.06 XXX
restag.
G0215............... TC............ C PETimg wholebod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag.
G0216............... .............. C PET img wholebod dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melanoma.
G0216............... 26............ A PET img wholebod dx 1.50 0.51 0.51 0.05 2.06 2.06 XXX
melanoma.
G0216............... TC............ C PET img wholebod dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melanoma.
G0217............... .............. C PET img wholebod init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melan.
G0217............... 26............ A PET img wholebod init 1.50 0.51 0.51 0.05 2.06 2.06 XXX
melan.
G0217............... TC............ C PET img wholebod init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melan.
G0218............... .............. C PET img wholebod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag mela.
G0218............... 26............ A PET img wholebod 1.50 0.52 0.52 0.05 2.07 2.07 XXX
restag mela.
G0218............... TC............ C PET img wholebod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag mela.
G0219............... .............. N PET img wholbod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melano nonco.
G0219............... 26............ N PET img wholbod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melano nonco.
G0219............... TC............ N PET img wholbod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melano nonco.
G0220............... .............. C PET img wholebod dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lymphoma.
G0220............... 26............ A PET img wholebod dx 1.50 0.51 0.51 0.05 2.06 2.06 XXX
lymphoma.
G0220............... TC............ C PET img wholebod dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lymphoma.
G0221............... .............. C PET imag wholbod init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lympho.
G0221............... 26............ A PET imag wholbod init 1.50 0.51 0.51 0.05 2.06 2.06 XXX
lympho.
G0221............... TC............ C PET imag wholbod init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lympho.
G0222............... .............. C PET imag wholbod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resta lymph.
[[Page 1240]]
G0222............... 26............ A PET imag wholbod 1.50 0.52 0.52 0.05 2.07 2.07 XXX
resta lymph.
G0222............... TC............ C PET imag wholbod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resta lymph.
G0223............... .............. C PET imag wholbod reg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dx head.
G0223............... 26............ A PET imag wholbod reg 1.50 0.51 0.51 0.05 2.06 2.06 XXX
dx head.
G0223............... TC............ C PET imag wholbod reg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dx head.
G0224............... .............. C PET imag wholbod reg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ini hea.
G0224............... 26............ A PET imag wholbod reg 1.50 0.51 0.51 0.05 2.06 2.06 XXX
ini hea.
G0224............... TC............ C PET imag wholbod reg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ini hea.
G0225............... .............. C PET whol restag 0.00 0.00 0.00 0.00 0.00 0.00 XXX
headneckonly.
G0225............... 26............ A PET whol restag 1.50 0.52 0.52 0.05 2.07 2.07 XXX
headneckonly.
G0225............... TC............ C PET whol restag 0.00 0.00 0.00 0.00 0.00 0.00 XXX
headneckonly.
G0226............... .............. C PET img wholbody dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esophagl.
G0226............... 26............ A PET img wholbody dx 1.50 0.53 0.53 0.05 2.08 2.08 XXX
esophagl.
G0226............... TC............ C PET img wholbody dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esophagl.
G0227............... .............. C PET img wholbod ini 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esophage.
G0227............... 26............ A PET img wholbod ini 1.50 0.52 0.52 0.05 2.07 2.07 XXX
esophage.
G0227............... TC............ C PET img wholbod ini 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esophage.
G0228............... .............. C PET img wholbod restg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esopha.
G0228............... 26............ A PET img wholbod restg 1.50 0.51 0.51 0.05 2.06 2.06 XXX
esopha.
G0228............... TC............ C PET img wholbod restg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esopha.
G0229............... .............. C PET img metaboloc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
brain pres.
G0229............... 26............ A PET img metaboloc 1.50 0.51 0.51 0.05 2.06 2.06 XXX
brain pres.
G0229............... TC............ C PET img metaboloc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
brain pres.
G0230............... .............. C PET myocard viability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
post.
G0230............... 26............ A PET myocard viability 1.50 0.53 0.53 0.05 2.08 2.08 XXX
post.
G0230............... TC............ C PET myocard viability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
post.
G0231............... .............. C PET WhBD colorec; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0231............... 26............ A PET WhBD colorec; 1.50 0.51 0.51 0.05 2.06 2.06 XXX
gamma cam.
G0231............... TC............ C PET WhBD colorec; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0232............... .............. C PET whbd lymphoma; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0232............... 26............ A PET whbd lymphoma; 1.50 0.52 0.52 0.05 2.07 2.07 XXX
gamma cam.
G0232............... TC............ C PET whbd lymphoma; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0233............... .............. C PET whbd melanoma; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0233............... 26............ A PET whbd melanoma; 1.50 0.52 0.52 0.05 2.07 2.07 XXX
gamma cam.
G0233............... TC............ C PET whbd melanoma; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0234............... .............. C PET WhBD pulm nod; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0234............... 26............ A PET WhBD pulm nod; 1.50 0.52 0.52 0.05 2.07 2.07 XXX
gamma cam.
G0234............... TC............ C PET WhBD pulm nod; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0236............... .............. F Digital film convert +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
diag ma.
G0236............... 26............ F Digital film convert +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
diag ma.
G0236............... TC............ F Digital film convert +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
diag ma.
G0237............... .............. A Therapeutic procd 0.00 0.47 NA 0.02 0.49 NA XXX
strg endur.
G0238............... .............. C Oth resp proc, indiv. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0239............... .............. C Oth resp proc, group. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0242............... .............. X Multisource photon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ster plan.
G0243............... .............. X Multisour photon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stero treat.
G0244............... .............. E Observ care by 0.00 0.00 0.00 0.00 0.00 0.00 XXX
facility topt.
G0245............... .............. R Initial foot exam pt 0.88 0.79 0.32 0.06 1.73 1.26 XXX
lops.
G0246............... .............. R Followup eval of foot 0.45 0.54 0.16 0.02 1.01 0.63 XXX
pt lop.
G0247............... .............. R Routine footcare pt w 0.50 0.51 0.21 0.06 1.07 0.77 ZZZ
lops.
G0248............... .............. R Demonstrate use home 0.00 6.75 NA 0.01 6.76 NA XXX
inr mon.
G0249............... .............. R Provide test 0.00 3.91 NA 0.01 3.92 NA XXX
material,equipm.
G0250............... .............. R MD review interpret 0.18 0.06 0.06 0.01 0.25 0.25 XXX
of test.
G0251............... .............. E Linear acc based 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stero radio.
G0252............... .............. N PET imaging initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dx.
G0252............... 26............ N PET imaging initial +1.50 0.60 0.60 0.04 2.14 2.14 XXX
dx.
G0252............... TC............ N PET imaging initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dx.
G0253............... .............. C PET image brst 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dection recur.
G0253............... 26............ A PET image brst 1.87 0.71 0.71 0.08 2.66 2.66 XXX
dection recur.
G0253............... TC............ C PET image brst 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dection recur.
G0254............... .............. C PET image brst eval 0.00 0.00 0.00 0.00 0.00 0.00 XXX
to tx.
G0254............... 26............ A PET image brst eval 1.87 0.71 0.71 0.08 2.66 2.66 XXX
to tx.
G0254............... TC............ C PET image brst eval 0.00 0.00 0.00 0.00 0.00 0.00 XXX
to tx.
G0255............... .............. N Current percep 0.00 0.00 0.00 0.00 0.00 0.00 XXX
threshold tst.
G0255............... 26............ N Current percep 0.00 0.00 0.00 0.00 0.00 0.00 XXX
threshold tst.
G0255............... TC............ N Current percep 0.00 0.00 0.00 0.00 0.00 0.00 XXX
threshold tst.
G0256............... .............. D Prostate brachy w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
palladium.
G0257............... .............. E Unsched dialysis ESRD 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pt hos.
G0258............... .............. E IV infusion during 0.00 0.00 0.00 0.00 0.00 0.00 XXX
obs stay.
G0259............... .............. E Inject for sacroiliac 0.00 0.00 0.00 0.00 0.00 0.00 XXX
joint.
G0260............... .............. E Inj for sacroiliac jt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anesth.
G0261............... .............. D Prostate brachy w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
iodine see.
G0262............... .............. D Sm intestinal image 0.00 0.00 0.00 0.00 0.00 0.00 XXX
capsule.
G0262............... 26............ D Sm intestinal image 0.00 0.00 0.00 0.00 0.00 0.00 XXX
capsule.
G0262............... TC............ D Sm intestinal image 0.00 0.00 0.00 0.00 0.00 0.00 XXX
capsule.
[[Page 1241]]
G0263............... .............. E Adm with CHF, CP, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
asthma.
G0264............... .............. E Assmt otr CHF, CP, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
asthma.
G0265............... .............. X Cryopresevation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Freeze+stora.
G0266............... .............. X Thawing + expansion 0.00 0.00 0.00 0.00 0.00 0.00 XXX
froz cel.
G0267............... .............. X Bone marrow or psc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
G0268............... .............. A Removal of impacted 0.61 0.63 0.25 0.05 1.29 0.91 000
wax md.
G0269............... .............. B Occlusive device in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vein art.
G0270............... .............. A MNT subs tx for 0.00 0.47 NA 0.01 0.48 NA XXX
change dx.
G0271............... .............. A Group MNT 2 or more 0.00 0.19 NA 0.01 0.20 NA XXX
30 mins.
G0272............... .............. D Naso/oro gastric tube 0.00 0.00 0.00 0.00 0.00 0.00 000
pl MD.
G0273............... .............. D Pretx planning, non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Hodgkins.
G0273............... 26............ D Pretx planning, non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Hodgkins.
G0273............... TC............ D Pretx planning, non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Hodgkins.
G0274............... .............. D Radiopharm tx, non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Hodgkins.
G0274............... 26............ D Radiopharm tx, non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Hodgkins.
G0274............... TC............ D Radiopharm tx, non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Hodgkins.
G0275............... .............. A Renal angio, cardiac 0.25 NA 0.10 0.01 NA 0.36 ZZZ
cath.
G0278............... .............. A Iliac art 0.25 NA 0.10 0.01 NA 0.36 ZZZ
angio,cardiac cath.
G0279............... .............. C Excorp shock tx, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
elbow epi.
G0280............... .............. C Excorp shock tx other 0.00 0.00 0.00 0.00 0.00 0.00 XXX
than.
G0281............... .............. A Elec stim unattend 0.18 0.11 NA 0.01 0.30 NA XXX
for press.
G0282............... .............. N Elect stim wound care 0.00 0.00 0.00 0.00 0.00 0.00 XXX
not pd.
G0283............... .............. A Elec stim other than 0.18 0.11 NA 0.01 0.30 NA XXX
wound.
G0288............... .............. A Recon, CTA for surg 0.00 10.66 NA 0.18 10.84 NA XXX
plan.
G0289............... .............. A Arthro, loose body + 1.48 NA 0.56 0.33 NA 2.37 ZZZ
chondro.
G0290............... .............. E Drug-eluting stents, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
G0291............... .............. E Drug-eluting 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stents,each add.
G0292............... .............. E Adm exp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
drugs,clinical trial.
G0293............... .............. E Non-cov surg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
proc,clin trial.
G0294............... .............. E Non-cov proc, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
clinical trial.
G0295............... .............. N Electromagnetic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy onc.
G0296............... .............. C PET imge restag 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thyrod cance.
G0296............... 26............ A PET imge restag 1.87 0.71 0.71 0.08 2.66 2.66 XXX
thyrod cance.
G0296............... TC............ C PET imge restag 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thyrod cance.
G0297............... .............. X Insert single chamber/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cd.
G0298............... .............. X Insert dual chamber/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cd.
G0299............... .............. X Inser/repos single 0.00 0.00 0.00 0.00 0.00 0.00 XXX
icd+leads.
G0300............... .............. X Insert reposit lead 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dual+gen.
G0302............... .............. X Pre-op service LVRS 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
G0303............... .............. X Pre-op service LVRS 0.00 0.00 0.00 0.00 0.00 0.00 XXX
10-15dos.
G0304............... .............. X Pre-op service LVRS 1- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
9 dos.
G0305............... .............. X Post op service LVRS 0.00 0.00 0.00 0.00 0.00 0.00 XXX
min 6.
G0306............... .............. X CBC/diffwbc w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
platelet.
G0307............... .............. X CBC without platelet. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0308............... .............. A ESRD related svc 12.74 8.54 8.54 0.42 21.70 21.70 XXX
4+mo<2yrs.
G0309............... .............. A ESRD related svc 2- 10.61 7.10 7.10 0.36 18.07 18.07 XXX
3mo<2yrs.
G0310............... .............. A ESRD related svc 1 8.49 5.68 5.68 0.28 14.45 14.45 XXX
visit<2yr.
G0311............... .............. A ESRD related svs 4+mo 9.73 4.72 4.72 0.34 14.79 14.79 XXX
2-11yr.
G0312............... .............. A ESRD relate svs 2-3 8.11 3.92 3.92 0.29 12.32 12.32 XXX
mo 2-11y.
G0313............... .............. A ESRD related svs 1 6.49 3.14 3.14 0.22 9.85 9.85 XXX
mon 2-11y.
G0314............... .............. A ESRD related svs 4+ 8.28 4.42 4.42 0.27 12.97 12.97 XXX
mo 12-19.
G0315............... .............. A ESRD related svs 2- 6.90 3.67 3.67 0.23 10.80 10.80 XXX
3mo 12-19.
G0316............... .............. A ESRD relate svs 1 5.52 2.94 2.94 0.17 8.63 8.63 XXX
vist 12-19.
G0317............... .............. A ESRD related svs 4+mo 5.09 2.86 2.86 0.17 8.12 8.12 XXX
20+yrs.
G0318............... .............. A ESRD related svs 2-3 4.24 2.38 2.38 0.14 6.76 6.76 XXX
mo 20+y.
G0319............... .............. A ESRD related svs 1 3.39 1.90 1.90 0.11 5.40 5.40 XXX
visit 20+.
G0320............... .............. A ESRD related svs home 10.61 7.10 7.10 0.36 18.07 18.07 XXX
under2.
G0321............... .............. A ESRD related svs home 6.90 3.67 3.67 0.23 10.80 10.80 XXX
mo<2ys.
G0322............... .............. A ESRD relate svs home 8.11 3.92 3.92 0.29 12.32 12.32 XXX
mo12-19.
G0323............... .............. A ESRD related svs home 4.24 2.38 2.38 0.14 6.76 6.76 XXX
mo 20+.
G0324............... .............. A ESRD related svs home/ 0.35 0.24 0.24 0.01 0.60 0.60 XXX
dy<2y.
G0325............... .............. A ESRD relate home/dy 2- 0.23 0.12 0.12 0.01 0.36 0.36 XXX
11 yr.
G0326............... .............. A ESRD relate home/dy 0.27 0.13 0.13 0.01 0.41 0.41 XXX
12-19y.
G0327............... .............. A ESRD relate home/dy 0.14 0.08 0.08 0.01 0.23 0.23 XXX
20+yrs.
G0328............... .............. X Fecal blood scrn 0.00 0.00 0.00 0.00 0.00 0.00 XXX
immunoassay.
G0338............... .............. X Linear accelerator 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stero pln.
G0339............... .............. X Robot lin-radsurg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
com, first.
G0340............... .............. X Robot linear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
steroradio max5.
G3001............... .............. X Admin + supply, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tositumomab.
G9001............... .............. X MCCD, initial rate... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9002............... .............. X MCCD,maintenance rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9003............... .............. X MCCD, risk adj hi, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
initial.
G9004............... .............. X MCCD, risk adj lo, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
initial.
G9005............... .............. X MCCD, risk adj, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maintenance.
G9006............... .............. X MCCD, Home monitoring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 1242]]
G9007............... .............. X MCCD, sch team conf.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9008............... .............. X Mccd,phys coor-care 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ovrsght.
G9009............... .............. X MCCD, risk adj, level 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3.
G9010............... .............. X MCCD, risk adj, level 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.
G9011............... .............. X MCCD, risk adj, level 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5.
G9012............... .............. X Other Specified Case 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Mgmt.
G9016............... .............. N Demo-smoking 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cessation coun.
M0064............... .............. A Visit for drug 0.37 0.34 0.12 0.01 0.72 0.50 XXX
monitoring.
P3001............... .............. A Screening pap smear 0.42 0.18 0.18 0.01 0.61 0.61 XXX
by phys.
Q0035............... .............. A Cardiokymography..... 0.17 0.45 NA 0.03 0.65 NA XXX
Q0035............... 26............ A Cardiokymography..... 0.17 0.07 0.07 0.01 0.25 0.25 XXX
Q0035............... TC............ A Cardiokymography..... 0.00 0.38 NA 0.02 0.40 NA XXX
Q0091............... .............. A Obtaining screen pap 0.37 0.66 0.14 0.01 1.04 0.52 XXX
smear.
Q0092............... .............. A Set up port xray 0.00 0.32 NA 0.01 0.33 NA XXX
equipment.
Q3014............... .............. X Telehealth facility 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fee.
R0070............... .............. C Transport portable x- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ray.
R0075............... .............. C Transport port x-ray 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multipl.
R0076............... .............. B Transport portable 0.00 0.00 0.00 0.00 0.00 0.00 XXX
EKG.
V5299............... .............. R Hearing service...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ 1 CPT codes and descriptions only are copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 2003 American Dental Association. All rights reserved.
\3\ + Indicates RVUs are not used for Medicare payment.
Federal Register / Vol. 69, No. 4 / Wednesday, January 7, 2004 /
Rules and Regulations
[[Page 1242]]
--------------------
\1\ CPT codes and descriptions only are copyright 2003 American Medical
Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 2003 American Dental Association. All rights reserved.
\3\ + Indicates RVUs are not used for Medicare payment.
[[Page 1242]]
Addendum C.--Codes With Interim RVUs
--------------------------------------------------------------------------------------------------------------------------------------------------------
Physician Non- Mal- Non-
CPT \1\ HCPCS \2\ MOD Status Description work facility Facility practice facility Facility Global
RVUs \3\ PE RVUs PE RVUs RVUs total total
--------------------------------------------------------------------------------------------------------------------------------------------------------
11400............... .............. A Exc tr-ext b9+marg 0.85 2.00 0.89 0.07 2.92 1.81 010
0.5 < cm.
11401............... .............. A Exc tr-ext b9+marg 1.23 2.07 1.03 0.11 3.41 2.37 010
0.6-1 cm.
11402............... .............. A Exc tr-ext b9+marg 1.51 2.25 1.10 0.14 3.90 2.75 010
1.1-2 cm.
11403............... .............. A Exc tr-ext b9+marg 1.79 2.42 1.33 0.19 4.40 3.31 010
2.1-3 cm.
11404............... .............. A Exc tr-ext b9+marg 2.06 2.73 1.41 0.22 5.01 3.69 010
3.1-4 cm.
11406............... .............. A Exc tr-ext b9+marg 2.76 3.10 1.67 0.30 6.16 4.73 010
4.0 cm.
11420............... .............. A Exc h-f-nk-sp b9+marg 0.98 1.77 0.94 0.10 2.85 2.02 010
0.5 <.
11421............... .............. A Exc h-f-nk-sp b9+marg 1.42 2.08 1.12 0.13 3.63 2.67 010
0.6-1.
11422............... .............. A Exc h-f-nk-sp b9+marg 1.63 2.27 1.34 0.17 4.07 3.14 010
1.1-2.
11423............... .............. A Exc h-f-nk-sp b9+marg 2.01 2.61 1.46 0.21 4.83 3.68 010
2.1-3.
11424............... .............. A Exc h-f-nk-sp b9+marg 2.43 2.82 1.61 0.25 5.50 4.29 010
3.1-4.
11426............... .............. A Exc h-f-nk-sp b9+marg 3.77 3.52 2.11 0.41 7.70 6.29 010
4 cm.
11440............... .............. A Exc face-mm b9+marg 1.06 2.28 1.33 0.10 3.44 2.49 010
0.5 < cm.
11441............... .............. A Exc face-mm b9+marg 1.48 2.40 1.51 0.13 4.01 3.12 010
0.6-1 cm.
11442............... .............. A Exc face-mm b9+marg 1.72 2.59 1.58 0.17 4.48 3.47 010
1.1-2 cm.
11443............... .............. A Exc face-mm b9+marg 2.29 2.97 1.83 0.22 5.48 4.34 010
2.1-3 cm.
11444............... .............. A Exc face-mm b9+marg 3.14 3.54 2.19 0.30 6.98 5.63 010
3.1-4 cm.
11446............... .............. A Exc face-mm b9+marg 4.48 4.11 2.78 0.36 8.95 7.62 010
4 cm.
11600............... .............. A Exc tr-ext mlg+marg 1.31 2.65 0.98 0.11 4.07 2.40 010
0.5 < cm.
11601............... .............. A Exc tr-ext mlg+marg 1.80 2.72 1.23 0.14 4.66 3.17 010
0.6-1 cm.
11602............... .............. A Exc tr-ext mlg+marg 1.95 2.86 1.27 0.16 4.97 3.38 010
1.1-2 cm.
11603............... .............. A Exc tr-ext mlg+marg 2.19 3.11 1.33 0.19 5.49 3.71 010
2.1-3 cm.
11604............... .............. A Exc tr-ext mlg+marg 2.40 3.41 1.40 0.22 6.03 4.02 010
3.1-4 cm.
11606............... .............. A Exc tr-ext mlg+marg 3.42 4.11 1.75 0.34 7.87 5.51 010
4 cm.
11620............... .............. A Exc h-f-nk-sp 1.19 2.62 0.96 0.11 3.92 2.26 010
mlg+marg 0.5 <.
11621............... .............. A Exc h-f-nk-sp 1.76 2.73 1.25 0.14 4.63 3.15 010
mlg+marg 0.6-1.
11622............... .............. A Exc h-f-nk-sp 2.09 3.00 1.39 0.18 5.27 3.66 010
mlg+marg 1.1-2.
11623............... .............. A Exc h-f-nk-sp 2.61 3.36 1.59 0.24 6.21 4.44 010
mlg+marg 2.1-3.
11624............... .............. A Exc h-f-nk-sp 3.06 3.79 1.78 0.30 7.15 5.14 010
mlg+marg 3.1-4.
11626............... .............. A Exc h-f-nk-sp mlg+mar 4.29 4.70 2.40 0.42 9.41 7.11 010
4 cm.
11640............... .............. A Exc face-mm 1.35 2.69 1.12 0.12 4.16 2.59 010
malig+marg 0.5 <.
11641............... .............. A Exc face-mm 2.16 3.06 1.54 0.18 5.40 3.88 010
malig+marg 0.6-1.
11642............... .............. A Exc face-mm 2.59 3.44 1.73 0.22 6.25 4.54 010
malig+marg 1.1-2.
11643............... .............. A Exc face-mm 3.10 3.85 1.96 0.29 7.24 5.35 010
malig+marg 2.1-3.
11644............... .............. A Exc face-mm 4.02 4.74 2.47 0.40 9.16 6.89 010
malig+marg 3.1-4.
11646............... .............. A Exc face-mm mlg+marg 5.94 5.81 3.49 0.55 12.30 9.98 010
4 cm.
20982............... .............. A Ablate, bone tumor(s) 7.27 105.35 2.99 0.69 113.31 10.95 000
perq.
21030............... .............. A Excise max/zygoma b9 4.49 6.84 4.31 0.72 12.05 9.52 090
tumor.
21040............... .............. A Excise mandible 4.49 6.87 4.14 0.23 11.59 8.86 090
lesion.
21685............... .............. A Hyoid myotomy & 12.98 NA 10.09 1.52 NA 24.59 090
suspension.
21742............... .............. C Repair stern/nuss w/o 0.00 0.00 0.00 0.00 0.00 0.00 090
scope.
21743............... .............. C Repair sternum/nuss w/ 0.00 0.00 0.00 0.00 0.00 0.00 090
scope.
22532............... .............. A Lat thorax spine 23.96 NA 14.82 4.56 NA 43.34 090
fusion.
22533............... .............. A Lat lumbar spine 23.09 NA 13.48 3.84 NA 40.41 090
fusion.
22534............... .............. A Lat thor/lumb, add'l 5.99 NA 3.04 1.18 NA 10.21 ZZZ
seg.
[[Page 1243]]
31622............... .............. A Dx bronchoscope/wash. 2.78 4.17 0.89 0.17 7.12 3.84 000
31623............... .............. A Dx bronchoscope/brush 2.88 5.05 0.89 0.17 8.10 3.94 000
31624............... .............. A Dx bronchoscope/ 2.88 4.28 0.90 0.16 7.32 3.94 000
lavage.
31625............... .............. A Bronchoscopy w/ 3.36 5.37 1.26 0.19 8.92 4.81 000
biopsy(s).
31628............... .............. A Bronchoscopy/lung bx, 3.80 5.53 1.34 0.17 9.50 5.31 000
each.
31629............... .............. A Bronchoscopy/needle 3.36 NA 1.22 0.16 NA 4.74 000
bx, each.
31630............... .............. A Bronchoscopy dilate/ 3.81 NA 2.00 0.36 NA 6.17 000
fx repr.
31631............... .............. A Bronchoscopy, dilate 4.36 NA 2.02 0.37 NA 6.75 000
w/stent.
31632............... .............. A Bronchoscopy/lung bx, 1.03 0.76 0.32 0.17 1.96 1.52 ZZZ
add'l.
31633............... .............. A Bronchoscopy/needle 1.32 0.91 0.40 0.17 2.40 1.89 ZZZ
bx add'l.
31635............... .............. A Bronchoscopy w/fb 3.67 NA 1.67 0.25 NA 5.59 000
removal.
31640............... .............. A Bronchoscopy w/tumor 4.93 NA 2.35 0.45 NA 7.73 000
excise.
33310............... .............. A Exploratory heart 18.48 NA 9.65 2.73 NA 30.86 090
surgery.
33315............... .............. A Exploratory heart 22.34 NA 10.95 3.50 NA 36.79 090
surgery.
34805............... .............. A Endovasc abdo repair 21.85 NA 9.46 1.99 NA 33.30 090
w/pros.
35510............... .............. A Artery bypass graft.. 22.97 NA 10.17 2.10 NA 35.24 090
35512............... .............. A Artery bypass graft.. 22.47 NA 10.00 2.10 NA 34.57 090
35522............... .............. A Artery bypass graft.. 21.73 NA 9.74 2.10 NA 33.57 090
35525............... .............. A Artery bypass graft.. 20.60 NA 9.35 2.10 NA 32.05 090
35697............... .............. A Reimplant artery each 3.00 NA 1.03 0.41 NA 4.44 ZZZ
36511............... .............. A Apheresis wbc........ 1.74 NA 0.71 0.07 NA 2.52 000
36512............... .............. A Apheresis rbc........ 1.74 NA 0.71 0.07 NA 2.52 000
36513............... .............. A Apheresis platelets.. 1.74 NA 0.71 0.07 NA 2.52 000
36514............... .............. A Apheresis plasma..... 1.74 NA 0.71 0.07 NA 2.52 000
36515............... .............. A Apheresis, adsorp/ 1.74 NA 0.73 0.07 NA 2.54 000
reinfuse.
36516............... .............. A Apheresis, selective. 1.22 NA 0.51 0.07 NA 1.80 000
36555............... .............. A Insert non-tunnel cv 2.68 6.00 0.82 0.21 8.89 3.71 000
cath.
36556............... .............. A Insert non-tunnel cv 2.50 5.85 0.74 0.10 8.45 3.34 000
cath.
36557............... .............. A Insert tunneled cv 5.09 13.56 2.58 0.59 19.24 8.26 010
cath.
36558............... .............. A Insert tunneled cv 4.79 13.45 2.47 0.59 18.83 7.85 010
cath.
36560............... .............. A Insert tunneled cv 6.24 29.19 2.96 0.59 36.02 9.79 010
cath.
36561............... .............. A Insert tunneled cv 5.99 29.11 2.87 0.59 35.69 9.45 010
cath.
36563............... .............. A Insert tunneled cv 6.19 38.09 2.98 0.68 44.96 9.85 010
cath.
36565............... .............. A Insert tunneled cv 5.99 22.15 2.87 0.59 28.73 9.45 010
cath.
36566............... .............. A Insert tunneled cv 6.49 22.95 3.04 0.59 30.03 10.12 010
cath.
36568............... .............. A Insert tunneled cv 1.92 8.19 0.59 0.21 10.32 2.72 000
cath.
36569............... .............. A Insert tunneled cv 1.82 7.39 0.57 0.16 9.37 2.55 000
cath.
36570............... .............. A Insert tunneled cv 5.31 40.27 2.64 0.59 46.17 8.54 010
cath.
36571............... .............. A Insert tunneled cv 5.29 35.64 2.63 0.59 41.52 8.51 010
cath.
36575............... .............. A Repair tunneled cv 0.67 3.35 0.26 0.59 4.61 1.52 000
cath.
36576............... .............. A Repair tunneled cv 3.19 7.71 1.76 0.59 11.49 5.54 010
cath.
36578............... .............. A Replace tunneled cv 3.49 10.54 2.20 0.59 14.62 6.28 010
cath.
36580............... .............. A Replace tunneled cv 1.31 6.76 0.41 0.16 8.23 1.88 000
cath.
36581............... .............. A Replace tunneled cv 3.43 13.27 1.84 0.59 17.29 5.86 010
cath.
36582............... .............. A Replace tunneled cv 5.19 26.63 2.76 0.59 32.41 8.54 010
cath.
36583............... .............. A Replace tunneled cv 5.24 13.13 2.77 0.59 18.96 8.60 010
cath.
36584............... .............. A Replace tunneled cv 1.20 7.23 0.54 0.16 8.59 1.90 000
cath.
36585............... .............. A Replace tunneled cv 4.79 35.46 2.62 0.59 40.84 8.00 010
cath.
36589............... .............. A Removal tunneled cv 2.27 2.20 1.41 0.25 4.72 3.93 010
cath.
36590............... .............. A Removal tunneled cv 3.30 6.41 1.64 0.41 10.12 5.35 010
cath.
36595............... .............. A Mech remov tunneled 3.59 19.71 1.46 0.28 23.58 5.33 000
cv cath.
36596............... .............. A Mech remov tunneled 0.75 4.39 0.49 0.05 5.19 1.29 000
cv cath.
36597............... .............. A Reposition venous 1.21 3.18 0.43 0.07 4.46 1.71 000
catheter.
36838............... .............. A Dist revas ligation, 20.60 NA 9.36 2.99 NA 32.95 090
hemo.
37765............... .............. A Phleb veins - extrem - 7.34 NA 4.55 0.48 NA 12.37 090
to 20.
37766............... .............. A Phleb veins - extrem 9.29 NA 5.26 0.48 NA 15.03 090
20+.
37785............... .............. A Ligate/divide/excise 3.83 5.14 2.64 0.49 9.46 6.96 090
vein.
38207............... .............. I Cryopreserve stem 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cells.
38208............... .............. I Thaw preserved stem 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cells.
38209............... .............. I Wash harvest stem 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cells.
38210............... .............. I T-cell depletion of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
38211............... .............. I Tumor cell deplete of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvst.
38212............... .............. I Rbc depletion of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
38213............... .............. I Platelet deplete of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
38214............... .............. I Volume deplete of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
harvest.
38215............... .............. I Harvest stem cell 0.00 0.00 0.00 0.00 0.00 0.00 XXX
concentrte.
43235............... .............. A Uppr gi endoscopy, 2.39 5.04 1.07 0.16 7.59 3.62 000
diagnosis.
43237............... .............. A Endoscopic us exam, 3.98 NA 1.61 0.27 NA 5.86 000
esoph.
43238............... .............. A Uppr gi endoscopy w/ 5.02 NA 1.97 0.27 NA 7.26 000
us fn bx.
43242............... .............. A Uppr gi endoscopy w/ 7.30 NA 2.78 0.35 NA 10.43 000
us fn bx.
43259............... .............. A Endoscopic ultrasound 5.19 NA 2.04 0.27 NA 7.50 000
exam.
43752............... .............. A Nasal/orogastric w/ 0.68 0.26 0.26 0.02 0.96 0.96 000
stent.
47133............... .............. C Removal of donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
liver.
47140............... .............. A Partial removal, 54.92 NA 22.74 4.80 NA 82.46 090
donor liver.
47141............... .............. A Partial removal, 67.40 NA 27.39 4.80 NA 99.59 090
donor liver.
[[Page 1244]]
47142............... .............. A Partial removal, 74.89 NA 29.97 4.80 NA 109.66 090
donor liver.
53500............... .............. A Urethrlys, transvag w/ 12.19 NA 6.19 0.89 NA 19.27 090
scope.
57425............... .............. A Laparoscopy, surg, 15.73 NA 6.69 1.74 NA 24.16 090
colpopexy.
58545............... .............. A Laparoscopic 14.58 NA 7.19 1.75 NA 23.52 090
myomectomy.
58546............... .............. A Laparo-myomectomy, 18.97 NA 8.98 1.75 NA 29.70 090
complex.
58550............... .............. A Laparo-asst vag 14.17 NA 7.31 1.74 NA 23.22 090
hysterectomy.
58552............... .............. A Laparo-vag hyst incl 15.98 NA 8.02 1.74 NA 25.74 090
t/o.
58553............... .............. A Laparo-vag hyst, 18.97 NA 8.97 1.48 NA 29.42 090
complex.
58554............... .............. A Laparo-vag hyst w/t/ 21.97 NA 10.46 1.48 NA 33.91 090
o, compl.
59070............... .............. A Transabdom amnioinfus 5.24 5.12 2.41 0.28 10.64 7.93 000
w/ us.
59072............... .............. A Umbilical cord occlud 8.99 NA 3.13 0.68 NA 12.80 000
w/ us.
59074............... .............. A Fetal fluid drainage 5.24 4.61 2.41 0.28 10.13 7.93 000
w/ us.
59076............... .............. A Fetal shunt 8.99 NA 3.13 0.68 NA 12.80 000
placement, w/ us.
59897............... .............. C Fetal invas px w/ us. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
61537............... .............. A Removal of brain 24.96 NA 14.45 6.49 NA 45.90 090
tissue.
61538............... .............. A Removal of brain 26.77 NA 15.38 6.49 NA 48.64 090
tissue.
61539............... .............. A Removal of brain 32.03 NA 17.85 7.98 NA 57.86 090
tissue.
61540............... .............. A Removal of brain 29.96 NA 17.48 7.98 NA 55.42 090
tissue.
61543............... .............. A Removal of brain 29.18 NA 16.46 7.37 NA 53.01 090
tissue.
61566............... .............. A Removal of brain 30.95 NA 17.42 6.49 NA 54.86 090
tissue.
61567............... .............. A Incision of brain 35.45 NA 20.73 6.49 NA 62.67 090
tissue.
61863............... .............. A Implant 18.97 NA 9.21 4.79 NA 32.97 090
neuroelectrode.
61864............... .............. A Implant 4.49 NA 2.29 1.13 NA 7.91 ZZZ
neuroelectrde, add'l.
61867............... .............. A Implant 31.29 NA 13.81 4.79 NA 49.89 090
neuroelectrode.
61868............... .............. A Implant 7.91 NA 4.03 1.21 NA 13.15 ZZZ
neuroelectrde, add'l.
63101............... .............. A Removal of vertebral 31.95 NA 19.34 5.69 NA 56.98 090
body.
63102............... .............. A Removal of vertebral 31.95 NA 19.34 5.69 NA 56.98 090
body.
63103............... .............. A Remove vertebral body 3.89 NA 2.01 0.76 NA 6.66 ZZZ
add-on.
64449............... .............. A N block inj, lumbar 3.00 NA 0.97 0.10 NA 4.07 010
plexus.
64517............... .............. A N block inj, hypogas 2.20 2.70 0.87 0.13 5.03 3.20 000
plxs.
64680............... .............. A Injection treatment 2.62 5.97 1.28 0.18 8.77 4.08 010
of nerve.
64681............... .............. A Injection treatment 3.54 8.71 2.10 0.18 12.43 5.82 010
of nerve.
65780............... .............. A Ocular reconst, 10.23 NA 9.94 0.35 NA 20.52 090
transplant.
65781............... .............. A Ocular reconst, 17.64 NA 13.31 0.35 NA 31.30 090
transplant.
65782............... .............. A Ocular reconst, 14.98 NA 11.66 0.35 NA 26.99 090
transplant.
67912............... .............. A Correction eyelid w/ 5.67 20.38 5.27 0.28 26.33 11.22 090
implant.
68371............... .............. A Harvest eye tissue, 4.89 NA 4.62 0.21 NA 9.72 010
alograft.
70557............... 26............ A Mri brain w/o dye.... 2.90 0.98 0.98 0.08 3.96 3.96 XXX
70558............... 26............ A Mri brain w/ dye..... 3.20 1.08 1.08 0.10 4.38 4.38 XXX
70559............... 26............ A Mri brain w/o & w/ 3.20 1.08 1.08 0.12 4.40 4.40 XXX
dye.
75901............... 26............ A Remove cva device 0.49 0.16 0.16 0.02 0.67 0.67 XXX
obstruct.
75902............... 26............ A Remove cva lumen 0.39 0.13 0.13 0.02 0.54 0.54 XXX
obstruct.
75998............... 26............ A Fluoroguide for vein 0.38 0.13 0.13 0.05 0.56 0.56 ZZZ
device.
76082............... 26............ A Computer mammogram 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ
add-on.
76083............... 26............ A Computer mammogram 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ
add-on.
76514............... 26............ A Echo exam of eye, 0.17 0.08 0.08 0.01 0.26 0.26 XXX
thickness.
76937............... 26............ A Us guide, vascular 0.30 0.10 0.10 0.05 0.45 0.45 ZZZ
access.
78800............... 26............ A Tumor imaging, 0.66 0.22 0.22 0.04 0.92 0.92 XXX
limited area.
78801............... 26............ A Tumor imaging, mult 0.79 0.27 0.27 0.04 1.10 1.10 XXX
areas.
78802............... 26............ A Tumor imaging, whole 0.86 0.30 0.30 0.04 1.20 1.20 XXX
body.
78803............... 26............ A Tumor imaging (3D)... 1.09 0.38 0.38 0.05 1.52 1.52 XXX
78804............... 26............ A Tumor imaging, whole 1.07 0.37 0.37 0.04 1.48 1.48 XXX
body.
79100............... 26............ A Hematopoetic nuclear 1.32 0.46 0.46 0.06 1.84 1.84 XXX
therapy.
79400............... 26............ A Nonhemato nuclear 1.96 0.67 0.67 0.10 2.73 2.73 XXX
therapy.
79403............... 26............ A Hematopoetic nuclear 2.25 0.90 0.90 0.10 3.25 3.25 XXX
therapy.
85396............... .............. A Clotting assay, whole 0.37 NA 0.17 0.04 NA 0.58 XXX
blood.
88112............... 26............ A Cytopath, cell 1.18 0.51 0.51 0.06 1.75 1.75 XXX
enhance tech.
88342............... 26............ A Immunohistochemistry. 0.85 0.37 0.37 0.04 1.26 1.26 XXX
88358............... 26............ A Analysis, tumor...... 0.95 1.23 1.23 0.12 2.30 2.30 XXX
88361............... 26............ A Immunohistochemistry, 0.94 0.41 0.41 0.12 1.47 1.47 XXX
tumor.
91110............... 26............ A Gi tract capsule 3.64 1.30 1.30 0.02 4.96 4.96 XXX
endoscopy.
93784............... .............. A Ambulatory BP 0.38 1.55 NA 0.03 1.96 NA XXX
monitoring.
93786............... .............. A Ambulatory BP 0.00 0.91 NA 0.01 0.92 NA XXX
recording.
93788............... .............. A Ambulatory BP 0.00 0.51 NA 0.01 0.52 NA XXX
analysis.
93790............... .............. A Review/report BP 0.38 0.13 0.13 0.01 0.52 0.52 XXX
recording.
95990............... .............. A Spin/brain pump refil 0.00 1.50 NA 0.06 1.56 NA XXX
& main.
95991............... .............. A Spin/brain pump refil 0.77 1.43 0.19 0.06 2.26 1.02 XXX
& main.
96110............... .............. A Developmental test, 0.00 0.19 NA 0.18 0.37 NA XXX
lim.
96111............... .............. A Developmental test, 2.60 1.07 NA 0.18 3.85 NA XXX
extend.
97537............... .............. A Community/work 0.45 0.27 NA 0.01 0.73 NA XXX
reintegration.
97755............... .............. A Assistive technology 0.62 0.29 NA 0.02 0.93 NA XXX
assess.
G0308............... .............. A ESRD related svc 12.74 8.54 8.54 0.42 21.70 21.70 XXX
4+mo<2yrs.
G0309............... .............. A ESRD related svc 2- 10.61 7.10 7.10 0.36 18.07 18.07 XXX
3mo<2yrs.
G0310............... .............. A ESRD related svc 1 8.49 5.68 5.68 0.28 14.45 14.45 XXX
visit<2yr.
G0311............... .............. A ESRD related svs 4+mo 9.73 4.72 4.72 0.34 14.79 14.79 XXX
2-11yr.
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G0312............... .............. A ESRD relate svs 2-3 8.11 3.92 3.92 0.29 12.32 12.32 XXX
mo 2-11y.
G0313............... .............. A ESRD related svs 1 6.49 3.14 3.14 0.22 9.85 9.85 XXX
mon 2-11y.
G0314............... .............. A ESRD related svs 4+ 8.28 4.42 4.42 0.27 12.97 12.97 XXX
mo 12-19.
G0315............... .............. A ESRD related svs 2- 6.90 3.67 3.67 0.23 10.80 10.80 XXX
3mo 12-19.
G0316............... .............. A ESRD relate svs 1 5.52 2.94 2.94 0.17 8.63 8.63 XXX
vist 12-19.
G0317............... .............. A ESRD related svs 4+mo 5.09 2.86 2.86 0.17 8.12 8.12 XXX
20+yrs.
G0318............... .............. A ESRD related svs 2-3 4.24 2.38 2.38 0.14 6.76 6.76 XXX
mo 20+y.
G0319............... .............. A ESRD related svs 1 3.39 1.90 1.90 0.11 5.40 5.40 XXX
visit 20+.
G0320............... .............. A ESRD related svs home 10.61 7.10 7.10 0.36 18.07 18.07 XXX
under2.
G0321............... .............. A ESRD related svs home 6.90 3.67 3.67 0.23 10.80 10.80 XXX
mo<2ys.
G0322............... .............. A ESRD relate svs home 8.11 3.92 3.92 0.29 12.32 12.32 XXX
mo12-19.
G0323............... .............. A ESRD related svs home 4.24 2.38 2.38 0.14 6.76 6.76 XXX
mo 20+.
G0324............... .............. A ESRD related svs home/ 0.35 0.24 0.24 0.01 0.60 0.60 XXX
dy<2y.
G0325............... .............. A ESRD relate home/dy 2- 0.23 0.12 0.12 0.01 0.36 0.36 XXX
11 yr.
G0326............... .............. A ESRD relate home/dy 0.27 0.13 0.13 0.01 0.41 0.41 XXX
12-19y.
G0327............... .............. A ESRD relate home/dy 0.14 0.08 0.08 0.01 0.23 0.23 XXX
20+yrs.
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\1\ CPT codes and descriptions only are copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 2003 American Dental Association. All rights reserved.
\3\ + Indicates RVUs are not used for Medicare payment.
Federal Register / Vol. 69, No. 4 / Wednesday, January 7, 2004 /
Rules and Regulations
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[FR Doc. 03-32323 Filed 12-31-03; 8:45 am]
BILLING CODE 4120-01-C